Pan American Health Organization · 2020
Guidance on preparing sodium hypochlorite disinfecting solutions for healthcare settings in the Americas.
- Issuer
- Pan American Health Organization
- Edition
- 2020
- Audience
- Healthcare facility staff, infection prevention and control teams
- Reviewed
- 21 Oct 2026 · GMJ
What this guideline says
GMJ summary
This procedural guidance provides recommendations for preparing disinfecting solutions using sodium hypochlorite in health establishments. The document instructs healthcare facilities to use the concentration of sodium hypochlorite available locally and prepare solutions according to intended use.
The guidance was issued during the early phase of the COVID-19 pandemic to support infection prevention and control measures in healthcare settings across the Americas.
Key points
For clinicians — doses and thresholds as stated in the guideline
- Use locally available sodium hypochlorite concentration as the starting material for preparing disinfecting solutions
- Preparation methods must be adjusted according to the intended use of the disinfecting solution
- Follow the specific indications presented in the document for different applications in healthcare settings
- Healthcare establishments should ensure appropriate disinfecting solution preparation as part of infection prevention and control protocols
From the guideline
Verbatim
“The concentration of sodium hypochlorite available in the country must be used to prepare the disinfecting solution according to the intended use, following the indications presented in this document.”
Editor’s perspective
Why this matters for Georgia and the region
Prof. Giorgi Pkhakadze, MD, MPH, PhD
Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration
As infection prevention and control remains a cornerstone of healthcare quality in Georgia, particularly following lessons from the COVID-19 pandemic, this PAHO guidance offers relevant practical recommendations for our healthcare facilities. The emphasis on adapting preparation protocols to locally available sodium hypochlorite concentrations is especially pertinent, as Georgian hospitals source disinfectants from various suppliers with differing concentrations. I would stress to infection control practitioners in our facilities the importance of establishing standardised institutional protocols that account for the specific concentrations available, ensuring consistency across departments. The main implementation challenge will be ensuring that all staff involved in preparing disinfectant solutions receive proper training and have access to appropriate measuring equipment, particularly in rural and district-level facilities where resources may be limited.
ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 21 Oct 2026
Applicability
Georgia and the South Caucasus
This guidance is directly applicable to Georgian healthcare facilities as part of infection prevention and control programmes. National infection control protocols should incorporate standardised procedures for disinfectant preparation, particularly given variation in commercially available sodium hypochlorite concentrations across the region. Healthcare facilities in Georgia and neighbouring South Caucasus countries would need to determine locally available sodium hypochlorite concentrations and ensure consistent application of dilution protocols across all departments.
Questions this guideline answers
Quick answers
Why does the concentration of sodium hypochlorite matter when preparing disinfecting solutions?
Different countries and regions have varying concentrations of sodium hypochlorite available commercially (typically ranging from 0.5% to 12%). The dilution calculations and volumes required depend on the starting concentration to achieve the effective concentration needed for specific uses in healthcare settings.
What types of uses in healthcare settings require different disinfectant concentrations?
Healthcare settings typically require different concentrations for general environmental cleaning, disinfection of patient-care equipment, cleaning of blood or body fluid spills, and high-level disinfection of critical surfaces. Each application requires specific sodium hypochlorite concentrations for effectiveness.
How should healthcare facilities in Georgia determine which concentration to prepare?
Facilities should first identify the concentration of sodium hypochlorite available locally, then follow the document's indications to calculate the appropriate dilution for each intended use, ensuring staff are trained in proper preparation methods.
What safety considerations apply when preparing sodium hypochlorite solutions?
Staff preparing disinfecting solutions should use appropriate personal protective equipment, ensure adequate ventilation, avoid mixing with other chemicals (particularly acids), use calibrated measuring equipment, label solutions clearly with concentration and preparation date, and store appropriately.
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Quality & accreditation
- ASF Hospital — Standard 5 — Safety & Emergency Preparedness
- ASF Medical Transport — Standard 5 — Infection Prevention & Control
- ASF Laboratory — Standard 7 — Examination: Process & Safety
- ASF Hospital — Standard 7 — Governance & Management
- ASF Hospital — Standard 4 — Care & Treatment
- ASF Hospital — Standard 11 — Critical Care
- ASF Medical Transport — Standard 6 — Emergency Response During Transport
Other guidelines on this topic
- Requirements and technical specifications of personal protective equipment (PPE) for the novel coronavirus (2019-nCoV) in healthcare settings
- The Immunization Program in the Context of the COVID-19 Pandemic
- Rapid Assessment of service delivery for NCDs during the COVID-19 pandemic in the Americas
- Checklist for the Management of Human Resources for Health in Response to COVID-19
- Infection prevention and control practices for care of patients in nontraditional settings with focus to the novel coronavirus (COVID-19)
- Issuer
- Pan American Health Organization
- Type
- Procedures, manuals, guidelines
- Status
- Current
- Published
- 2020-01-01
- Audience
- Healthcare facility staff, infection prevention and control teams
- Licence
- CC BY-NC-SA 3.0 IGO
- Record history
- Created 21 Oct 2026 · updated 21 Oct 2026 · next check Apr 2027
Pan American Health Organization. Recommendations for Preparing Disinfecting Solution in Health Establishments, 9 April 2020. Washington, D.C.: PAHO; 2020. IRIS: 10665.2/52257.GMJ Guidelines Library records are original summaries written by the GMJ editorial team from the issuer’s published document and reviewed by a physician. They do not replace the full guideline. The document is the copyright of its issuer and is linked, not hosted. Spotted an error or a newer edition? Tell the Guidelines Desk.
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