Presentation on theme: "Best Practices for Environmental Cleaning Module 4 – General Cleaning Part A - Cleaning Principles."— Presentation transcript:
Best Practices for Environmental Cleaning Module 4 – General Cleaning Part A - Cleaning Principles
2 Learning Objectives 1.To identify factors that determine frequency of cleaning. 2.To correctly sequence tasks for cleaning. 3.To demonstrate proper procedures for different cleaning applications. 4.To describe other considerations in environmental management (e.g. waste handling, sharps safety, biological spill cleaning)
3 General Cleaning These principles apply to all settings where hospital clean is required.
4 Hotel Clean & Hospital Clean Hotel Clean: is a measure of cleanliness based on visual appearance that includes dust and dirt removal, waste disposal and cleaning of windows and surfaces. Hospital Clean is a hotel clean PLUS: High touch surfaces in patient/resident/client care areas are cleaned and disinfected with hospital grade disinfectant Non-critical medical equipment is cleaned and disinfected between patients/residents/clients AND Cleaning practices are periodically monitored and audited with feedback and education
5 Cleaning Frequencies – Factors Influencing Frequency Surfaces high-touch or low-touch Door knob vs window sill Type of activity taking place in the area and risks associated with the activity Critical care vs office setting Vulnerability of patients/residents housed in the area Intensive care vs patient/resident room Probability of contamination based on the amount of body fluid contamination in the area Washroom vs lounge Presence of antibiotic resistant organisms (AROs)
6 Cleaning Frequencies – Factors Influencing Frequency High-Touch Surfaces: Are those that have frequent contact with hands. Examples: doorknobs, elevator buttons, telephones, call bells, bedrails, light switches, computer keyboards, etc. High-touch surfaces in care areas require more frequent cleaning and disinfection than minimal contact surfaces. Cleaning and disinfection is usually done at least daily and more frequently if the risk of environmental contamination is higher e.g. in intensive care units, during outbreaks.
7 Cleaning Frequencies – Factors Influencing Frequency High-touch surfaces Examples of High-touch Items and Surfaces in the Health Care Environment NOTE: Dots indicate areas of highest contamination and touch High-touch surfaces How many high touch surfaces can you identify in this picture? Figure 1
Cleaning Frequencies – Factors Influencing Frequency High-touch surfaces More examples of high-touch Items and Surfaces in the Health Care Environment. Note: the dots indicate areas of highest contamination and touch 8
9 Cleaning Frequencies – Factors Influencing Frequency Low-Touch Surfaces: Are those that have minimal contact with hands. Examples - floors, walls, ceilings, mirrors and window sills. Require cleaning on a regular (but not necessarily daily) basis, when soiling or spills occur, and when a resident is discharged from the health care setting. Many low-touch surfaces may be cleaned on a periodic basis rather than a daily basis if they are also cleaned when visibly soiled.
10 Cleaning Frequencies – Factors Influencing Frequency High-Touch vs Low-Touch Surfaces: The frequency of cleaning and the level of cleaning are dependent upon the risk classification of the area to be cleaned
11 Factors that Impact Cleaning Factors that will impact the frequency of environmental cleaning include: Probability of contamination with pathogens Vulnerability of clients/patients/residents to infection Potential for exposure
12 Probability of contamination Heavy – surfaces/equipment routinely exposed to copious amounts of fresh blood or other body fluids (e.g. birthing suite, ER, bathrooms if visible soil) Moderate – surfaces/equipment does not routinely (but may) become contaminated with blood or body fluids (all bathrooms) Light – surfaces not exposed to blood or other body fluids or items that have contact with these (e.g. lounges, libraries, offices)
13 Vulnerability of client/patient/resident More susceptible – those who are susceptible to infection due to medical condition or lack of immunity e.g. elderly individuals who have underlying illnesses Less susceptible – all other individuals and areas Potential for exposure High-touch surfaces – those that have frequent contact with hands Low-touch surfaces – those that have minimal contact with hands Vulnerability to infection
14 Determine the risk Probability of Contamination with pathogens High-touch surfaces (score = 3) Low-touch surfaces (score = 1) More susceptible Score=1 Less susceptible Score=0 More susceptible score=1 Less susceptible Score=0 Heavy Score= Moderate Score= Light Score= Risk Stratification
15 Determine the cleaning frequency based on risk stratification matrix Total Risk Score Risk TypeMinimum Cleaning Frequency 7High RiskClean after each case/event/procedure and at least twice per day Clean additionally as required 4-6Moderate RiskClean at least once daily Clean additionally as required (e.g. gross soiling) 2-3Low RiskClean according to a fixed schedule Clean additionally as required (e.g. gross soiling) Risk Stratification Matrix
16 Example - Hospital An Intensive Care Unit: Probability of contamination is heavy = 3 Potential for exposure is high (high touch) = 3 Vulnerability of patients in ICU - more susceptible = 1 Total score = 7 – Clean at least twice per day and additionally as required e.g. if gross soiling
17 Example - LTC A Resident Activity Room: Probability of contamination is moderate = 2 Potential for exposure is high (high touch) = 3 Vulnerability of residents – Those participating in activities may be considered less susceptible = 0 Total score = 5 – Clean at least once daily and additionally as required e.g. if gross soiling
18 Learning Checkpoint
19 Learning Checkpoint Identify whether the following items are high-touch or low-touch surfaces. Toilet handle Soap dispenser Baseboard Wall Bathroom mirror Faucet handles Window coverings Ceiling lights
20 Learning Checkpoint Answers The correct answers are: Toilet handle - high Soap dispenser - high Baseboard - low Wall – low Bathroom mirror – low Faucet handles - high Window coverings – high/low depending on setting – use risk stratification matrix Ceiling lights - low
21 References Fig 1-2: Provincial Infectious Diseases Advisory Committee (PIDAC). Best Practices for Environmental Cleaning for Prevention and Control of Infections in All Health Care Settings [cited March 27, 2013]:28-29 Available from: Cleaning.pdf Cleaning.pdf