FINAL MODULE 13 ENVIRONMENTAL CLEANING 2.ppt
- 1. ENVIRONMENTAL CLEANING INFECTION PREVENTION AND CONTROL FACILITATOR’S GUIDE, 2016 MODULE 13
- 2. Objectives At the end of the session learners will be able to: Describe the importance of environmental cleaning in health care facilities Describe the general principles on the proper use of personal protective equipment during environmental cleaning Describe different disinfectants for environmental cleaning Prepare disinfectant cleaning solution 2
- 3. Objectives At the end of the session learners will be able to: Explain the guidelines for cleaning specific areas of health care facilities Explain the guidelines for cleaning spills of blood or other body fluids Explain how to handle cleaning items/equipment appropriately 3
- 4. Environmental cleaning (introduction) Contamination of surfaces in the health care environment plays an important role in the transmission of many pathogens. These organisms can be transferred from surfaces to the hands of health care workers to vulnerable patients. 4
- 5. Environmental cleaning: definition Environmental cleaning refers to the: o general cleaning of surfaces and non-critical equipment in health care facilities. o process of maintaining a clean, healthy, and pleasing patient and work environment. It includes the removal of visible dirt from objects and surfaces, normally accomplished manually or mechanically, using water with detergents or enzymatic cleaners.
- 7. Benefits of environmental cleaning Housekeeping is important in order to: Reduce the number of microorganisms that come in contact with clients or staff. Reduce the risk of accidents through the prevention of falls. Provide a pleasant environment. 7
- 8. Logistics for cleaning (Cleaning solutions) Cleaning solution is any combination of soap (detergent) and water, with or without a chemical disinfectant, used to wash or wipe down environmental surfaces. Several combinations are available commercially or can be prepared as needed at the health care facility (e.g., alkaline detergents with chlorine compounds). Note: Not all soaps (detergents) and disinfectants are compatible.
- 9. Logistics for cleaning (Cleaning solutions) Commonly used solutions Plain detergent and water: used for low-risk areas and general cleaning tasks. Disinfectant solution (0.5% sodium hypochlorite solution: used for high risk and other patient care are
- 10. Preparing disinfectant cleaning solution Prepare a 0.5% chlorine solution or obtain any disinfectant that contains 5% carbolic acid like lysol. Add some detergent and mix. Continue adding detergent until the solution becomes mildly foamy or bubbly. Note: chlorine solutions should never be mixed with cleaning products containing ammonia, ammonium chloride or phosphoric acid as this will result in release of chlorine gas.
- 11. Factors to consider when selecting cleaning solutions Intended use (e.g., cleaning, disinfection, or both) Efficacy (e.g., does it claim to kill organisms that are commonly found in the local environment at the recommended contact time) Acceptability (i.e., smell, leaves a film, ability to damages surfaces) Safety (i.e., side effects) 3
- 12. Factors to consider when selecting cleaning solutions Cost and availability (i.e., does it fit the budget, is it easy to obtain in the required amounts) Volume needed and size of product available based on facility requirements Easy of preparing diluted solution 4
- 13. Cleaning solutions for different care areas Cleaning patient care areas (general wards, treatment rooms, washrooms, sluice rooms, etc) o Use disinfectant cleaning solution. Cleaning non-patient care areas (offices, waiting rooms, etc) - Domestic cleaning is adequate. May use only detergent and water.
- 14. Cleaning different care areas Isolation rooms and other areas that have patients with known transmissible infectious diseases should be cleaned with disinfectant cleaning solution. 6
- 17. Other logistics for Environmental Cleaning Personal protective equipment Mop Mop bucket Sweeping brush Ceiling brush Dusters Absorbent pad for cleaning spills 2
- 18. General principles for cleaning health care facilities 5
- 19. Environmental Cleaning (general guidelines) All wards and units must have cleaning schedules. Always wear utility gloves, plastic aprons, protective shoes and mask when cleaning. Cleaning should always progress from the least soiled areas to the most soiled areas. Use damp or wet mop or cloth for walls, floors, etc. Complete damp dusting before starting other cleaning in the room
- 20. Environmental Cleaning (general guidelines) … Clean or wash surfaces from top to bottom Use sweeping brush not broom. Pay attention to high-touch surfaces such as door handles, light switches, countertops, bedrails and end of beds Change cleaning solution whenever it appears dirty. Use separate equipment for high risk areas. Decontaminate mop and other items after use.
- 22. Flooding and fogging Flooding: Areas with floor drains can be flooded with cleaning solution. The cleaning solution should be drained away using the floor drain. Any excess fluid should be removed using a mop that absorbs the remaining fluid left on the floor. Fogging: As a general rule do not perform disinfectant fogging for air and surface disinfection for general infection control in routine patient-care areas ? 16
- 23. Cleaning spills Small spills: disinfect with disposable absorbent material (e.g., disposal clothes) soaked in disinfectant cleaning solution and clean. Large spills: First remove the visible organic matter with absorbent material, e.g., disposable towel or paper, and discard into an appropriate leak-proof bin then disinfect with 1%-5% sodium hypochlorite disinfectant. Mop and clean the area and allow to air-dry.
- 24. Cleaning spills Clean up spills of potentially infectious materials immediately. Besides preventing the spread of infections, prompt removal also prevents accidents. Staff who are cleaning up spills must wear appropriate protective clothing.
- 25. Spill management Nature of the spill, e.g. blood, urine, faeces Possible pathogens that may be involved Size of the spill, e.g., spot, splash, puddle, large spill Type of surface involved, e.g., linoleum, carpet Area involved, e.g., preparatory laboratory, teaching areas, common access areas, etc. Likelihood of bare skin contact with the soiled area
- 26. Cleaning spills
- 27. Cleaning spills Large spills of cultures – flood with disinfectant (e.g. 0.5% chlorine solution or available stock strength of chlorine), clean and apply fresh disinfectant, clean and allow to air dry. Note: A suggested technique when flooding the spill with germicide is to lay absorbent material down on the spill and apply sufficient germicide to thoroughly wet both the spill and the absorbent material.
- 28. How to clean used cleaning equipment Mob, mop bucket and brush Empty mop buckets or container, decontaminate and clean, rinse and air-dry. Ensure to wipe brush handles and cleaning carts (if used) by wiping with disinfectant cleaning solution, then wide down with a new cloth soaked in soapy water, rinse and air-dry. 18
- 29. How to clean used cleaning equipment Dusters, etc Soak in 0.05% chlorine solution, wash and air-dry Curtains, screens, etc. All health facilities should have schedule for changing and washing curtains, screens, etc 18
- 30. Cleaning surgical settings (General guidelines) Wear scrub suit Cleaning must NOT be conducted in the presence of any open sterile packs or sterile instruments Use clean, lint-free cloth moistened with disinfectant cleaning solution Clean after each surgical or invasive procedure and do terminal cleaning at the end of each day and each 24-hour period during the regular work week.
- 31. Terminal cleaning/ Cleaning after discharge This is the process used to clean a patient’s room after the patient has been discharged or transferred for patient treatment areas including operation theaters at the end of the day.
- 34. Terminal cleaning/ Cleaning after discharge Disinfect beds, lockers and cupboards, etc with low- level disinfectant e.g. Cetrimide Change all linen Disinfect plastic covering of pillows and mattresses and air-dry for at least an hour before the next admission. All mattresses and pillows must have plastic covering.
- 35. Fumigation Fumigation does not reduce contamination in your facility and should not be used. They are just time consuming, waste valuable resources and do not decrease the risk of infection in the facility. Formaldehyde have no scientific basis. Besides being ineffective, these agents are toxic and irritating to the eyes and mucous membranes.
- 36. Monitoring cleaning Common methods Physical examination of absence of dirt, debris and stains on surfaces Collecting environmental cultures to test for microorganisms on different surface
- 37. Cleaning schedule- washroom Date/Time Cleaned by name /sign Supervisor name/sign
- 38. Summary Globally, there has been an increased interest in the role the environment plays in the transmission of infections. Cleaning is a process of maintaining a clean, healthy, and pleasing patient and work environment and involves sweeping, mopping, dusting and scrubbing. Disinfectant cleaning solution should be used for patient care areas while detergent and water could be used for non-patient care areas 29
- 39. Summary Appropriate use of PPEs in imperative In order to be effective, the cleaning staff must be well trained on the appropriate cleaning methods Fumigation for the purposes of IPC is not recommended. 29
- 41. 30 THANK YOU
Editor's Notes
- #8: These organisms can be transferred from surfaces to the hands of health care workers to vulnerable patients (Weber, Anderson, and Rutala 2013)
- #10: Plain detergent and water This is used for low-risk areas and general cleaning tasks. Detergents remove dirt and organic material and dissolve or suspend grease, oil and other matter so it can easily be removed by scrubbing. 2. Disinfectant solution (0.5% sodium hypochlorite solution – see Section 8: Patient Care Equipment) Disinfectants rapidly kill or inactivate infectious micro-organisms during the cleaning process. Disinfectants are also used to decontaminate an area so that it is safer for staff to clean. In most settings, a 0.5% sodium hypochlorite solution made from locally available bleach is the cheapest disinfectant, but alternatives include commercial disinfectants that have bactericidal, fungicidal and virucidal properties.
- #20: Cleaning should always progress from high (e.g., ceilings and walls) to low areas so that the dirtiest areas and debris that falls on the floor will be cleaned up last. Dry sweeping, mopping, and dusting should be avoided to prevent dust, debris, and microorganisms from getting into the air and landing on clean surfaces. Airborne fungi and bacteria may act as opportunistic human pathogens (i.e., pathogens that take advantage of individuals with low immune responses).
- #21: Cleaning cloths, mops, and cleaning solutions should be changed regularly, when visibly dirty, after cleaning an isolation room, and after cleaning the most soiled areas. Studies have shown that wiping hard surfaces with contaminated cloths can contaminate hands, equipment, and other surfaces. Cleaning equipment must be kept clean and in good repair. (Bush et al. 2006; CDC 2008)