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Safe Management Environment and Blood and Body Fluid Spillages

Introduction

Staff groups should know their environmental cleaning schedules and specific responsibilities. Healthcare facilities should have a cleaning protocol that includes responsibility for, frequency, and method of environmental decontamination. The protocol should be based on the National Standards of Healthcare Cleanliness 2021

The healthcare environment must be:

  • Visibly clean, dry, and dust-free
  • Well maintained and in a good state of repair
  • Remove all non-essential items and equipment to ensure efficient cleaning
  • A fresh general-purpose neutral detergent mixed with warm water is recommended for routine cleaning. This should be changed when it becomes dirty, or at 15-minute intervals, or when changing tasks.
  • Routine use of environmental disinfectants is not recommended for low-frequency hand-touch surfaces. However, 1,000 available chlorine should be used regularly in sanitary fittings.
  • For high-frequency hand touch surfaces, after a thorough cleaning with detergent, the use of appropriate disinfectants is required based on the local guidelines and the manufacturer’s recommendation 
  • Refillable bottles should not be used in settings where immunocompromised patients receive care (e.g., haematology and oncology, cardiac surgery, bone marrow and stem cell transplant, neonatal, paediatric, and adult ICU transplant units).
  • Where refillable bottles are appropriate, cleaning products should be freshly made (never topped up) and discarded after 24 hours (or sooner, depending on manufacturer instructions). The refillable bottle should be washed and thoroughly dried between uses.

Patient isolation/cohort rooms/areas should be thoroughly cleaned and disinfected at least daily, and the IPC team may recommend increasing the frequency. In addition, increased frequency of cleaning and disinfection schedules should be incorporated into the environmental decontamination schedules for areas with higher environmental contamination rates (toilets, commodes, etc.), particularly if patients have diarrhoea. In addition, special attention must be paid to frequently touched surfaces (door and toilet handles, locker tops, over-bed tables, bed rails, etc.). All areas and rooms must be cleaned from highest to lowest points and from least to most contaminated points. Refer to the National Cleaning Standards for enhanced cleaning in different settings.

For Terminal cleaning after discharge/death of infected patients and Procedure for terminal cleaning, please refer to the section on transmission-based precautions

Reference

National Standards of Healthcare Cleanliness 2021

Literature Review

Safe Management of the Care Environment (Environmental Decontamination)

Flow chart

Management of blood and body fluid spills