Table 2.

Principles of disinfection policies

Objectives and purposes	To prevent infection but in practical terms to reduce the bioburden to a level at which infection is unlikely. Need to consider the standard of hygiene expected by patients and staff
Categories of risk for patients and treatment of equipment and environment
High risk	Sterilization by heat or other methods (eg, ethylene oxide; low temperature steam formaldehyde); high-level disinfection may be acceptable (eg, GTA, OPA, PAA)
Intermediate risk	Disinfection
Low risk	Cleaning and drying usually sufficient; disinfection
Minimal risk	Cleaning and drying; disinfection in case of contaminated spillage
Requirements of chemical disinfectants
Spectrum of activity	“cidal” rather than “static” activity
Efficacy	Rapid action, notably on surfaces
Incompatibility	should not be neutralized/quenched easily, eg, by hard water, soap, organic load
Toxicity	Should be minimal
Damages to products/surfaces Costs	Corrosiveness should be minimal, especially at in use dilution. Should not damage the surface/articles to be disinfected, eg, endoscopes should be acceptable and supplies assured
Implementations of the disinfection policies
Organization	Infection control team should be responsible. Need clear cut and well defined responsibilities
Training	End users (nursing and domestic staff) should be trained appropriately. Clear schedules and supervision by trained staff should be in place.
Distribution and dilution	Staff training is essential. Suitable dispensers of disinfectants should be available
Testing of disinfectants	Need to be properly documented and assessed preferably by an independent organisation following standard protocols.
Costs	Should be considered carefully

Abbreviations: GTA, glutaraldehyde; OPA, ortho-phthalaldehyde; PAA, peracetic acid.