STEPS TO CLEANING PATIENT ROOMS
Key points :
Cleaning is the physical removal of material from the surface, including dust, soil, blood, secretions, pathogens, and organisms.
Cleaning is essential to complete prior to disinfection, as the chemicals cannot work if the surface is covered in materials.
Disinfection is the inactivation of disease. The chemical must be allowed to air dry for the time specified by the manufacturer to be effective, otherwise known as dwell time.
There are three different forms of transmission precautions:
Contact Precautions-Intended to prevent the transmission of pathogens spread by direct or indirect contact with the patient or the patient’s environment. Required PPE is gloves and an isolation gown.
Droplet Precautions-Intended to prevent transmission of pathogens spread through close respiratory or mucous membrane contact with respiratory secretions. Required PPE is gloves and a mask.
Airborne Precautions-Intended to prevent transmission of infectious agents that remain infectious over long distances when suspended in the air. TB rooms need to sit for one hour with the door closed before being cleaned. Required PPE is gloves and a PAPR.
7 STEPS TO CLEANING OCCUPIED PATIENT ROOMS:
Remove general waste
High dust (do not high dust over patient)
Clean and disinfect all flat surfaces (do not move patient personal items, unless requested)
Clean and disinfect bathroom
Dust mop bedroom floor or vacuum
Stock supplies and perform final inspection
Wet mop bedroom then bathroom
Isolation Room Clean Procedure:
Enter room carefully Wear appropriate PPE for situation. The isolation sign states the PPE that is required for the specific type of transmission precaution in the room.
Perform hand hygiene and don gloves before entering.
ALWAYS knock on door before entering, wait for permission to enter.
Greet the patient and family or visitors, follow AIDET and identify yourself and explain why you are there and how long the cleaning process will take.
If doctor, nurse, minister or other clinical person is in the room, excuse yourself and go back later.
Leave the cleaning cart in the hallway, keeping the cart within your sight at all times. Never block doorway of patient room with cart.
Gather your cleaning clothes, mop, mop stick, Johnny Mop, supplies, and chemicals before entering the room. If there is a reason for leaving the room before completion, PPE must be fully removed. Upon reentering the room, clean PPE must be worn
Step 1: Remove general waste:
Close, twist and tie a knot in the top of the trash can liner while it is still in the waste basket. Remove liner using caution and look for protruding objects in the waste. Never reach into or push on the liner/bag to compress the trash. If you see a needle and/or sharps, follow facility procedure for removal.
Leave trash inside the room, by the door until the room is fully cleaned. Once the room is clean, carry the liner/bag away from your body.
Deposit the liner/bag of trash into a waste collection container. NEVER use your hands to push bags of trash down into a waste collection container.
Disinfect the waste basket using a dampened cloth, wipe interior and exterior of the waste basket – allow to air dry.
Remove infectious waste, if applicable.
Remove gloves, perform hand hygiene, and don new gloves.
Step 2: High dust:
Using a long handled duster, high dust the tops of items that are at or above shoulder height. NEVER high dust over the patient
Step 3: Clean & disinfect all flat surfaces:
Dampen the cloth with an EPA registered hospital grade disinfectant. Wipe surfaces and leave to air dry. Begin at entrance door and work around the room paying special attention to door handles, thermostats, light switches, ledges and windowsills.
Clean and disinfect furnishings such as lights, chairs, chair frames, counters, fronts of cabinets, writing surfaces, shelves, telephones and tables.
Spot clean visible soil from doors, walls, windows and blinds.
Spot clean/vacuum couches; clean under cushions, behind and underneath couch.
Do NOT remove personal patient items, unless requested.
Step 4: Clean & Disinfect restroom:
• Wet wipe:
Clean and disinfect surfaces frequently touched such as door handles, light switches and walls. Pay attention to walls near dispensers and waste containers.
• Clean the mirror:
Spray glass cleaner on mirror and wipe the surface until it is dry
• Clean the sink:
Apply a cream cleanser to the inside of sink. Clean and rinse.
Clean and disinfect the interior and exterior surface, all metal handles and faucets, allow to air dry.
Wipe all metal fittings dry to avoid spotting.
Wipe down the plumbing underneath the sink.
Use abrasive hand pad with bathroom cleaner to remove stains
• Clean shower:
Apply an EPA registered hospital grade disinfectant to the interior surfaces including curtain, walls, soap dish, faucets and shower head.
Use a cleaning cloth or hand pad to remove soap scum, especially from the walls, floor and door.
Rinse thoroughly using the shower spray if possible.
Damp wipe all chrome handles and fittings and dry with a clean, dry cloth to prevent spotting.
Remove any debris from drain
• Clean toilet:
Flush toilet to reduce water level.
Clean inside of toilet with Johnny mop and an EPA registered hospital grade disinfectant, paying special attention to the underside of the flush rim.
Clean and disinfect all exterior surfaces with a cleaning cloth that has been soaked in an EPA registered hospital grade quaternary disinfectant, going from the cleanest part to the dirtiest.
Remove gloves, perform hand hygiene and don new gloves.
Step 5: Dust Mop floor:
Dust mop floor.
Step 6: Stock supplies and perform the final inspection:
Ensure supplies are filled and liners are replaced.
Look over the room carefully to make sure you have performed all required steps and that the room meets department standards. Straighten all furniture and make sure everything is in the proper place.
Notify patient that you are finished and ask if there is anything else that you can do for them. Thank the patient for allowing you to clean their room.
Remove PPE and take all cleaning supplies, trash and linen out of the room and place in the appropriate locations.
Step 7: Wet Mop floor:
Post caution sign in doorway.
Use a clean flat mop thoroughly moistened with solution.
Outline a section of the floor around the baseboard paying particular attention to edges and corners.
Clean the outlined floor section using a figure-eight motion.
Be sure to mop under and behind furniture, including waste containers.
Mop bedroom first and bathroom last, or use a separate mop for the bathroom.