Environmental Cleaning
Objectives
Participants should be able to:
• Explain the importance of the environment in
infection transmission
• Describe the cleaning principles
• Explain the common methods of environmental
cleaning and disinfection
• Explain the difference between routine and terminal
cleaning
Introduction
• Microbes survive and grow in the environment
• Microbes are transferred directly and indirectly from
contaminated surfaces to patients
• Exposure to contaminated surfaces is associated with
infection
Introduction cont…
• The healthcare environment can be a breeding
ground for microorganisms
• Cleaning in the healthcare setting refers to the
removal of dirt, dust, debris and pathogens
• Good infection control practices start with a clean
environment
• Cleaning results in reduction in environmental
contamination
Importance of environmental
cleaning
• Contributes to prevention of healthcare associated
infection
• Reduces visible dirt and makes the environment look
neat and appealing
• Removes substances from the environment that may
be conducive for microbial growth
• Reduces the number of microbes in the patients’
surroundings
Principles of environmental cleaning
• Cleaning programme should be in place
– cleaning protocols, staff training and monitoring of
cleaning
• An institution-approved liquid detergent should be
used in all areas
• The manufacturer’s instructions regarding dilution of
cleaning solutions should always be followed
Principles cont…
• Surfaces must be allowed to dry completely
• A cleaning schedule should be devised for each
service area
• Clean from least to most contaminated areas
• Water must be clean and potable
• Water must be changed when visibly dirty
• Work moving backwards, making a figure of 8,
overwrapping each stroke
Principles cont..
• Supervision and inspection using a checklist should
be done
• Regular cleaning schedules
• On job training is important
• Immediate cleaning when there is gross
contamination or spillage
Principles cont…
• Adequate time must be allotted in order to remove
all soil from a surface
• Agitation-scrubbing with brushes, abrasive pads, or
microfiber cloths is necessary to break through
biofilm
• Remember the environmental cleaning motto
NO Dust, NO Spots, NO Stains, NO Smells
Types of environmental cleaning
• Routine cleaning
– Occurs while the patient is admitted
– Focus on patient zones
– Aims to reduce organic materials
– Provide a visual clean environment
• Terminal cleaning
– Occurs after discharged or transferred
– Focuses on the entire room, cubicle or bed-space,
bed, bedside equipment and environmental surfaces
Routine Cleaning
Frequency depends on:
• High touch vs low touch surfaces
• Type of activity in the area
• Vulnerability of patients in the unit/ ward
• Probability of body substance contamination
in the area
PPE for Cleaning staff
The following PPE must be used
• Face masks
• Goggles
• Heavy duty gloves
• Heavy duty aprons
• Gum boots
Cleaning Products
Selection should be based on:
• Intended use
• Efficacy
• Acceptability
• Safety
• Cost
Properties of cleaning Products
Should accomplish the following
• Suspension - suspend fats in water
• Saponification - make fats water-soluble
• Surfaction - decreases the surface tension of
water and allow greater penetration of the agent
into the dirt or soil
Products cont…
• Dispersion - breaking up of soil into small particles
• Protein destruction (enzymatic)- breaking up
proteins
• Softening the water - removal of calcium and
magnesium
Cleaning methods
Can be dry or wet. In health facilities wet cleaning is
recommended.
The following methods are used
• Damp dusting
• Mopping
• Scrubbing
• Washing - laundry
• Sweeping – health facility grounds
Cleaning methods cont…
Cobweb and stain removal
• Remove all cob webs prior to dusting or mopping
• Remove all stains from walls, windows, curtains
and other surfaces
Methods Cont…
Dump Dusting
• For walls, ceilings, doors, windows, furniture, other
environmental surfaces and highly touched surfaces
• Use soapy water, clean water, disinfectant (0.1%
chlorine solution) and cleaning cloths
• Avoid dry dusting and dust cloths and mops should
never be shaken
• Dusting should be done in a systematic way
Cleaning methods
Mopping
3-bucket technique
• Three different buckets are used
• One has soapy water , disinfectant and plain water
• Three mops are used
• This technique extends the life span of the cleaning
solution, saves labor and material cost
Management of Spills
• Wear appropriate PPE
• Wet materials that will be used to absorb and scoop
spill with 0.5% chlorine solution
• Cover spill with absorbent material, (cloth,
paper, absorbent powder, etc)
• Wipe up all visible excreta
• Dispose of materials into medical waste bin
• Clean and disinfect surface
Management of spill cont...
Small spills:
– Wear gloves, remove visible material using a cloth
soaked with 0.5% chlorine solution.
– Wipe clean
Large spills:
– Scoop the spills or use absorbent material.
– Mop up with soapy water
– Finish with chlorine and clean water
Cleaning the operating room
Between cases
• Center of operating room - surrounding the
operating room bed[ mop with a disinfectant
cleaning solution (if visibly soiled)]
• Waste - collect and remove all waste from the
operating room in closed leak-proof containers
• Sharps containers- close and remove containers
from the operating room when they are ¾ full
Between Each Case
• Spills – follow protocol for either small or large
spills
• Operating room table - wipe all surfaces and
mattress pads
• Instrument table - wipe all flat surfaces that have
come in immediate contact with a patient or body
fluids
Between Each Case
• Soiled Instruments- Remove covered containers
with instruments from the operating room and
replace them with clean containers
• Soiled linen -remove soiled linen in leak proof,
covered waste containers
• Waste- remove waste in covered containers
Summary
THANK YOU
