What is the difference between a standard cleaner/disinfectant and one deemed hospital-grade?

This is defined by the EPA under: DIS/TSS-1 Jan 22, 1982 EFFICACY DATA REQUIREMENTS Disinfectants for Use on Hard Surfaces

•    A cleaner is a product that does not make any antimicrobial claims or pesticide claims.

•    A product cannot make a claim against an organism without testing it first and requires EPA approval of the data.

•    A “Hospital Grade” Disinfectant only requires 2 organisms to be tested: Pseudomonas aeruginosa and Staphylococcus aureus.

•    A one step disinfectant cleaner is an EPA registered disinfectant that has been tested in 5% blood serum.

Standard disinfectants are those found in household cleaning closets and are able to kill common bacteria.

Hospital disinfectants are EPA-registered for use in hospitals, clinics, dental offices, and other medical facilities, and must kill microorganisms often found in healthcare, including S. aureus, S. enterica and P. aerugionsa. Hospital disinfectants should be used on medical equipment and on environmental surfaces as part of a bundled infection prevention approach. Low, intermediate, and high-level disinfectants can be used in healthcare settings:

•    Low-Level Disinfectants are EPA-registered hospital disinfectants that are effective for vegetative bacteria, most fungi, and most viruses. Typical active ingredients include quaternary ammonium (quats) or phenols.

•    Intermediate-Level Disinfectants are EPA-registered hospital disinfectants that are effective against TB, vegetative bacteria, fungi and viruses, and some may have spore claims.  Typical active ingredients include 70-90% alcohol, hypochlorite, hydrogen peroxide, phenols, or some quats.

•    High-Level Disinfectants fall under FDA jurisdiction. They are effective against TB, bacteria, fungi, and viruses, and some, but not all, spores. Typical active ingredients include glutaraldehyde, OPA, hydrogen peroxide, or peracetic acid.  These are required for instruments that come in contact with mucus membranes (bronchoscopes, endoscopes), but do not enter sterile body tissues.