What are some criteria and guidelines that hospitals should look at when setting up their cleaning and disinfection programme?
Housekeeping staff cleaning, mopping and scrubbing is a common sight at all hospitals, such that we usually don’t give much thought to the purpose and process of their tasks. In fact, hospital cleaning and disinfection is a critical activity towards infection control and prevention.
With patients who may be immunocompromised or more vulnerable, it is important to ensure they are not exposed to secondary infections in hospitals, for example from multidrug-resistant organisms (MROs). MROs, which are resistant to many antimicrobials, are difficult to treat, cause poorer patient outcomes, and increase costs to the healthcare system.
Guidelines for cleaning and disinfection procedures
To mitigate this risk, national health ministries or associations issue guidelines for strict, structured cleaning programmes and regimes in healthcare facilities.
For example, Singapore’s Ministry of Health published the Environmental Cleaning Guidelines for Healthcare Settings, which “deal with cleaning of the physical environment in health care as it relates to the prevention and control of infections.” These cover the procedures for daily or terminal cleaning, steps to follow when an outbreak occurs, as well as cleaning and disinfection standards and frequency of cleaning.
Similarly, the Asia Pacific Society of Infection Control (APSIC) – an organisation of infection control professionals in the region – put together the Guidelines for Environmental Cleaning and Decontamination, with the aim to provide evidence on environmental cleaning in limiting pathogen transmission, as well as best cleaning practices.
Both sets of guidelines align in basing the frequency of cleaning and disinfection on a set of four criteria, which evaluates the infection risk of an area in the hospital:
1. Whether surfaces are high-touch or low-touch
Surfaces with a high frequency of contact, such as patient room door knobs, have more potential for exposure to pathogens, and hence require more frequency cleaning and disinfection. Cleaning is done at least daily or possibly more, with cleaning procedures conducted more rigorously.
Mr Eddie Yin, Senior Director of Commercial Operations APAC at Rubbermaid Commercial Products, pointed to microfibre cloths as beneficial in cleaning of these areas. “Microfibre cloths, such as HYGEN™, have been proven to remove 99.7% or more of microorganisms. The individual microfibres can trap microscopic particles and liquids far more effectively than larger fibres. Hence, they are ideal for high-touch areas and other high-risk settings.”
2. Type of activity taking place
Critical care areas will carry a higher risk of infection, as compared to administrative areas or meeting rooms. Thus, these areas will need to undergo deeper and more thorough cleaning.
3. Vulnerability of patients housed in the area
Patients of certain profiles, for example oncology patients, those with severe burns or those undergoing invasive or operative procedures, are more susceptible to infection. Areas housing these patients needs to be scheduled for more frequent cleaning.
For such areas, microfibre mops – which do not require water buckets, thus eliminating the need for staff to change out water from the mop bucket multiple times throughout the day – are an efficient way to keep floors clear of microbes, said Mr Yin. These can come with disposable mop heads which reduce the risk of cross-contamination.
4. Probability of contamination based on the amount of body fluid contaminating surfaces in the area
The probability of contamination is based on the activity in the area, the type of pathogens involved and the microbial load. Areas with high contamination probability include birthing suites, autopsy suites and burns unit, where surfaces and/or equipment are exposed to significant amounts of blood or body fluids.
For the above-mentioned areas which require more frequent cleaning, spacious cleaning carts that can hold multiple cleaning equipment – mops, cloths, gloves and so on – help boost efficiency by reducing the need for cleaning staff to return to the supply room to restock.
The use of appropriate cleaning solutions, in conjunction with other infection control measures such as hand hygiene and proper use of personal protection equipment (PPE), will greatly mitigate the risk of hospital infections, in turn leading to better patient outcomes and experience.
“Rubbermaid’s suite of cleaning and disinfection solutions are customised for the healthcare setting. This includes microfibre cloths and mops, which effectively removes microbes and pathogens in the environment; and also cleaning carts and flexible mops handles which are ergonomically designed for ease of use and prevents workplace injuries in housekeeping staff,” said Mr Yin.
For more information on Rubbermaid hospital and healthcare cleaning solutions, click here.