FINAL MODULE 13 ENVIRONMENTAL CLEANING 2.ppt

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1. ENVIRONMENTAL
CLEANING
INFECTION PREVENTION AND CONTROL
FACILITATOR’S GUIDE, 2016
MODULE 13

2. Objectives
Attheendofthesessionlearnerswillbeableto:
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
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3. Objectives
Attheendofthesessionlearnerswillbeableto:
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
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4. Environmental cleaning
(introduction)
Contaminationofsurfacesinthehealthcare
environmentplaysanimportantroleinthe
transmissionofmanypathogens.
Theseorganismscanbetransferredfromsurfacesto
thehandsofhealthcareworkerstovulnerable
patients.
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5. Environmental cleaning: definition
Environmental cleaningrefers to the:
ogeneral cleaning of surfaces and non-critical
equipment in health care facilities.
oprocessofmaintainingaclean,healthy,and
pleasingpatientandworkenvironment.
Itincludestheremovalofvisibledirtfromobjectsand
surfaces,normallyaccomplishedmanuallyor
mechanically,usingwaterwithdetergentsor
enzymaticcleaners.

6. Environmental cleaning

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.
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8. Logistics for cleaning
(Cleaning solutions)
Cleaningsolutionisanycombinationofsoap
(detergent)andwater,withorwithoutachemical
disinfectant,usedtowashorwipedown
environmentalsurfaces.
Severalcombinationsareavailablecommerciallyor
canbepreparedasneededatthehealthcarefacility
(e.g.,alkalinedetergentswithchlorinecompounds).
Note:Notallsoaps(detergents)anddisinfectantsare
compatible.

9. Logistics for cleaning
(Cleaning solutions)
Commonlyusedsolutions
Plaindetergentandwater:usedforlow-riskareas
andgeneralcleaningtasks.
Disinfectantsolution(0.5%sodiumhypochlorite
solution:usedforhighriskandotherpatientcare
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)
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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
Easyofpreparingdilutedsolution
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13. Cleaning solutions for different care
areas
Cleaning patient care areas(general wards,
treatment rooms, washrooms, sluice rooms, etc)
oUse 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
Isolationroomsandotherareasthathave
patientswithknowntransmissibleinfectious
diseasesshouldbecleanedwithdisinfectant
cleaningsolution.
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16. Cleaning materials

17. Other logistics for
Environmental Cleaning
Personal protective equipment
Mop
Mop bucket
Sweeping brush
Ceiling brush
Dusters
Absorbent pad for cleaning spills
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18. General principles for cleaning
health care facilities
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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) …
Cleanorwashsurfacesfromtoptobottom
Use sweeping brush not broom.
Pay attention to high-touch surfacessuch 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.

21. General guidelines

22. Flooding and fogging
Flooding:Areaswithfloordrainscanbefloodedwith
cleaningsolution.Thecleaningsolutionshouldbe
drainedawayusingthefloordrain.Anyexcessfluid
shouldberemovedusingamopthatabsorbsthe
remainingfluidleftonthefloor.
Fogging:Asageneralruledonotperform
disinfectantfoggingforairandsurfacedisinfectionfor
generalinfectioncontrolinroutinepatient-careareas
?
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23. Cleaning spills
Small spills:
disinfect with disposable absorbent material (e.g.,
disposal clothes) soaked in disinfectant cleaning
solution and clean.
Large spills:
Firstremovethevisibleorganicmatterwith
absorbentmaterial,e.g.,disposabletowelorpaper,
anddiscardintoanappropriateleak-proofbinthen
disinfectwith1%-5%sodiumhypochlorite
disinfectant.Mopandcleantheareaandallowto
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:Asuggestedtechniquewhenflooding
thespillwithgermicideistolayabsorbent
materialdownonthespillandapplysufficient
germicidetothoroughlywetboththespilland
theabsorbentmaterial.

28. How to clean used cleaning
equipment
Mob,mopbucketandbrush
Emptymopbucketsorcontainer,decontaminateand
clean,rinseandair-dry.
Ensuretowipebrushhandlesandcleaningcarts(if
used)bywipingwithdisinfectantcleaningsolution,
thenwidedownwithanewclothsoakedinsoapy
water,rinseandair-dry.
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29. How to clean used cleaning
equipment
Dusters,etc
Soakin0.05%chlorinesolution,washandair-dry
Curtains,screens,etc.
All health facilities should have schedule for
changing and washing curtains, screens, etc
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30. Cleaning surgical settings
(General guidelines)
Wearscrubsuit
CleaningmustNOTbeconductedinthepresenceof
anyopensterilepacksorsterileinstruments
Useclean,lint-freeclothmoistenedwithdisinfectant
cleaningsolution
Clean after each surgical or invasive procedure and
doterminal cleaningat the endof each day and
each 24-hour period during the regular work week.

31. Terminal cleaning/ Cleaning after
discharge
Thisistheprocessusedtocleanapatient’s
room
afterthepatienthasbeendischargedor
transferred
forpatienttreatmentareasincluding
operationtheatersattheendoftheday.

32. Terminal cleaning

33. Terminal disinfection

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
Commonmethods
Physicalexaminationofabsenceofdirt,debrisand
stainsonsurfaces
Collectingenvironmentalculturestotestfor
microorganismsondifferentsurface

37. Cleaning schedule-washroom
Date/Time Cleanedby
name /sign
Supervisor
name/sign

38. Summary
Globally,therehasbeenanincreasedinterestinthe
roletheenvironmentplaysinthetransmissionof
infections.
Cleaningisaprocessofmaintainingaclean,
healthy,andpleasingpatientandworkenvironment
andinvolvessweeping,mopping,dustingand
scrubbing.
Disinfectantcleaningsolutionshouldbeusedfor
patientcareareaswhiledetergentandwatercould
beusedfornon-patientcareareas
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39. Summary
AppropriateuseofPPEsinimperative
Inordertobeeffective,thecleaningstaffmustbe
welltrainedontheappropriatecleaningmethods
FumigationforthepurposesofIPCisnot
recommended.
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