Presentation on theme: "Best Practices for Environmental Cleaning"— Presentation transcript:
1 Best Practices for Environmental Cleaning MODULE 3 –Cleaning Products and ToolsWelcome to Module 3 – Cleaning Products and Tools. My name is insert name and title and I will be your presenter for this module.
2 Learning Objectives Define and describe cleaning and disinfection Explain the difference between detergents and disinfectants and indicate their appropriate use.Describe the importance of proper chemical dilutions.Explain the need for dedicated equipment/space and care of equipment.Have an increased awareness of new technologies.At the end of this session, the participant will be able to:Read from slide
3 Glossary of termsCleaning – The physical removal of foreign material (e.g. dust, soil) and organic material (e.g. blood, secretions, excretions, microorganisms). Cleaning physically removes rather than kills microorganisms. It is accomplished with water, detergents and mechanical action.Detergent – A synthetic cleaning agent that can emulsify oil and suspended soil.Disinfection – The inactivation of disease-producing microorganisms. Disinfection does not destroy bacterial spores. Equipment must be cleaned thoroughly before effective disinfection can take place.You play a critical role in the prevention and control of infection in your facility. As such it is important that you understand the principles of cleaning and disinfecting environmental surfaces. We will begin with some definitions:Cleaning - read from slideAlways remember: the key to cleaning is the use of friction or mechanical action to remove microorganisms and debris.Detergent – read from slideDisinfection – read from slideAlways remember: the key to disinfection is that an item or surface be free from visible soil and other items that might interfere with the action of the disinfectant, such as adhesive products
4 Glossary of termsDisinfectant – A product that is used on surfaces or medical equipment/devices which results in disinfection of the surface. Some products combine a detergent with a disinfectant.Hospital-grade disinfectant – A low-level disinfectant that has a drug identification number (DIN) from Health Canada indicating its approval for use in Canadian hospitalsDisinfectant - read from slideAlways remember: a disinfectant is only to be used to disinfect and must not be used as a general cleaning agent, unless combined with a cleaning agent as a detergent-disinfectant. Skin antiseptics must never be used as an environmental disinfectant (e.g. alcohol-based hand rub)Cleaning and disinfection should be done as soon as possible after items have been usedHospital-grade disinfectant – read from slideFinally, whenever possible, cleaning and disinfection should be done as soon as possible after items have been used
5 Glossary of termsHotel Clean: A measure of cleanliness based on visual appearance that includes dust and dirt removal, waste disposal and cleaning of windows and surfaces. Hotel Clean is the basic level of cleaning that takes place in all areas of a health care setting.Hospital Clean: A measure of cleanliness routinely maintained in client care areas of the health care setting. Hospital Clean is “Hotel Clean” with the addition of disinfection, increased frequency of cleaning, auditing and other infection control measures in client care areas.Hotel Clean – read from slideThe “hotel component” is the area not involved in client care; this includes public areas such as lobbies and waiting rooms, offices, corridors, elevators, stairwells and service areas.Hospital Clean – read from slideThe “hospital component” is the area that is involved in client care; this includes client units (including nursing stations), procedure rooms, bathrooms, clinic rooms and diagnostic and treatment areas.
6 Cleaning and Disinfectant Agents Hospital Grade DisinfectantsAlcohols (60-90% ethyl or isopropyl)Chlorine - sodium (bleach) and calcium hypochloritePhenolicsQuaternary Ammonium Compounds (Quats)IodophorsAccelerated Hydrogen Peroxide (AHP)The above list represents the different hospital grade disinfectants available on the market. Although “Hospital Grade” terminology is used, many of these disinfectants are used in other health care organizations.A Hospital Grade disinfectant may be used for environmental surfaces and items that do not come in contact with skin and may also be used for equipment that only touches intact skin (non-critical equipment/devices); examples include intravenous pumps and poles, hydraulic lifts, blood pressure cuffs, apnea monitors and sensor pads, electrocardiogram (ECG) machines/cables and crutches, etc.Some disinfectants such as Quaternary Ammonium Compounds (Quats) and Accelerated Hydrogen Peroxide (AHP) are more commonly used than others listed here, but each disinfectant has its own unique properties, advantages and disadvantages. For more information on Hospital-grade Disinfectants and Sporicides please refer to the PIDAC Best Practices document.
7 Hospital-grade Disinfectants and Sporicides Process OptionUses/CommentsAdvantagesDisadvantagesQuaternaryammoniumcompounds(QUATs)- Floors, walls andfurnishings- Blood spills prior to disinfectionNon corrosiveNon-toxic,low irritant- Good cleaning ability,usually have detergentproperties- May be used on foodsurfaces-Not to be used to disinfectinstruments- Limited use as disinfectantbecause of narrow microbicidalspectrum- Diluted solutions may supportthe growth of microorganisms- May be neutralized by variousmaterials (e.g., gauze)Focus on those products that are used in your facility, describe primary use and 1 or 2 advantages and disadvantages for each.
8 Hospital-grade Disinfectants and Sporicides Process OptionUses/CommentsAdvantagesDisadvantagesAcceleratedHydrogenPeroxide 0.5%(7% solution diluted1:16)- Isolation roomSurfaces- Clinic and procedureroom surfacesLow level disinfection isachieved after 5minutes of contact at20°C.- Safe for environment- Non-toxic- Rapid action- Available in a wipe- Active inorganic materials- Excellent cleaningdue to detergent properties- Contraindicated for use oncopper, brass, carbon-tippeddevices and somealuminumPeroxide 4.5%- Disinfection of washrooms/commodesC.difficile patientsFollowing cleaning,sterility is achieved witha 4.5% solution after 10minutes of contact.- Sporicidal- Available in a gel format- Expensive- Contraindicated on surfaces as aboveDo not use on monitorsHydrogen peroxide3%- home healthcare equip- Floors, walls,furnishingsDisinfection after30 minutes of contact- Safe for the environmentcopper, zinc, brass, aluminum- Store in cool place, protect from light
9 Hospital-grade Disinfectants and Sporicides Process OptionUses/CommentsAdvantagesDisadvantagesChlorines-Non-critical equipmentHydrotherapy tanksBlood spillsDilutionUndilute 5.25%Blood spill -1:10 (major) or 1:100 (minor)Surface cleaning 1:50Low costRapid actingReadily availableSporicidal- Corrosive- Irritant to mucous membranes- Use immediately after diluted- Need good ventilation
10 Hospital-grade Disinfectants and Sporicides Process OptionUses/CommentsAdvantagesDisadvantagesAlcohols (70-95%)- External equipment surfaces(e.g., stethoscopes)- Noncritical equipmentused for home healthcare- Disinfection is after 10 minutes contact.- Fire coderestrictions for storage- Non-toxic- Low cost- Rapid action- Non-staining- No residue- Effective on cleanequipment/devices that canbe immersed- Evaporates quickly - not agood surface disinfectant- Evaporation may diminishconcentration- Flammable storage of large volumes problematic-Coagulates protein; a poorcleaner-May harm or deteriorate some materials and surfaces- Inactivated by organic material- Contraindicated in the O.R.
11 Hospital-grade Disinfectants and Sporicides Process OptionUses/CommentsAdvantagesDisadvantagesIodophors(Non-antisepticformulations)Hydrotherapy tanksThermometersHard surfacesRapid actionNon-toxicCorrosive to metal unlesscombined with inhibitors Inactivated by organicPhenolics- Floors, walls andfurnishings- Hard surfaces andequipment that do nottouch mucousmembranes (e.g., IVpoles, wheelchairs,beds, call bells)DO NOT usephenolics in nurseries- Leaves residual film onenvironmental surfaces- Commercially availablewith added detergents toprovide one-step cleaningand disinfecting- Slightly broader spectrumof activity than QUATs- Cannot use is some settings (nurseries,food contact surfaces)May be absorbed through skin- May be toxic if inhaled- Corrosive-Some synthetic flooring may become sticky
12 Importance of chemical dilutions For effective cleaning and disinfecting ensure that:Manufacturer’s instructions for dilution and contact time are followedDisinfectant solution is frequently changed to reduce contamination and maintain the proper dilutionCloths do not re-enter the disinfectant solution once removed (i.e. no “double dipping”)Read bullet 1Read bullet 2The frequency with which you should change your cleaning solution will depend on the product and how it’s being used. Always check with your supervisor.Read bullet 3
13 Learning CheckpointHere is a learning checkpoint. Ask the group the question on the next slide.13
14 Learning Checkpoint What are the key components of cleaning and disinfection?mechanical action / frictioncontact time / dwell timeproper chemical dilutionall of the aboveRead question
15 Learning Checkpoint Answer The answer is all of the aboveChemicalThe answer is: all of the aboveThe application of the chemical in the proper dilution, combined with friction, supplied by you, and the appropriate contact time, as directed by the manufacturer, will ensure that surfaces are properly cleaned and disinfected. We call this the “golden triangle”.Additional Facility discussion:What cleaners are used in this facility?What disinfectants are used in this facility?Contact / Dwell timeAction / Friction
16 Storage and cleaning of housekeeping equipment Cleaning equipment requires attention to avoid cross-transmission of microorganisms and growth of microorganisms in dirty environmentsTools and equipment used for cleaning and disinfecting must be cleaned and dried between uses (e.g. buckets, mop handles, squirt bottles, wet floor signs)Mop heads and cloths should be laundered daily and dried thoroughly before storageIt is equally important to ensure that the equipment you are using for cleaning and disinfecting of the environment must itself be cleaned and disinfected between uses.Read from slide.
17 Storage and cleaning of housekeeping equipment Cleaning equipment shall be well maintained, clean and in good repairCleaning carts:Should have a separation between clean and soiled items;Should never contain personal clothing or grooming supplies, food or beverages;Should be thoroughly cleaned at the end of the day;In long-term care homes, cleaning carts shall be equipped with a locked compartment for storage of hazardous substances and each cart shall be locked at all times when not attended.Read bullet 1Read bullet 2 and sub-bulletsSafety audits conducted by the Ministry of Labour include a visual check to ensure that cleaning carts are well maintained, clean and in good repairFinally, remember that even though your automatic scrubber or cleaning cart may have a cup holder, you should never use it
18 Storage and cleaning of housekeeping equipment All cleaning products should be appropriately labeled and stored safelyChemicals must be clearly labeled with Workplace Hazardous Materials Information System (WHMIS) information and MSDS must be readily available for each itemHousekeeping Rooms/Closets should never contain personal clothing or grooming supplies, food or beveragesRead from slideBullet 3 – Remember that you have a role to play in ensuring that you neither bring germs into your facility nor take them home with you
19 Densely constructed polyester and nylon fibres New TechnologiesMicrofibres:Densely constructed polyester and nylon fibresPositively charged microfibres attract dust and bacteria and hold it tightly so that it is not redistributed around the room during cleaningAvailable as cloths, floor mops and high dustersAs with all things, new technology is appearing all the time. Some, such as the use of microfibre technology for surface cleaning and mopping have been quite successful and are now widely used. Other technologies are still evolving and we will review some of these today. In all cases, we work with Infection Prevention and Control and Occupational Health and Safety when making decisions relating to changes in cleaning and disinfection methods and products.Read from slide
20 New Technologies Air Disinfection/Fogging: Not currently in general use in CanadaVapourized Hydrogen Peroxide (VHP) – vapour is delivered by computer-controlled distribution system that ensures even distribution throughout the roomOzone Gas – should only be used in areas that may be completely sealed off for the duration of treatmentSuper-oxidized Water – use as a disinfectant fog shows promise but requires more study before applying it to the health care environmentRead from slide
21 New Technologies Steam Vapour Portable steam generators may be used to clean kitchens, bathrooms, floors, walls and other surfaces using steam delivered with a nozzle brushSteam vapour effectively travels through biofilm to kill microorganisms that may be unreachable by the surface application of disinfectantsRead from slide
22 New Technologies Anti-microbial impregnated Supplies and Equipment: Treated surfaces and equipment have not been well studied and little data exists to show how these antimicrobial chemicals will endure after exposure to hospital-grade cleaners and disinfectants or whether they will prevent diseaseThese products are not recommendedRead from slide
23 Learning CheckpointHere is a learning checkpoint. Ask the group the question on the next slide.23
24 Learning Checkpoint Properly labelled cleaning products 1. Things that belong in a housekeeping closet are: (check all that apply)Properly labelled cleaning productsA cup of coffee and bottle of waterCleaning toolsPersonal clothingRead question
25 Learning checkpoint answer Correct answer is: a and cThe PIDAC best practice document and the Occupational Health and Safety Act state that personal clothing, beverages and food should not be on a housekeeping cart. This is to protect the housekeeper and other staff/clients/residents/patients from transfer of microorganisms.The correct answer is a and c – read answer
26 Learning checkpoint How often should the housekeeping cart be cleaned? WeeklyDailyDoes not need routine cleaningRead question
27 Learning checkpoint answer 2. Correct answer is bThe PIDAC best practice document recommends that housekeeping carts are cleaned daily to reduce the risk of contamination with microorganisms.The correct answer is b – read answer
28 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.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.2828
29 Thank You!This concludes module 3 on Cleaning Products and Tools. Thank you!29