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Healthcare Associated Infections
Environmental Cleaning: Barriers to Effective Cleaning and Disinfection

healthcare-associated infectiosn (HAI) program

Barriers to Effective Cleaning and Disinfection

Who should be responsible for cleaning all the various devices, surfaces, and equipment in a patient room?

All personnel are responsible for cleaning the environment

Nursing service
Environmental service
Physical therapy
Respiratory therapy
Sterile processing

Identify individual responsibilities and incorporate into facility policy
All personnel must be oriented to proper cleaning and disinfection methods

Holmer et al. AJIC. 2014 (poster)

How much time should be allotted for cleaning and disinfecting a patient room?

Proper cleaning requires adequate time

Daily cleaning can take 20-25 minutes
Terminal cleaning (after a patient has been discharged from a room) takes 40-45 minutes

Create a cleaning benchmark time for the facility based on time needed to complete a patient room cleaning and disinfection checklist

Seek input from frontline staff to develop a checklist
Consider room size, amount of equipment, furniture and clutter that need to be cleaned or cleaned or cleaned around
Disseminate information to all nursing units

www.ahe.org/ahe/learn/press_releases/2009/20090924_minimal_time_guidelines.shtml (read press release via Association for the Healthcare Environment)

What guidance can be provided if EVS staff feel pressured to clean faster and cannot do a thorough job?

Seek assistance from others to speed the process
Clean in an organized and expedient manner
Consider not taking a break in mid process
Bring the issue to the attention of the EVS Manager, the infection preventionist, and other pertinent staff for resolution and documentation

www.infectioncontroltoday.com/articles/2015/09/room-turnover-times-trashanddash-approach-jeopardizes-patient-outcomes.aspx (read article via Infection Control Today)

Summary of Key Points

A properly cleaned care environment is essential to prevent or contain HAIs
A surface must be physically cleaned before it can be disinfected
Consistent use of best practices and clarity of roles should be emphasized
Use of technologies such as microfiber, monitoring systems, and whole-room disinfection after cleaning are increasingly becoming the community standard of care
EVS staff should be valued and supported so they can maximize their unique contributions to preventing HAI