1. Best Practices for Environmental Cleaning
Module 4 – General Cleaning
Part C - Other Considerations
Welcome to the Best Practices for Environmental Cleaning. This is Part C of Module 4 on General Cleaning. Part C of this module deals with other considerations around cleaning. My name is insert name and title and I will be your presenter

2. Learning Objectives
To identify factors that determine frequency of cleaning.
To correctly sequence tasks for cleaning.
To demonstrate proper procedures for different cleaning applications.
To describe other considerations in environmental management (e.g. waste handling, sharps safety, biological spill cleaning)
Part C of this module addresses the last objective and looks at the other considerations in environmental management such as waste handling, sharps safety and dealing with spills of blood or body fluids

3. Categories of Waste Biomedical General Cytotoxic Chemical
Includes:
Anatomical
Microbiological
Fluid (e.g. blood)
Sharps
General
Cytotoxic
Chemical
Pharmaceutical
Most waste generated in resident/patient areas is not biomedical waste.
Biomedical waste includes all of the categories identified. Cytotoxic waste includes chemotherapy agents.
Waste definitions will be dependent on the federal, provincial and municipal/regional legislation.

4. Storage of Waste
Placed in appropriate container at or near point of origin
Store in a designated enclosed room with access only by authorized staff
Biomedical waste
Placed in a locked area
Refrigerated space (4°C) if stored > 4days
Contingency plan needed for:
Excess waste
Disruption of refrigerated area
Disruption of waste removal services
Storage of waste is mandated within the legislation. Waste should be placed in an appropriate container at or near the point of origin.
Store waste in a designated enclosed room which is accessible only to authorized staff
Biomedical waste should be stored in a locked area and refrigerated if stored longer than 4 days
There should be a plan for dealing with – read bullets

5. Transportation of Waste
ALL waste should be transported within the health care setting incorporating the following procedures:
Clearly define transport routes
Minimize manual handling of waste
Avoid crossing through clean zones, public areas or patient/resident care units
If dedicated elevator not available – avoid transporting on same elevator as patients/residents or food serving carts
Waste should not be transported at same time as patients/residents are transported
Transport waste in leak-proof carts which are cleaned daily
Read slide

6. Cleaning of Biological Spills
Assemble materials required for dealing with the spill prior to putting on PPE
Inspect the area around the spill thoroughly for splatters or splashes
Restrict the activity around the spill until the area has been cleaned and disinfected and is completely dry
Put on gloves; if there is a possibility of splashing, wear a gown and facial protection (mask and eye protection or face shield)
Confine and contain the spill
Wipe up any blood or body fluid spills immediately using either disposable towels or a product designed for this purpose
When cleaning up blood or body fluid spills Read slide

7. Cleaning of Biological Spills
Dispose of materials by placing them into regular waste receptacle, unless the soiled materials are so wet that blood can be squeezed out of them, in which case they must be segregated into the biomedical waste container (i.e., yellow bag).
Disinfect the entire spill area with a hospital-grade disinfectant and allow it to stand for the amount of time recommended by the manufacturer.
Wipe up the area again using disposable towels and discard into regular waste.
Care must be taken to avoid splashing or generating aerosols during the clean up.
Remove gloves and perform hand hygiene.
Dispose of materials by placing them into the regular waste container. If the materials are so wet that blood can be squeezed out of them, they must be disposed of into the biomedical waste container
Read remaining bullets

8. Sharps are devices that are capable of causing a cut or puncture wound
Sharps Handling
Sharps are devices that are capable of causing a cut or puncture wound
All sharps must be handled with care to prevent injury
Read slide

9. Sharps Handling Prevention of sharps injuries may be achieved by:
Using safety engineered medical devices, such as needle-less devices;
Never re-capping a used needle;
Never reaching into waste or sharps containers;
Providing rigid, puncture-resistant sharps containers at or near the point-of-use to permit safe one-handed disposal;
Replacing sharps containers when they are three-quarters full or the sharps have reached the fill line and securely closing the lid;
Handling laundry with care; and
Educating staff about the risks associated with sharps, including safe disposal of sharps in puncture-resistant containers if found in the environment (e.g. sharps in laundry, waste, bedside, floor).
Read slide

10. Safe Disposal of a Sharp
Put on a pair of gloves
Ideally, take a sharps container to the needle and syringe
NEVER re-cap a needle and syringe even if a cap is available
Use tongs/forceps, or similar implement, to pick up the needle and syringe. If no implement is available, carefully pick up the needle and syringe with the needle furthest away from your fingers and body
Carefully place the needle and syringe into the sharps container
Report the incident to your supervisor or manager
In order to safely dispose of a sharp: Read slide

11. Non-critical Equipment
Non-critical medical equipment within the client/patient/resident environment and that is used between clients/patients/residents requires cleaning and disinfection after each use
Policies and procedures should clearly define the frequency and level of cleaning required for each piece of equipment plus assign responsibility for cleaning
Examples:
Person taking the equipment to use must clean prior to using or;
Person using the equipment cleans after use
Selection of new equipment must include considerations for cleaning and disinfection
Like the client/patient/resident environment, non-critical equipment may play a role in transmission of organisms in a healthcare setting.
Read first two bullets
When purchasing new equipment, the ability to effectively clean and disinfect the item must be taken into consideration prior to purchase

12. Non-critical Equipment
Low-level disinfection should be used for all non-critical equipment
Examples of non-critical equipment include:
Bath seat and raised toilet seat
Resuscitation cart
Blood pressure cuff
Commode chairs
IV pumps
ECG machine and cables
Transfer boards
Stethoscope
Read slide

13. Learning Checkpoint
Here is a learning checkpoint. Ask the group the question on the next slide.

14. Learning Checkpoint True or False
Waste may be transported on an elevator at the same time as patients/residents.
To neutralize a blood spill, apply the disinfectant before wiping up.
Laundry should be handled with care to avoid a sharps injury due to sharps being left in the laundry.
Commodes within the patient/resident environment and that are used between patients/residents require cleaning and disinfection after each use
Read slide

15. Learning Checkpoint Answers
False – waste should not be transported on an elevator at the same time as patients/residents to minimize the risk of contamination.
False – blood spills should be contained and material wiped up before applying the disinfectant. Disinfectants will be ineffective if applied before cleaning the spill.
True – Sharps, accidentally left in bedding, may pose a risk to healthcare workers. Care should be taken when handling all linen.
True – All non-medical equipment that is shared between patients/residents should be cleaned and disinfected before being used with another patient/resident.
Read answers

16. When you return to your job, what will you do differently as a result of this session?
Read question… Make a list of three things you will do differently as a result of this session.
Ask question. Offer suggestions. May also be used as small group activity with larger groups.
Another option would be ask participants to write their ideas on paper – collect and read back.
Note: This is an important application activity. Be sure to allow time for it. 16 16

17. Thank You!
This concludes module 4 on General Cleaning. Thank you! 17

18. Image Sources – Module 4C
Getty Images used in slide 12
Microsoft Office Clipart used in slide 13
Images in slides 9 & 19 are © PHO 2013