This document provides guidance on environmental cleaning and infection prevention in healthcare facilities. It outlines the importance of cleaning in reducing pathogen transmission. Proper cleaning methods are described, including using disinfectant solutions in patient areas and detergent in non-patient areas. Personal protective equipment should be worn, and high-touch surfaces prioritized. Spills should be cleaned immediately using absorbent materials followed by disinfection. Terminal cleaning after patient discharge or transfer is crucial. Monitoring programs help ensure cleaning is effective. Training staff on cleaning protocols is important for infection prevention.

1. ENVIRONMENTAL
CLEANING
INFECTION PREVENTION AND CONTROL
FACILITATOR’S GUIDE, 2016
MODULE 13

2. Objectives
At the end of the session learners will be able to:
 Describe the importance of environmental cleaning
in health care facilities
 Describe the general principles on the proper use of
personal protective equipment during environmental
cleaning
 Describe different disinfectants for environmental
cleaning
2
Prepare disinfectant cleaning solution

3. Objectives
At the end of the session learners will be able to:
 Explain the guidelines for cleaning specific areas of
health care facilities
 Explain the guidelines for cleaning spills of blood or
other body fluids
 Explain how to handle cleaning items/equipment
appropriately
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4. Environmental cleaning
(introduction)
 Contamination
environment
of surfaces in the
plays an important
health care
role in the
transmission of many pathogens.
 These organisms can be transferred from surfaces to
the hands of health care workers to vulnerable
patients.
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5. Environmental cleaning: definition
 Environmental cleaning refers to the:
o general cleaning of surfaces and non-critical
equipment in health care facilities.
o process of maintaining a clean, healthy, and
pleasing patient and work environment.
 It includes the removal of visible dirt from objects and
manually or
detergents or
surfaces, normally accomplished
mechanically, using water with
enzymatic cleaners.

6. Environmental cleaning

7. Benefits of environmental
cleaning
Housekeeping is important in order to:
 Reduce the number of microorganisms that come
in contact with clients or staff.
 Reduce the risk of accidents through the
prevention of falls.
 Provide a pleasant environment.
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8. Logistics for cleaning
(Cleaning solutions)
 Cleaning solution is any combination of soap
(detergent) and water, with or without a chemical
disinfectant, used to wash or wipe down
environmental surfaces.
 Several combinations are available commercially or
can be prepared as needed at the health care facility
(e.g., alkaline detergents with chlorine compounds).
all soaps (detergents) and disinfectants are
Note: Not
compatible.

9. Logistics for cleaning
(Cleaning solutions)
Commonly used solutions
 Plain detergent and water: used for low-risk areas
and general cleaning tasks.
 Disinfectant solution (0.5% sodium hypochlorite
used for high risk and other patient care
solution:
are

10. Preparing disinfectant cleaning
solution
 Prepare a 0.5% chlorine solution or obtain any
disinfectant that contains 5% carbolic acid like lysol.
 Add some detergent and mix.
 Continue adding detergent until the solution
becomes mildly foamy or bubbly.
 Note: chlorine solutions should never be mixed
with cleaning products containing ammonia,
ammonium chloride or phosphoric acid as this
will result in release of chlorine gas.

11. Factors to consider when
selecting cleaning solutions
 Intended use (e.g., cleaning, disinfection, or both)
 Efficacy (e.g., does it claim to kill organisms that are
commonly found in the local environment at the
recommended contact time)
 Acceptability (i.e., smell, leaves a film, ability to
damages surfaces)
 Safety (i.e., side effects)
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12. Factors to consider when
selecting cleaning solutions
 Cost and availability (i.e., does it fit the budget, is it
easy to obtain in the required amounts)
 Volume needed and size of product available
based on facility requirements
 Easy of preparing diluted solution
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13. Cleaning solutions for different care
areas
 Cleaning patient care areas (general wards,
treatment rooms, washrooms, sluice rooms, etc)
o Use disinfectant cleaning solution.
 Cleaning non-patient care areas (offices, waiting
rooms, etc) - Domestic cleaning is adequate. May
use only detergent and water.

14. Cleaning different care areas
rooms and other areas that have
 Isolation
patients
diseases
with known transmissible
should be cleaned with
infectious
disinfectant
cleaning solution.
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16. Cleaning materials

17. Other logistics for
Environmental Cleaning
 Personal protective equipment
 Mop
 Mop bucket
 Sweeping brush
 Ceiling brush
 Dusters
 Absorbent pad for cleaning spills
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18. General principles for cleaning
health care facilities
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19. Environmental Cleaning
(general guidelines)
 All wards and units must have cleaning schedules.
 Always wear utility gloves, plastic aprons, protective
shoes and mask when cleaning.
 Cleaning should always progress from the least
soiled areas to the most soiled areas.
 Use damp or wet mop or cloth for walls, floors, etc.
 Complete damp dusting before starting other
cleaning in the room

20. Environmental Cleaning
(general guidelines) …
 Clean or wash surfaces from top to bottom
 Use sweeping brush not broom.
 Pay attention to high-touch surfaces such as door
handles, light switches, countertops, bedrails and end
of beds
 Change cleaning solution whenever it appears dirty.
 Use separate equipment for high risk areas.
 Decontaminate mop and other items after use.

21. General guidelines

22. Flooding and fogging
 Flooding: Areas with floor drains can be flooded with
cleaning solution. The cleaning solution should be
drained away using the floor drain. Any excess fluid
should be removed using a mop that absorbs the
remaining fluid left on the floor.
 Fogging: As a general rule do not perform
disinfectant fogging for air and surface disinfection for
general infection control in routine patient-care areas
 ?
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23. Cleaning spills
 Small spills:
 disinfect with disposable absorbent material (e.g.,
disposal clothes) soaked in disinfectant cleaning
solution and clean.
 Large spills:
 First remove the visible organic matter with
absorbent material, e.g., disposable towel or paper,
and discard into an appropriate leak-proof bin then
disinfect with 1%-5% sodium hypochlorite
disinfectant. Mop and clean the area and allow to
air-dry.

24. Cleaning spills
 Clean up spills of potentially infectious
materials immediately. Besides preventing the
spread of infections, prompt removal also
prevents accidents.
 Staff who are cleaning up spills must wear
appropriate protective clothing.

25. Spill management
 Nature of the spill, e.g. blood, urine, faeces
 Possible pathogens that may be involved
 Size of the spill, e.g., spot, splash, puddle,
large spill
 Type of surface involved, e.g., linoleum, carpet
 Area involved, e.g., preparatory laboratory,
teaching areas, common access areas, etc.
 Likelihood of bare skin contact with the soiled
area

26. Cleaning spills

27. Cleaning spills
 Large spills of cultures – flood with
disinfectant (e.g. 0.5% chlorine solution or
available stock strength of chlorine), clean and
apply fresh disinfectant, clean and allow to air
dry.
 Note: A suggested technique when flooding
the spill with germicide is to lay absorbent
material down on the spill and apply sufficient
germicide to thoroughly wet both the spill and
the absorbent material.

28. How to clean used cleaning
equipment
Mob, mop bucket and brush
 Empty mop buckets or container, decontaminate and
clean, rinse and air-dry.
 Ensure to wipe brush handles and cleaning carts (if
used) by wiping with disinfectant cleaning solution,
then wide down with a new cloth soaked in soapy
water, rinse and air-dry.
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29. How to clean used cleaning
equipment
Dusters, etc
 Soak in 0.05% chlorine solution, wash and air-dry
Curtains, screens, etc.
 All health facilities should have schedule for
changing and washing curtains, screens, etc
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30. Cleaning surgical settings
(General guidelines)
 Wear scrub suit
 Cleaning must NOT be conducted in the presence of
any open sterile packs or sterile instruments
 Use clean, lint-free cloth moistened with disinfectant
cleaning solution
 Clean after each surgical or invasive procedure and
do terminal cleaning at the end of each day and
each 24-hour period during the regular work week.

31. Terminal cleaning/ Cleaning after
discharge
 This is the process used to clean a patient’s
room
 after the patient has been discharged or
transferred
 for patient treatment areas including
operation theaters at the end of the day.

32. Terminal cleaning

33. Terminal disinfection

34. Terminal cleaning/ Cleaning after
discharge
 Disinfect beds, lockers and cupboards, etc with low-
level disinfectant e.g. Cetrimide
 Change all linen
 Disinfect plastic covering of pillows and mattresses
and air-dry for at least an hour before the next
admission.
 All mattresses and pillows must have plastic
covering.

35. Fumigation
 Fumigation does not reduce contamination in
your facility and should not be used. They are
just time consuming, waste valuable
resources and do not decrease the risk of
infection in the facility.
 Formaldehyde have no scientific basis.
Besides being ineffective, these agents are
toxic and irritating to the eyes and mucous
membranes.

36. Monitoring cleaning
Common methods
 Physical examination of absence of dirt, debris and
stains on surfaces
 Collecting environmental cultures to test for
microorganisms on different surface

37. Cleaning schedule- washroom
Date/Time Cleaned by
name /sign
Supervisor
name/sign

38. Summary
 Globally, there has been an increased interest in the
role the environment plays in the transmission of
infections.
 Cleaning is a process of maintaining a clean,
healthy, and pleasing patient and work environment
and involves sweeping, mopping, dusting and
scrubbing.
Disinfectant cleaning solution should be used for
patient care areas while detergent and water could
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be used for non-patient care areas

39. Summary
 Appropriate use of PPEs in imperative
 In order to be effective, the cleaning staff must be
well trained on the appropriate cleaning methods
 Fumigation for the purposes of IPC is not
recommended.
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THANK YOU