Reading a Hospital-Grade Disinfectant Label: A Guide for Clinic Managers

Every clinic cleaning quote promises "hospital-grade disinfectant". It's in our GP clinic checklist too. But the phrase only means something if the product really is one, and it is used the way the label says. Few practice managers have time to check either. This post shows you how, in about five minutes per product.

What "hospital grade" means in Australia

Disinfectants in Australia fall into broad groups, and the group decides what the product is allowed to claim:

• Household and commercial grade disinfectants are for homes and general premises. They are not entered on the Australian Register of Therapeutic Goods (ARTG).
• Hospital-grade disinfectants are for use in health care settings on surfaces that aren't critical or semi-critical instruments. They must be entered on the ARTG and meet the TGA's testing requirements.
• Instrument-grade products and sterilants are for reprocessing medical devices. They are your clinical team's business and nothing to do with an environmental cleaner.

So the first check is simple. A hospital-grade disinfectant has an ARTG number on the label, usually shown as "AUST L" or "AUST R" followed by digits. If the product a cleaner leaves in your cupboard has no number, it isn't hospital grade, whatever the quote said. You can search the number on the TGA's public ARTG database to see what it is listed as.

The four things to read on the label

1. Claims. Hospital-grade products state what they have been shown to work against. Some make extra claims, such as specific viruses. If you need a product for gastro outbreaks, check that the label or the manufacturer's data supports norovirus, or a suitable surrogate, rather than assuming every hospital-grade product does.

2. Dilution. Concentrates need to be mixed to a stated ratio. Too weak and they don't work. Too strong doesn't make them better: it costs more, leaves residue, wears out surfaces and irritates skin and airways. Ask your cleaner how they measure. "A splash in the bucket" is not a dilution. Pre-diluted products or dosing systems take the guesswork out.

3. Contact time. This is the most ignored line on the label. The surface has to stay wet for the stated time, often several minutes, for the claim to hold. A disinfectant sprayed and wiped dry straight away has mostly just cleaned the surface. A good cleaner works in a pattern: apply across a room's touch points, then come back to wipe, so the contact time passes while they work.

4. Surface compatibility. Some products damage vinyl, upholstery, screens or the coating on an examination couch. If a couch keeps splitting or a reception counter is going cloudy, check what is being used on it.

Mistakes that leave a disinfectant doing nothing

Skipping the clean. Dirt, grease and body fluids stop most disinfectants working. The NHMRC's infection control guidelines treat cleaning with detergent as the foundation. Disinfection comes after cleaning where it is needed, not instead of it. Unless the label says the product is a combined detergent-disinfectant used to its instructions, it's two steps.

The wrong cloth. Some disinfectants, particularly quaternary ammonium ("quat") products, can be taken up by certain cloth materials, which lowers how much active ingredient reaches the surface. Use the cloths the manufacturer recommends and change them often. One cloth for a whole floor is a problem whatever is in the bottle.

Mixing products. Never mix chlorine-based products with acids or ammonia, and don't top up one product with another. It is dangerous for the cleaner and it destroys the product.

Old solution. Diluted product doesn't keep its strength forever, and chlorine solutions in particular lose strength. Mix fresh at the start of each clean. Never pour leftover solution back into the concentrate.

Unlabelled bottles. Every spray bottle should say what is in it. If your cleaner's trolley has bottles with no label, you can't know whether the right product is being used anywhere.

What to keep on file

For accreditation, and for your own peace of mind:

1. A product list naming every product your cleaner uses, what it is used on, and its ARTG number where it is a hospital-grade disinfectant.
2. Current safety data sheets, stored where staff can find them.
3. The dilution and contact time for each disinfectant, written into the scope so a relief cleaner follows the same method.
4. A note of any change. If the cleaner swaps products, the list and the data sheets are updated before the new one is used, not afterwards.

We give every practice this list before the first clean. We also sign every visit in and out on our app inside a geofence around the practice, with a photo, and a supervisor inspects every three weeks. That gives you evidence that the right product was used and evidence that someone was there to use it.

For what to do when the products are put to the test, see spills, gastro and flu season. We clean medical practices across Melbourne, including in Kew, Blackburn, Pascoe Vale and Mount Waverley. See medical cleaning Melbourne, or ask for a walkthrough and bring your current product list.