Hygiene Protocol for Long-Term Care
Hygiene Protocol for Long-Term Care
October 2020
ENSURE SAFE
OPERATIONS
UNDERSTANDING RISK FACTORS
1[Link]
3
FOCUS ON PERSONAL + ENVIRONMENTAL HYGIENE
Develop policies for worker protection and provide training on proper product
use and how to read a Safety Data Sheet (SDS) to all cleaning staff.
RESPOND WITH RISK MANAGEMENT STRATEGIES
Follow CDC and WHO guidance to protect yourself and others:
Source: [Link] 9
PROMOTE PROPER HAND HYGIENE
HAND HYGIENE Hands are a primary mode of transmission so hygiene must be judiciously implemented.
10
YOUR MOMENTS FOR HAND HYGIENE
* [Link]
PROPER GLOVING
How to DON (put on) disposable gloves How to DOFF (take off) disposable gloves
Wash hands.
Wash hands.
BARRIER MASK USAGE
14
RECOMMENDATIONS ON HOW TO WORK IN LOCATIONS WITH KNOWN
COVID-19
Follow local and plant-specific guidelines and recommendations for infection prevention, including the appropriate use of personal
protective equipment (PPE).
Infection prevention includes proper hand hygiene, the disinfection of hard surfaces and the handling of laundry and waste.
Perform hand hygiene between steps if hands become contaminated and immediately after
removing all PPE
16
LOOKING AHEAD
Enhanced cleaning and disinfection for your operation
Pay attention to:
Selecting the proper solution(s) for the job (i.e., product, tool and
application method)
The importance of contact time to achieve disinfection
Increasing frequency of cleaning and disinfection as infection risk,
foot traffic and soil load increases
Increased awareness of safety considerations (disposable PPE, etc.)
Ensure correct overall procedures, to ensure doing everything possible
to protect employees and residents
17
DETERMINE FREQUENCY OF CLEANING AND DISINFECTION
As infection risk, foot traffic or soil load increase, frequency of cleaning and disinfection should also increase.
Standard Frequency
Frequency should be determined at the unit level and
re-evaluated as environmental variables change.
Environmental Variables
APPLICATION METHODS
Not all spray applicators are the same; some require additional safety and operational measures…
*Follow product label directions for use when applying to ensure adherence to surface wetting and contact time, PPE, compatibility, and any required rinse post-application.
ELECTROSTATIC SPRAYING -
GUIDELINES FOR USE
DO’S For Electrostatic Spraying DON’TS For Electrostatic Spraying
DO place signage indicating area is closed or out of service DON’T spray flammable products –
DO ensure no bystanders are present spray only products recommended
by Ecolab
DO address any ventilation concerns (i.e., avoid confined
spaces with poor ventilation) DON’T spray electronics or sensitive items
unless this application is
DO ensure food or food related items are removed confirmed with the manufacturer.
from space and any food contact surfaces are rinsed
with potable water post-spray DON’T spray directly on people
or animals.
DO avoid contact with eyes, skin or inhalation while spraying
DON’T use electrostatic spraying to
DO ensure spraying is away from user breathing zone treat the air.
DO move from sprayed areas to unsprayed areas
DO wear proper PPE (minimally – sealed dust/mist
mask/N95 in addition to any required per the SDS)
DO allow for 15-minute resettling time post-spray
Detailed Procedures
DO treat areas with sources of heat, open flames, sparks
or other ignition sources with care
Available!
ENSURE ENVIRONMENTAL HYGIENE
DISINFECTING NON-FOOD CONTACT SURFACES
*Refer to product label for use directions. Always wear appropriate PPE
[Link]
BEST PRACTICES
ACROSS YOUR
OPERATION
PUBLIC AREAS
General Instructions
2. In OPL laundries without separation in dirty and clean side, a Products and tools you need
disinfection of the used laundry equipment (machine, transport cars)
is recommended as a pre-caution measure: To avoid Laundry Machine & Chemistry
recontamination of the clean laundry, the outside of the machine
including the machine door should be disinfected with an appropriate Cleaner Disinfectant
surface disinfectant after the machine has been loaded. Also, the
transport equipment for the dirty laundry should be disinfected with Laundry Container/Laundry Bags
the same disinfectant.
Disposable Gloves
3. BPR (Biocidal Products Regulation) viricidal applied processes*
Conc. Conc. Bath Cloth
Detergent Disinfectant Temperature Time
Detergent Disinfectant Ratio *The BPR guidance for PT2-4 states that at temperatures ≥40 °C Murine Parvovirus is the required
Ecobrite Magic heat resistant reference organism. This virus is more resistant against thermal and chemical influences
1,5 ml/l Ozonit Super 2 ml/l 60 °C 1:5 12 min
Emulsion than the one responsible of the COVID-19 disease, an enveloped virus. Therefore, a product passing
Ecobrite Magic EN14476 with Murine Parvovirus can also be claimed to have virucidal efficacy against enveloped
1,5 ml/l Ozonit** 4 ml/l 60 °C 1:5 12 min
Emulsion viruses, such as SARS-CoV-2.
Eltra 7 g/l 60 °C 1:5 20 min
Eltra 40 Extra 7 g/l 40 °C 1:5 10 min **Ecolab statement on the read-across of efficacy test report data from Ozonit Super to Ozonit for
Mop Eltra 6 g/l 60 °C 1:5 15 min determining dose concentrations.
29
FOODSERVICE: DINING AREAS
General Instructions
33
WAREWASHING
High-touching Objects
Disinfection of Wares
Dishes
Procedures: Cutlery
1. According to the German Public Health Authority (the Robert Koch Glasses
Institute, RKI), there is no risk associated with using the standard
machine ware wash process to establish the required safety required Pot & pans
to eliminating the novel SARS-CoV-2 virus from ware.
Cutting boards
2. Statement of the Robert Koch Institute (RKI): “Dishes may be
transported in closed containers to the dishwasher and washed with Utensils
a program as usual in a hospital“ (translated from German).
Transport container
3. Based on the RKI statement, we suggest transporting both soiled
ware and cleaned ware in separate, closed containers to minimize Bain marie
the possibility of contamination outside of the normal cleaning
process.
4. Containers for used ware shall of course be disinfected after use and
those for clean ware cleaned appropriately. Use an appropriately
labeled container for transporting ware to/from the dish room and
sort ware into the dishwasher using disposable gloves.
5. In the dish washing process, it should be ensured that a wash
temperature of min. 60 °C and a rinse temperature of min. 82 °C
is achieved.
34
ASSURANCE TACTICS - BEST PRACTICES
Increase frequency of cleaning and disinfection in public spaces during high-traffic
periods to increase visibility of these tasks.
Script a message for your staff to share with visitors and new or prospective
residents
Communicate new cleaning standards through your website and via email or
newsletter to residents and their families
Be clear about expectations for behavior of residents and guests in common areas
with obvious signage (e.g. masks, distancing, temperature checks).
Provide disinfectant and cloths or disinfecting wipes in public areas for use by
employees or residents to encourage heightened sanitation.
35
PRINTABLE
WALLCHARTS
36
PUBLIC AREAS
Hard Surfaces (Non-Food Contact)
37
PUBLIC AREAS
Daily Floor Cleaning
2 Fill bucket with cold 4 For heavy soiling leave 6 Mop dry or squeegee
water and Floor to soak and/or use to drain and allow to air
Cleaner as indicated on deck brush. dry.
product label.
38
PUBLIC AREAS
Trashing
Wear protective gloves. Empty trash can and Empty trash cart in
1 3 5
Line trash cart with the wipe outside with Multi- main dumpster
appropriate size trash Purpose Cleaner or area.
bag. disinfect, if needed.
39
PUBLIC AREAS
Mirrors & Glasses
Spray Glass Cleaner onto a clean cloth. DO NOT spray cleaning solution
directly onto mirror.
NOTE: To minimize streaking, do not use cloths treated with fabric softener.
Beginning at top, wipe surface by moving cloth from left to right and flipping as
necessary until surface is dry and streak-free.
40
PUBLIC AREAS
Large Glass Surfaces
Dip window scrubber Beginning at top, remove Collect solution at
1 3 5
into Glass Cleaner and cleaning solution by bottom with cleaning
apply to window. dragging squeegee cloth.
across window moving
left to right until window
is dry and streak-free.
41
PUBLIC AREAS
Gym
Apply Disinfectant
2 4 Wipe all areas to ensure
Solution using a effective disinfection.
foaming trigger to all
areas to be cleaned.
42
PUBLIC DINING
Table Surface
Clean entire surface, bottom/underneath side of all tables Use a Disinfection Solution to disinfect entire counter or
at least 15-20 cm from the edge of tabletop/counter using tabletop surface with either a clean cloth and pail
Multi-Purpose Cleaner. Use with a clean cloth and bucket application (damp, wrung-out cloth) or spray bottle
application (damp, wrung-out cloth), or spray bottle and DISINFECT application (spray surface, do not wipe dry). Allow the
clean cloth application (spray surface and wipe clean). surfaces to remain wet for the time specified on the product
label. Allow to air dry before placing items on the
tabletop/counter or before returning to use.
43
PUBLIC DINING
Seating
44
PUBLIC DINING
Buffets
45
PUBLIC DINING
Beverage Machines
Remove mixing nozzles, diffusers and cup rest Clean exterior surface (top and sides) and panel
from machine and thoroughly clean and bottom (soda splash area) with Multi-Purpose
Disinfect using the Dishwasher or Manual Cleaner and wipe with clean cloth.
cleaning procedures. NOTE: Pour hot water (min. 45 °C) down drip
NOTE: For Machine Method, use a rack pan to ensure proper drainage.
designed for small items.
To Clean Ice Bin (if present): Remove ice from Spray exterior food contact surface area with
bin. Prepare Multi-Purpose Cleaner as Disinfection Solution. Allow to sit per time
specified by the product label. Place solution specified by product label. Allow to air dry.
into the machine. Allow to soak for at least 5 Reinstall nozzles, diffusers and cup rest. Stock
minutes. Drain the solution and rinse with fresh ice bin with fresh ice, if applicable.
water.
46
PUBLIC DINING
Beverage Refrigerator
Remove beverages and place in temporary Spray surface with Disinfection Solution and allow
refrigerated storage. Remove shelving, to sit for time specified on product label. Allow to air
brackets, etc. dry.
NOTE: Pour disinfection product per label directions
into drain trough to prevent development of mold
and odor-producing bacteria.
Wash, rinse and disinfect all removed parts Return refrigerator to proper temperature. Use
using either the machine or manual solution of Multi-Purpose Cleaner to clean
method. exterior.
47
PUBLIC DINING
Coffee/Espresso Maker
1 Prepare use solution with Delimer Allow the machine to run at least 2 cycles
2x 4 with fresh water.
Product as indicated on product
label.
48
PUBLIC DINING
Work Areas (e. g. Bars, Preparation Areas, Host Stand)
Remove all items such as bowls or utensils. 4 Rinse surfaces with clean water and
wipe dry.
Spray Multi-Purpose Cleaner over all 6 Rinse with clean water and wipe area
3
surfaces, bottom/underneath side of all dry with a clean cloth.
tables at least 15-20 cm from the edge of
tabletop/counter and clean with cloth. Pay
attention to legs, sides and under shelves.
49
RESIDENT ROOMS
Evaluate & Prepare
Remove all dishes and glassware
Look for any spills or stains on the carpet. to be washed outside of room.
50
RESIDENT ROOMS
Dust Cleaning
Finish room by spraying Air Freshener on soft
Spray Multi-Purpose Cleaner onto cloth. Wipe surfaces, including carpet and curtains. Start at the
down all high-touch points (TV, remote control, light back of the room and work toward the door.
switches, door handles, trash can, etc.). Reapply
product to cloth as needed.
Vacuum carpet.
51
RESIDENT ROOMS
Bedding
Remove bed linens to be replaced. You might also To avoid soiling linens, dust surfaces above the bed
want to change linens which do not look using Multi-Purpose Cleaner before replacing bed
linens.
Inspect mattress for bed bugs. Make bed with fresh linens. Use sticky roller on bed
to remove hair and fine particles.
52
RESIDENT ROOMS
Clean Resident Bathroom
Apply Bathroom Cleaner as needed. Scrub Wipe down toilet. Use toilet brush to scrub
complete interior surface of shower/tub. bowl.
Rinse and dry surface completely.
Spray Glass Cleaner onto cloth. Wipe Spray Disinfecting Solution on a clean cloth
mirrors top to bottom until there are no and wipe all high-touch points including fixtures
streaks. and light switches.
Wipe down vanity and sink with Bathroom Replace bath towels. Spray floor with
Cleaner. Floor Cleaner. Wipe thoroughly.
53
RESTROOMS
Mirrors & Glass Surfaces
54
RESTROOMS
Partitions & Walls
Spray Multi-Purpose Cleaner on clean cloth and wipe
stall partitions, doors and bathroom walls (from the floor
to an average arm reach height – 61 cm). Allow proper
time to remove heavy soiling.
55
RESTROOMS
Hard Surfaces (Counter & Sink)
Wear protective gloves. Pick up debris Scrub surfaces with a non-abrasive sanitary sponge
around sink. or color-coded microfiber cloth (yellow).
Spray sinks, counter tops – including faucets, To disinfect, spray surfaces with Disinfectant
handles, soap dispensers, paper towel Solution and allow surfaces to remain wet for time
dispenser… with Bathroom Cleaner. specified on product label. Make certain to include all
high-touch surfaces, such as faucet handles.
56
RESTROOMS
Floors
57
RESTROOMS
Toilets & Urinals
7 8 9
58
KITCHEN
Food Contact Surfaces
59
KITCHEN
Tableware
When sorting soiled wares, place flatware in Thoroughly spray the loaded rack to remove
separate bus pan or open rack. Dump liquid loosened food. Wash in dishmachine with
from glasses and cups, and place in glass and Machine Detergent. Use Rinse Aid for
cup racks. Remove excess food from spotless wares.
tableware by hand-scraping into garbage.
After hand-scraping wares, sort and stack the Stack clean dishes in the appropriate dish
same type and size of dishes together (Decoy dolly. Each compartment in the dish dolly
method). should be filled with only one size dish. When
dolly is completely loaded, store in assigned
area and cover to prevent contamination
60
KITCHEN
Cutlery/Flatware
Fill presoak tub or bus pan with Presoak Sort flatware and transfer from open rack to the
solution as specified by the product label. baskets. Run through dishmachine wash cycle
NOTE: Change presoak solution when water with handles down.
cools or is dirty.
Sort dirty flatware and place into presoak Shake off excess water and allow to air dry and
solution. Ensure flatware is completely cool down. Transfer to empty basket and store
submerged into the solution. Soak for a flatware with handles up. Do not touch eating
minimum of 20-30 minutes. ends of flatware.
61
KITCHEN
Warewashing: final work flatware and cutlery
Spray Multi-Purpose Cleaner generously Apply Disinfection Solution with either a clean
with cloth and wipe so surface remains wet. cloth and bucket or spray bottle application, so
surface remains wet. Allow the surfaces to
remain wet for the time specified on the product
label. Allow to air dry.
64
KITCHEN
Food Processing Equipment (e. g. Blender, Slicers)
1 With dry hands, disconnect 4 Clean all removable parts 7 Rinse surrounding areas
unit from power supply before and rinse, preferably using with clean water and cloth.
you start cleaning.. a dishwasher. Allow to air dry.
65
KITCHEN
Food Cart - Tray Dispenser
Spray surfaces with Multi-Purpose Cleaner. Wipe surface of food cart/tray dispenser clean with
If soil on surface is greasy, use Degreaser as a dry paper towel or clean cloth. Be certain to clean
specified by the product label. all surfaces including the cart legs.
66
KITCHEN
Sink Area
Drain and rinse all sinks. Squeegee water from all flat
Fill all sinks to low level with hot water and Manual
surfaces. Wipe exterior surfaces with a clean, dry cloth.
Detergent. For sinks with grease buildup and stubborn
stains, use Degreaser.
67
KITCHEN
Refrigerator/Freezer Reach-in
Spray surfaces with Disinfection Solution and allow
Remove all food containers and place in temporary
to sit for time specified on product label. Rinse with
refrigerated storage. Remove shelving, brackets,
clean water and allow to air dry.
etc.
NOTE: Pour disinfection product per label directions
NOTE: Freezer temperature must be adjusted to
into drain trough to prevent development of mold and
above freezing (0 °C) before cleaning.
odor-producing bacteria.
68
KITCHEN
Refrigerator/Freezer Walk-in
Remove all unpacked foods and food packaging from Wipe area with mop to loosen and remove soil.
area. Clear floor of all movable equipment including floor Dry mop or squeegee to remove excess liquid and
mats, plastic door curtains, inside and outside walls, wipe with a dry cloth, if needed, to aid drying. A
each shelving unit and container, carts to be used for wet vacuum may also be used. When dry, replace
moving and holding food. unpacked foods and food packaging and turn on
recirculation fan.
Turn off recirculation fan.
NOTE: If using a product other than Freezer Cleaner, all
food must be removed, and freezer temperature must
be adjusted to above freezing 0 °C.
Wipe up spills and sweep away any loose soil and After cleaning, disinfect with a Disinfection
debris. Use a scraper or abrasive pad to remove Solution and let the surfaces remain wet for the
built-up deposits. time specified on the product label. Allow to air
dry. Do not rinse.
69
KITCHEN
Cutting Boards/Meat Blocks
Remove excess food and loose soil with a spatula into garbage.
1
Store Cutting Boards upright with a gap in between and allow to air dry.
3
70
KITCHEN
Ice Machines
Unplug the machine. Remove and discard all Use Multi-Purpose Cleaner to clean exterior.
ice.
Clean the inside of the unit with Manual Spray exterior of tray and door with Disinfection
Detergent. Give special attention to the floor Solution and allow surfaces to remain wet for
of the bin, corners, doors, gaskets, hinges and time specified on the product label. Rinse with
latches. Scrub built-up deposits with nylon clean water and allow to air dry. Plug in machine.
brush or scraper. Fill machine with fresh, new ice.
NOTE: Above procedure is only for the ice bins. For procedure to clean the ice
maker, please refer to instructions in the OEM manual.
71
KITCHEN
Mobile Event Equipment (e. g. Live Cooking Equipment)
1 Where necessary, unplug 4 Rinse surfaces with clean 7 Rinse surfaces with
item and ensure it is cool water and wipe dry. clean water.
and empty.
2 5 8
Remove physical debris. Apply Disinfection Wipe area with a clean
Solution directly over all cloth.
surfaces or with a well
wrung cloth.
72
LAUNDRY
Collection
Enter the room. Leave cart Stained towels should Stained sheets and
outside of the room. be placed in a small pillow cases should be
laundry bag. placed in the cart's
laundry bag
Enter the bathroom, collect Remove sheets and Transport dirty and
towels and roll them into a pillow cases from the stained linen to the
ball. Put them in the cart's bed. Roll dirty sheets laundry area for sorting.
laundry bag. into a ball and put
them in the cart's
laundry bag.
If guest is suspected or confirmed of having Covid-19 all linen should be placed in a sealed bag and laundry staff informed of
using the correct washing process.
In the event of an Outbreak face protection must be worn.
73
LAUNDRY
Transport
Transport in a closed and appropriately labeled
Wear protective gloves. Separate stained linen
container or laundry bag to the laundry and sort
into separate collection bags.
into laundry machine with disposable gloves
74
LAUNDRY
Operation
Replace product when
empty. Check liquids levels Check formula chart to If properly loaded, linen
frequently. identify the correct should be at the 10:00
wash formula and 2:00 position between
rotations.
75
STORAGE & LOADING
Storage Area
Remove all items from Allow cleaning solution Apply Disinfecting Solution
the shelf and temporarily to penetrate soils. Use a with a well wrung cloth so
store in a clean, dry, safe scraper or non-scratch surface remains wet. Let
area that does not block pad to loosen any dried- product sit for time specified
traffic or create a hazard. on food particles. on product label. Allow to air
dry.
76
STORAGE & LOADING
Loading Bay / Hard Surfaces (Non-Food Contact)
1
2 Pre-clean visibly soiled areas to be Allow the surfaces to remain wet for the
3
disinfected. time specified on the product label.
77
ELECTROSTATIC SPRAYING PROCEDURE
CLEANING AND DISINFECTION GUIDELINES
1 2 3 4
Don required PPE (minimally – Remove trash/debris, Vacuum carpet/entrance Empty trash cans and
sealed dust/mist mask/N95 in linens, food and any ware. mats and vacuum or recycling bins. Replace liners.
addition to any required per the sweep hard-surfaced
SDS), and place ‘Area floors (tile/wood/LVT).
Closed/Out of Service’ signage.
5 6 7 8
Refill air freshener, hand Remove or cover Pre-clean visibly soiled To disinfect using an
sanitizer and disinfectant electronics, high-value areas (e.g., food/drink electrostatic sprayer, apply
wipe dispensers as needed. items or sensitive surfaces. spills) using multi- multi-purpose
purpose disinfectant. disinfectant solution to hard,
non-porous environmental
surfaces.
ELECTROSTATIC SPRAYING PROCEDURE
CLEANING AND DISINFECTION GUIDELINES
9 10 11 12
Begin spraying area from the Ensure treated surfaces remain Wipe surfaces (recommended) Clean glass and windows by
farthest corner ensuring no more wet for contact time indicated or let air dry. For electronics, spraying multi-purpose
than 2 feet (60 cm) between the on product label. Allow spray to spray a cloth and wipe surface. disinfectant or glass cleaner
spray nozzle and the surface. Be settle for 15 minutes before re- on a fresh microfiber to
aware of possible overspray. entering the area. ensure a streak-free finish.
*Always follow manufacturer direction when treating electronic surfaces. Spray a cloth and wipe surface.
For more information contact
your Ecolab Representative
or visit [Link]/coronavirus