CLEANLINESS OF THE CLEANLINESS OF THE WARD AND ITS ANNEXESWARD AND ITS ANNEXES

HAMENU VAVA CYRIL

Environmental Environmental Management / Controls Management / Controls (Housekeeping and Waste (Housekeeping and Waste Disposal) Disposal) Environmental controls are

practices that are performed to render the health care facility environment safe from infections or reduce the infections to the barest minimum.

General cleanliness and hygiene of a facility (housekeeping) are vital to the health and safety of staff, clients, visitors and the community at large.

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General cleanliness and hygiene are vital for safety

General cleanliness and hygiene are vital for safety

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General Cleaning General Cleaning Guidelines Guidelines Ward/Unit supervisors shall draw

up cleaning schedules for the different areas of the ward and post them where all housekeeping staff can see them.

To reduce the spread of dust and microorganisms, use a damp or wet mop or cloth for walls, floors and surfaces instead of dry-dusting or sweeping.

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General Cleaning General Cleaning Guidelines Guidelines Scrubbing is the most effective

way to remove dirt and microorganisms

Wash surfaces from top to bottom so that debris falls to the floor and is cleaned up last. Clean the highest fixtures first and work downwards e.g. from shelves to tables, lockers and then the floor.

Change cleaning solutions whenever they appear to be dirty as a solution is less likely to kill infectious microorganisms if it is heavily soiled 6

General Cleaning General Cleaning Guidelines Guidelines

Clean and disinfect surfaces that are likely to be contaminated with pathogens that are touched frequently such as bed rails, bed tables, door knobs frequently compared to other surfaces such as walls that are not touched.

Clean from less contaminated area to heavily contaminated area.

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General Cleaning General Cleaning Guidelines Guidelines Use separate equipment

(brushes and cloths) for high risk areas which are more likely to be contaminated e.g. toilets

Housekeeping staff shall have regular in-service training.

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Immediate Physical Environment Immediate Physical Environment of the Patientof the Patient

Cleaning Procedures for Cleaning Procedures for Different Clinic AreasDifferent Clinic AreasNon-patient Care Areas: Low Risk

Areas (waiting rooms, administrative areas) where clinical services are not provided. These areas are not usually heavily contaminated with infectious microorganism and so the risk of infection is very minimal.

Routine cleaning (daily, or when the area is dirty) is good enough.

Toilets and sluice Rooms 10

Cleaning Schedule: Toilets and sluice Rooms

Task

Clean walls

Clean ceilings

Clean counter and other surfaces

ScheduleWipe with a disinfectant cleaning solution each day (or more often if necessary)

Wipe with a disinfectant solution each week

Wipe with disinfectant solution each day

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Cleaning Schedule: Toilets and sluice Cleaning Schedule: Toilets and sluice RoomsRooms

Clean floors

Clean sinks and toilets

Empty waste containers

Clean waste containers

Use mop and disinfectant cleaning solution each day or more often

Scrub with a disinfectant cleaning solution and rinse with clean water each day or more often.

Each day or more often

scrub to remove soil or organic material with disinfectant cleaning solution each day or more often

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Cleaning SchedulesCleaning Schedules

Client Care Areas (operating theatres, procedure rooms, laboratories, areas where instruments are processed, wards, toilets, sluice rooms etc.). In these area, there is greater potential for contamination with infectious materials hence needs special care using a disinfectant cleaning solutions.

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Cleaning Schedule for Client-Care Cleaning Schedule for Client-Care AreasAreas

A the

beginning

of each day

Between Clients

Clean operating/procedure tables, examination couches, chairs, trolley tops, Mayo stands, lamps, counters with disinfectant solutions to remove dust that has accumulated overnight.

Clean operating/procedure tables, examination couches, trolley tops or Mayo stands, counters, lamps and any other potentially contaminated surfaces in operating theatres and procedure room with a cloth dampened with a disinfectant cleaning solution. Alternatively, spray the solution onto the surfaces and wipe off with a damp cloth.

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Cleaning Schedule for Client-Care Cleaning Schedule for Client-Care AreasAreasBetween

Clients

At the end of each clinic session or day

Clean spills of blood or other body fluids with 0.5% chlorine solution immediately

Clean visibly soiled areas of the floor; walls, or ceiling.

Put waste in a leak-proof container and empty the container when it is ¾ full.

Wipe down all surfaces including counter, tables, sinks, lights, door handles and wall with a cloth dampened with a disinfectant cleaning solution or spray the solution. Always wipe from top to bottom paying particular attention to the base, sides and legs. Rinse sinks with clean water.

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Cleaning Schedule for Client-Care Cleaning Schedule for Client-Care AreasAreasAt the end

of each clinic session or day

Each week

Mop the floors with a mop soaked in disinfectant cleaning solution

Check sharp-disposal containers: remove and replace when ¾ full Remove medical or hazardous chemical waste and burn or bury as soon as possible to limit contact.

Wash containers with a disinfectant cleaning solution and rinse with water

Clean ceilings with a mop dampened with a disinfectant cleaning solution.

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Cleaning of SpillsCleaning of Spills

If spill is small, wipe it with a cloth that has been saturated with a disinfectant (0.5% chlorine) solution immediately.

If the spill is large, cover or flood the area with a disinfectant (0.5%) solution, mop up the solution, and then clean the area with a disinfectant cleaning solution immediately. 17

Supplies and equipment used for cleaning (mops, buckets, and cloths) should be decontaminated with a disinfectant 0.5% chlorine solution cleaned in detergent and water, rinsed in clean water and dried before reuse

Types of Cleaning Types of Cleaning SolutionsSolutionsThree kinds of cleaning solutions

are used during housekeeping at a health facility:

1.Detergent or Plain Soap and Water

This is used for low-risk areas and general tasks. Detergents remove dirt and organic material and dissolve or suspend grease, oil and other matter for easy removal by scrubbing

Types of Cleaning Types of Cleaning SolutionsSolutions2. Disinfectant (0.5%

Chlorine Solution The disinfectant rapidly kill or

inactivate infectious microorganisms during the cleaning process. Disinfectants are used to clean up spills or blood or other body fluids.

Types of Cleaning Types of Cleaning SolutionsSolutions3. Disinfectant Cleaning Solutions

This solution contains detergent, disinfectant and water is used for cleaning areas that may be contaminated with infectious materials e.g. OT rooms, sluice room, toilets etc. The disinfectants kill/inactivates the microorganisms while the detergents remove dirt and organic material.

To constitute a disinfectant cleaning solution, prepare 0.5% chlorine solution and add liquid/powdered detergent until foamy

Types of Cleaning Types of Cleaning SolutionsSolutions

Other equally good disinfectants that can be used include

PhenolLysolQuaternary ammonium

compounds

Preparation of 0.5% Preparation of 0.5% Chlorine SolutionChlorine SolutionChlorine is commonly used for

disinfection because it 1.Is a powerful killer of

microorganisms2.Deordourises3.Is not poisonous to humans in

the accepted concentrations used

4.Leaves no poisonous residues5.Colourless, easy to handle and

economical to use.

Preparation of 0.5% Preparation of 0.5% Chlorine SolutionChlorine Solution

Chlorine may be supplied in the following forms:

1.Liquid (sodium hypochloride)2.Powder (calcium

hypochloride or chlorinated lime)

3.Chlorine Releasing Tablets (Sodium dichlorocyanurate)

Preparation of 0.5% Preparation of 0.5% Chlorine SolutionChlorine SolutionThe amount of active chlorine in

a chlorine containing compound is usually described in percentage (or in degrees chlorum in some francophone countries). Chlorine in the various preparations comes in different concentrations.

When the solution is prepared, the active chlorine available should be 0.5%.

Preparation of 0.5% Chlorine Preparation of 0.5% Chlorine SolutionSolution

1. Using the liquid household bleach

Parts of water = % of active chlorine in liquid bleach -1

0.5%

OrParts of water = 2X – 1Where X is the figure/numeral in the expressed

percentage indicating the active chlorine in the stock solution

Preparation of 0.5% Chlorine Preparation of 0.5% Chlorine SolutionSolution

2. Using Bleach Powder; calculate the ratio of bleach to water as follows

Grams of powder = 0.5% (desired strength active chlorine in bleach powder X 1000

Preparation of 0.5% Chlorine Preparation of 0.5% Chlorine SolutionSolutionUsing Chlorine-Releasing TabletsSince the percentage of active chlorine

in these products varies, the manufacturer’s instructions should be followed