The different categories are Category IA, Category IB, Category IC, Category II, and No Recommendation. Category IA and IB are STRONGLY recommended for implementation. The difference is that Category IA is strongly supported by well-designed experimental, clinical, or epidemiological studies. Category IB is supported by some experimental, clinical, or epidemiological studies, and by a strong theoretical rationale. When equipment is classified as Category IC, it means that it is required by state or federal regulations. Category II is a suggestion for implementation and supported by suggestive clinical or epidemiological studies or by a theoretical rationale. The last category is No Recommendation which is an unresolved issue. There is insufficient evidence or no consensus exists regarding efficacy. A common cleaning and disinfectant solution would be detergent and water which is mostly used in non patient care areas such as offices which falls under Category II. Another cleaning and disinfectant agent would be an EPA-registered tuberculocidal agent which is used to disinfect areas contaminated with blood spills.
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A common disinfectant that one can find within a hospital setting would be bleach wipes, Sani-Cloth Bleach wipes by PDI, are highly useful in the hospital environment as they provide a wide range of both viruses and bacteria that they can kill. Some nurses don’t like using this as a cleaner as it has a strong smell and a kill time of 4 minutes, even after the 4 minutes are up the surfaces are still wet which causes a short wait between readmitting patients. Some of them will use the PDI Super Sani-Cloth as it has a more pleasant smell to it and a kill time of 2 minutes. The Super Sani-Cloth also dries quickly and allows for the surface that was disinfected, whether that be a bed or medical equipment to be used in a timelier manner. This however cannot be the go-to disinfectant, as both the Bleach Wipes and Super Sani-Cloth react to certain surfaces and can damage them causing cracks and fading in plastics. I have been a witness to the Super Sani-Cloth degrading the plastic casing of a piece of respiratory equipment. In the IFU it states that the chemicals found inside of the Super Sani-Cloth should never be used on the equipment’s surface as it will degrade the plastic. The nurses accidentally swapped over to this cleaner without realizing it had that chemical in it and were surprised at the reaction it had to their equipment within a years’ time. A piece of equipment should always be sterilized if it comes into contact with any bodily fluids such as blood, urine, and feces. Sterilization cannot always be done depending on the type of equipment that needs to be cleaned so it is important to know the manufacturer’s recommendations in the IFU on how to disinfect it to the highest degree. For instance, Transducers cannot be sterilized all the time depending on their model, but the Trophon 2 uses a High Level Disinfectant method to ensure that the transducer head for an ultrasound has been cleaned of any pathogens that may have been picked up when used in a situation where someone with open wounds needed to be examined.
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It is important for medical professionals to understand the different categories of cleaning and disinfecting agents in order to properly select and utilize them in various settings. Category IA and IB are strongly recommended for implementation, with IA having stronger support from studies. Category IC equipment is required by regulations. Category II is a suggestion for implementation supported by suggestive studies or a theoretical rationale, and No Recommendation means insufficient evidence or no consensus exists. Bleach wipes and Super Sani-Cloth are common disinfectants found in hospitals, but it is important to be aware of their potential damage to certain surfaces and to follow manufacturer recommendations for disinfecting equipment. Sterilization should always be done if equipment comes into contact with bodily fluids, and the Trophon 2 can be used to disinfect ultrasound transducers with a high level disinfectant.
