BCD: Lessons Learned from early Infection Control and Response Visits (ICARs) with LTCF: Topic 3

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Healthcare-Associated Infections (HAI) Prevention Program

Early Infection Control Assessment and Response Visits:
Lessons Learned

Topic 3: Environmental Cleaning


In early April 2020, the DPH Healthcare-Associated Infections (HAI) Prevention Program began performing telephone-based, COVID-19-focused infection control assessment and response visits (ICARs) with long-term care facilities (LTCF) around the state.

ICARs are educational discussions that cover a range of infection prevention and control topics that can impact the spread of COVID-19 within a facility. ICARs provide opportunities for questions and discussion, a review of policies and practices, and "just in time" education.

The HAI program and its partners in this effort, including the Superior Health Quality Alliance and local health departments, have conducted more than 165 ICARs to date.  

This "Early ICAR Lessons Learned" series of messages will highlight common recommendations and clarifications our team of infection preventionists are making during these calls, as they promote best practices and alignment with CDC and DHS guidance.


Environmental Cleaning

  • Facilities should use disinfection products included on EPA List N.  Per its website, “EPA expects all products on List N to be effective against SARS-CoV-2 (COVID-19) when used according to label directions.” It is easiest to check whether products are included on List N based on a product’s EPA Registration Number, rather than the product name.
  • Facilities should consider creating and maintaining a master disinfectant chart, to identify each product in use, product indications and contact times, and staff who use each product. Non-environmental services staff are disinfecting high-touch surfaces and equipment, so it is critical that all staff understand how to use these products properly.
  • Facilities should frequently audit to ensure that cleaning products are being handled properly. This includes ensuring that products are being mixed correctly, if applicable, and that the required contact time per the label is met. The contact time (or wet time) is the length of time that the product needs to remain wet to disinfect. If the surface dries before the indicated contact time, the product needs to be re-applied so that the surface remains wet for the full amount of time indicated. Disinfectants with long contact times may be challenging for staff to use.

Note that the recommendations highlighted here do not replace the value of a facility having its own ICAR, or the need to stay current on CDC and DHS guidelines.  ICARs are non-regulatory and complement infection control surveys, with a focus on education and infection prevention. 

To request an ICAR for your facility, email the HAI Prevention Program or call 608-267-7711.