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hand hygiene disinfectants EPA List N EPA List K EPA List Q infection prevention

Hand Hygiene and Surface Disinfection: Reading EPA Lists N, K, and Q

How to pick hand sanitizer, soap, and surface disinfectants by the rules: CDC hand hygiene guidance and the EPA lists that tell you which product kills which.

Hand Hygiene and Surface Disinfection: Reading EPA Lists N, K, and Q

Most disinfectant purchasing mistakes are not about price. They are about buying a product that is registered for the wrong organism, or a hand sanitizer that meets the label but not the guideline. The rules are public and short. Here is how to use them when you write the order.

Hand hygiene: what CDC says

CDC's guidance for healthcare personnel is direct. Unless hands are visibly soiled, alcohol-based hand sanitizer is preferred over soap and water in most clinical situations because it is more effective at killing germs on hands than soap. CDC recommends sanitizers that contain at least 60 percent alcohol.

Soap and water are the choice when hands are visibly soiled, before eating, after using the restroom, and during the care of patients with suspected or confirmed infection during outbreaks of Clostridioides difficile and norovirus. Alcohol does not reliably inactivate C. difficile spores or norovirus, so washing physically removes them.

CDC also cites the reason facilities keep sanitizer at the point of care: in one 500-bed hospital study, hand hygiene compliance rose from 38 percent at baseline to 63 percent after alcohol-based sanitizer was made available. Placement drives use.

What that means for a purchase order:

  • Alcohol-based hand sanitizer at 60 percent alcohol or higher, in dispenser formats that fit your wall units and carts.
  • Soap and water supplies at every sink, with the outbreak protocol written down so staff know when to switch.
  • For surgical and procedural areas, a surgical hand antiseptic labeled for that use, such as 3M Avagard, now part of Solventum.

Surface disinfection: the EPA lists

Surface disinfectants sold in the United States are registered with the EPA, and the label lists the organisms the product has been shown to kill with a specific contact time. EPA publishes lists that sort registered products by claim.

ListWhat it coversWhen you use it
List NProducts expected to kill SARS-CoV-2 (COVID-19) when used according to the labelRoutine surface disinfection in clinical and public spaces
List KProducts registered for Clostridioides difficile sporesRooms and equipment of patients with C. difficile
List QProducts with an emerging viral pathogen claim, organized in tiersOutbreaks of rare or novel viruses such as Ebola, Marburg, mpox, or hantavirus

EPA's List N page was last updated on April 1, 2026, and EPA notes that inclusion is not an endorsement. To check a product, find the EPA registration number on the label and search the first two number sets in EPA's tool. List Q groups viruses by how hard they are to inactivate: Tier 1 covers enveloped viruses including Ebola, Marburg, mpox, and SARS-CoV-2; Tier 3 covers small non-enveloped viruses such as rabbit hemorrhagic disease virus. A product qualified for the harder tier covers the easier ones.

Two rules apply to every list. Follow the label's contact time, meaning the surface stays wet for the full stated period. And use the product only on the surfaces the label allows.

Building the standard list

A facility standard list for hand hygiene and surface disinfection usually fits on one page:

  1. Alcohol-based hand sanitizer, 60 percent alcohol or higher, in the dispenser format your wall units use.
  2. Hand soap for sinks and outbreak use.
  3. A surgical hand antiseptic for procedural areas.
  4. A List N disinfectant wipe for routine surfaces and shared equipment.
  5. A List K product for C. difficile rooms and terminal cleaning.
  6. A List Q Tier 1 product held in reserve for outbreak response.
  7. Alcohol wipes for small devices and probes, where the device manufacturer allows.

Keep the EPA registration number for each product on the list, so a substitute can be checked against the same list before it is accepted.

What Keystone supplies

Keystone stocks alcohol wipes and sanitizing wipes from GERMisept and Germs Be Gone, hospital-grade surface disinfectants and wipes, hand soap and sanitizer refills, and 3M Avagard surgical hand antiseptic in Edina, Minnesota. Every quote lists the EPA registration number for disinfectants so your infection prevention lead can verify the claim before the order ships. Standing monthly delivery is available for clinics, senior living, schools, and public buildings.

Browse disinfectants, wipes, and hand hygiene or request a quote with your standard list.

Sources

← Senior Living: One Vendor for Medical and Janitorial SupplySchool District Glove Bids: How to Write a Spec That Gets the Right Glove →
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