Deep cleaning and sterilising is an essential part of providing medical and healthcare facility cleaning services. It ensures that facilities are safe for both patients and employees by controlling the spread of infection that may further compromise the health of patients.
However, when it comes to cleaning medical equipment and keeping sterile areas to the required standards, there are some more advanced considerations that need specialist training and experience to deal with them properly.
This blog post from CiE will cover our specialist cleaning services specifically designed for medical facilities, hospitals and care / nursing home facilities as well as best practice guidelines for keeping your team safe and protecting service users while they do their jobs.
The importance of medical and healthcare facility cleaning
The medical and healthcare industry is one of the most important industries in the world. Lives depend on it every day. But with healthcare facilities being such sensitive areas for cleanliness, it’s also critical for healthcare managers to appoint the right cleaning company with the experience and the skills to meet the high standards required by health, hygiene and safety regulations.
Doctors, nurses and other medical staff receive training in the essential techniques involved in preventing the spread of disease and infection as part of their qualification. By understanding the key role cleaning staff play in keeping patients, staff and visitors safe as well as how cleaning staff can protect themselves from pathogens, healthcare providers and cleaning contractors can work together to provide the right training to produce the best possible cleaning services.
If cleaning services are contracted out, the training requirements can be drawn up as part of a service level agreement.
The risk factors in medical and healthcare cleaning
A medical facility should be a place of healing, not infection. But the truth is that there are many risk factors that can lead to the spread of infections not least of which is poor cleaning practices. In addition, a lack of awareness about how infection can be spread only increases the risk. It is important to consider:
- Measures taken to ensure that infection and disease is not brought onto the premises from outside
- Disease is not spread from patient to patient as a result of poor cleaning practises.
- Disease is not spread from staff to patient through poor work practice management
- Cleaning and medical staff are kept safe from the chances of being infected
- How the highest standards of personal and professional protection can be maintained
A regime commonly referred to as universal precautions is the procedure most often used to mitigate risk.
When it comes to your cleaning regime universal precautions is a term that means all blood and other body fluids be treated as if they are infectious. Universal Precautions are a set of guidelines used in health care to prevent the transmission of infectious diseases between patients and by employees of health care providers covering:
- Maintaining personal hygiene at all times with regular hand washing. Washing hands with soap and warm water or special sterilising wash before entering the premises, before and after treating patients, handling medical equipment or entering rooms where patients have been treated.
- Using personal protective equipment (PPE): Covering footwear when entering a facility. Wearing gloves and gowns when handling body fluids or contaminated items; wearing masks when near patients who are coughing or sneezing; wearing eye protection when cleaning up blood or body fluid.
- Managing linen by making sure clean and soiled linen are kept completely separate. Putting in an effective linen management system is a vital step in ensuring that there is no cross contamination between clean and soiled linen.
- Proper equipment cleaning and disinfection. When considering medical equipment, it’s vital to make sure that germs are not spread from one patient to another. Using a disinfectant like bleach or alcohol wipes to kill bacteria and viruses and making sure that you have a process in place should also clean instruments after each use so that no one else is exposed to any pathogens.
The main goal is to make sure that your cleaning regime ensures that infected blood or body fluid from one person cannot enter another person’s body whether patient to patient or patient to employee. Universal precautions apply to:
- Saliva, vomit, urine
- Skin, tissue
The main concerns
Transmission-Based Precautions: are used in addition to Standard Precautions for patients with known or suspected infections.
- Blood-borne infections like Hepatitis C and HIV spread through cross-contamination
- Air-borne droplet infections from pathogens spread by respiratory secretions from coughing and sneezing: A typical example being SARS/Cov
- Infections spread as a result of touch focusing on skin, tissue, and cell cultures
Employee Universal Precaution Procedures
The following is a list of the steps that should be taken to ensure the cleanliness of a medical facility. This list is not meant to be exhaustive, but rather to serve as a guide for facility managers and employees who are responsible for ensuring that their hospital, clinic, or other medical facility remains sanitary and safe.
- Hand washing: First, all employees must wash their hands with soap and warm water before entering the premises a patient’s room or touching any equipment or supplies. They also need to wash their hands after going to the bathroom and after visiting other areas of the facility where they may have come into contact with bodily fluids or other potentially infectious materials. This includes bathrooms (especially those used by patients), cafeterias and waiting rooms.
- PPE: Employees should wear chemical resistant gloves when handling any patient-related materials (such as bedsheets or bandages) or any equipment that might be contaminated with blood or other body fluids (for example: surgical equipment). Employees must also wear gowns over their clothing to protect themselves from contamination. Mask wearing is important in an environment dealing with respiratory disease.
- Reporting: If an employee notices blood on his/her hands during work hours (or if he/she has been exposed to blood outside of work), then they should immediately report this and give a full account of their activities prior to the discovery.
Glove use – best practices for cleaning staff
One of the most basic aspects of cleaning, the use of gloves is often misinterpreted so here we provide guidelines for glove usage for cleaning:
- Perform hand hygiene immediately before putting on gloves and directly after taking them off
- Always wear gloves when the patients nearby are on transmission-based precautions
- Always wear gloves when there is risk of hand contact with blood or body fluids
- Always wear gloves during prolonged contact with disinfectants (e.g. during terminal cleaning)
- Always change change gloves between each cleaning session
- Outside of the above circumstances constant glove wearing is not essential when supported by regular hand washing
Personal attire / grooming best practices for cleaning staff
- Keep sleeves at or above the elbow to avoid interference with glove use or hand hygiene.
- Wearing rubber-soled closed toe shoes or boots (i.e., not sandals), to protect from slips or falls and exposure to chemicals, dirt and bacteria.
- Removing wristwatches and jewellery before beginning cleaning tasks
- Keep fingernails short and free from any sort of varnish and hair tied back or contained
Healthcare cleaning tips and techniques.
Cleaning in healthcare facilities is extraordinarily complicated because they contain all kinds of sensitive medical equipment, operating theatres and other zones that must be kept sterile at all times. They are especially vulnerable to infection and the cleaning regime is under constant pressure to keep Healthcare-Associated Infections (HAI) at bay whilst at the same time, dealing with sick people every day.
Hospital cleaning is a specialised service that requires many of the same skills and techniques as other types of commercial cleaning but with some unique additional requirements. It requires high-level specialist training to learn how to clean properly. Not just anyone can walk into a medical facility and start cleaning with no additional training.
There has been a lot of focus on hospital acquired infection (HAI) recently and of course, much of that discussion has been on how to improve hospital cleaning processes in order to minimise it. So let’s now take a more in depth look at how this is achieved.
Terminal cleaning for patient rooms and wards
Terminal cleaning is a thorough, deep-cleaning of an intensive care unit (ICU), patient room or bed space between occupants. The aim is to clear the space of infectious agents so that the next occupant has a sanitary space in which to heal and recover. Terminal cleaning protocols vary because they are dependent on the type of care provided, the area to be cleaned and the level of cleaning technology available.
- Remove and safely dispose of soiled/used personal care items
- Remove facility-provided linens like towels and gowns for either cleaning and reprocessing or disposal
- Visually inspect partitioning and window curtains. If soiled remove them for laundering.
- Clean and reprocess all reusable patient care equipment. Non-critical and reusable patient care equipment equipment includes stethoscopes, IV poles, blood pressure cuffs and bedpans.
- Clean and disinfect all low and high-touch surfaces like patient mattress, bed frame, tops of shelves, and vents
- Clean (scrub) and disinfect handwashing sinks.
- Clean and disinfect the floor
Use of technology in terminal cleaning
Modern technology now plays an an important part in terminal cleaning and particularly if the area to be cleaned in self-contained and can be sealed off. There are two emerging technologies referred to as one time sanitisers that support terminal.
Hydrogen peroxide misters (sometimes referred to as foggers). These devices emit a hydrogen peroxide vapour, which falls on all the exposed surfaces of a room, killing bacteria and other pathogens.
UV light emitters emit UV light at a pathogen-destroying frequency that kills all pathogens in direct line-of-sight exposure.
Both technologies require rooms to be sealed off while the sanitising cycle is completed and both come as portable systems that can be easily moved around the facility. Although these technologies require significant financial investment, improvements in cleaning that reduce Hospital Acquired Infection bring down costs in the long term.
Cleaning for surgeries and sterile zones
When performing surgery, it’s important not only for the patient but also for the surgeon and other doctors involved in the procedure that everything is sterile and free from harmful bacteria or other microorganisms which could cause an infection or disease.
The aim is that after surgery has been performed successfully without any complications there is no possibility of infections occurring during recovery time while a patient remains in hospital. This is an important responsibility that often falls to the specialist cleaning team.
An important tool for effective and methodical cleaning of sterile areas zoning, divides the area to be cleaned into sections.
Proximity zoning divides an area between close proximity to the patient (within 10 feet) and areas outside of the proximity zone. It will also define high and low levels with the aim of cleaning from highest first.
Zoning will also divide highly contaminated areas and less contaminated with the aim of cleaning less contaminated areas first and then moving on to contaminated areas like patient toilet and washing facilities.
Sterilising surgical instruments
The Centre for Disease Control (CDC) in its Guidelines for Disinfection and Sterilisation of Healthcare Facilities concludes that pressurised steam is the most dependable and effective method of sterilising surgical instruments. It kills spores and microbes fast by breaking them down irreversibly and is non-toxic.
The device most commonly used for this purpose is known as an autoclave. Coming in portable desktop versions as well as larger permanent installations, an autoclave expels all the air in and around the items to be sterilised. It then injects hot steam at temperatures of 121°C or higher into the chamber.
Vacuuming and Mopping
In most circumstances, dry sweeping and dry mopping is not appropriate in a sterile environment because it dislodges particulates and sends them airborne. Instead a combination of hard surface vacuuming and wet mopping is used.
Preferred materials for mop heads for environmental cleaning are either microfibre or cotton. Use a 2 bucket system or a 3 bucket system when intense cleaning is required. The 2 bucket system has one bucket containing the cleaning solution and one for clean rinsing. The three bucket system provides a secondary clean rinsing container.
Remember that disinfectants are used after cleaning and not for the actual cleaning process. They are not substitutes unless they are a combined detergent-disinfectant product. Mop in a figure of eight pattern taking approximately three square metres of floor space at a time.
Many healthcare facilities have moved towards vacuuming of hard surfaces and floors and away from dust mopping. Vacuuming reduces the amount of dust and other bacteria such as polyps and spores that can become airborne.
Use of high power vacuuming machines with HEPA filtering is essential to keep the environment clear of these airborne toxins and infectious spores.
Low-decibel vacuums that provide minimal noise disturbance to patients are a good choice and the use of cordless backpack versions has improved levels of convenience while at the same time reduced the danger of trips and falls.
CiE medical and healthcare facility cleaning services
Having the right staff is an essential part of any business and that includes choosing a cleaning contractor. We offer expert services for all types of medical facilities. We supply the highly trained specialist cleaners that have been given the proper tools and training to work safely and effectively in a healthcare environment.
You’re looking to provide your patients with a clean, sanitary environment while also keeping costs down and CiE is here to help with that.
We know the importance of keeping everything in your hospital or healthcare facility clean and well-maintained. We offer a wide range of services for hospitals and health facilities including:
- Healthcare facility cleaning—whether it’s daily cleaning of public areas or intense surgical cleaning, we will help make your healthcare facility a safe space for staff and patients
- Medical Cleaning Services—From basic disinfection through to intensive deep cleans for sterile zones and surgeries, our teams are equipped with the training and technology to fight Healthcare Acquired Infection
- Preparation of maximum effect cleaning strategies
- Monitoring and recording cleanliness and hygiene standards
- Linen and uniform decontamination, cleaning and processing
- Disinfection and sterilisation of operating theatres
If you are interested in learning more about our medical and healthcare facility cleaning services, visit our service page for more information. Don’t hesitate to contact us today using our Online Contact Form or giving us a call.