1. Housekeeping

2. Objectives KEY CONCEPTS you will learn: Why housekeeping is important
General principles
How to prepare disinfectant cleaning solutions
When and how to clean low- and high-risk areas
How to clean spills of blood and body fluids
How to clean and store housekeeping equipment

3. Why It Is Important?
“Accumulation of dust, soil, and microbial contaminants on environmental surfaces is both aesthetically displeasing and a potential source of nosocomial infections. Effective cleaning methods and schedules are, therefore, necessary to maintain a clean and healthy environment in healthcare settings.” (Chou 2002)

4. General Principles
Scrubbing (frictional cleaning) is the best way to remove dirt, debris, and microorganisms.
Cleaning is required prior to any disinfection procedure.
Cleaning products should be selected according to their use, efficacy, safety, and cost.
Cleaning should progress from the least to the most soiled areas and from high to low.
Dry sweeping, mopping, and dusting should be avoided.

5. General Principles…Cont’d
Mixing instructions should be followed when using disinfectants, too much or too little of water may reduce effectiveness
Cleaning methods and schedules should be based on the type of surface, amount, and type of soil and purpose of the area.
Routine cleaning is necessary; schedules should be posted.

6. Cleaning Disinfectant Solution
Prepare a 0.5% chlorine solution (alternative disinfectants include 1–2% phenols or 5% carbolic acid).
Add enough detergent to the 0.5% chlorine solution or other disinfectant to make a mild, soapy cleaning solution.

7. Cleaning Methods
Wet mopping is the most common and preferred method to clean floors:
Single-bucket (basin) technique;
The solution must be changed when dirty. The killing power of the cleaning product decreased with the increased load of soil and organic material present
Double-bucket technique;
can extends the life of the cleaning solution
Triple-bucket technique
Flooding is recommended for the surgical suite
This process eliminates mopping and increase contact time of the disinfectant

8. Cleaning Methods…Cont’d
Dusting is the most used method for cleaning walls, ceilings, doors, windows, furniture, and other surfaces:
Wet clean cloths or mops
The double-bucket (basin) system is recommended.
Use a starting point as a reference.
Dry vacuuming is only recommended for cleaning carpets

9. Use of PPE Handling disinfectants Cleaning patient care areas
Cleaning heavily contaminated areas
Handling soiled linen
Handling soiled items and instruments
Handling or disposing of waste
When spills or splashes are expected

10. Cleaning
or cleaning up after an operation

11. Cleaning Schedules and Procedures
Look at Reference Manual pages 16-6 to 16-8 (specific areas), and 16-8 to 16-9 (operating room)

15. Poorly Handled Stretcher

16. How to Clean Spills of Blood and Other Body Fluids
Small spills:
Wearing gloves, remove visible material using a cloth soaked with 0.5% chlorine solution.
Then wipe clean with a disinfectant cleaning solution.
Large spills:
Wearing gloves, flood the area with 0.5% chlorine solution.
Mop up the solution and then clean as usual with detergent and water.

17. How to Clean Soiled and Contaminated Cleaning Equipment
Decontaminate cleaning equipment by soaking it for 10 minutes in a 0.5% chlorine solution.
Wash cleaning buckets, cloths, brushes, and mops with detergent and water daily, or sooner if visibly dirty.
Dry completely before reuse (wet cloths and mop heads are heavily contaminated with microorganisms).

18. Fumigation and the use of UV light
Are common housekeeping practice in many health facilities,
These practices are time consuming, waste valuable resources, and do not decrease the risk of infection in your facility

19. Fumigation (Disinfectant fogging)
Fumigation with formalin or formaldehyde is an ineffective method of reducing the risk of infection,
It is perfect example of a practice that is not based on scientific findings,
Besides being ineffective, these agents are
toxic and irritating to the eyes and mucus membranes
Potential carcinogen

20. Fumigation…Cont’d.
Fumigation is time consuming and makes rooms unavailable for use,
Thorough cleaning with a disinfectant cleaning solution and scrubbing should be used instead of fumigation,
Can safely be used on surgical endoscopes (laparoscopes) because 8% formaldehyde will not corrode metal or damage lensed instruments, plastics or rubber.

21. Ultraviolet (UV) light
In general, this is neither practical nor cost-effective,
In the largest and best-designed scientific study on this topic, no decrease was shown in the wound –infection rate when UV light was used,
UV light is unsatisfactory for general use in health care facilities because:

22. UV light…Cont’d The killing ability of UV light decreases sharply:
If relative humidity is greater than 60-70%
If dust is present (in the air, on surfaces or on the bulb itself)
UV light doesn’t penetrate most substances (including fluids and organic matter such as mucus)

23. UV light…Cont’d
The intensity of UV light needed to effectively kill microorganisms is damaging to humans. Prolonged exposure can lead to reddened skin and irritated eyes.
UV light fixtures are expensive to install and maintain.
Regular servicing, including dust from the bulbs, is required.

24. Take Home Messages Don’t: Do: Dry mop or dust Sweep Wet mop and dust
Terminal cleaning of the surgical unit every 24 hours
Clean the OR and procedure rooms between patients
Decontaminate, wash, and dry cleaning equipment before reuse