1. Best Practices for Environmental Cleaning Module 4 – General Cleaning Part B - Cleaning Procedures

2. 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. 3 Sequencing of Cleaning Tasks Before Cleaning: 1.Check for Additional Precautions signs; follow precautions indicated 2.Follow the manufacturer’s instructions for proper dilution and contact time for cleaning and disinfecting solutions 3.Ensure sufficient cleaning supplies and materials are readily available 4.Clean hands using ABHR and put on gloves before entering the room

4. 4 Sequencing of Cleaning Tasks During Cleaning Clean from the least soiled areas (low-touch) to the most soiled areas (high-touch) and from high surfaces to low surfaces Remove gross soil prior to cleaning and disinfection Dry mop prior to wet/damp mop - never shake mops No ‘double-dipping’ of cloths Change cloths and mop heads frequently

5. 5 Sequencing of Cleaning Tasks After Cleaning: Clean tools used for cleaning and disinfecting between uses Launder mop heads and cloths daily; all washed mop heads and cloths must be dried thoroughly before re- use Clean housekeeping cart and carts used to transport waste daily Do not overstock rooms

6. 6 General Cleaning Requirements If using a bucket, change cleaning solutions as per manufacturer’s instructions:  more frequently in heavily contaminated areas;  when visibly soiled; and  immediately after cleaning blood and body fluid spills Containers for liquid soap, cleaners/disinfectants are disposable;  the practice of ‘topping up’ is not acceptable since it can result in contamination of the container and solution Vacuum carpets using vacuums fitted with a HEPA filter

7. 7 General Cleaning Requirements Be alert for needles and other sharp objects;  Pick up sharps using a mechanical device e.g. tongs/forceps and place into sharps container;  Report incident to supervisor Collect waste, handling plastic bags from the top (do not compress bags with hands) Remove gloves and clean hands on leaving the room

8. 8 Mopping Floors – Dry/Dust Mopping Remove any gross soilage e.g. feces, urine Work from less soiled areas to more soiled areas Remove debris from floor Remove gum or other sticky residue from floor Do not lift dust mop off the floor once you have started; use swivel motion of frame and wrist to change direction Move furniture as required and replace after dust mopping, including under and behind bed Carefully dispose of debris, being careful not to stir up dust

9. 9 Mopping Floors – Wet Loop Mop and Bucket Place ‘wet floor’ caution sign outside of room or area being mopped Immerse mop in cleaning solution and wring out Work from clean to more heavily soiled areas In open areas, use a figure eight stroke, overlapping each stroke; turn mop head over every five or six strokes Mop a three metre by three metre (nine feet by nine feet) area, then rinse and wring mop Repeat until entire floor is done

10. 10 Mopping Floors – Wet Loop Mop and Bucket Change the mop head when heavily soiled and at the end of the day Change cleaning solution frequently enough to maintain appropriate concentration of solution (e.g., every four rooms and when heavily soiled) Send all soiled mop heads for laundering at the end of the day

11. 11 Mopping Floors – Microfibre Mop Use a facility approved cleaning solution Attach microfibre pad to mop head frame Work from clean to more heavily soiled areas Remove pad when soiled and set aside for laundering Send soiled microfibre pads for laundering at the end of the day

12. 12 Washrooms - Hospital clean required Working from clean areas to dirty areas: Remove soiled linen from floor; wipe up any spills; remove waste Clean gross soilage (e.g. feces, urine) and set aside cloth for laundering Clean door handle and light switch Clean chrome wall attachments and mirror Clean all dispensers and frames Clean call bell and cord Clean support railings, ledges/shelves

13. 13 Washrooms – Hospital clean required Clean shower/tub faucets, walls and railing, scrubbing as required to remove soap scum:  apply disinfectant to interior surfaces of shower/tub, including soap dish, faucets and shower head;  ensure sufficient contact time, rinse and wipe dry;  inspect and replace shower curtains monthly and as required Clean bedpan support, entire toilet including handle and underside of flush rim Remove gloves and perform hand hygiene on leaving the room Replenish paper towel, toilet paper, waste bag, soap and ABHR as required Report mould and cracked, leaking or damaged areas for repair

14. 14 Discharge/Vacancy/Transfer Cleaning Procedures 1.Check for Additional Precautions signs and follow the precautions indicated 2.Ensure sufficient cleaning supplies and materials are readily available 3.Clean hands using ABHR and put on gloves before entering the room 4.Remove dirty linen:  Strip the bed, discarding linen into soiled linen bag; roll sheets carefully to prevent aerosols  Inspect bedside curtains and window treatments; if visibly soiled, clean or change  Check privacy curtains for visible soiling and replace if required  Remove gloves and clean hands using ABHR 5.Apply clean gloves and clean the room; work from less soiled to more soiled and from high to low areas of the room Note: Allow surfaces to air dry to maximize contact time

15. 15 Discharge/Vacancy/Transfer Cleaning 6.Use fresh cloth(s) for cleaning each patient/resident bed space: 7.If a bucket is used, do not ‘double-dip’ cloth(s) back into cleaning solution once used  Change the cleaning cloth when it is no longer saturated with disinfectant and after cleaning heavily soiled areas such as toilet and bedpan  If there is more than one patient/resident bed space in the room, use fresh cloth(s) for each and complete the cleaning in each bed space before moving to the next 8.High dust room/vacuum window coverings – launder/wipe clean if visibly soiled 9.Clean doors, door handles, push plate and touched areas of frame

16. 16 Discharge/Vacancy/Transfer Cleaning 10.Check walls for visible soiling and clean if required; remove tape from walls, clean stains 11.Clean light switches and thermostats 12.Clean wall mounted items (e.g., ABHR dispenser, glove box holder) 13.Clean all glass and mirrors 14.Clean all furnishings both vertical and horizontal surfaces. Clean inside drawers. 15.Clean inside and outside of patient/resident closet

17. 17 Discharge/Vacancy/Transfer Cleaning 16.Clean the bed  Check for cracks or holes in mattress - replace as required  Clean entire mattress - inspect for pests  Clean exposed platform and frame  Clean foot board, headboard, bed rails, call bell, bed controls and all cords; pay particular attention to areas that are visibly soiled and surfaces frequently touched by staff  Clean all lower parts of bed frame, including casters

18. 18 Discharge/Vacancy/Transfer Cleaning 17.Clean washroom (see washroom cleaning procedure). In addition:  Clean high dust areas  Clean piping under sink  Clean interior/exterior of medicine cabinet/shelves  Clean interior of dispensers  Replenish supplies  Dispose of toilet brush

19. 19 Discharge/Vacancy/Transfer Cleaning 18.Remove gloves and clean hands with ABHR; if hands are visibly soiled, wash with soap and water; 19.DO NOT LEAVE ROOM WEARING SOILED GLOVES 20.Remake bed and replenish supplies as required (e.g., gloves, ABHR, soap, paper towels, toilet brush) and other items as per your operational needs 21.Disposal  Place soiled cloths in designated container for laundering  Place obvious waste in receptacles  Close waste bags and remove; clean waste can/holder and add a clean bag 22.Clean floors (see floor cleaning procedure)

20. 20 Learning Checkpoint

21. 21 Learning Checkpoint 1.When using a loop mop and bucket, cleaning solutions should be changed: a)More frequently in heavily contaminated areas b)When visibly soiled c)Immediately after cleaning blood and body fluid spills d)All of the above

22. 22 Learning Checkpoint Answer Correct answer is d. In the first three examples, solutions become contaminated and should be changed.

23. 23 Thank You!

24. Image Sources – Module 4B Microsoft Clipart used in slides 12 & 20 Images in slides 9 & 19 are © PHO 2013