A thorough cleaning regiment must be employed by hospital cleaning and janitorial staff in order to ensure proper microbe and disease remediation for the safety of employees, and most importantly of patients. A hospital or healthcare environment is unique in the respect that it houses people with compromised health, while also housing potentially deadly diseases and microbes in proximity, and often in the same room. It’s for this reason that hospital cleaning procedures and methods must be full-proof and carried out by qualified staff who can ensure satisfactory microbial and disease remediation.
This blog will cover steps on the treatment of patient facilities that require special attention due to certain afflictions or organisms, in addition to the basic tenants of hospital and medical facility cleaning procedures and methods. These will ensure proper microbial remediation and upkeep of environments of care in order to ensure continued patient safety and health, while decreasing the chance of contamination. Throughout this blog, the environment of care we will refer to pertains strictly to hospital cleaning procedures and methods, and the impact that it has.
The majority of these methods could also be considered as part of terminal cleaning plan, terminal cleaning should not be handled by staff or a typical janitorial team. A specialist should be contacted when dealing with terminal cleaning of specific hospital rooms and facilities.
What Is an Environment of Care?
An environment of care is made up of three parts:
- The building or facility, and how it’s arranged to protect staff and patients
- Equipment used to support patient care and ensure safety
- Individuals; either employees, patients or visitors that have a responsibility to minimize risk
An environment of care is the sum of all the parts that help staff establish an environment fit for the safe care of patients. In this context, an environment of care requires proper cleaning and disinfection on the part of not just cleaning staff, but visitors and other patients to safeguard the integrity of the hospital or healthcare facility. This not only includes prudent and well-trained environment service and cleaning staff, but also the participation of other staff and visitors.
Visitors should always wash their hands after touching door handles and interacting with the environment that their loved ones or other patients are contained in; the proper washing or sanitizing of a visitor’s hands can greatly reduce the spread of contagious organisms and diseases throughout a hospital or healthcare facility. These steps should be followed by all hospital or medical facility staff, who must take proper precautions when entering contaminated or specialty areas with strict environmental controls or standards.
Hospital Cleaning Procedures & Methods
It’s tantamount that proper hospital cleaning procedures and methods be used for all patients, but this is especially true for patients with multidrug-resistant organisms (MDROs). MDROs are a catchall for nasty organisms like Methicillin Resistant Staph aureus (MRSA), Vancomycin Resistant Enterococci (VRE) and Klebsiella pneumoniae carbapenemase (KPC), which are resistant to several different types of antibiotics and medications that can wreak havoc on patients and staff1. Environmental services and cleaning staff need to be trained and frequently drilled on proper cleaning and disinfection techniques to prevent the spread of MDROs.
Cleaning staff should wear barrier garments, such as face masks, gloves and gowns to prevent contact and subsequent contamination with MDROs. Every applicable surface in the room should be disinfected with an EPA hospital-grade cleaner. In addition to counters, sinks, toilets and other apparent surfaces that need to be thoroughly disinfected, some more heavily trafficked items that need to be thoroughly disinfected are:
- The entirety of the patient’s bed, including the headboard, side rails and mattress
- The nurse-call device button and cord
- The television remote
Privacy curtains should be removed and inserted into a plastic bag and sealed, which should then be double-bagged in a laundry bag. This bag should be passed out of the room to another cleaning technician or environmental services staff member to be disposed of or laundered at the appropriate facility. The last individual to handle the bag containing the privacy curtain should remove their gloves and wash their hands with antimicrobial soap, or douse in alcohol rub before reapplying a new pair of gloves to continue cleaning or moving to another task.
Windows, walls and ceilings should not be disinfected unless they’re visibly soiled, or if the patient or staff has reported that there was significant contact with any of these surfaces. Any equipment used in the patient’s room or in the treatment of the patient should be disinfected and sent to a sterile cleaning department for a more thorough cleaning before it’s reimplemented into regular circulation.
If applicable, the use of electrostatic spray disinfection should be used in place of the previously recounted steps; in addition to coating services evenly with minimal effort, the walls and ceiling of a room that contained a patient with a MDRO can be more easily disinfected.
After a thorough disinfection, all barrier garments should be disposed of, with gloves being last and care being taken to not touch the outside of the gloves. All the garments should be placed in a plastic bag and sealed before being disposed of or sent to a facility with the appropriate cleaning facilities before being reused.
Although barrier garments may not be required depending on the reason for the patient’s stay, standard patient facilities should be disinfected in a similar fashion. All hallways and counters outside of patient facilities should also be rigorously disinfected to the highest standards in order to prevent the spread of contagious organisms and diseases. By applying rigorous disinfection standards for hospital cleaning procedures and methods, the spread of MDROs and other organisms can be prevented, thus strengthening the environment of care for healthcare facilities and hospitals.
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