Decontamination and the CNA: Working Against Microscopic Enemies

Article Categories: Diseases & Environment

A clean environment is good for patient health, but because most patients have weakened immune systems, cleanliness is not enough. CNAs must perform decontamination at specified times to rid surfaces of harmful bacteria, viruses, and fungi that cause infections.

Harmful microorganisms abound in hospitals, nursing homes, and other health care settings, and these microscopic enemies come from different sources including from workers and patients alike. They cause hospital-acquired infections (HAI), or diseases contracted within the timeframe a patient was receiving care in a hospital.

If you hear about an outbreak with a fancy name like Clostridium difficile, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Acinetobacter baumannii, or Pseudomonas aeruginosa, this is a raging battle with bacteria that are very difficult to kill, even with the most powerful antibiotics. They also survive on surfaces for a long time, even after thorough cleaning and decontamination.

You see, the war with these invisible enemies is all too real!

Let’s begin by differentiating between cleaning and decontaminating.

CLEANING is a method for removing visible dirt such as dust, soil, oil, and food particles as well as the germs that come with these contaminants. It also involves keeping the environment free of clutter so that the surroundings look organized and spotless. It is an essential step before decontamination.

DECONTAMINATION, on the other hand, is a process of making materials or surfaces safe to be touched and handled. It is a way to significantly reduce (called disinfection) or even totally kill (called sterilization) harmful microorganisms.

Decontamination of the environment is important to prevent the spread of deadly microorganisms that cause infections. But, learning how to decontaminate can be tricky.

For example, you see a blood stain high up on the wall. It was cleaned a long time ago, but the stain remained. The stain came from blood, and you have the feeling that you need to remove it completely, as it is a source of infection.

The truth is, it could be a risk if it came in contact with a susceptible person, such as a sick elderly patient. But what are the odds that that patient (or even staff) can reach that high?

Also, the possibility of it infecting anyone is truly small because it is only a stain and not fresh, and the surface has been dry and untouched for a long time. The stain, even though it is blood, is therefore not a major hazard.

Now, let's consider the phone in the nursing station. It is sparkling clean because you made sure of it yourself when you wiped it earlier during your shift. There are no sick employees who could have touched the phone.

You might be thinking that the phone is already germ-free and doesn’t need to be decontaminated. However, it is an item that is repeatedly used by different people who have been in different places. The surface may look clean, but it could be teeming with microorganisms.

Remember that the enemies are microscopic—looking clean does not guarantee zero contamination.

This is where decontamination comes into play:

1. First, review your agency policies on how often you need to decontaminate. Some surfaces must be decontaminated regularly, such as bed pans and stethoscopes. Refer to the manuals and use their recommended product features to disinfect surfaces.

2. Next is to identify surfaces that need regular and frequent decontamination, such as the floor, kitchen tops, urinals, door knobs, and toilets. These surfaces have the highest microbial counts.

3. Use the right materials and disinfectants.

a. Some liquid disinfectants may damage or discolor equipment
b. Avoid chlorine-based solutions when cleaning metals because they cause rusting

4. Take note of contact time or the time that a disinfectant should stay on the surface before it is wiped off or prior to the item being used.

5. Ensure that PPEs, or personal protective equipment, are worn at all times.

Some cleaning materials are so strong that they damage regular latex hospital gloves, so CNAs must use more appropriate household gloves when cleaning and disinfecting.

Decontamination is a necessary part of infection control and you as a nursing assistant must meticulously carry out these procedures to prevent hospital-acquired infections in patients. Not only is the patient’s safety at stake, but yours is as well. These invisible foes should never accompany you home!


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