Environmental Cleaning Procedures and Disinfectants PDF

Chemical Disinfectants in Infection Control Chemical disinfectants are crucial for infection control. They kill harmful microorganisms on surfaces and equipment. This reduces pathogen transmission in healthcare and high-risk settings. by Heba Rashed ‫ﺏ ﺿﻮﺋﻴﺎ ‪CamScanner‬‬ ‫ﺓﺣﻮﺳﻤﻤﻼ‬ Are chemi...

Chemical Disinfectants in Infection Control Chemical disinfectants are crucial for infection control. They kill harmful microorganisms on surfaces and equipment. This reduces pathogen transmission in healthcare and high-risk settings. by Heba Rashed ‫ﺏ ﺿﻮﺋﻴﺎ ‪CamScanner‬‬ ‫ﺓﺣﻮﺳﻤﻤﻼ‬ Are chemical materials used for sterilization but are toxic to the human tissues and cells. Antiseptic: Are chemicals for sterilization but not toxic to the human body e.g."mouth gargles". Examples of disinfectant and antiseptics There are a number of chemicals that can act as disinfectants or antiseptics.These include: Phenol and its derivatives e.g.Dettol. Halogens e.g.Chlorine,Tincture iodine.  Alcohols e.g.ethyl alcohol. pK Ethyl Alcohol Alcohol Aldehydes e.g.glutaraldehyde(CIDEX ),Formalin. Mode of action: It kills all microorganisms,including spores ·Quaternary Ammonium Compounds (Cationic detergents). Types of Chemical Disinfectants: Alcohols 1 Effectiveness 2 Common Use 3 Examples Alcohols work against Used for small surfaces Ethanol and isopropanol bacteria, fungi, and some and as hand sanitizers are common alcohol- viruses. They're less effective due to quick-drying based disinfectants. on bacterial spores. properties. Chlorine and Chlorine Compounds Broad Spectrum Effective against bacteria, viruses, and spores. Applications Used for large areas, equipment, and bodily fluid spillages. Caution Can be corrosive and require careful handling.  Quaternary Ammonium Compounds (QACs) Uses Effectiveness Properties Non-critical surfaces like Works on most bacteria, Less irritating and non- floors, furniture, and fungi, and enveloped corrosive compared to walls. viruses. other disinfectants. Hydrogen Peroxide 1 Mechanism Powerful oxidizing agent effective against various microorganisms. 2 Low Concentration Used for surface disinfection in healthcare settings. 3 High Concentration Employed for sterilization of medical equipment.  Phenolics and Aldehydes Effective against bacteria, Phenolics mycobacteria, fungi Glutaraldehyde High-level disinfection, sterilization Formaldehyde Toxic, requires well- ventilated areas Surface and Equipment Disinfection Non-critical Items Semi-critical Items Result Furniture and floors routinely Medical instruments contacting Reduced likelihood of infections in disinfected to maintain low mucous membranes require healthcare settings. microbial load. thorough disinfection. Environmental Cleaning 1 Routine Cleaning Regular disinfection of high-touch areas in healthcare facilities. 2 Terminal Cleaning Thorough disinfection of patient rooms and operating rooms. 3 Impact Breaks transmission pathways of healthcare-associated infections (HAIs). Spill and Contamination Management Bleach Solution Used for cleaning blood and potentially infectious material spills. Inactivation Disinfectants ensure pathogens are neutralized in contaminated areas. Safety Proper disinfection makes areas safe for further use.  Air and Surface Decontamination Hydrogen Peroxide Vapor Aerosolized Disinfectants Outbreak Control Used for simultaneous Applied in specialized Useful for thorough air and surface situations like operating decontamination during decontamination. rooms. disease outbreaks.  Considerations for Effective Use 1 Contact Time Disinfectants need sufficient time on surfaces for maximum efficacy. 2 Surface Compatibility Choose disinfectants that won't damage the materials being cleaned. 3 Proper Dilution Follow correct ratios to maintain efficacy and minimize harmful effects. 4 Safety Measures Use appropriate PPE and ventilation when handling disinfectants. Challenges: Resistance Development 1 Overuse Excessive use of disinfectants can lead to microbial resistance. 2 Misuse Improper application may not kill all microorganisms, allowing resistant strains to survive. 3 Consequence Some microorganisms develop resistance to commonly used disinfectants. What is Environmental Cleaning? Routine Cleaning Environmental cleaning involves the regular and thorough cleaning of all surfaces and high-touch areas to remove dirt, debris, and potential pathogens. Disinfection In addition to cleaning, disinfection using EPA-approved products is essential to kill harmful microorganisms and prevent the spread of infections. Standardized Protocols Environmental cleaning follows established protocols and procedures to ensure consistency, effectiveness, and compliance with infection control guidelines.  How do we break this chain of infection? 和 Contaminated Contaminated hands environmental surfaces or gloves of healthcare Colonized,or and noncritical personnel,caretakers, Susceptible infected patients equipment visitors patients Environmental cleaning breaks pathway Glove removal and hand hygiene breaks pathway CamScanner-ggadl Importance of Environmental Cleaning Effective environmental cleaning is crucial for reducing the risk of healthcare-associated infections (HAIs). Clean and disinfected surfaces can help prevent the spread of pathogens, protecting both patients and healthcare workers. Regular cleaning removes dirt, debris, and organic matter that can harbor harmful microorganisms. Disinfection further eliminates these microbes, contributing to a safer, healthier environment. Key Principles of Environmental Cleaning Standardization Prioritization Accountability Collaboration Establish clear, Focus cleaning efforts on Implement robust Foster close coordination consistent protocols and high-touch, high-risk monitoring and auditing between environmental procedures for areas that are most systems to ensure services, infection environmental cleaning prone to pathogen cleaning protocols are prevention, and clinical across all facilities and transmission. being followed correctly. teams to optimize departments. cleaning practices. Cleaning vs. Disinfection Cleaning Removes visible dirt, debris, and organic matter from surfaces using soap or detergent and water. Disinfection Kills or inactivates microorganisms using EPA-registered chemicals or other methods like UV light. Importance of Both Cleaning is a crucial first step that prepares surfaces for effective disinfection. Together, they provide comprehensive environmental hygiene. High-Touch Surfaces Bed Railings Bedside Tables Doorknobs and Handles Bed railings are a prime example of Bedside tables and other furniture in Doorknobs, handles, and other a high-touch surface that requires patient rooms frequently harbor common touchpoints are high-risk regular cleaning and disinfection to germs and must be thoroughly areas that must be cleaned and prevent the spread of infections. cleaned to maintain a sanitary disinfected regularly to stop the environment. transmission of pathogens. Cleaning Product Selection Efficacy Safety Select cleaning products that Consider the safety of cleaning are proven effective against the staff and building occupants target pathogens, based on EPA when choosing products, or other regulatory approvals. prioritizing low-toxicity and environmentally-friendly options. Compatibility Ease of Use Ensure the cleaning products Select products that are easy to are compatible with the mix, apply, and rinse to promote surfaces and equipment in the consistent and efficient cleaning facility to avoid damage. practices. Correct Cleaning Techniques 1 Proper Cleaning Sequence Always clean from top to bottom, and from clean to dirty areas, to avoid spreading contaminants. 2 Microfiber Effectiveness Use microfiber cloths and mops, which attract and trap more dirt and bacteria than traditional materials. 3 Overlapping Strokes Ensure complete coverage by using overlapping, back- and-forth strokes when cleaning surfaces. Dwell Time for Disinfection Effective disinfection requires allowing the disinfectant product to remain wet on the surface for a specific amount of time, known as the dwell or contact time. This dwell time is crucial for the disinfectant to kill the targeted microorganisms. Disinfectant Type Recommended Dwell Time Alcohol-based 30 seconds to 2 minutes Chlorine-based 1 to 10 minutes Quaternary Ammonium 2 to 10 minutes Phenolic 5 to 10 minutes Following the recommended dwell time ensures thorough disinfection and maximizes the efficacy of the cleaning products. Adherence to these guidelines is essential for effective infection prevention and control. Best practices for cleaning procedures Priority! 1. Proceed from cleaner to dirtier: Immediately attend to any Clean high-touch surfaces outside the patient body fluid spills prior to starting routine cleaning zone before high-touch surfaces inside the patient zone Clean patient beds before patient toilets Clean low-touch surfaces before high-touch surfaces (terminal clean) Clean general patient areas before isolation areas Example of a cleaning strategy from cleaner to dirtier areas CamScanner- go gal Best practices for cleaning procedures 2.Proceed from high to low (top to bottom): 一 Clean bed rails before bed legs - Clean environmental surfaces before floors 3. Proceed in a methodical,systematic manner; 一 Left to right 一 Clockwise or counterclockwise  Best practices for surface cleaning Use fresh cleaning cloths to start Change cleaning cloths when no longer Start by folding the cloth 2 Then fold the cloth in half again in half saturated Change cleaning cloths between each patient zone (in high-risk areas) Make sure you have enough You now have a Switch to a different side after Submerge the folded cloth cloth with eight each one has been soiled.When all 3 different cleaning sides have been used,dispose of cleaning cloths to finish the into cleaning soution only surfaces cloth appropriately as waste or once,do not“double dip” laundry and use a new cloth to as this will contaminate continue the task the solution cleaning session (From Soapbox,2018“TEACH CLEAN”) Never double-dip! CamScanner-ggadl Best practices for floor cleaning 1.Display wet-floor sign 2. Immerse mop in bucket with cleaning solution and wring out 3. Mop in a figure eight,overlapping stroke,turn the mop head regularly (e.g.,every 5-6 strokes) 4.After cleaning a small area(e.g.,3m x3m), immerse mop in bucket with rinse water and wring out 5.Repeat from step 2 Preparing cleaning and disinfectant solutions Prepare solutions in dedicated environmental cleaning services area Provide training and simple instructions for preparing solutions - Pictorial job aids (e.g.,posters)helpful if possible * Provide any required PPE needed for preparing solutions according to the product safety data sheet |If feasible,use an automatic dispensing system to prepare solutions (calibrated regularly) - If preparing manually,use standardized containers for measuring If feasible,use test strips to confirm correct concentrations | CamScanner- Preparing chlorine solutions How to Make 0.1%(1,000ppm)Chlorine Solution Always wear PPE when Use 0.1%(1,000ppm)chlorine solution to disinfect frequently touched surfaces and items. Make new 0.1%chlorine solution every day. Throw away any leftover solution from the day before. Proceed with only one of the following:2a or 2b or 2c preparing and using chlorine- From Strong(0.5%)Solution 1 part OR From HTH (709%) OR From Chlorine Powder(35%) 4 parts based solutions ofHTH Store in a covered,plastic ag of chl 20 liter 24 of water container away from direct Make sure to wear required PPE Add TWO tablespoons (30q)of high-test Pour4 parts water and 1 part strong hypochlorte (Hit) ( 70%)to 20 liters of Add FOURtablespoons (60g)of chlorine powder (35%)to 20 liters (0.5% )solution into a bucket. water in a bucket. sunlight of water in a bucket 10 sec Test concentration every day (test strips)or make new 30 1 utes 0. 1 % Chlorine Solution Disinfecting solution every day Stir well for 10 seconds,or until chlorine Wait 30 minutes before use. Label bucket "0.1%Chlorine Cover bucket with lid.Do not store in NEVER mix chlorine solutions powder/granules have dissolved. Solution-Disinfecting." direct sunlight. with any other cleaning Measuring Bucket Strong (0.5%)chlorine Wate cup or with lid solution OR 70%HTHOR bottle and spigot ②Needed a5%chlorine powder Do NOTr Do NOT put chlorine products solution with other Supplies solution in mouth oreyes. deaning produrte https://www.cdc.gov/coronavirus/2019-ncov/downloads/make-chlorine-solution.pdf CamScanner g Environmental cleaning supplies and equipment Surface cleaning:cloths can be cotton or microfiber - Different colored cloths should be stocked to allow color- coding,for example: One color for cleaning and one color for disinfection steps One color for toilets,one color for general patient areas,one color for isolation areas Floor cleaning:mop heads or floors cloths can be used (cotton or microfiber) -Two or three-buckets needed,depending on need for floor disinfection -Always use wet floor sign! CamScanner g l Personal Protective Equipment (PPE)for Cleaning Hand hygiene should always be performed,before and after PPE removal Required persenal protective uype of clenring tnsk equlpmentfor deaning staf Routine cleaning (standard None(unless spills or contamination risk—see precautions) below) Terminal cleaning (standard Reusable rubber gloves precautions) Blood and body fluid spills and high Gown and/or plastic apron contamination risk areas (e.g.,cleaning bed of Reusable rubber gloves an incontinent patient,labor and delivery Face shield or face mask and goggles (if splash wards) risk or large spill) Droplet precautions (routine and Gown and/or plastic apron terminal Reusable rubber gloves cleaning) Face shield or face mask and goggles Contact precautions (routine and Gown and/or plastic apron terminal Reusable rubber gloves cleaning) Airborne precautions (routine and Respirator (N95 or FPP2),fit tested terminal Reusable rubber gloves cleaning) Preparation of disinfectant products According to specifications in SDS and (manufacturer instructions) solutions If SDS not available,then: Chemical-resistant gloves (e.g.,nitrile) Cleaning staff PPE for Gown and/or apron COVID-19 Face shield or face mask and goggles CamScanner-ggadl ‫ﺏ ﺿﻮﺋﻴﺎ ‪CamScanner‬‬ ‫ﺓﺣﻮﺳﻤﻤﻼ‬