Descriptive Study for Status of Usage of Disinfectants in Korea

Park, Eun Suk; Kim, Og Son; Kim, Kyung Mi; Kim, Young Suk; Jeong, Sun Young; Yoon, Sung Won

Abstract

BACKGROUND
The usage of appropriate disinfectants is essential for infection control in a hospital. Inadequate use of disinfectants is the cause of human or environmental toxicity and is a waste of cost. The objective of this study was to describe the status of the usage of disinfectants in Korean hospitals. METHOD: One hundred and eighty three hospitals of over 300 beds were investigated by a questionnaire distributed by mall. Data collection was done on November 1999. The questionnaire was made by the Association of Infection Control Nurses in Korea, based on references and protocols of the Korean Society of Nosocomial Infection Control. Numerical and percentage data were analyzed by SPSS.
RESULTS
The collection rate of the questionnaire was 43.7% (80/300). Thirty five hospitals (46.7%) had an official process in selecting disinfectants in their hospitals. Regarding skin antiseptics, 10% povidone iodine and 70% alcohol were commonly used in skin preparation for intravenous catheterization or pre-operative skin disinfection, For disinfection of mucosal membranes such as mouth and periurethral area, 3% boric acid solution or 3% H202 were used. Most of the hospitals decontaminated contaminated medical instruments manually with dodecyl diamino ethyl glycine (20.8%). glutaraldehyde (15.6%). quaternary ammonium compounds (13.8%), virkon (12.3%) and sodium hypochlorites (11.7%). Glutaraldehyde and virkon were frequently used for disinfection of endoscopes. Sodium hypochlorites (48.9%) and quaternary ammonium compounds (19.8%) were the most commonly used environmental disinfectants. Some noticeable problems in disinfectants were as follows. First, for mouth care, many hospitals (41.7%) over-used boric acid, which has cumulative toxicity for humans. Second, many hospitals had an incorrect protocol of disinfecting endoscopes. Third, for environmental decontamination and instrument cleaning, some hospitals used high level disinfectants such as glutaraldehyde, which is too costly and provides unnecessary safety problems. Fourth, after patient discharge, many hospitals did not use disinfectants at all. Considering the specific Korean medical environment of high incidence of multi-drug resistant microorganisms, use of disinfectants for discharged environments may be warranted.
CONCLUSION
This study included only hospitals of over 300 beds, which has a limitation in representing the status of disinfectants usage in a country. However, significant problems from misunderstanding the basic principles of disinfectants and misusages of disinfectants were observed in this investigation. These observations will provide useful information for designing a guideline for the appropriate uses and for efficient education of disinfectants, and also for planning a national control program for proper disinfectants usage in this country.