HOUSEKEEPING GUIDE A. The OSHA standard on bloodborne pathogens requires HCCC to ensure that the workplace is maintained in a clean and sanitary condition. This includes requirements for cleaning and decontaminating as outlined below: 1. After completion of procedures (i.e. pelvic exams, sutures, biopsies, mole removals), employees must decontaminate work surfaces, and equipment with an appropriate cleanser. 2. At the end of the work day, employees must decontaminate all work surfaces. 12 3. If surfaces or their protective coverings have been overtly contaminated or after any spill of blood or other potentially infectious materials, employees must decontaminate those surfaces immediately or as soon as feasible. 4. All bins, pails, cans and similar receptacles intended for re-use which have a reasonable likelihood for becoming contaminated with blood or other potentially infectious materials must be inspected and decontaminated on a regularly scheduled basis. They must be cleaned and decontaminated immediately or as soon as feasible upon visible contaminations. 5. All medical instruments will be disinfected with recommended solutions before autoclaving. 6. Biohazard labels shall be present on all sharps containers, infectious waste containers, refrigerators containing blood or other potentially infectious materials. 7. All work areas should be clean and uncluttered, with chemicals and equipment being properly labeled and stored. B. Housekeeping checklist (area specific schedules) All employees shall be made aware of the following housekeeping requirements of the OSHA standard on bloodborne pathogens: 1. Decontamination of Patient Care Surfaces/Areas: After treatment of each patient and at the completion of daily work activities, countertops, exam tables, and patient care unit surfaces should be cleaned using an appropriate cleaning agent. Surfaces that are visibly soiled or that can be reasonably assumed to be contaminated with patient material, blood, or bodily fluids should then be disinfected with a suitable chemical germicide*. The following procedure should be followed when cleaning these surfaces: a) Don gloves and secure the appropriate chemical germicides and disposable towel/cloth. b) Clean contaminated surfaces with a chemical germicide until they have become reasonably saturated. c) Per manufacturer’s recommendation. d) The towel can be disposed into the regular trash unless it is visually contaminated with blood or body fluids. 2. Protective Covering of Equipment and Environmental Surfaces: Equipment that is stored in areas that are prone to exposure by body fluids is occasionally given a protective covering (plastic wrap, aluminum foil, imperviously-backed absorbent paper) to protect the equipment from direct exposure. These coverings can be disposable or not depending on the specific use of the equipment. As the name would indicate, disposable covers should be removed and replaced at end of work shift, between patients, or when obviously contaminated with blood or other potentially infectious materials. Other more permanent coverings should be decontaminated per the procedure for patient care surfaces/areas. 13 3. Decontamination of Instruments and Equipment: Routinely check for contamination Decontaminate when contaminated with blood or other potentially infectious materials Decontaminate prior to servicing or shipping 4. Decontamination of Receptacles: Inspect, clean and disinfect on a regularly scheduled basis any reusable bins, pails, cans and similar receptacles that have a potential of becoming contaminated. Clean and decontaminate immediately or as soon as possible when visibly contaminated. 5. Disposable and So Called “Single Use” Items Disposable and single use items shall be disposed of immediately after use or contamination. While some research indicates that some single use items can indeed be reused, the organization has decided not to allow such practices except during emergency situations. Furthermore, these items can be disposed in regular disposal units unless they are visibly contaminated with blood, body fluids, or patient material. In the case of contamination, the items shall be placed in the nearest bio-hazardous trash receptacle. *Germicidal chemical This organization utilizes Birex (Dental), Precise, Citrex, sani-cloth, EZ Kill wipes, cavi-wipes, or a solution of one part household bleach and 10 parts water for use in its facilities. *A chemical germicide registered with the EPA as a "hospital disinfectant" and labeled for "tuberculocidal" (i.e., mycobactericidal) activity is recommended for disinfecting surfaces that have been soiled with patient material. These intermediate-level disinfectants include phenolics, iodophors, and chlorinecontaining compounds. Because mycobacteria are among the most resistant groups of microorganisms, germicides effective against mycobacteria should be effective against many other bacterial and viral pathogens. A fresh solution of sodium hypochlorite (household bleach) prepared daily is an inexpensive and effective intermediate-level germicide. (a 1:10 dilution of bleach and tap water) are effective on environmental surfaces that have been cleaned of visible contamination. Caution should be exercised, since chlorine solutions are corrosive to metals, especially aluminum. Low-level disinfectants -- EPA-registered "hospital disinfectants" that are not labeled for "tuberculocidal" activity (e.g., quaternary ammonium compounds) -- are appropriate for general housekeeping purposes such as cleaning floors, walls, and other housekeeping surfaces. Intermediate- and low-level disinfectants are not recommended for reprocessing critical or semicritical medical instruments. 14 6. CLEANING OF ALL HCCC SITES BY A REPUTABLE CLEANING COMPANY WILL INCLUDE THE FOLLOWING: OFFICES/COMMON AREA/EXAM ROOMS Daily duties unless otherwise noted. 1. Completely empty wastebaskets. 2. Dust all hard furniture (exposed) such as shelves, ledges, bookcases, file cabinets, televisions, etc. 3. Low dust all horizontal surfaces to hand height. 4. High dust (as needed). 5. Dust mop open tile areas. 6. Damp mop open tile areas using germicidal detergent. 7. Vacuum all open carpet areas. 8. Spot clean glass. 9. Spot clean fingerprints from door frames, sills, light switches, push and kick plates, etc. 10. Clean walls as needed. 11. Damp clean and sanitize all drinking fountains. WASHROOM SANITATION 1. Disinfect and sanitize all porcelain fixtures. 2. Clean and polish all chrome faucets and fixtures. 3. Damp clean all glass and mirrors. 4. Empty all containers and disposals inserting liners where required. 5. Dust mop tile floors. 6. Damp mop floor with germicidal detergent. 7. Spot clean metal partitions. 8 Refill all dispensers (supplies provided by the client). FLOOR MAINTENANCE 1. All tile floors will be scrubbed, buffed, and re-coated as needed to maintain high gloss appearance. 2. Floor stripping and re-coating will be done annually. FREQUENCY Service will be provided five (5) times a week.