Best Practices for Environmental Cleaning for Prevention and Control of Infections in All Health Care Settings, 3rd Edition April 2018 Public Health Ontario Public Health Ontario is a Crown corporation dedicated to protecting and promoting the health of all Ontarians and reducing inequities in health. Public Health Ontario links public health practitioners, frontline health workers and researchers to the best scientific intelligence and knowledge from around the world. Public Health Ontario provides expert scientific and technical support to government, local public health units and health care providers relating to the following: . communicable and infectious diseases . infection prevention and control . environmental and occupational health . emergency preparedness . health promotion, chronic disease and injury prevention . public health laboratory services Public Health Ontario's work also includes surveillance, epidemiology, research, professional development and knowledge services. For more information, visit www.publichealthontario.ca. How to cite this document: Ontario Agency for Health Protection and Promotion (Public Health Ontario), Provincial Infectious Diseases Advisory Committee. Best practices for environmental cleaning for prevention and control of infections in all health care settings. 3rd ed. Toronto, ON: Queen’s Printer for Ontario; 2018. Public Health Ontario acknowledges the financial support of the Ontario Government. © Queen’s Printer for Ontario, 2018 Publication history: 1st edition: December 2009 2nd edition: May 2012 3rd edition: April 2018 PIDAC: Best Practices for Environmental Cleaning for Prevention and Control of Infections | April 2018 i About PIDAC-IPC The Provincial Infectious Diseases Advisory Committee on Infection Prevention and Control (PIDAC-IPC) is a multidisciplinary scientific advisory body that provides evidence-based advice to Public Health Ontario (PHO) regarding multiple aspects of infectious disease identification, prevention and control. Provincial Infectious Diseases Advisory Committee (PIDAC) Tel: 647-260-7100 Email: [email protected] Disclaimer This document was developed by the Provincial Infectious Diseases Advisory Committee on Infection Prevention and Control (PIDAC-IPC). PIDAC-IPC is a multidisciplinary scientific advisory body that provides evidence-based advice to Public Health Ontario (PHO) regarding multiple aspects of infectious disease identification, prevention and control. PIDAC-IPC’s work is guided by the current best available evidence at the time of publication and updated as required. Best Practice documents and resources produced by PIDAC-IPC reflect consensus positions on what the committee deems prudent practice and are made available as a resource to public health and health care providers. The application and use of this document is the responsibility of the user. PHO assumes no liability resulting from any such application or use. This document may be reproduced without permission for non-commercial purposes only and provided that appropriate credit is given to PIDAC-IPC and PHO. No changes and/or modifications can be made to this document without express written permission from PHO. PIDAC: Best Practices for Environmental Cleaning for Prevention and Control of Infections | April 2018 ii Authors/Contributors Public Health Ontario would like to acknowledge the contribution and expertise of the following individuals who participated in the development of this document: PIDAC-IPC MEMBERS Dr. Matthew Muller, chair Judy Dennis Medical Director, Infection Prevention and Control Manager, Infection Prevention and Control St. Michael’s Hospital, Toronto Children’s Hospital of Eastern Ontario, Ottawa Chingiz Amirov Dr. Susy Hota Director, Infection Prevention and Control Medical Director, Infection Prevention and Control Baycrest Health Sciences, Toronto University Health Network, Toronto General Hospital, Toronto Dr. Irene Armstrong (up to June 2016) Associate Medical Officer of Health Dr. Allison McGeer Toronto Public Health, Toronto Director, Infection Control Mount Sinai Hospital, Toronto Anne Bialachowski (up to June 2017) Manager, Infection Prevention and Control Vydia Nankoosingh St. Joseph’s Health Centre, Hamilton Manager, Infection Prevention and Control The Scarborough Hospital, Toronto Sandra Callery (up to June 2016) Director (former), Infection Prevention Catherine Richard (up to December 2016) and Control Manager, Occupational Health & Safety Program Sunnybrook Health Sciences Centre, Toronto Champlain Community Care Access Centre Dr. William Ciccotelli Dr. Herveen Sachdeva (from October 2016) Infectious Disease and Medical Microbiology Associate Medical Officer of Health Grand River Hospital, Kitchener Toronto Public Health, Toronto EX-OFFICIO MEMBERS Erika Bontovics (up to April 2016) Caroline Marshall (from October 2016 to April Manager (former), Infectious Diseases Policy and 2017) Programs Senior Policy and Program Advisor, Ministry of Health and Long-Term Care, Toronto Infectious Diseases Policy and Programs Unit Ministry of Health and Long-Term Care, Toronto Dr. Gary Garber Chief, Infection Prevention and Control Dr. Deborah Parachin (January and February 2017) Public Health Ontario, Ottawa Senior Medical Consultant, Health Care Unit Occupational Health and Safety Branch Dr. Leon Genesove (up to December 2016) Ministry of Labour, Toronto Chief Physician, Health Care Unit Occupational Health and Safety Branch Dr. Nikhil Rajaram (from March 2017) Ministry of Labour, Toronto Medical Consultant, Health Care Unit Occupational Health and Safety Branch Melissa Helferty (from May 2017) Ministry of Labour, Toronto Manager, Infectious Diseases Policy and Programs Unit Ministry of Health and Long-Term Care, Toronto PIDAC: Best Practices for Environmental Cleaning for Prevention and Control of Infections | April 2018 iii PUBLIC HEALTH ONTARIO STAFF Sandra Callery (from June 2016) Colin MacDougall Director, Infection Prevention and Control Research Coordinator/Technical Writer Dr. Maureen Cividino Francine Paquette Infection Prevention and Control Physician Regional Infection Prevention and Control Specialist Tim Cronsberry Dr. Samir Patel Director (Acting), Infection Prevention and Control Clinical Microbiologist Public Health Ontario Laboratory Cathy Egan (up to December 2015) Director (former), Infection Prevention and Control Dr. Jennifer Robertson Manager, Infection Prevention and Control Dr. Jennie Johnstone Infection Prevention and Control Physician Barbara Shea (up to November 2016) Network Coordinator Dr. Kevin Katz Infection Prevention and Control Physician Jeff Smith Research Coordinator Mabel Lim Program Infection Prevention and Control Dr. Mary Vearncombe, former chair (up to April Specialist/Technical Writer 2017) Infection Prevention and Control Physician EXTERNAL CONSULTANTS Additionally, PIDAC-IPC would like to thank the following individuals for their time and commitment in supporting PIDAC-IPC in its review and update of this PIDAC best practice document: Keith Sopha Environmental Services Consultant and Founder of CleanLearning Barbara Paul Education Chair, Ontario Healthcare Housekeepers’ Association Inc. (OHHA) PIDAC: Best Practices for Environmental Cleaning for Prevention and Control of Infections | April 2018 iv In addition, PIDAC-IPC is grateful to the following individuals who contributed to the development and production of the 2012 edition of this document: PIDAC-IPC MEMBERS Dr. Mary Vearncombe, Chair Dr. Kevin Katz Medical Director Infectious Diseases Specialist and Medical Infection Prevention and control, Microbiology Microbiologist Sunnybrook Health Sciences Centre, Toronto Medical Director, Infection Prevention and Control North York General Hospital, Toronto Dr. Irene Armstrong Associate Medical Officer of Health Dr. Allison McGeer Toronto Public Health, Toronto Director, Infection Control Mount Sinai Hospital, Toronto Donna Baker Manager, Infection Prevention and Control Shirley McLaren Bruyère Continuing Care, Ottawa Director of Client Services CanCare Health Services, Kingston Anne Bialachowski Manager, Infection Prevention and Control Dr. Kathryn Suh St. Joseph’s Healthcare, Hamilton Associate Director, Infection Prevention and Control Rena Burkholder The Ottawa Hospital, Ottawa Infection Prevention and Control Professional Guelph General Hospital, Guelph Dr. Dick Zoutman Professor, Divisions of Medical Microbiology and Judy Dennis Infectious Diseases Manager, Infection Prevention and Control Queen’s University, Kingston Children’s Hospital of Eastern Ontario, Ottawa Chief of Staff, Quinte Health Care, Belleville EX-OFFICIO MEMBERS Erika Bontovics Dr. Doug Sider Manager, Infectious Diseases Policy and Programs Acting Director, Infection Prevention and Control Ministry of Health and Long-Term Care, Toronto Public Health Ontario, Toronto Dr. Leon Genesove Liz Van Horne Chief Physician, Health Care Unit Scientific Lead; Manager, Infectious Disease Occupational Health and Safety Branch Prevention and Control Resources Ministry of Labour, Toronto Public Health Ontario, Toronto Pat Piaskowski Network Coordinator Northwestern Ontario Infection Control Network Public Health Ontario, Thunder Bay PIDAC: Best Practices for Environmental Cleaning for Prevention and Control of Infections | April 2018 v PUBLIC HEALTH ONTARIO STAFF Camille Achonu Shirley McDonald Epidemiologist, Infection Prevention and Control Infection Prevention and Control Resource Expert/Technical Writer Joann Braithwaite Manager, Communicable Diseases