Key terms of surface disinfection

When cleaning and disinfecting surfaces, healthcare facilities should observe the recommendations of the Robert Koch-Institute (RKI)¹. Crucial prerequisite for effective hygiene management is to perfectly match disinfection measures with the risk potential. In terms of frequency and extent, there are different surface disinfection procedures:

Routine disinfection (also: regular, prophylactic or preventive disinfection)

Purpose: To control the spread of pathogens during patient care and treatment.
Surfaces concerned: Focus is on near-patient surfaces or those with frequent hand or skin contact that presumably became contaminated with infectious materials without noticeable or visible evidence, e.g. bedframes, bedside tables, doorknobs.
Disinfection measure: Wipe disinfection with a bactericidal and yeasticidal surface disinfectant (which usually also is virucidal against enveloped viruses).
Reuse of disinfected surfaces: After all routine surface disinfection measures, surfaces may be used again as soon as they are visibly dry.
Listings: Products listed by the Association for Applied Hygiene (VAH)/German Society for Hygiene and Microbiology (DGHM) are suitable for routine disinfection.

Terminal disinfection (also: final disinfection)

Purpose: To prepare complete rooms or areas for subsequent patients or residents for them to be treated or cared for without the risk of acquiring an infection.
Surfaces concerned: Rooms and areas where an infected or colonised patient/resident has been cared for or treated. Depending on the disease or type of pathogen, all near-patient surfaces/objects and those within reach, respectively that are or might be contaminated, e.g. floors or walls.
Disinfection measure: Wipe disinfection with a bactericidal and yeasticidal surface disinfectant (which usually also is virucidal against enveloped viruses). Depending on the patient’s infectious disease, other concentrations and procedures and disinfectants with a broader spectrum of activity than for routine disinfection may be necessary. When surfaces are contaminated visibly, the organic material needs to be collected with a disposable wipe soaked with disinfectant first.
Reuse of disinfected surfaces: The surfaces must not be used again before the exposure time specified by the manufacturer is over.
Listings: Products listed by the Association for Applied Hygiene (VAH)/German Society for Hygiene and Microbiology (DGHM) are suitable for terminal disinfection.

Disinfection in the event of outbreaks

Purpose: To quickly and reliably prohibit the spread of infections with pathogens such as noroviruses or Clostridium difficile in case they occur increasingly.
Surfaces concerned: All surfaces potentially contaminated (compare terminal disinfection); if applicable, further surfaces outside the patient room that need to be considered contaminated are to be disinfected.
Disinfection measure: Wipe disinfection with a spectrum of activity matching the pathogen. For example, outbreaks with noroviruses require a virucidal preparation. When surfaces are contaminated visibly, the organic material needs to be collected with a disposable wipe soaked with disinfectant first.
Reuse of disinfected surfaces: The surfaces must not be used again before the exposure time specified by the manufacturer is over.
Listings: Products listed by the Association for Applied Hygiene (VAH)/German Society for Hygiene and Microbiology (DGHM) are suitable for the disinfection in the event of outbreaks.

Disinfection in case of officially ordered decontaminations (also: epidemics)

Purpose: To prevent and control epidemic outbreaks with communicable, notifiable diseases in accordance with Art. 18, Para. 1 of IfSG (Federal Law on the Prevention of Infectious Diseases in Humans).
Surfaces concerned: All surface potentially contaminated (compare terminal disinfection); if applicable, further surfaces outside the patient room that need to be considered contaminated are to be disinfected.
Disinfection measure: Only disinfectants and procedures listed by the RKI are suitable. When surfaces are contaminated visibly, the organic material needs to be collected with a disposable wipe soaked with disinfectant first.
Reuse of disinfected surfaces: After the disinfection in case of epidemics, the surface must not be used again before the end of the exposure time.
Listings: According to Art. 18 IfSG, only products listed by the RKI may be used.

Targeted disinfection of visibly contaminated surfaces

Purpose: To prevent the spread of pathogens and to reduce the patient’s/resident’s risk of infection in a targeted manner.
Surfaces concerned: Surfaces visibly contaminated with organic material such as blood, pus, excretions or other body fluids.
Disinfection measure: All visible contaminations are removed with a disposable wipe soaked with disinfectant; the wipe is discarded. Afterwards, the surface is to be disinfected as usual.
Reuse of disinfected surfaces: With surfaces contaminated by a patient suspected to have or definitely having an infection, the surfaces must not be used again before the exposure time specified by the manufacturer is over.
Listings: Products listed by the Association for Applied Hygiene (VAH)/German Society for Hygiene and Microbiology (DGHM) are suitable for targeted disinfection.

Sources:

¹ Robert Koch-Institut (2004) Anforderungen an die Hygiene bei der Reinigung und Desinfektion von Flächen. Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention beim Robert Koch-Institut Bundesgesundheitsbl - Gesundheitsforsch - Gesundheitsschutz, 47: 51–61.