Dosing Spotlight: Good policies & Best Practice

Using chemicals is a constant battle between science and subjective preferences. We may enjoy billowing clouds of foam in our kitchen sink with a “feeling” that greasy pots need just one more squirt of detergent.

Do subjective preferences lead to inaccurate dosing of detergents in healthcare?

Without clear policy and training, technicians may dose according to color, odor or amount of suds in the diluted solution. In a busy work environment, if the sinks are not marked for fill volume or the dosing wall pump is clogged, technicians will devise quick work-arounds with less accuracy.

Automated dosing pumps are convenient and reduce guesswork but they need scheduled maintenance and calibration to verify the pump dispenses correct amount of chemical. Pump “squeeze tubing” must be checked and replaced at regular intervals specified by the pump manufacturer.

Over-dosing of cleaning chemicals may lead to excess foam and residue in cleaning equipment and on instruments. Foam prevents visualizing sharp items in the sink and may inhibit pumps and spin action in automated washers.

Underdosing is also a risk leading to inadequate cleaning. For example, super concentrated detergents are convenient and useful if dosed correctly. But when only one to two ounces (30 to 60 mL) of cleaning chemical goes into a wash cycle, pump calibration must be more exact.

Over or underdosing can be prevented with good policy, training and documentation. Patient safety and compliance with standards should lead us all to a renewed focus on accurate dosing of chemicals.