Module 7 Cleaning & Disinfection

Module 7

Cleaning & Disinfection

WASH FIT

OverviewCleaning, disinfection, decontamination

When to use cleaning, disinfection, or sterilization The cleaning, disinfection and sterilization processThe safe management of used linen

Cleaning of reusable PPE (Ebola)

What is decontamination?Decontamination is the process of making an object or area safe by removing contaminants such as micro-organisms or hazardous materials, including chemicals, radioactive substances, and infectious substances.

Decontamination process

:Cleaning, Disinfection and Sterilization

Why is decontamination important?To prevent the spread of micro-organisms and other contaminants that may threaten the health of human beings or animals or damage the

environment.

Principles of cleaning and disinfectionAlways move from cleanest area to dirtiest areaAlways be sure to clean patient care equipment between each patient use

One bucket = One jobBuckets for specific purposes must be labeled and/or coloredCleaning supplies for isolation should be kept and only used in isolation

Where possible, the isolation area should be cleaned last..

Cleaning General removal of debris (dirt, food, feces, blood, saliva and other body secretions)Reduces amount of organic matter that contributes to proliferation of bacteria and

viruses.By removing organic matter, increases effectiveness of chemical disinfection

Cleaning process (6 steps) Remove rubbish / Recycle

Remove liners and reline all waste containers.Remove soiled linen. Change the bag when ¾ full or if the area is closed for the day.Check sharp containers (change when ¾ full). Clean waste

containers.DustAlways use a wet cloth to dustHigh dust everything above shoulder level or out of reach. Use an extension pole with duster head.Never high dust around people.

Cleaning process (6 steps) Damp wipe

Wipe everything you are able to reach.Use germicide for all surfaces except glass.Use a dry cloth or paper towel to polish interior and low-level glass to a streak free appearance.Start with the door and work around the room in a circular pattern.Be sure to include: wall spotting, light switches, call buttons, telephones, wall moldings, dispensers, windowsills, and furniture.

Clean bathroomsStart at the door and end with the toilet. Use a bowl mop inside the bowl and wipe the outside with a disinfectant damp wiper. Do not use the cleaning wiper on any other surface after cleaning the toilet.

Cleaning process (6 steps) Damp mop

Place a ‘Wet Floor’ sign at the entrance before you begin.Start with the corner furthest from the door and work your way out.Mop the corners to prevent build up of dust and dirt.

Inspect the roomReport any repairs that are needed.Correct any deficiencies.Is the room ready for another patient?

DisinfectionRemoves most organisms present on surfaces that can cause infection or disease

Disinfection process (4 steps)CLEAN using soap or detergent and waterRemove visible soil

May need to disconnect or separate instrument parts Avoid organic material drying on equipment by rinsing or soaking in an enzymatic solution DISINFECT using an effective and approved disinfectant

WASH OFF any remaining disinfectant using clean waterLet air DRY or take outside to dry in the sunNEVER SPRAY disinfectant directly on spill body fluid, it can create splashes or make the spill biggerUse towel or cloth to remove

any spill

Materials for cleaning and disinfectionRisk appropriate personal protective equipment Detergent and water Cloths and towelsBucket

and mopDisinfectantNon-infectious waste bagInfectious waste bag

SterilizationThe killing or removal of all organisms

Sterilization (Steam Autoclave)Achieves rapid heating and penetration Short exposure times(<20minutes) but temperature must be maintained throughout No toxicity to workers Can damage delicate instruments

Items to be sterilized must be CleanedPackaged so that the steam can penetrate Autoclave must be loaded correctly

Liberia hospital, November 2015

Rapid Cycle or Flash Sterilization “Unwrapped” steam sterilization Should only be used when necessary Do not flash whole trays of instruments Items must be used immediately

Items to be sterilized must be cleanedMust be loaded correctly

Cleaning and disinfecting an Isolation AreaCleaners should always wear the recommended PPE when cleaning the isolation areaIsolation areas should have their own cleaning supplies that are separate from clean patient care areas

All waste from the isolation area is considered infectious waste

How to manage used linen (in the Ebola context )All linen should be

handled as if contaminated with blood or body fluids When handling used linen wear PPE (face shield or mask and goggles, gown and gloves)

Place linens, at point of use, into leak-proof bags or buckets labeled “soiled” for transport to laundryBefore washing the linen remove any waste and rinse excess blood Use a washing machine (preferable)Laundry equipment must be maintained functional

How to Clean Reusable PPECollect PPE items (boots, rubber glove, aprons, and goggles) from the doffing area

Remove any waste and wash off any bloodWash with soap and waterSoak in appropriate disinfectant Rinse with clean water

Hang to dry

Item

Frequency

High hand touch surfaces (any surface with frequent contact with hands)

Clean with detergent followed by disinfectant between cases

Minimal touch surfaces

(floors, walls, tables, chairs)

Regularly

cleaning (at least daily) with detergent only or when soiling occurs

Clean after a patient has been discharged

Medical equipment

(axillary thermometers)

After every patient

Refer to manufacturer's

instructions

Plates and utensils

After every patient

Reusable

PPE

(aprons, boots)

After

procedures

After exiting an isolation area

When visibly soiled

Linens

and mattresses

After

every patient

When visibly soiled

Recommended frequency of cleaning

Place

Frequency

Screening area

At least twice daily

After a patient with a suspected infectious disease

Isolation area

At least once daily

After every patient

Non-Patient

care

areas

At least once

daily

Latrines/toilets

At least twice daily

When visibly soiled

All

areas

Immediately following

possible contamination with blood or body fluids

Recommended f

requency of cleaning

Cleaning staff

REMEMBER!

Cleaners and support staff should be valued as much as clinical staff

Cleaning & disinfection indicators (1)3.8 Floors and horizontal work surfaces appear clean.3.9

Appropriate and well maintained materials for cleaning (i.e. detergent, mops, buckets, etc.) are available. 3.10 At least two pairs of household cleaning gloves and one

pair of overalls or apron and boots in a good state, for each cleaning and waste disposal staff member.3.11 At least one member of staff can demonstrate the correct procedures for cleaning and disinfection and apply them as required to maintain clean & safe rooms

Cleaning & disinfection indicators (2)3.13 A mechanism exists to track supply of IPC-related materials (such as gloves and protective equipment) to

identify stock-outs.3.14 Record of cleaning visible and signed by the cleaners each day.3.15

Laundry facilities are available to wash linen from patient beds between each patient.NB: the missing indicators are covered in other modules

Questions