Environmental Cleaning Policies & Procedures Manual Including Infection Control for
Paediatric Hospices
Infection Control Cleaning Management Gordon House, Station Road, Mill Hill, London NW7 2JU Telephone: 020 8906 2777
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i www.infectioncontrolcleaning.co.uk
ISO 9001 REGISTERED FIRM
INTERNATIONAL ACCREDITATION BOARD Registration No. 0044/1
Environmental Cleaning Policies & Procedure Manual for All Staff Paediatric Hospices Section
Page
1: CONTEXT 1.1 Introduction 1.2 Aims 1.3 Health & Safety 1.4 Roles and Responsibilities 2 General Principles 2.1 General Principles for Staff Undertaking Cleaning 2.2 Personal Safety 2.3 Documentation 2.4 Training 2.5 Storage 2.6 Colour Coding for Hygiene 2.7 Cleaning Equipment 2.8 Microfibre 2.9 Cleaning Chemicals 2.10 Adenosine Triphosphate (ATP) Swabbing 2.11 Infection Prevention & Control (IPC) 3 Environmental Cleaning Plan 3.1 Functional Area Risk Assessment 3.2 Cleaning Responsibilities Framework 3.3 Elements, Performance Parameters and Cleaning Frequencies 3.4 High Frequency Touchpoints 3.5 Enhanced Cleaning 3.6 Assurance Programmes 3.7 Standards Rating Protocols 3.8 Governance Appendices 1: Colour Coding Poster 2: Cleaning and Disinfection Chemicals 3: Functional Area Risk Assessment 4: Cleaning Responsibilities Framework 5: Elements, Performance Parameters and Cleaning Frequencies 6: Sample Room Checklist 7: Method Statements Glossary References
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SECTION 1: CONTEXT 1.1 Introduction The National Standards of Healthcare Cleanliness 2021 require all organisations providing health and care services to seek assurance their cleaning policies and processes are effective. The Care Quality Commission (CQC) will continue the inspection programme against the Code of Practice for the prevention and control of infections (2022), which includes the provision of a safe and clean environment. The National Standards reference the Revised Healthcare Cleaning Manual 2009, originally issued by the National Patient Safety Association. Since 2014, it is managed by the Association of Healthcare Cleaning Professionals. In addition, BSI (British Standards Institute) have produced guidance which can be found at https://shop.bsigroup.com/products/specification-for-the-planning-application-measurementand-review-of-cleanliness-services-in-hospitals/standard Steps must be taken in all health and care settings to protect patients, staff and visitors from infection. Cleaning of environmental surfaces is essential; on occasions disinfection processes may be required. Good housekeeping and a clean, tidy environment reflect the standards of care maintained within premises. It is important there are clear processes in place, with proportionate assurance programmes, and that patients, as well as regulators and commissioners, receive assurance of standards of environmental cleaning. 1.2 Aims The aim of this manual is to facilitate the delivery of a high standard of cleanliness in compliance with the principles of the National Standards of Healthcare Cleanliness. Maintaining a clean environment is the responsibility of everyone working in the facility. Achieving high standards will require: • • • • • •
Clarity of roles and responsibilities for cleaning underpinned by strong, clear leadership that encourages a culture where cleanliness is important Risk assessment of different areas of the facility to determine cleaning requirements Identifying and using the most up to date and appropriate cleaning products and methods Cleanliness and performance to be constantly reviewed and improved where necessary A structured and proactive education and training program to be provided to ensure that all staff are competent in the delivery of a high standard of cleanliness in the home Any new facilities or service, or refurbishment, should be designed with ease of appropriate cleaning in mind
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APPENDIX 1: COLOUR CODING POSTER
COLOUR CODING FOR CLEANING EQUIPMENT CLINICS Adapted from NPSA 2007
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Table 6 – Specialised Cleaning Tasks Terminal cleans of vacated rooms – using a chlorine based disinfectant cleaning product
Equipment & Materials required • •
•
• • • • • • • • • • • •
• •
•
Colour-coded bucket Colour-coded disposable cloths Colour-coded domestic gloves suitable for chemical resistance and complying with the PPE Directive (89/686/EEC) Single-use gloves Disposable apron Colour-coded mop handle Colour-coded mop bucket Colour-coded mop head Colour-coded high-duster Dust-control tool Dust-control head Cleaning trolley Laundry bag Warning signs Disinfectant cleaning product giving sodium hypochlorite solution of strength 1000 parts per million available chlorine Product dilution container Clean curtains Stepladder
Method
• The use of dual-purpose disinfectant cleaning products, which provide a solution of 1000 (one thousand) parts per million available chlorine combined with a detergent property, has largely replaced the previous use of generalpurpose detergent solution followed by an application of a disinfectant product. • This method statement reflects this. Ventilation in the room should be increased during and after cleaning. • Pressurised steam cleaning can also be used successfully for this task and local policy will determine practice. For use of steam cleaning machines, refer to the cleaning with steam method statement.
•
• Wash hands and put on gloves • Prepare the cleaning solution. The area should be well • • • • •
• • • • •
•
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The use of hydrogen peroxide vapour fogging machines, or other new technologies for disinfection of these rooms is increasing. Manufacturers instructions must always be sought and followed
ventilated, if there are no windows, the door should be left open. Make up the solution in the product diluting container, never directly in the bucket. Use cold water only. When prepared, decant carefully into the buckets. Wash hands, put on single-use gloves and other protective wear required and prior to entering the room. Display the warning signs, and enter the room Take down curtains, if fabric place in separate clearly marked infected linen laundry bag, if disposable treat as clinical waste Strip the examination couch, any linen should be placed into a separate clearly marked infected linen laundry bag, disposable items disposed of as clinical waste i.e., examination couch paper roll. High-dust the room Dust-control the floor Using a disposable cloth dampened in the disinfectant cleaning solution, begin cleaning surfaces Changing cloths and solution as they become soiled Work in the following order: curtain tracks and high ledges; furniture and fittings; Service User equipment, alcoholbased hand rub, soap and paper towel dispensers; examination couch frame; wash hand basin, office furniture. Place all waste in the clinical waste bag. Remove and dispose of clinical waste bag, damp-dust waste bag holder
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GLOSSARY Bactericidal
Chemical agents capable of killing bacteria
Bacteriostatic
Chemical agents that inhibit the growth of bacteria but does not necessarily kill them
Biocide or germicide
Kills microorganisms
Body substances
Refers to fluid or tissue from a service user, specimen or spillage, i.e. wound exudate, blood, sputum, urine, faeces or other sections or fluids
Cleaning
The physical removal of foreign material which removes rather than kills microorganisms. It is accomplished with water, detergents, and mechanical action. It reduces or eliminates the reservoirs of potential pathogenic microorganisms
Detergent
A cleansing substance that acts similarly to soap but is made from chemical compounds rather than fats and lye. Any synthetic organic cleaning agent that is liquid or water soluble and has wetting agent and emulsifying
Disinfectant
The inactivation of disease producing microorganisms used on inanimate objects and usually involves chemicals, heat, or ultraviolet light. The nature of chemical disinfection varies with the type of product, but disinfection does not destroy bacterial spores
Disinfection
Defined as reducing the number of microorganisms on a surface to very low levels
Fungicidal
Chemical agents capable of killing fungi
Fungicide
Kills fungi
Safety Data Sheets
Provides information on chemical products that will help the users of those chemicals to make a risk assessment. The sheet describes the hazards the chemical presents and gives information on the handling, storage, and emergency measures in case of an accident or spillage
Sporicidal
Chemical agents capable of killing spores
Virucide
Inactivates viruses
Virucidal
Chemical agents capable of killing viruses
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