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healthcare-associated infectiosn (HAI) program

Barriers to Effective Cleaning and Disinfection  

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​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

Environmental Cleaning Resources

CDC/HICPAC Guidelines for Environmental Infection Control in Health-Care Facilities, 2003

CDC/HICPAC Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008

CDC Options for Evaluating Environmental Cleaning Toolkit

CDC Environmental Checklist for Monitoring Terminal Cleaning

CDC Environmental Checklist (scroll to bottom of page and download word doc)

CDC Environmental Cleaning Eval Worksheet (scroll to bottom of page and download excel doc)

CDC/HICPAC Guidelines for Hand Hygiene in Healthcare Settings Published 2002

WHO Guidelines on Hand Hygiene in Healthcare (2009)  

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