Housekeeping and laundry Learning objectives

1. Idenfy the role of infecon prevenon and control in environmental services, housekeeping, and laundry sengs. December20131, 2. Outline the role of chemicals, training, and work pracces in infecon prevenon. 3. Explain the importance of the environment in infecon prevenon and control. 2 Time involved

• 35 minutes December20131,

3 Key Points

• Cleaning performed using water and detergent • Neutral detergents adequate for most cleaning purposes

• Cleaning staff must be properly trained and December20131, supervised • An ongoing cleaning schedule must be established • All linen, whether visibly soiled or superficially clean, must be processed to the same high

standard 4 Sources of Infection

• The infected paent is the primary source of infecon • The inanimate environment is rarely December20131, the primary source of infecon outbreaks • Contaminated water and bedding may result in opportunisc infecons

5 The Environment

Around an infected paent, the close environment may be contaminated by December20131, • Direct paent shedding • droplet-contact or airborne-contact) • Healthcare workers touching instruments, door knobs or other surfaces 6 • indirect contact Why Cleaning? • Clean the environment around discharged paents to prevent build-up of material that may harbour potenal pathogens • A clean, well-maintained healthcare facility inspires confidence in paents, staff and the public

Dirt breeds dirt ...

December 1, 2013 7 Disinfectants

• Surface disinfectants • Chemical in nature • Hazardous and must be handled only by trained December20131, staff • Pose a risk to the environment • Use detergent/disinfectants that clean well and are not inacvated by organic maer

8 General Cleaning – 1

• Vigorous cleaning with water and neutral detergents reduces or eliminates reservoirs of potenal pathogens December20131, • Cleaners must be properly trained and supervised • An ongoing cleaning schedule must be established

9 General Cleaning – 2

• Visible dust and dirt should be removed • Duct, fan, and air condioning systems should be

cleaned on a roune basis December20131, • Keep housekeeping surfaces visibly clean on a regular basis • floors, walls, and tabletops • Clean up spills promptly

10 Cleaning Schedule - 1

• Who is responsible for specific jobs • Work procedures, including special equipment and supplies December20131, • cleaning and storage of equipment • mop head changing • Use of protecve clothing • Accountability

11 Cleaning Schedule -2

Frequency of • floor cleaning • soluon and mop change

• furniture cleaning December20131, • toilet, commode and fixture cleaning • cleaning fixtures such as ice machines • cleaning grilles and air-ducts

12 Cleaning items

December20131,

13 Cleaning Schedule -3

• Walls do not need frequent cleaning • Floors and tables collect dust and need cleaning

with water and detergent December20131, • Small surfaces frequently touched may need more frequent cleaning

Good hand hygiene is important for nursing staff, cleaners, helpers, and paents!

14 Surface/object Procedure Horizontal surfaces 1. Thorough regular cleaning 2. Cleaning when soiled

3. Cleaning between paents/clients and aer discharge Walls, blinds, curtains Should be cleaned regularly with a detergent and as splashes/visible soil occur. Floors 1. Thorough regular cleaning 2. Cleaning when soiled December20131, 3. Cleaning between paents/clients and aer discharge. Damp mopping preferred Carpets/upholstery Should be vacuumed regularly and shampooed as necessary. Toilets and commodes 1. Thorough regular cleaning 2. Cleaning when soiled 3. Clean between paents/clients and aer discharge. Use a low level disinfectant. 15

From Infecon Control Guidelines - Hand Washing, Cleaning, Disinfecon and Sterilizaon in Health Care CCDR Supplement Volume 24S8, December 1998 Laundry Services

• Sorng procedures • Washing processes December20131,

16 Objectives

• To prevent the transmission of infecous disease between paents and staff • To enhance paent comfort December20131, • To process all linen to the same high standard • To remove gross soil (e.g., faeces) by dumping it into a sluice, clinical sink, or down a toilet

17 Sorting Procedures: In the Ward

• Avoid contaminang hands with soil • Place soiled linen in a water-impermeable December20131, laundry bag • Secure bag when ¾ full • Leave bags in secure place for pick-up and transport Beware of the risk to laundry workers from sharp objects left in soiled linen! 18 Linen Transport

• Bags should be ed securely and not over-filled when transported either by December20131, chute or cart

19 Sorting Procedures: In the Laundry

• Sort laundry bags in area for dirty linen • Educate laundry sorters December20131, • Provide sorters with gloves and aprons/gowns • Presort soiled linen into washer loads • Minimise handling of soiled linen

20 In the Washing Machine

• Prewash rinse cycle 15 minutes

• Wash in cold water wash, add December20131, bleach (2 mL/ litre of water) with detergent or • Wash at >71oC if detergents with bleach are not used • Add souring agent during rinse cycle 21 Handling after Washing

• Dry linen soon aer washing to prevent any regrowth of bacteria

• Hot air drying or drying on a clothesline in December20131, sunlight reduces numbers of bacteria • Ironing will destroy pathogens • especially using a steam iron

22 Storage and Packaging

• Store and transport clean linen so that contaminaon is December20131, avoided • Wrap linen to be sterilised appropriately

23 Role of Infection Prevention &

Control

• Help perform a risk assessment to idenfy high-touch surfaces December20131, • Provide advice on cleaning strategy and schedules • Evaluate products • Especially any disinfectants

24 References

• Malik RE, et al. Use of audit tools to evaluate the efficacy of cleaning systems in hospitals. Am J Infect Control 2003; 31:181-7.

• Deenkofer M, et al. Does disinfecon of environmental December20131, surfaces influence nosocomial infecon rates? Am J Infect Control 2004; 32(2):84-9. • Spencer RC. Importance of environmental decontaminaon--a crical view. J Hosp Infect 2007; 65 (Suppl 2):55-7.

25 Quiz

1. A key role of infecon prevenon and control in housekeeping/laundry involves working with staff on safe pracces. T/F? 2. Potenal housekeeping-related infecon risks are a) Proximity of paents to each other December20131, b) An infected paent c) Air quality d) All of the above 3. Cleaning influences the spread of infecons by: a) Decreasing soil that might carry pathogens b) Dry dusng walls c) The type of carpet in paent rooms d) All of the above 26

Quiz

4. Proper storage of clean linen includes a) Avoiding contaminaon b) Use of a single storage space c) Separaon from soiled linen

d) All of the above December20131, 5. Handling linen properly influences the spread of infecons by: a) Removing gross soil b) Use of bleach c) Washing at >71°C d) All of the above

27 International Federation of

Infection Control • IFIC’s mission is to facilitate internaonal networking in order to improve the prevenon and control of healthcare associated infecons worldwide. It is an umbrella organisaon of sociees and associaons of December20131, healthcare professionals in infecon control and related fields across the globe . • The goal of IFIC is to minimise the risk of infecon within healthcare sengs through development of a network of infecon control organisaons for communicaon, consensus building, educaon and sharing experse. • For more informaon go to hp://theific.org/ 28