CLEANLINESS OF THE WARD AND ITS ANNEXES

1. CLEANLINESS OF THE WARD AND ITS ANNEXES HAMENU VAVA CYRIL

2. Environmental Management / Controls (Housekeeping and Waste Disposal) • Environmental controls are practices that are performed to render the health care facility environment safe from infections or reduce the infections to the barest minimum. • General cleanliness and hygiene of a facility (housekeeping) are vital to the health and safety of staff, clients, visitors and the community at large.

3. General cleanliness and hygiene are vital for safety

4. General cleanliness and hygiene are vital for safety

5. General Cleaning Guidelines • Ward/Unit supervisors shall draw up cleaning schedules for the different areas of the ward and post them where all housekeeping staff can see them. • To reduce the spread of dust and microorganisms, use a damp or wet mop or cloth for walls, floors and surfaces instead of dry-dusting or sweeping.

6. General Cleaning Guidelines • Scrubbing is the most effective way to remove dirt and microorganisms • Wash surfaces from top to bottom so that debris falls to the floor and is cleaned up last. Clean the highest fixtures first and work downwards e.g. from shelves to tables, lockers and then the floor. • Change cleaning solutions whenever they appear to be dirty as a solution is less likely to kill infectious microorganisms if it is heavily soiled

7. General Cleaning Guidelines • Clean and disinfect surfaces that are likely to be contaminated with pathogens that are touched frequently such as bed rails, bed tables, door knobs frequently compared to other surfaces such as walls that are not touched. • Clean from less contaminated area to heavily contaminated area.

8. General Cleaning Guidelines • Use separate equipment (brushes and cloths) for high risk areas which are more likely to be contaminated e.g. toilets • Housekeeping staff shall have regular in-service training.

9. Immediate Physical Environment of the Patient

10. Cleaning Procedures for Different Clinic Areas Non-patient Care Areas: Low Risk Areas (waiting rooms, administrative areas) where clinical services are not provided. These areas are not usually heavily contaminated with infectious microorganism and so the risk of infection is very minimal. • Routine cleaning (daily, or when the area is dirty) is good enough. • Toilets and sluice Rooms

11. Task • Clean walls • Clean ceilings • Clean counter and other surfaces Schedule Wipe with a disinfectant cleaning solution each day (or more often if necessary) Wipe with a disinfectant solution each week Wipe with disinfectant solution each day Cleaning Schedule: Toilets and sluice Rooms

12. Clean floors • Clean sinks and toilets • Empty waste containers • Clean waste containers • Use mop and disinfectant cleaning solution each day or more often • Scrub with a disinfectant cleaning solution and rinse with clean water each day or more often. • Each day or more often • scrub to remove soil or organic material with disinfectant cleaning solution each day or more often Cleaning Schedule: Toilets and sluice Rooms

13. Cleaning Schedules • Client Care Areas (operating theatres, procedure rooms, laboratories, areas where instruments are processed, wards, toilets, sluice rooms etc.). In these area, there is greater potential for contamination with infectious materials hence needs special care using a disinfectant cleaning solutions.

14. A the beginning of each day Between Clients Clean operating/procedure tables, examination couches, chairs, trolley tops, Mayo stands, lamps, counters with disinfectant solutions to remove dust that has accumulated overnight. Clean operating/procedure tables, examination couches, trolley tops or Mayo stands, counters, lamps and any other potentially contaminated surfaces in operating theatres and procedure room with a cloth dampened with a disinfectant cleaning solution. Alternatively, spray the solution onto the surfaces and wipe off with a damp cloth. Cleaning Schedule for Client-Care Areas

15. Between Clients • At the end of each clinic session or day • Clean spills of blood or other body fluids with 0.5% chlorine solution immediately • Clean visibly soiled areas of the floor; walls, or ceiling. • Put waste in a leak-proof container and empty the container when it is ¾ full. • Wipe down all surfaces including counter, tables, sinks, lights, door handles and wall with a cloth dampened with a disinfectant cleaning solution or spray the solution. Always wipe from top to bottom paying particular attention to the base, sides and legs. Rinse sinks with clean water. Cleaning Schedule for Client-Care Areas

16. At the end of each clinic session or day • Each week • Mop the floors with a mop soaked in disinfectant cleaning solution • Check sharp-disposal containers: remove and replace when ¾ full Remove medical or hazardous chemical waste and burn or bury as soon as possible to limit contact. • Wash containers with a disinfectant cleaning solution and rinse with water • Clean ceilings with a mop dampened with a disinfectant cleaning solution. Cleaning Schedule for Client-Care Areas

17. Cleaning of Spills • If spill is small, wipe it with a cloth that has been saturated with a disinfectant (0.5% chlorine) solution immediately. • If the spill is large, cover or flood the area with a disinfectant (0.5%) solution, mop up the solution, and then clean the area with a disinfectant cleaning solution immediately.

18. Supplies and equipment used for cleaning (mops, buckets, and cloths) should be decontaminated with a disinfectant 0.5% chlorine solution cleaned in detergent and water, rinsed in clean water and dried before reuse

19. Types of Cleaning Solutions Three kinds of cleaning solutions are used during housekeeping at a health facility: • Detergent or Plain Soap and Water This is used for low-risk areas and general tasks. Detergents remove dirt and organic material and dissolve or suspend grease, oil and other matter for easy removal by scrubbing

20. Types of Cleaning Solutions • Disinfectant (0.5% Chlorine Solution The disinfectant rapidly kill or inactivate infectious microorganisms during the cleaning process. Disinfectants are used to clean up spills or blood or other body fluids.

21. Types of Cleaning Solutions • Disinfectant Cleaning Solutions This solution contains detergent, disinfectant and water is used for cleaning areas that may be contaminated with infectious materials e.g. OT rooms, sluice room, toilets etc. The disinfectants kill/inactivates the microorganisms while the detergents remove dirt and organic material. To constitute a disinfectant cleaning solution, prepare 0.5% chlorine solution and add liquid/powdered detergent until foamy

22. Types of Cleaning Solutions Other equally good disinfectants that can be used include • Phenol • Lysol • Quaternary ammonium compounds

23. Preparation of 0.5% Chlorine Solution • Chlorine is commonly used for disinfection because it • Is a powerful killer of microorganisms • Deordourises • Is not poisonous to humans in the accepted concentrations used • Leaves no poisonous residues • Colourless, easy to handle and economical to use.

24. Preparation of 0.5% Chlorine Solution Chlorine may be supplied in the following forms: • Liquid (sodium hypochloride) • Powder (calcium hypochloride or chlorinated lime) • Chlorine Releasing Tablets (Sodium dichlorocyanurate)

25. Preparation of 0.5% Chlorine Solution The amount of active chlorine in a chlorine containing compound is usually described in percentage (or in degrees chlorum in some francophone countries). Chlorine in the various preparations comes in different concentrations. When the solution is prepared, the active chlorine available should be 0.5%.

26. Preparation of 0.5% Chlorine Solution • Using the liquid household bleach Parts of water = % of active chlorine in liquid bleach-1 0.5% Or Parts of water = 2X – 1 Where X is the figure/numeral in the expressed percentage indicating the active chlorine in the stock solution

27. Preparation of 0.5% Chlorine Solution 2. Using Bleach Powder; calculate the ratio of bleach to water as follows Grams of powder = 0.5% (desired strength active chlorine in bleach powder X 1000

28. Preparation of 0.5% Chlorine Solution • Using Chlorine-Releasing Tablets Since the percentage of active chlorine in these products varies, the manufacturer’s instructions should be followed

29. QUESTIONS?