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Now we’re going to talk about how to disinfect contaminated work surfaces. There's several things that we're gonna start with. First of all there's certain materials you've gotta have present to be able to do this properly. Personal protective equipment is the utmost important. So if you think there's a chance that you're gonna get a splash in the eyes, get it on your clothing, you need to have personal protective equipment equivalent to what you're going to need to do. So let's say this was machinery that you've gotta spray down and there's a chance that it could splash back, you might have a disposable apron with gloves and a face shield, eye shield combination. In this case this is a flat work surface, we have some droplets of blood from an injury that took place a while ago. The blood is already starting to coagulate and so it's not going to splash anywhere unless I do it. So we just need to have care when we do that. I'm going to make sure that I've got at least a few pair of gloves, because we want to remember that we're actually gonna be changing our gloves every time we might touch contamination, and then go to a clean object. So when I first do the first wipe down, I'm gonna throw all that away, put new gloves on properly and then grab my bleach solution, spray down the surface, wipe it down, throw that away, take off the gloves appropriately and then yet a third pair of gloves to grab the bottle and spray down for our wet to dry disinfecting time. And you'll see that as we go here in how I'm gonna display this. We also want to make sure that we've got the right kind of cleaning material, wiping material. You don't to use toilet paper that's gonna shred or maybe like household napkins, they tend to break down in fluids and that's not what we're looking for. We're looking for maybe a more commercial grade paper towel or something that's appropriate to wipe up these spills. So let's go ahead and get started. If there were any sharp objects, remember that we would remove those sharp objects, broken glass, sharps, needles, things like that with tongs. Put them into a contaminated sharps protecting basin of sorts so that we can disinfect that at a later time or dispose of it properly in a sharps container. We do not have any sharps so I'm gonna go ahead and put on my first pair of gloves. After my first pair of gloves are on, I'm gonna take my towels and I'm gonna wipe down, being careful not to cross contaminate. I want to keep all the fluids on the surface and just kinda wipe up the majority of the copious amounts of the spill. We're not trying to get it perfect. Then we're going to properly remove the gloves. Then the finger on the inside. Into the trash it goes. Now we don our second pair of clean gloves. You might notice these are blue gloves, these are the nitrile gloves. But these are medical grade. You want to make sure that your gloves are medical grade so that the pores of whatever the protecting barrier is is small enough to protect from any of the infectious diseases. Hepatitis B, Hepatitis C, HIV. Industrial grade gloves may not have that quality. The pores may be too big, they may have permeable pin hole size things in there. They're not graded the same as medical grade gloves. So that's a distinguishing piece you want to be careful about. Now this is a really big one. You can look this up on the CDC's guidelines, but I'm gonna simplify it for you here. The Centers for Disease Control will say one part bleach to ten parts water to make the appropriate bleach solution concentration that is appropriate for killing all bloodborne pathogens. Okay, I'm gonna just repeat that one more time. One part bleach to ten parts water. So if I just got a little tiny spill, that means I'm gonna do one table spoon of bleach, household bleach, over the counter, to ten more table spoons of water to make the appropriate solution that is strong enough to kill all bloodborne pathogens. That's important to remember, and it can be in any size increment that's appropriate. But now I'm gonna take my bleach solution, which is extremely cost effective. If you use another chemical to disinfect, you just need to remember that the chemical must be legally approved to kill the appropriate micro-organisms to disinfect and to protect against viruses, bacteria and other pathogens. So you'll want to make sure that you're using an industry grade appropriate chemical if you're not gonna use the bleach solution. Grab a couple more of the paper towels, now we're wiping down the surface that's been sprayed with the bleach solution in this case. Making sure not to cross contaminate and spill it off the edges. If it does, then we're gonna have some floor to clean up. Once again, glove on glove, skin on skin, for removing the gloves. Now I throw those in the trash, and now one more time. I know this seems redundant, but this is so that we're not cross contaminating between potentially infectious materials and clean items, and that would be the same as if you were grabbing fresh paper towels or opening doors or whatever the case may be. Taking off your gown. If you were to take off your gown that might have splash on it, you would take it off with dirty gloves, then take the dirty gloves off, throw them in the trash, grab another pair of clean gloves, and then take off your face shield with your eye shield and throw that in the trash, and then put on new clean gloves. So we're always making sure to put a barrier, which we talked about earlier, to break the route of infection. That's why personal protective equipment is so effective. Lastly with clean gloves on, we're gonna lightly mist the surface that was contaminated. This would include a floor or materials and now we allow this surface to evaporate. The evaporation time from wet to dry is the appropriate amount of time for bleach solution and in many cases even industrial strength disinfectants to actually have what we call a kill time, and that's important to remember when you're doing the final step of this disinfection of a contaminated surface.
Your gloves are your first line of defense against bloodborne pathogens and other potentially infectious materials when cleaning up and disinfecting a scene. In this lesson, we'll show you the exact procedure of how to properly and safely remove them.
You don't want blood and other bodily fluids to touch your skin, but you especially don't if you have cuts, scrapes, abrasions, or other openings in the skin. Even hangnails could pose a problem and provide an opening for a foreign invader to enter.
Remember, not all gloves are created equally. Always use medical-grade gloves when cleaning bloodborne pathogens and OPIM. While the term industrial-grade sounds strong and safe, this isn't always the case, as industrial grade gloves tend to have larger pores than medical-grade gloves, which may not keep all the bad stuff out.
Ideally, you'll have nitrile gloves. As latex allergies are becoming more common, nitrile gloves provide a better option for many people.
Pro Tip #1: While putting on your gloves may sound like common sense and something not requiring instruction, there are three important points to note:
- Gloves will sometimes stick together, and this may make getting them on more difficult than it should be. (Though most gloves now have a coating or powder on them to prevent this.) Which is why you may have seen someone blow a puff of air into the wrist to make squeezing a hand in easier. This is not appropriate when it comes to infectious materials cleanup, even with clean gloves. Also, you don't want to spread any germs you may have onto the clean gloves.
- Size matters. Gloves come in many sizes. If your employer has only small or medium size gloves and you're a 300-pound man with sausage fingers, good luck. And do you know what happens when you try and squeeze an extra-large hand into a small glove? Well, let's just say it'll look like your hand is wearing a halter top, and your protection will go bye-bye. So, make sure your employer has your glove size in stock. Because one size rarely fits all.
- Inspect the gloves for defects, like holes, rips, or cuts. Just like our halter top gloves scenario above, if your gloves have any type of hole, you're not getting that protective barrier you need to stay safe, and you could wind up spreading a pathogen rather than containing and cleaning it up. Safety first, always.
Remember, when handling or cleaning up infectious materials and bloodborne pathogens, your goal is to create barriers. These barriers will halt the spread of infection. When it comes to gloves, they're like having an additional protective layer of skin.
How to Remove Contaminated Gloves
If you've seen the video lesson that corresponds with this written version, you may have noticed that glove removal is not a normal process for most people and one that may require a bit of practice to perfect. And since perfection equals being disease and infection-free, practicing taking off your contaminated gloves may not be the worst idea.
Pro Tip #2: Keep in mind your goal as it pertains to glove removal – keeping the contaminated materials on one side and your skin on the other. The two sides should always remain separate.
To this end, the glove removal process is as follows:
1. Pinch the palm side of one glove on the outside near your wrist. (Glove on glove contact only.)
2. Pull the glove slowly and carefully toward your fingertips, turning it inside out as you pull it off your hand.
3. Wad up the dirty glove into the palm of your still-gloved hand.
Pro Tip #3: You want to completely wad the glove up into that hand so the other glove can easily pass over your fist and not catch on any of the material from the first glove. However, you don't want to squeeze so hard that infectious material comes oozing out.
4. Carefully slip two fingers under the wrist of the other glove. Avoid touching the outside of the glove. (Skin on skin contact only.)
5. Pull the glove slowly and carefully toward your fingertips, turning it inside out as you pull it off your hand. The other glove is now contained inside.
By now, you should be holding the inside lining of one glove with the other glove trapped deep down inside. You can also do this with a bloody gauze pad or contaminated paper towel in one of your gloved hands, as all items will wind up at the bottom of the first glove removed.
Warning: When removing your gloves, it's important that you don't snap the glove material, so make sure you have a good grip and work slowly and carefully. Snapping the glove's materials could send pathogens and infectious materials flying – into eyes and other mucous membranes or onto clean surfaces.
6. Toss both gloves into the trash along with other PPE. Ideally, you'll have access to a trash receptacle that you can open using a foot pedal. And make sure the liner is appropriate for handling bloodborne pathogens and other potentially infectious materials per your regulations.
7. And finally, wash your hands thoroughly with soap and running water, if available. Otherwise, rub your hands thoroughly with an alcohol-based hand sanitizer if they are not visibly soiled and then wash your hands as soon as it is practical.