How Many? How Often? How Long? Proper Use of Disinfectant Wipes a Mystery

Ready to use (RTU) disinfectant wipes have been a hot topic since the arrival of coronavirus disease 2019 (COVID-19) in the United States and quickly became a hot commodity as hospitals struggled to maintain an adequate supply, and the public bought as many as they could, emptying entire store shelves doing so. But information about just how to use the wipes to greatest efficiency is also hard to come by, according to a pre-proof study in the American Journal of Infection Control.

The wipes vary considerably in their composition and the disinfectants that they’re using, according to the study’s author, John M. Boyce, MD, a healthcare consultant in Middletown, Conn.

“With reusable dry wipes, the ratio of wipe material to disinfectant and the amount of disinfectant absorbed by the wipe and delivered to surfaces is difficult to standardize, which may affect their efficacy,” the study states. “The manner in which wipes are used by healthcare personnel is highly variable, due in part to insufficient instructions for use and inadequate education of relevant personnel.”

Hospitals and other healthcare facilities need to provide better access to educational materials dealing with RTU wipes to environmental services (EVS) teams and nurses. They need to tell them how to best use wipes and invite feedback from healthcare workers to monitor compliance and to also find out what might be hindering disinfecting efforts and/or the following of disinfecting protocols.

In addition, there needs to be created “an internationally-accepted standard method for evaluating the efficacy of wipes, taking into account the mechanical effects of wiping and the impact of impregnated disinfectants.”

No such standardized guidelines currently exist when it comes reusable wipes, says the study. The ratio of the size of the wipe and disinfectant on it to the size of the area being wiped down varies widely. Healthcare workers using the wipes tend to rely on their own judgment when it comes to just how long a wipe should be used before it’s discarded. Boyce says that’s due in part because of a lack of instructions for use and training for the workers who will be using the wipes, in many cases members of the EVS teams.

“Combining disinfectants effective against target pathogens with the appropriate wipe material and assuring that they are applied correctly are essential to obtain optimal removal of bacteria from surfaces and prevent the transfer of microorganisms from one surface to another by wipes,” the study states.

Boyce makes some recommendations. For instance, the makers of liquid disinfectants that are used as sprays or for soaking dry wipes need to say what fabrics the wipes should be composed of. Conversely, the manufacturers of dry wipes should tell customers what fabrics or fibers those wipes are made of.

“Manufacturers of various disinfectants should collaborate with the [US Environmental Protection Agency] to assure that adequate and practical contact times are listed on product labels, which will facilitate compliance with label claims,” the study states. “RTU wipe manufacturers should provide detailed instructions for use, including recommendations on how large a surface can be disinfected with a single wipe. End users should periodically test the concentration of disinfectants that require dilution or mixing, and concentrations released from wipes that are soaked in reusable buckets. This is particularly important if cotton or microfiber cloths are used with quaternary ammonium-based disinfectants.”

The data were collected via comprehensive searches of the Pubmed database and internet of articles published from 1953 to September 2019. Pertinent online documents were also reviewed.