Housekeeping and laundry Learning objectives
1. Iden fy the role of infec on preven on and control in environmental services, housekeeping, and laundry se ngs. December20131, 2. Outline the role of chemicals, training, and work prac ces in infec on preven on. 3. Explain the importance of the environment in infec on preven on 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 pa ent is the primary source of infec on • The inanimate environment is rarely December20131, the primary source of infec on outbreaks • Contaminated water and bedding may result in opportunis c infec ons
5 The Environment
Around an infected pa ent, the close environment may be contaminated by December20131, • Direct pa ent 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 pa ents to prevent build-up of material that may harbour poten al pathogens • A clean, well-maintained healthcare facility inspires confidence in pa ents, 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 inac vated by organic ma er
8 General Cleaning – 1
• Vigorous cleaning with water and neutral detergents reduces or eliminates reservoirs of poten al 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 condi oning systems should be
cleaned on a rou ne 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 protec ve clothing • Accountability
11 Cleaning Schedule -2
Frequency of • floor cleaning • solu on 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 pa ents!
14 Surface/object Procedure Horizontal surfaces 1. Thorough regular cleaning 2. Cleaning when soiled
3. Cleaning between pa ents/clients and a er 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 pa ents/clients and a er 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 pa ents/clients and a er discharge. Use a low level disinfectant. 15
From Infec on Control Guidelines - Hand Washing, Cleaning, Disinfec on and Steriliza on in Health Care CCDR Supplement Volume 24S8, December 1998 Laundry Services
• Sor ng procedures • Washing processes December20131,
16 Objectives
• To prevent the transmission of infec ous disease between pa ents and staff • To enhance pa ent 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 contamina ng 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 a er 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 contamina on is December20131, avoided • Wrap linen to be sterilised appropriately
23 Role of Infection Prevention &
Control
• Help perform a risk assessment to iden fy 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.
• De enkofer M, et al. Does disinfec on of environmental December20131, surfaces influence nosocomial infec on rates? Am J Infect Control 2004; 32(2):84-9. • Spencer RC. Importance of environmental decontamina on--a cri cal view. J Hosp Infect 2007; 65 (Suppl 2):55-7.
25 Quiz
1. A key role of infec on preven on and control in housekeeping/laundry involves working with staff on safe prac ces. T/F? 2. Poten al housekeeping-related infec on risks are a) Proximity of pa ents to each other December20131, b) An infected pa ent c) Air quality d) All of the above 3. Cleaning influences the spread of infec ons by: a) Decreasing soil that might carry pathogens b) Dry dus ng walls c) The type of carpet in pa ent rooms d) All of the above 26
Quiz
4. Proper storage of clean linen includes a) Avoiding contamina on b) Use of a single storage space c) Separa on from soiled linen
d) All of the above December20131, 5. Handling linen properly influences the spread of infec ons 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 interna onal networking in order to improve the preven on and control of healthcare associated infec ons worldwide. It is an umbrella organisa on of socie es and associa ons of December20131, healthcare professionals in infec on control and related fields across the globe . • The goal of IFIC is to minimise the risk of infec on within healthcare se ngs through development of a network of infec on control organisa ons for communica on, consensus building, educa on and sharing exper se. • For more informa on go to h p://theific.org/ 28