Answer: d. When you're trialing and comparing spray-and-wipe solutions or pre-treated, packaged wipes, you may also want to consider whether a product has broad-spectrum effectiveness or whether its formulation has an edge in germicidal, virucidal or sporicidal use, as determined by its active ingredients; the pathogens present in your facility's surgical site infection incidents; whether the product's use will require additional staff training; and even its usable shelf life. (osmag.net/oK3AnF)

Answer: c. Antimicrobial products fall under the EPA's Office of Pesticide Programs. Lists of the solutions it has deemed effective against specific pathogens can be found at its registration page: osmag.net/FbkSN1. Infection prevention-minded accreditation surveyors will likely check the labels on your surface disinfection agents to ensure that they've got the EPA's seal of approval.

Answer: b. Surfaces that are contaminated by dust, dirt, bodily fluids or other organic and potentially infectious material can't be disinfected until they're clean. Keep in mind that not all contaminants are easily visible. So pre-cleaning with a detergent solution is recommended to clear the surface and allow effective disinfection. While some pre-treated wipes include both detergent and disinfectant and are marketed as a single-step option, make sure that they're used properly to completely remove gross contamination and also leave the surface wet for disinfectant contact, even if it takes multiple wipings.

Answer: c. Even though pre-treated wipes contain a disinfectant agent, using them on more than one surface — even if you flip them to the other side — runs the risk of cross-contamination. While wipes are ideally suited for smaller surfaces, don't be stingy with their use if you're swabbing down a larger area. Use as many wipes as you need to avoid shuffling bacteria around. And always close the wipe container's lid, to prevent the wipes from drying out.

Answer: b. The antimicrobial effect of disinfectants doesn't occur on contact. They should remain wet for the entire length of their prescribed contact time, also known as "kill time" or "dwell time," and the surfaces that they've been applied to should air dry and not be wiped dry.

Answer: c. As mentioned above, a disinfectant agent must remain wet in order to remain effective. If a product's actual wet time is less than its designated contact time, repeated reapplication — spraying the surface again with the same agent or wiping again with a fresh wipe — is necessary to achieve a complete microbial kill.

Answer: a. If both are EPA-approved and both are used in a manner consistent with their manufacturers' instructions for use, then they'll both deliver similar antimicrobial effects. Given the quicker room turnovers that the 2-minute disinfectant will facilitate, not to mention the greater likelihood that staff will comply with its requirements and won't have to reapply the product to cover the entire wet time, the product with the shorter contact time may actually be the better bet.

Answer: b. Once you've wiped down the OR table, the overhead light, the Mayo stand and the boom-mounted equipment, the room's good to go, right? Wrong. Don't neglect such highly touched surfaces as IV pole hooks, light switches, portable vital signs monitors, equipment cords and supply cabinet doorknobs.

Answer: d. Researchers at Northwestern Memorial Hospital in Chicago, Ill., found that installing UV-C lamps over computer keyboards and mice in the hospital's intensive care units reduced bacterial colonization of the components by more than 99% (osmag.net/4pBsTQ). Sealed, submersible keyboards are available from several manufacturers, and keyboard covers are easier to wipe down than the crevices between each key.

Answer: c. Mounting a container of wipes on a provider's workstation, and making sure to replace it when it runs out, will make it easier for the provider to thoroughly disinfect surface areas, knobs, dials and other high-touch surfaces between cases, as well as medication vial lids and injection ports throughout a procedure.

Answer: b. The OR floor must be fully mopped during terminal cleaning, of course, but between cases mopping the immediate surgical area as well as any high-traffic areas should suffice, infection prevention experts say, unless bodily fluids have spilled or dripped elsewhere, or other visible soiling has occurred.

Answer: c. To be effective, a liquid disinfectant solution must be mixed to and applied at the proper concentration, which will be designated in the manufacturer's directions. Topping off the bucket will dilute the concentration and result in contamination.

Answer: a. While recent studies have explored the antimicrobial properties of copper alloys when they're integrated into such healthcare surfaces as stretcher bed rails, IV poles and tray tables, science has not yet developed a molecular airborne form of the metal that can remotely deactivate bacterial contaminants.

Answer: b. Automated whole-room disinfection systems attack the same microbes that manual surface cleaning does. They also eliminate the risk of human error due to improper disinfectant application or contact time. But they usually require more time to treat a room than manual efforts do. That's why in ambulatory surgery settings it's generally seen as a terminal cleaning aid rather than a between-case option.

Answer: d. UV light disinfection requires direct illumination to kill microbes. If surfaces are too distant from the light or obscured by shadows, you might have to reposition the units for repeat cycles or deploy multiple units for a single cycle to treat all surfaces.

Answer: b. Hydrogen peroxide won't harm electronic components, but it can irritate the eyes and respiratory system. Seal doors and ventilation ports of the treated room, and vacate the room during the cycle.

Answer: a. Familiarize yourself with the microbes that a surface disinfectant product is effective against, and the required contact time. Clostridium difficile's spores, for example, can live on hard surfaces for several months, surviving regular treatments if they don't involve chlorine bleach or high concentrations of hydrogen peroxide.

Answer: d. Visual inspection isn't particularly reliable for determining the presence of microbes surviving on a surface following routine cleaning. While quick swabbing tests like preemptive fluorescent markers or ATP's warning signals can only spot-check select surfaces, they deliver more rapid results than the 2 days that colony counts require.

Answer: b. Microbes can survive for long periods of time on OR surfaces. Biofilms can form on dry surfaces as well as wet ones. And the hands of your perioperative team members provide convenient transportation between a bed rail or door handle and a patient's skin.

Answer: a. Reviewing 80 surface disinfection studies published in the medical literature between 1998 and 2014, researchers from the University of Pennsylvania found few qualitative comparisons of cleaning methods or resulting surface cleanliness. Many of the studies (osmag.net/j8cNTR) simply charted a single product's before-and-after levels of contamination. Researchers suggested further research was necessary to prioritize surfaces to be disinfected, and to determine which agents and methods are most effective. OSM