TITLE D ISCHARGE/TRANSFER C LEANING (ISOLATION) DOCUMENT # ES-PROT-CLN-005 APPROVAL LEVEL Senir Operating Officer, Nutritin & Fd Services / Linen & Envirnmental Services SPONSOR Envirnmental Services CATEGORY Envirnmental Cleaning INITIAL APPROVAL DATE April 13, 2012 INITIAL EFFECTIVE DATE April 13, 2012 REVISION EFFECTIVE DATE January 30, 2016 NEXT REVIEW January 30, 2019 OBJECTIVES T utline the steps fr cleaning and disinfecting an islatin rm upn discharge / transfer. APPLICABILITY Cmpliance with this prtcl is required by all Alberta Health Services (AHS) Envirnmental Services (ES) emplyees, students, vlunteers, and any ther persns acting n behalf f AHS Envirnmental Services (including cntracted service prviders as applicable). PROTOCOL 1. Cleaning Tls & Equipment Needed 1.1. Cleaning cart, hand pail, cleaning clths, wet mp, bucket and wringer (r Micrfiber System), tilet swab, tilet caddy, cleaning/disinfecting prduct(s), step-ladder, dispenser refills, dispenser keys, tl(s) fr damp dusting, wet flr signs, scraper/putty knife, garbage bags, linen bags (fr siled linen), curtains (cubicle/shwer), islatin gwn, mask, glves, and safety gggles/glasses. a) Refer t Material Safety Data Sheet (MSDS) fr safe handling f cleaning and disinfectant prducts. b) Staff must fllw AHS Wrkplace Health & Safety (WHS) Ladder Safety practices. Alberta Health Services 2016 PAGE: 1 f 8
DISCHARGE/TRANSFER CLEANING (ISOLATION) January 30, 2016 ES-PROT-CLN-005 2 f 8 2. Safety Practices 2.1. Place flr sign where it is readily seen at all entrances and exits. 2.2. Always fllw safe wrk practices, including prper ergnmic practices, (i.e. prper prcedures fr reaching, bending, etc.), as per staff training. 2.3. Cleaning carts are t be stred apprpriately in secured designated rms when nt needed r in use. Cleaning carts are nt t be used t hld r stre fd and/r beverages. 2.4. Infectin Preventin & Cntrl (IPC) Hand Hygiene and Persnal Prtective Equipment (PPE) resurces are available thrugh the AHS External Website: http://www.albertahealthservices.ca/6410.asp. a) They type f PPE required will vary based n the level f precautins required (i.e., cntact, drplet, airbrne, etc.). 2.5. Change glves and ther PPE if they are visibly siled, are damaged, r if mving frm a dirty task t a clean task t prevent crss cntaminatin. 2.6. Care must be taken when handling sharps cntainer as these are puncture-resistant, nt puncture-prf. This may present a risk f sharps injury. 2.7. Verify with Nursing that apprpriate Additinal Precautin signage is psted next t patient rm. Verbal instructins frm nursing is nt sufficient. 3. Cleaning Steps and Key Pints 3.1. Change cleaning clths when clth is visibly siled r is n lnger wet enugh t allw fr the apprpriate cntact time. 3.2. Using cleaning principles, all cleaning activities shuld g frm clean t dirty areas. When mving frm a dirty task t a clean task staff must perfrm hand hygiene and change PPE befre cleaning the next surface/area. 3.3. Cleaning steps may vary slightly fr different types f equipment. Always fllw the manufacturer s instructins fr cleaning and disinfecting specialized equipment. Please cntact yur supervisr if yu have any questins r require assistance. 3.4. Frequency f cleaning must be dne as per the Envirnmental Services Cleaning Frequency Expectatin Table (ES-STD-CLN-002-Att A). If there is a difference between the cleaning frequencies listed in this dcument, and the Cleaning Frequency Expectatin Table, the frequencies listed in the Expectatin Table shuld be fllwed.
DISCHARGE/TRANSFER CLEANING (ISOLATION) January 30, 2016 ES-PROT-CLN-005 3 f 8 PREPARATION OF CLEANING / DISINFECTANT SOLUTIONS 1. Cllect all supplies and equipment needed t clean rm. 2. Perfrm hand hygiene. Put n (Dn) PPE (i.e. glves and gggles) t prepare cleaning / disinfectant prducts as per MSDS fr the prduct(s). 3. Prepare apprved cleaning/disinfecting prduct(s) fr hand pail and mp bucket, diluting as required. 4. Remve (Dff) PPE. Perfrm hand hygiene. Fllw prper hand hygiene prtcls. See Putting n (Dnning) Persnal Prtective Equipment (PPE) pster. Cleaning clths must nt be duble dipped int any cleaning/disinfecting slutin(s). Fllw prper hand hygiene prtcls. See Taking Off (Dffing) Persnal Prtective Equipment (PPE) Pster. CLEANING 5. Place wet flr sign at rm entrances/exits. 6. Review Additinal (Islatin) Precautin signage n patient rm dr t determine the apprpriate PPE and t cnfirm precautins prir t entering the rm. 7. Perfrm hand hygiene. Put n (Dn) apprpriate PPE as per risk assessment. Place cleaning cart utside drway t prevent ging back and frth t cart. Bring step-ladder int the rm by the dr. Signage must be n dr. D nt prceed until signage is psted. Fllw prper hand hygiene prtcls. See Putting n (Dnning) Persnal Prtective Equipment (PPE) pster.
DISCHARGE/TRANSFER CLEANING (ISOLATION) January 30, 2016 ES-PROT-CLN-005 4 f 8 8. Check t make sure that the fllw items have been remved by nursing/unit staff: Meal trays Suctin cntainers (used) Bdy fluids (urinals etc.) Bed stripped f linen (by nursing - site specific) If items are still in the rm, ntify the Nursing Desk. 9. Check fr patient belngings left behind in rm (tables, lcker / shelving, cabinets etc.). 10. Discard all dispsable waste items (e.g., paper twels, tilet paper, glves, Kleenex, etc.) as apprpriate. Discard any magazines r bks. 11. Empty waste cntainers by remving the bag. Take dwn curtains (cubicle, windw, shwer). Suctin cntainer hlders and medical supplies must be remved by nursing/unit staff befre beginning cleaning the rm. Remval f all utensils and meal trays shuld be dne by nursing/unit staff prir t the request fr a discharge/transfer clean. Other items t be remved by nursing/unit staff are: wash basins, sap dish, glass, urinal, etc. If persnal items are fund, place them int a bag and ntify the Nursing Desk nce rm cleaning is cmplete. Indicating rm and bed number where the items were fund. If items can be cleaned and disinfected, and are un-pened, clean and disinfect the exterir and leave the prduct in the rm. Refer t the IPC Best Practice Guideline: Guidelines fr Management f Patient Supplies n Discharge r Transfer. Magazines and bks must nt recirculate. Place waste bag(s) and siled linen bag(s) by the cart, by the dr. Fllw WHS ladder safety practices. Gather any expsed / excess linen stck in the rm and place int the siled linen bag / hamper. Check sharps cntainer. If ¾ filled, remve it. (site specific) Ensure the sharps cntainer is sealed shut prir t dispsal.
DISCHARGE/TRANSFER CLEANING (ISOLATION) January 30, 2016 ES-PROT-CLN-005 5 f 8 12. Unlck bed wheels and pull the bed away frm the wall. Raise the bed t a suitable height fr cleaning and lwer the bed rails. Strip the bed f linen. Place linen int siled linen bag. Any excess linen in rm must als be placed int siled linen bag(s). 13. Remve glves. Perfrm hand hygiene. Apply new glves. 14. Perfrm high dusting (damp dust nly) n surfaces that are ut f reach. 15. Clean and disinfect arund the perimeter f the rm: wall fixtures (i.e. wall brackets) windws and ledges hrizntal surfaces wipe cubicle curtain rds and tps f clsets dr, frame, kick plate, hinges 16. Clean and disinfect high tuch surfaces: walls used fr mbility supprt light fixtures light switches furniture hand rails dr handles windw curtain rds/crds (if applicable) etc. Stripping f beds may be site specific. Fllw training fr bed stripping/making. Place the siled linen bags at the dr inside the rm. D nt verfill bag (n mre than ½ full). D nt perfrm hand hygiene while wearing glves. Dispsable glves may nt be re-used. Wear eye prtectin during high dusting (damp dusting). Always clean and disinfect arund the rm mving frm cleanest t dirtiest (entrance t washrm). Wall brackets t hld glve bxes, sharps cntainer etc. Remember t clean inside, utside and underside f furnishings. (i.e. tables, lckers, etc.) Including interir glass windws, drs, and partitins.
DISCHARGE/TRANSFER CLEANING (ISOLATION) January 30, 2016 ES-PROT-CLN-005 6 f 8 17. Clean and disinfect hand hygiene sinks/fixtures, plumbing pipes, dispensers, and mirrrs. 18. Clean and disinfect headwall and fixtures (i.e. bld pressure cuffs etc). Clean and disinfect: ver-bed table bedside table call bell & crd light crd headbard ftbard bed rails side-chair ft stls suctin cntainers IV ple(s) Clean internal surfaces f the dispensers. All legs r wheels n furnishings are t be wiped. D nt clean/disinfect technical equipment, including cmputers. Nte: Other items (i.e. wheelchairs, cmmdes etc.) in the rm must be cleaned and disinfected befre remval frm the rm. 19. Clean and disinfect bed, pillws and under bed frame. Allw t air dry. Reprt any damage f mattress r pillw t Unit staff and yur Supervisr. Refer t Bed Cleaning (Discharge- Transfer) ES-PROT-CLN-042 prtcl. Pillws are cleaned in the rm and are nt t g t laundry. D nt remve cardiac bed lcks. 20. Clean and disinfect wipe waste cntainer(s) inside and ut if siled. 21. Remve glves. Perfrm hand hygiene. Apply new glves. D nt perfrm hand hygiene while wearing glves. Dispsable glves may nt be re-used. 22. Clean and disinfect the washrm. Fllw the Patient Washrm Cleaning Prtcl (ES-PROT-CLN-034).
DISCHARGE/TRANSFER CLEANING (ISOLATION) January 30, 2016 ES-PROT-CLN-005 7 f 8 23. Remve glves. Perfrm hand hygiene. Apply new glves. 24. In patient bed area: Damp mp (wash) flrs. Washrm area: Damp mp washrm flr. D nt perfrm hand hygiene while wearing glves. Dispsable glves may nt be re-used. Damp mp flr using cncept f far crner t dr. Pay particular attentin t crners, edges, and basebards (scraper may be needed). Remve and place mp head(s) int a siled linen bag after use. 25. Clean and disinfect handles and utside f cleaning equipment. 26. Take the Additinal (Islatin) signage ff the dr and clean and disinfect it. 27. Remve (Dff) PPE. Perfrm hand hygiene. Equipment that was taken int the rm must be thrughly cleaned t prevent crss cntaminatin. Site specific. Fllw prper hand hygiene prtcls. See Taking Off (Dffing) Persnal Prtective Equipment (PPE) Pster. 28. Plish any streaks n windws, mirrrs etc. with clean clth. 29. Remake bed with clean linens. Replace furniture in standard lcatin. 30. Replenish dispenser supplies and paper supplies. Re-line waste cntainers. Refer t Bed Making (ES-PROT-CLN- 043) prtcl. Arrange in a neat and rderly fashin. Only prvide ne extra bag in cntainer (hang ver the rim). Site specific requirement. Re-hang curtains. 31. Let the Nursing Desk knw that rm has been cmpleted r fllw electrnic bed system. 32. Take waste and siled linen bags t siled utility rm fr dispsal.
DISCHARGE/TRANSFER CLEANING (ISOLATION) January 30, 2016 ES-PROT-CLN-005 8 f 8 33. Remve wet flr sign when flr is dry. 34. Take all equipment t janitr clset / husekeeping rm. Empty pails and clean and disinfect befre prceeding t next islatin rm Pails must be cleaned and disinfected befre prceeding t the next rm. Micrfiber (flat head) mp system des nt require changing f pail. Clean and re-stck cart. 35. Prceed t next assignment. DEFINITIONS Fr a full list f standard cleaning terms, please refer t the Envirnmental Services Cleaning Standard (ES-STD-CLN-005). REFERENCES AHS Gvernance Dcuments Hand Hygiene (# PS-02) Wrkplace Health & Safety (#1121) WHS Ladder Safety (n Insite) IPC Best Practice Guideline: Guidelines fr Management f Patient Supplies n Discharge r Transfer (n IPC webpage) ES Gvernance Dcuments Envirnmental Services Cleaning Standard (ES-STD-CLN-005) Cleaning Frequency Standard (ES-STD-CLN-002) Cleaning Frequency Expectatins Table (ES-STD-CLN-002-Att A) Persnal Prtective Equipment Standard (ES-STD-WHS-001) REVISIONS December 2015