Housekeeping and laundry Learning objectives 1. Iden'fy the role of infec'on preven'on and control in environmental services, housekeeping, and laundry sengs. December 1, 2013 2. Outline the role of chemicals, training, and work prac'ces in infec'on prevenon. 3. Explain the importance of the environment in infec'on preven'on and control. 2 Time involved • 35 minutes December 1, 2013 3 Key Points • Cleaning performed using water and detergent • Neutral detergents adequate for most cleaning purposes • Cleaning staff must be properly trained and December 1, 2013 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 December 1, 2013 the primary source of infec'on outbreaks • Contaminated water and bedding may result in opportunis'c infec'ons 5 The Environment Around an infected paent, the close environment may be contaminated by December 1, 2013 • 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 poten'al 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 December 1, 2013 staff • Pose a risk to the environment • Use detergent/disinfectants that clean well and are not inac'vated by organic maer 8 General Cleaning – 1 • Vigorous cleaning with water and neutral detergents reduces or eliminates reservoirs of poten'al pathogens December 1, 2013 • 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 December 1, 2013 • 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 December 1, 2013 • 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 December 1, 2013 • toilet, commode and fixture cleaning • cleaning fixtures such as ice machines • cleaning grilles and air-ducts 12 Cleaning items December 1, 2013 13 Cleaning Schedule -3 • Walls do not need frequent cleaning • Floors and tables collect dust and need cleaning with water and detergent December 1, 2013 • 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 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 December 1, 2013 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 Steriliza:on in Health Care CCDR Supplement Volume 24S8, December 1998 Laundry Services • Sorng procedures • Washing processes December 1, 2013 16 Objectives • To prevent the transmission of infec'ous disease between paents and staff • To enhance paent comfort December 1, 2013 • 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 December 1, 2013 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 December 1, 2013 chute or cart 19 Sorting Procedures: In the Laundry • Sort laundry bags in area for dirty linen • Educate laundry sorters December 1, 2013 • 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 December 1, 2013 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 December 1, 2013 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 December 1, 2013 avoided • Wrap linen to be sterilised appropriately 23 Role of Infection Prevention & Control • Help perform a risk assessment to iden'fy high-touch surfaces December 1, 2013 • 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 disinfec'on of environmental December 1, 2013 surfaces influence nosocomial infec'on rates? Am J Infect Control 2004; 32(2):84-9. • Spencer RC. Importance of environmental decontaminaon--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 paents to each other December 1, 2013 b) An infected paent 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 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 December 1, 2013 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 internaonal networking in order to improve the preven'on and control of healthcare associated infec'ons worldwide. It is an umbrella organisaon of socie'es and associaons of December2013 1, 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 sengs through development of a network of infec'on control organisaons for communicaon, consensus building, educaon and sharing exper'se. • For more informaon go to hTp://theific.org/ 28 .