Practicing Proper Sanitization and Disinfection of Medical Equipment

Melissa Hirth

Product Support Manager, Champion Manufacturing
 
Welcome to Champions of Care, a Champion Chair podcast and your go-to resource for industry leading insights regarding medical seeding and their applications.
Hello everyone. Welcome to Champions of Care, a Champion Chair podcast. I'm your host Daniel Litwin, the voice of B2B. Everyone, thank you so much for joining us on this episode of the podcast. Make sure that you're subscribing wherever you listen to your podcast content. That could be Apple podcasts or Spotify, and make sure you're also going to our site www.championchair.com for more articles, blogs, videos, and podcasts as well as information about Champion Chair in general.
So for this episode we're keeping it timely. Let's jump right in. The US has officially become the country with the most confirmed coronavirus cases, and with that reality setting in, our medical infrastructure is feeling the strain of managing such an infectious virus. Besides critical care, a main concern is proper sanitization and disinfection of essential medical supplies, including chairs and care recliners. So on today's episode we're unpacking that concern for healthcare professionals, giving some important tips on managing those vital steps in your care facility, and also where Champion Chair can offer support.
I'd like to welcome Melissa Herth, product support manager for Champion Manufacturing to the podcast to give her insights on this very important topic. Melissa, how are you doing? Welcome to the podcast.
Good. Thank you for having me.
Absolutely. Looking forward to breaking this down with you. So let's get into it. Obviously, you interface with your contacts and clients and health care facilities often, and I'm sure there's been a lot of conversations during this pandemic. I just want to get a kind of feel for the field right now. What is the scene like right now in battling COVID-19 as you've been chatting with your clients in these facilities and how is that manifesting itself?
Well, nurses are extremely stressed out right now. Infection prevention supplies are really running low due to the pandemic. Normally, protective equipment such as masks or gowns, they're usually disposed of after one use, and now doctors and nurses are actually wiping down and reusing almost everything except their gloves. So in response to the shortages of these personal protective equipment, the CDC recommendations regarding those have actually been scaled back so people don't feel as protected due to the low supplies. Other infection prevention measures are more important than ever.
Interesting. How does that end up affecting their day-to-day having to reuse often disposable items? Are they prepared for that reality? Does that make disinfection and sanitization more difficult?
It does make it more difficult as our nurses and doctors are not used to this level of disinfection on products that really should be thrown away after each use. But because COVID-19 is such a rapidly evolving situation with constant development of new or even conflicting information, I can tell you that a lot of the studies confirm the detection of the virus is on surfaces. They last for hours or sometimes even days depending on the surface. So proper disinfection and choosing medical equipment that has those infection prevention measures is more important than ever. As for being prepared for them, I'm not sure that any of us were really prepared for how fast these products are flying off the shelves.
So obviously there is more of a focus on sanitization and disinfection than maybe ever because of how viral coronavirus is. So how is that basically turning every care facility into almost a focus group for infection prevention? Are you seeing more conversations between professionals, doctors, nurses, and other folks within the care facility on basically refocusing and putting a lot of effort towards infection prevention?
Absolutely. I would say that infection prevention now is more important than ever, especially with the spread of the COVID-19 virus. I think it's important to talk about the difference between cleaning and disinfecting. Although disinfecting is extremely, extremely important, cleaning is just as important, and a lot of times people don't really understand the difference between cleaning and disinfection or that there's actually a difference. And both of those are really, really important right now because we don't have a lot of those infection prevention supplies that are out there like those masks and the respirators.
So before we get into the specifics of some of the processes behind keeping medical gear, medical equipment and supplies clean, I think we need to draw some distinctions between phrasing around cleaning and really being conscientious and specific with our word choice. So there's two different kinds of cleanings that we're talking about here. There is just classic cleaning and then there's a more focused disinfection. Can you give us a brief rundown of the differences between those two terms in practice and why it's important to be clear on the differences between cleaning your supplies and disinfecting and sanitizing your supplies?
Yes, absolutely. The difference between cleaning and disinfection is really important to make that distinction. I would say that cleaning refers to the actual removal of dirt and grime from a surface. Cleaning helps to remove allergens and microorganisms from the environment, and in the process of cleaning a percentage of those germs on any given surface are removed. Cleaning a surface is accomplished with soap or detergent and water, and although cleaning does help to reduce the germs, it doesn't actually kill any germs. Thus, the potential risk for cross contamination. Think about what you use to clean with. We use sponges and cloths, sometimes those tools simply just move the germs from one surface to another, which brings me to disinfection.
So disinfection then refers to killing a high percentage of germs on a surface which renders them incapable of reproducing, which is much like sanitizing. However, sanitizing just lowers the number of germs on the surface to safe levels. Safe levels are judged by public health standards, but neither of those are as effective as sterilization, which that's an extreme physical or chemical process that will kill all types of life. So it's important to understand that disinfecting doesn't necessarily mean that dirt and impurities are being removed from the actual surface, but rather that germs and viruses are.
Gotcha.
So really I think what you should be doing is both cleaning and disinfecting your surfaces in that order. So dirt and debris can act as a barrier preventing the disinfectant from reaching the surface and doing its job. So of course you would want to clean first so your disinfectant will work. I would recommend these four steps to cleaning.
I would start with step one, thoroughly cleaning your surfaces. Step two, I would surface rinse. Step three, I would disinfect your surfaces making sure that you leave that disinfectant on the surface for as long as those manufacturing instructions tell you to. So each different cleaner, whether using bleach wipes or quat-based cleaner, they will give you specific instructions on how long to leave on the surface. So always follow those instructions first. And then step four, rinse again after the guide's explanation on telling you how long to leave it onto the surface. Rinsing in between cleaning and disinfecting is crucial. After cleaning the grime off of the chair, you really want to rinse it. Doesn't that make sense?
Right, exactly. Yeah, and it's funny you mentioned that. There has been other podcasts I've done, obviously, outside of Champion Chair's podcast, but speaking with other people in building management and facility management who mentioned just how, I guess uneducated, the entire public is on that one simple fact that when you wipe down with that Clorox wipe, you can't just leave that there. You then have to go back after it's dried and you should rinse that surface if you really want to finish cleaning it. It's such a simple step, but it's essential, especially in a healthcare setting. So important to hammer that home.
It really is that important. Rinsing not only cleans the grime off after you've cleaned it, but also if you rinse after you disinfect your surfaces it'll save the life of your product. So I know that CDC guidelines will tell you to disinfect your surface and then put a sheet over it and let it air dry. It's just important to go back after that and then rinse it off. If you don't rinse off afterwards, you're actually going to end up cracking vinyl on your chairs because that's getting into the surface and it's breaking down all of the oils.
I know that there are products out there that are advertised as both a cleaning product that also disinfects. So, basically combining two steps into one. Do you see any medical professionals when cleaning try to combine the clean and the disinfectant step in one sweep? And how does that impact the actual process and ability to keep things clean?
I would say that most people are actually more focused on disinfection of surfaces rather than cleaning surfaces. So they're using their bleach-based products to clean the chair as well as disinfect. People don't really understand that the importance of soap and water is almost more important, or just as important, as using the bleach-based cleaners or your disinfection process. What's going on is usually, in my experience when talking to facilities, they are only using the disinfection process and they're just doing the cleaning once a week. So as for finding a way to do both of them, I would say due to people really being uneducated, they're thinking maybe that they're taking care of both by using those bleach-based wipes or those quaternary cleaners, but they're really not.
We're in the middle of a pandemic, obviously, which presents new challenges and new standards for cleaning and disinfection. For COVID-19 are there any specific disinfection and sanitization protocols? And if so, how easy are they to integrate into day-to-day for healthcare professionals?
Well, the CDC now says that the COVID-19 spread from person to person happens most frequently among close contacts, which is kind of like within about six feet of each other. This type of transmission occurs via respiratory droplets. However, if those droplets land on surfaces, the virus can live there for some time. So surface cleaning and disinfecting has never been more important than now due to COVID. So thoroughly cleaning those visibly dirty surfaces followed by that disinfection is a best practice measure, in my opinion, for COVID-19.
Those household strength cleaners, they're recommended for cleaning surfaces. You should follow cleaning with a disinfecting step using an EPA registered disinfectant with active ingredients like hydrogen peroxide, bleach, or quaternary ammonium alcohol. Thorough disinfection does take detailed time and attention, so completing this task correctly is more important now than ever due to the virus. But clinical staff are also more stressed for time and attention than ever. So I would say this turns a relatively easy, but time consuming, process into a nightmare for healthcare personnel since they just don't have the time. They're so overworked right now with their COVID patients. I mean, they're turning floors into COVID units. They're stressed out constantly, and not to mention the constant fear of contracting the disease themselves.
We're having this conversation on Champions of Care because one of the most essential and maybe oft forgot pieces of medical equipment that need to be consistently sanitized, cleaned, and disinfected are medical recliners. And y'all are obviously the champions of medical recliners, pun intended. So when it comes to medical recliners, what are some specific challenges that come with trying to clean that piece of medical equipment? And are they usually built with medical cleaning in mind? Maybe you can answer in general and then you can focus in on Champion's chairs specifically if you'd like.
Yeah, absolutely. I would say that staff need products that not only don't hinder their disinfection efforts, but hopefully can actually facilitate these efforts. And some of the biggest challenges are cleaning and disinfecting those surfaces that you can't fully see or physically access. So when it comes to patient seating, with many products there are really difficult surfaces to see and reach that are designed into the chair. For example, that no man's land between the arm and the seat gets really disgusting. That's where blood and gunk runs off. So chairs that have fixed arms actually don't allow you to see or reach down into that space. And if you're taking some kind of a bleach wipe and you're just taking your hand and putting it down into the chair, you never know what's going to come back up, and I would think that's really disgusting.
So Champions clinical recliner designed features, those swing open arms, and they actually open 180 degrees for easy cleaning, also patient transfer. And additionally, we have a quick release seat that can be removed in minutes with no tools. So this is another way to help clean effectively. I would say with this combination of features on Champion recliners, clinicians and staff can see and reach almost every surface of the chair for effective disinfection.
And then, also, I would say that in these types of environments, abrasions and tears, they just happen. People get stressed out, they are picking at their chairs, especially for long seated therapies, but it's really important to replace the product immediately when these tears occur as it creates an infection control issue. So most other companies, they offer replacement parts but they're extremely expensive, and Champion doesn't just offer replacement parts with detailed instructions, but we actually also offer just the covers to help save on replacement costs.
So when you do get a tear, which always will happen, I mean, if you think about it, if the patient walks in and they have a pen in their pocket and they sit down and it pokes a hole and then leaves an ink stain. So all you would really need to do is replace the vinyl at that point, as long as you haven't poked all the way through. And we actually offer those replacement covers to help with those costs.
Another thing that I would say that we have where other people don't, is all of our heat massage components are gasketed for water and corrosion prevention. And then also, you'll often find that most chairs that have heat or massage components, they have a switch that's mounted onto a soft surface. So example, an inside of an arm, let's say, and unfortunately mounting something like that onto those soft surfaces can collect a buildup of bacteria behind that switch because it's really hard to mount a hard surface onto a soft surface and expect there to be no buildup. So Champion's switch is designed on the folding side table of the chair. That construction is between two hard surfaces and that actually eliminates the bacteria accumulation.
Interesting. Yeah, I mean baking in the cleaning and sanitization process into the manufacturing of these chairs feels essential to me, mostly because it needs to be an efficient cleaning process that doesn't impact daily care too much. How does cleaning a medical recliner end up impacting daily care? How long does it take? When is it typically done? Who is often doing that? And why is all of this amplified during the COVID-19 treatment process?
Well, usually the staff, so the nurses, they're actually cleaning their own units down and they should be doing it after every use. So after every patient gets out of the chair, they should be cleaning their chairs. So they're really important to make sure it's happening. However, it is time consuming if you're doing it correctly. I know that in the past when I've talked to facilities, they'll say that they'll do a deep cleaning treatment or a clear water rinse and soap and water once a week, almost sometimes once a month. And then they're disinfecting in between every patient.
So to do it properly, which would be cleaning and disinfecting between each patient, it really is time consuming and it's almost impossible for the nurses to get both of those done in the time allotment that they have because their time is actually allotted from minute to minute. So they'll call me and tell me, "I have 32 minutes in between this patient where I can do this, this, and this thing. I have to get all of these things accomplished and cleaning the chair." So it's kind of unrealistic almost to expect them to clean and disinfect all at once in between each patient.
It's really hard for their time to do that, especially because if you think about it, these chairs are creating revenue. So every patient that comes in and out of the chair is creating more revenue. So you want to get them in and out rather quickly not just for revenue, but for your patients as well to make sure that we're there on a timely manner, that they're not waiting too long. Because a lot of times when you go into these clinics, there are people waiting for another person to get up off the chair so they can get on it. So they don't have very much time in between. So I would say it's rather difficult to perform both of those, especially for our staff. So creating that modular design for our recliners is more important than ever due to the time constraints the nurses have.
Right. And those time constraints only increase during something like an incredibly viral pandemic. So I can assume that that time is very precious.
Yeah, their time is absolutely precious. That's why we also offer services to go replace their parts, to do anything. So the more that we can take away from them, the easier their lives are, and the easier then their patients' lives are, because the less stress our nurses have it can actually bleed over onto the patient. So more stress between the patients, more stress between the nurses, things go wrong, things end up breaking because of that. So the more that we can design our products for infection prevention measures, the easier of a time our staff actually has at disinfecting quickly in order to make the most of their time.
All right. I want to pivot the conversation to close out by doing a little chunk here where we chat more about Champion Chair specifically. You are a supplier of a medical equipment, but you weren't initially a medical gear cleaning service. However, due to requests from clients, the company has adapted and now does provide some of these disinfectant and sanitization processes for medical recliners. So I want to walk through that process of creating that new solution for your clients, why you did it and what the effect has been basically. So what were those initial conversations like from your clients that ended up motivating this new service for Champion Chair?
Well, actually I began working for Champion Chair about four years ago, and periodically the question would come up from various facilities about proper deep clean methods and if I either offered these services or knew of others that offered this service. And I found that most cleaning services either used soap and water to hand clean chairs or they used power washing. I hated referring my customers to either of these methods as hand cleaning takes so much time and in my opinion it doesn't really achieve what I would call a deep clean, and power washing also wasn't ideal as it could compromise the chair from the excess water and force. So after power washing rust is inevitable and the life of the product didn't seem to last as long.
So as time went on and I took on a management role, I really began to research cleaning and disinfecting products. I looked into methods of sterilization as I felt that would be a game changer if I could quickly kill bacteria and virus, and actually I found out there are four methods of sterilization. You can use thermal methods, you can use radiation methods, you can use filtration methods, and gaseous methods. I immediately ruled out gaseous methods as that used a lot of chemicals, and then I looked into UV radiation which was actually really interesting because it scrambles bug's DNA. However, I quickly disregarded that because I really, really wanted to hammer down and focus on finding a solution to both cleaning and disinfection. Is there a way to combine them in a safe way without using a bunch of chemicals? And that's actually when I started delving into steam cleaning, and not just regular steam cleaning, but dry vapor heat steam cleaning which combines the methods of dry heat and steam sterilization.
So the benefits of dry heat include good penetrability, no chemicals used and its non-corrosive nature. I've been in contact with our vinyl manufacturers to also make sure that dry heat temps will withstand. And I've been in contact with a lot of our technicians that I employ now to talk about deep cleaning methods. So after looking into specific dry vapor steam cleaners, I did find a promising company, and I called the manufacturer which really solidified my decision for me after they were able to tell me how effective this machine is for killing bacteria on contact.
So once you found that solution that seemed to work best for these medical recliners, how did you and the Champion Chair team actually begin to craft the business model for this solution? How did you roll it out? How did you scale it? How did you integrate it into the day-to-day business operations of Champion Chair? Because it is such a departure from the manufacturing and the interfacing with clients for gear. It's more of a cleaning, supplemental service. So I'm just interested in how that fits in.
Well, actually I haven't released this yet. Champion has pooled all of their efforts to get the service ready ahead schedule due to the current coronavirus outbreak. So we've actually pulled in more resources and have more employees working longer hours in order to get the service out on the market. I know that we'll be rolling it out in the upper Midwest where two of the fastest growing hot zones exist, Detroit and Chicago. So we really want to get into those areas. I know Indianapolis is also on the rise.
So really what's going to happen here with deep cleaning is the deep cleaning treatment will both disinfect and clean the recliners. The steam cleaner will reach a minimum of 240 degrees, which that converts the water into a dry steam. And the reason it's called dry is because no water or dampness is left behind from the steam. So after the process is done, the chairs are actually ready for immediate use. How this is going to work is the technician will come into the clinic after hours and line up a fleet of recliners. He will then clean all of the vinyl parts of the chairs at 240 degrees, and then he'll end up turning up the temperature to reach 400 degrees in order to clean all of the steel parts. If there are heat or massage components, the technician will wrap them before treatment. The whole process takes about 30 minutes per chair.
So Melissa, how did you end up actually landing on steam cleaning as the solution for Champion Chairs' disinfection is sanitization service? And how does it actually compare both functionally and financially in administering it to other deep cleaning methods?
I ultimately landed on steam cleaning because I thought this would be the most effective method that involves both disinfection and cleaning without using chemicals to achieve that outcome. Hand cleaning takes so much time, and as we all say, time is money, and also it uses chemical solutions that often lose their efficacy after a short amount of time unless using pre-packaged product which then produces a lot of waste. So steam cleaning technology is, I would say, initially more expensive due to the equipment purchase. However, the machine only uses water and not much water at that. So you're essentially saving in the long run by eliminating chemical costs. So I basically landed on steam cleaning due to no chemicals, no cost for chemicals, and the fact that it would take away both my cleaning process and my disinfection process all in one and it creates... I haven't really been able to find too many more solutions that take care of all of it.
So I know you said you were expediting this service to try to get it out there while the pandemic is continuing to spread. How is Champion Chair, besides that, supporting recliner deep cleans during the coronavirus outbreak? Do you have any other tips and tricks that you're giving to healthcare professionals? Any sort of care education that you're providing on the subject? What's your strategy there?
So always anyone can call Champion to ask for proper disinfecting methods and cleaning methods. Anyone that calls with a need for steam cleaning, we're absolutely going to try and do our best to get that out there for them as quickly as possible. I know we're rolling it out in the Midwest, but we actually have two machines purchased, so if this works out well and quickly, then we can go ahead and spread to some of the more hot centers like New York or California.
I would say that just because there's a COVID outbreak right now, obviously disinfection, the frequency of normal disinfection is more important, but I would still tell you that no matter what, the frequency of normal disinfection procedures should be utilized after every patient, whether you're on a COVID outbreak or whether it's just a normal day. And then when it comes to steam cleaning and deep cleaning treatments, really, the frequency just depends on the discretion of the user. I would say environments such as phlebotomy wouldn't need to have a heavy usage for a deep cleaning treatment, but environments such as dialysis, which is very wet and acidic would have a higher usage rate. So anybody really that wants to know more on whether they should employ steam cleaning tactics or regular disinfection tactics, I would advise you to call Champion and have a conversation.
All right, Melissa, I think that does it for our conversation today. Thank you so much for your insights and for breaking down the essential need for disinfection and cleaning processes, not just during a pandemic but during every kind of day-to-day care in any sort of health care facility. And thank you for giving us more insights on how Champion is supporting that mission for proper disinfection and sanitization of care equipment. Melissa Herth, product support manager for Champion Manufacturing. Appreciate your time today.
Thank you so much. I was glad being out here.
And thank you everyone for listening to today's episode of Champions of Care, and if you like what you heard and want to listen to previous episodes, you can find this podcast on Apple podcasts and Spotify. Make sure you're subscribing there. You can also find our podcast on championchair.com along with some other content, including videos and articles, and helpful information about Champion Chair's services. And make sure you're leaving a rating and a comment wherever you're listening to your podcast content. I'm your host, Daniel Litwin, the voice of B2B. Until next time.