S ur face C omp a t ibi l i ty i n D i s i n fec t a nt W i p e s : W h y A l c o h ol F r ee P ro d u c ts E x i st a n d W ha t a W ron g C h o ice C osts A w i p e deci s i on a nsw e rs two qu e st i ons a t t he s a m e t i m e T he fi rst on e i s m ic ro bi olo gica l : i s t hi s pro d u c t r igh t f or t he c ont a m i n a t i on on t hi s sur face T he s ec on d on e i s p h ys ica l : w ha t ha pp e ns to t he sur face af t e r t hi s pro d u c t ha s bee n us ed on i t s e v e r a l t i m e s a da y f or y ea rs M ost i n fec t i on c ontrol pro g r a ms wor k ha r d on t he fi rst qu e st i on a n d l ea v e t he s ec on d to w h o e v e r r e sto ck s t he c up b o a r d T he bi ll f or s ki pp i n g t he s ec on d qu e st i on d o e s not a rr i v e a s a n out b r eak I t a rr i v e s a s a c lou ded i n c u ba tor h oo d , a ke yp ad t ha t ha s g on e t ack y , a pro be h ous i n g t ha t no lon ge r s ea ls c l ea nly , a n d s e rv ice ca lls t ha t no b o d y tr ace s back to a c l ea n i n g pro d u c t A l c o h ol f r ee w i p e s e x i st beca us e o f t ha t s ec on d qu e st i on A l c o h ol wor k s w e ll on m a ny ha r d sur face s , b ut i t i s a lso a solv e nt , a n d s e v e r a l o f t he m a t e r ia ls t ha t m edica l e qu i pm e nt i s b u i lt f rom d o not tol e r a t e solv e nt c ont ac t t ha t i s r e p ea t ed a ll da y , e v e ry da y T ha t i s w h y a m a nu fac tur e r kee ps a s e p a r a t e a l c o h ol f r ee r a n ge i nst ead o f s e ll i n g on e w i p e f or t he e nt i r e b u i l di n g W ha t R e p ea t ed A l c o h ol C ont ac t D o e s to a D e v ice S ur face W i p e s a r e not on e che m i stry T he ca t eg ory c ov e rs a l c o h ol ba s ed pro d u c ts , qu a t e rn a ry a mmon i um c ompoun d s a n d h y d ro ge n p e rox ide f ormul a t i ons , a n d t he y beha v e v e ry diffe r e ntly tow a r d t he m a t e r ia ls t he y tou ch B eca us e t he s e a r e s i n g l e us e pro d u c ts , t he e xposur e a sur face r ecei v e s i s s e t b y h ow o f t e n i t i s w i p ed r a t he r t ha n b y h ow lon g a c lot h s i ts i n a b u cke t O n a mon i tor be z e l t ha t i s c l ea n ed be tw ee n p a t ie nts , t ha t f r e qu e n c y i s high A l c o h ol i s us ef ul p a rtly beca us e i t e v a por a t e s qu ick ly , a n d t he s a m e prop e rty m ake s i t de m a n di n g on ce rt ai n polym e rs P l a st ic , ac ryl ic a n d s i l ic on e a r e t he m a t e r ia ls most o f t e n affec t ed T he fi rst s ig n i s c osm e t ic : a d ull ed fi n i s h , a ha z e ac ross a tr a nsp a r e nt p a n e l , a sl igh t t acki n e ss w he r e t he sur face us ed to be smoot h W i t h r e p ea t ed c ont ac t t h os e sur face s ca n los e t hei r fi n i s h a lto ge t he r or def orm T r a nsp a r e nt p a rts a r e t he l ea st f or gi v i n g o f a ll , beca us e c lou di n g ca nnot be pol i s hed back out o f t he m T hi s i s ea sy to m i ss beca us e i t n e v e r pr e s e nts a s a h y gie n e fai lur e T he w i p e i s d o i n g e x ac tly w ha t i ts l abe l de s c r ibe s T he de v ice i s qu ie tly ge tt i n g wors e T he two pro b l e ms m e r ge l a t e r : a sur face t ha t ha s g on e rou gh , c r a z ed or st ick y i s ha r de r to c l ea n w e ll , beca us e so i l s e ttl e s i nto t he da m age a n d t he w i p e no lon ge r p a ss e s e v e nly ov e r i t M a t e r ia l c omp a t ibi l i ty stops bei n g a m ai nt e n a n ce top ic a t t ha t po i nt a n d bec om e s a n i n fec t i on c ontrol on e W he r e A l c o h ol F r ee S tops B ei n g a P r efe r e n ce C e rt ai n s e tt i n g s a r e s i n g l ed out f or a l c o h ol f r ee pro d u c ts , a n d i n each ca s e t he r ea son i s t he su b str a t e r a t he r t ha n t he or ga n i sm I n c u ba tors a n d n e on a t a l un i ts , w he r e tr a nsp a r e nt h oo d s , acce ss p a n e ls a n d f l e x ib l e s ea ls a r e w i p ed m a ny t i m e s a da y U ltr a soun d pro be s a n d e l ec tro de s , w he r e t he h ous i n g , t he f l e x ib l e c ont ac t a r ea a n d t he cab l e e ntry a r e a ll s e ns i t i v e p a rts o f on e e xp e ns i v e a ss e m b ly P l a st ic , ac ryl ic a n d s i l ic on e sur face s a nyw he r e i n t he b u i l di n g , f rom e qu i pm e nt c ov e rs to c ontrol p a n e ls V e t e r i n a ry c l i n ic s a n d l ab or a tor ie s , w he r e cage s , h ous i n g s a n d i nstrum e nt ca s i n g s a r e l a r ge ly polym e r a n d c l ea n i n g i s f r e qu e nt T he g roup i n g i s wort h not ici n g beca us e i t i s not or ga n i z ed b y de p a rtm e nt I t f ollows t he m a t e r ia l , w hich i s w h y pu b l i s hed us age g u ida n ce f or di s i n fec t a nt w i p e s s e p a r a t e s t he a l c o h ol f r ee a r ea s f rom ge n e r a l w a r d sur face s i nst ead o f n a m i n g a s i n g l e pro d u c t f or e v e ry room N e on a t a l e qu i pm e nt de s e rv e s i ts own not e I n c u ba tors c om bi n e tr a nsp a r e nt polym e r , ga s ke ts a n d w a rm h um id c on di t i ons , a n d t he y a r e c l ea n ed mor e o f t e n t ha n a lmost a nyt hi n g e ls e i n t he h osp i t a l T he c umul a t i v e e xposur e i s high , t he m a t e r ia ls a r e a mon g t he l ea st tol e r a nt , a n d a h oo d t ha t ha s g on e c lou d y c osts mor e t ha n t he r e pl ace m e nt p a rt : st aff los e t he c l ea r l i n e o f s igh t t he y de p e n d on O n e D e v ice , T e n M a t e r ia ls , a n d t he W eake st O n e S e ts t he R ul e C omp a t ibi l i ty i s usu a lly di s c uss ed a s t h ou gh a bed s ide mon i tor w e r e a s i n g l e o bjec t I t i s a st ack o f m a t e r ia ls A troll e y mount ed un i t ca n pr e s e nt a st ai nl e ss st ee l f r a m e , a n ABS h ous i n g , a poly ca r b on a t e w i n d ow , s i l ic on e s ea ls , P V C cab l i n g a n d a g l a ss s c r ee n i ns ide t he l e n g t h o f on e w i p e stro ke A pro d u c t t ha t su i ts n i n e o f t h os e a n d a tt ack s t he t e nt h i s not a c omp a t ib l e pro d u c t f or t ha t de v ice I t i s a pro d u c t w i t h a fai lur e po i nt , a n d t he fai lur e po i nt i s usu a lly t he p a rt no b o d y i nsp ec ts : t he ga s ke t a t t he edge o f t he di spl a y , or t he str ai n r e l ief w he r e t he cab l e e nt e rs t he h ous i n g T ha t i s w h y a m a t e r ia l l i st i s mor e us ef ul to a bi om edica l t ea m t ha n a room l i st T he c omp a t ibi l i ty s e t pu b l i s hed f or t he a l c o h ol f r ee D e trox w i p e s runs ac ross polystyr e n e , st ai nl e ss st ee l , P V C , poly ca r b on a t e , ce r a m ic , ABS , s i l ic on e , HDPE , ru bbe r a n d g l a ss R ead i t a s a n i nv e ntory o f w ha t c l i n ica l e qu i pm e nt i s ac tu a lly m ade o f M a t e r ia l W he r e i t usu a lly a pp ea rs on c l i n ica l e qu i pm e nt ABS H ous i n g s , be z e ls , ha n d l e s a n d troll e y p a n e ls P oly ca r b on a t e T r a nsp a r e nt c ov e rs , h oo d s , w i n d ows a n d di spl a y p a n e ls P olystyr e n e R igid tr a ys , h ol de rs a n d mol ded acce ssory p a rts HDPE C ont ai n e rs , b ottl e s a n d mol ded b o d y p a rts P V C C ab l i n g , tu bi n g a n d f l e x ib l e c ov e rs S i l ic on e S ea ls , ga s ke ts , ke yp ad s a n d f l e x ib l e c ont ac t a r ea s R u bbe r G a s ke ts , fee t a n d cab l e str ai n r e l ief s S t ai nl e ss st ee l F r a m e s , r ai ls , troll e ys a n d i nstrum e nt sur face s C e r a m ic D e nt a l sur face s a n d ha r d w ea r i n g p a rts G l a ss S c r ee ns a n d opt ica l w i n d ows R eadi n g a de v ice t hi s w a y a lso e xpl ai ns w h y t he s a m e w i p e qu e st i on ge ts a diffe r e nt a nsw e r i n two rooms t ha t loo k a l ike A n o ffice styl e ke y b o a r d a t a nurs e s st a t i on a n d a s ea l ed s i l ic on e ke yp ad on a v e nt i l a tor a r e b ot h ke yp ad s O nly on e o f t he m ha s a f l e x ib l e polym e r sur face t ha t w i ll r egi st e r e v e ry p a ss o f a solv e nt T wo A l c o h ol F r ee R out e s a n d W ha t E ach O n e I s B u i lt A roun d T aki n g a l c o h ol out o f a w i p e m ea ns putt i n g som e t hi n g e ls e i n , a n d t he r e i s mor e t ha n on e w a y to d o i t D e tro H ea lt hca r e , w hich m a nu fac tur e s un de r t he D e trox b r a n d , runs two a l c o h ol f r ee sur face w i p e l i n e s b u i lt on diffe r e nt che m i stry D e tro S a n HP W i p e s a r e r ead y to us e w i p e s i mpr eg n a t ed w i t h a h y d ro ge n p e rox ide a n d or ga n ic acid f ormul a t i on A lon g s ide a l c o h ol , t he f ormul a t i on a lso l ea v e s out p he nol , a l deh y de , ch lor i n e a n d p e r ace t ic acid , w hich i s a m ea n i n gf ul l i st on e qu i pm e nt w he r e w ha t st a ys behi n d on a sur face m a tt e rs a s mu ch a s w ha t t he pro d u c t r e mov e s C l ea n i n g a n d di s i n fec t i on ha pp e n i n a s i n g l e st e p T he e qu i pm e nt s c op e st a t ed f or t he l i n e i s e x ac tly t he s e ns i t i v e e n d o f t he i nv e ntory : i nt e ns i v e ca r e un i ts , i n c u ba tors , pro be s , de nt a l un i ts a n d ae r a tor head s D e tro S a n AF W i p e s r each t he s a m e a l c o h ol f r ee r e qu i r e m e nt b y a diffe r e nt ro ad , t h rou gh qu a t e rn a ry a mmon i um w i t h a m i n e c ont e nt , a n d t he y a r e f r ee o f p he nol a n d a l deh y de a s w e ll a s a l c o h ol O n e w i p e c ov e rs c l ea n i n g a n d di s i n fec t i on he r e too T he l i n e i s de s c r ibed i n t e rms o f w ide m a t e r ia l c omp a t ibi l i ty , w i t h a l c o h ol s e ns i t i v e sur face s , i n c u ba tors a n d pro be s n a m ed di r ec tly N ei t he r rout e i s t he be tt e r on e i n t he ab str ac t T he y diffe r i n w ha t t he y e x c lu de a n d i n h ow t he y ge t t hei r ac t i v i ty , a n d t ha t diffe r e n ce i s w ha t a bi om edica l t ea m w eigh s w he n a de v ice i nstru c t i on s hee t rul e s out a n e nt i r e c l a ss o f che m i stry T he C osts T ha t N e v e r S h ow U p i n a n I n fec t i on R e port W he n a m a t e r ia l i n c omp a t ib l e w i p e i s us ed on a f l ee t o f de v ice s f or a y ea r , t he da m age ge ts r ec or ded som e w he r e e ls e i n t he or ga n i z a t i on A tr a nsp a r e nt h oo d i s r e pl aced beca us e no b o d y ca n s ee t h rou gh i t A c ontrol p a n e l i s r e pl aced beca us e t he pr i nt ed l ege n d s ha v e worn a w a y A pro be l ea v e s s e rv ice beca us e i ts h ous i n g no lon ge r s ea ls A s e rv ice v i s i t i s b oo ked f or a de v ice t ha t i s f un c t i on a lly fi n e N on e o f t hi s r eache s a n i n fec t i on c ontrol r e port A ll o f i t r eache s a m ai nt e n a n ce or ca p i t a l l i n e , w he r e t he ca us e i s r a r e ly wr i tt e n d own T he s ec on d c ost i s ha r de r to qu a nt if y A pro d u c t t ha t v i s ib ly m a r k s e qu i pm e nt puts pr e ssur e on t he c l ea n i n g proto c ol i ts e l f , beca us e t he p e opl e r e spons ib l e f or t ha t de v ice now ha v e a r ea son to w i p e i t l e ss o f t e n , l e ss t h orou gh ly , or a roun d t he da m aged a r ea r a t he r t ha n str aigh t ac ross i t C h oos i n g f or m a t e r ia l c omp a t ibi l i ty i s not only ab out prot ec t i n g a n a ss e t I t kee ps a sur face c l ea n ab l e f or t he f ull s e rv ice l ife o f t he de v ice , w hich i s t he only c on di t i on un de r w hich a c l ea n i n g proto c ol ca n be f ollow ed a s wr i tt e n W ha t A l c o h ol F r ee D o e s N ot M ea n A l c o h ol f r ee de s c r ibe s w ha t a f ormul a t i on l ea v e s out I t i s not a st a t e m e nt ab out t he r a n ge o f ac t i v i ty , a n d i t d o e s not m ake a pro d u c t su i t ab l e f or e v e ry sur face b y defa ult A l c o h ol ba s ed w i p e s r e m ai n a s e ns ib l e ch o ice on m a ny ha r d sur face s t ha t tol e r a t e t he m , a n d mov i n g a n e nt i r e b u i l di n g onto on e a l c o h ol f r ee pro d u c t i s t he s a m e m i st ake i n t he oppos i t e di r ec t i on : ch oos i n g b y ca t eg ory i nst ead o f b y su b str a t e C omp a t ibi l i ty a lso ha s two s ide s T he w i p e m a nu fac tur e r st a t e s w hich m a t e r ia ls i ts pro d u c t i s c omp a t ib l e w i t h , a n d t he de v ice m a nu fac tur e r st a t e s w ha t m a y be a ppl ied to t he de v ice W he r e t he two di s ag r ee , t he de v ice d o c um e nt decide s , beca us e i t w a s wr i tt e n f or t he sp ecific a ss e m b ly i n f ront o f you r a t he r t ha n f or a m a t e r ia l fa m i ly i n ge n e r a l W hich pro d u c t g o e s on w hich de v ice , a n d h ow lon g a sur face ha s to st a y w e t f or t ha t pro d u c t to d o i ts wor k , a r e not qu e st i ons a n a rt ic l e s e ttl e s T he y a r e s e t b y t he m a nu fac tur e r i nstru c t i ons f or us e wr i tt e n f or t ha t pro d u c t , a n d b y w ha t e v e r each h osp i t a l , de nt a l pr ac t ice or l ab or a tory ha s fi x ed i n i ts own i n fec t i on c ontrol pol ic y Q u e st i ons T ha t C om e U p W he n a W a r d C ha n ge s W i p e s I s a qu ick a l c o h ol w i p e acce pt ab l e on a n i n c u ba tor if i t d r ie s i mm edia t e ly ? T he i ssu e i s not on e c ont ac t b ut t he sum o f t he m , a n d n e on a t a l e qu i pm e nt i s c l ea n ed mor e o f t e n t ha n most I n c u ba tors a n d n e on a t a l un i ts s i t a mon g t he a r ea s w he r e a l c o h ol f r ee pro d u c ts a r e ca ll ed f or i n t he fi rst pl ace , a n d t he c l ea n i n g i nstru c t i ons i ssu ed f or t ha t sp ecific i n c u ba tor norm a lly s e ttl e t he qu e st i on f or t ha t mo de l D o e s a l c o h ol f r ee m ea n a m i l de r or w eake r pro d u c t ? N o I t de s c r ibe s a n e x c lus i on , not a l e v e l T he ac t i v i ty c om e s f rom ot he r ac t i v e s : h y d ro ge n p e rox ide w i t h or ga n ic acid i n on e D e trox l i n e , qu a t e rn a ry a mmon i um w i t h a m i n e c ont e nt i n t he ot he r W ha t t he e x c lus i on cha n ge s i s h ow t he sur face beha v e s af t e rw a r d s a n d w ha t i s l ef t on i t H ow d o you t e ll che m ica l da m age f rom or di n a ry w ea r ? C he m ica l da m age t e n d s to be e v e n ac ross t he w h ol e w i p ed a r ea a n d f ollows t he p a t h o f t he w i p e r a t he r t ha n t he p a tt e rn o f ha n d l i n g I t s h ows fi rst on t he so f t e st m a t e r ia ls a n d a t edge s : ha z e on tr a nsp a r e nt c ov e rs , t acki n e ss on s i l ic on e , a cha l k y loss o f g loss on h ous i n g s , st iffe n i n g or fi n e c r ack s i n ru bbe r a t f l e x po i nts O r di n a ry w ea r c on ce ntr a t e s w he r e ha n d s , cab l e s a n d troll e ys m ake c ont ac t , a n d i t i s un e v e n