Standard Operating Procedure Template Title of Standard Operation Procedure: Cleaning Toys, Games and Play Equipment on the Paediatric Ward Reference Number: Version No: 1 Issue Date: Purpose and Background Scope (i.e. organisational responsibility) Vital functions affected by this procedure: Monitoring Compliance Review Date: 1 September 2019 The purpose of this document is to provide guidance on the cleaning and decontamination of toys and play equipment used in the acute paediatric clinical areas and paediatric clinics. The aim is to minimise the potential risk of cross infection from equipment that is used frequently by patients, staff and relatives. Scope: This document applies to all staff employed by East Cheshire NHS Trust who undertake all aspects of clinical care. Vital Functions Affected: To ensure that shared equipment is effectively cleaned and decontaminated following use, in order to reduce the risk of crosscontamination by micro-organisms Requirement to be monitored. Must include all requirements within NHS LA Standards Process to be used for monitoring e.g. audit Responsible individual/ committee for carrying out monitoring Frequency of monitoring Responsible individual/ committee for reviewing the results Responsible individual/ committee for developing action plan Responsible individual / committee for monitoring action plan N/A N/A N/A N/A N/A N/A N/A Escalations (if you require any further clarification regarding this procedure please contact): Matron Jo Shippey Paediatric Unit Consultation: Committees / Group Date Matron Jo Shippey Paediatric Unit Anita Swaine Lead Nurse Infection Control November 2017 Approval Committee Acute, Integrated and Paediatric SQS November 2017
Operating Procedure Management The overall responsibility for designating the cleaning of toys will be assigned to the matron/department manager. It is important that all staff take responsibility for cleaning toys and that they are aware of the cleaning requirements. A cleaning schedule must be devised and kept in an accessible place. A record must be kept of all cleaning activity. Evidence of toy cleaning must be kept in each department. An example of a checklist can be seen in Appendix 1. Paediatric unit will adhere to East Cheshire NHS Trust infection control policy and use that in conjunction with this SOP. Selection of Toys, Games and Play Equipment Age appropriate toys, games and equipment will be available for patients within the clinical setting as required. These must not increase the risk of spread of infection. This procedure applies to all toys/games/play equipment used by staff, patients and visitors. Toys must bear the C.E. European safety mark In areas where mental health is a key consideration, by following an appropriate risk assessment, this procedure remains relevant and all risk assessments must be documented in the patient s notes. Careful consideration must be given to how toys will be kept clean before they are purchased and adjustments must be made to facilitate effective cleaning Toys/games must be chosen with hard non-porous surfaces (which can be thoroughly cleaned Play equipment and storage containers used within the Trust, must be made of materials which can easily be cleaned using a disposable detergent wipe - Clinell Universal wipe Staff must examine each toy/game after use to ensure that it is fit for re-use i.e. check for broken parts/faults/loose parts etc. Soft toys are not recommended for general use unless dedicated as single patient use e.g. child s own / dedicated for individual children and taken home on discharge. Second hand toys are always gratefully received however care should be taken to ensure toys are in good working order and meet the above criteria for selection and cleaning. Unsuitable toys should be politely refused. Storage of Toys/Games Toys are stored in the designated play area. Other toys are available and are kept in lidded boxes for use in induvial clinic rooms and patient cubicles. Storage boxes must be used whenever practicable, these must be lidded and washable The area//cupboard//lidded box must be fit for purpose and will be the subject of a documented regular cleaning schedule It is the responsibility of the ward/department to ensure that soiled toys are removed from circulation and cleaned according to this SOP, prior to becoming available for re-use again. At the end of each play session all used toys must be cleaned before being returned to the lidded storage containers or play room. Only clean toys/games will be stored in this lidded box/cupboard/area All storage areas/cupboards/lidded boxes must be cleaned weekly and all documentation must be kept up to date. Outpatient Areas/Visitors Rooms The department manager must have a written system in place for staff to ensure that
used toys are cleaned and inspected at the end of each clinic session Toys will be kept to a manageable minimum so that appropriate cleaning can be undertaken after each use and at least weekly Staff will examine each toy/game regularly (at least weekly if not used) or when used, to ensure that it is fit for purpose or use. Any toys that have been used during a clinic session or during the day will be placed in the appropriate box (labelled dirty toys) and cleaned at the end of each clinic session. A notice will be displayed in each waiting area advising parents/ patients to report any dirty toys to a member of staff Cleaning/Decontamination Procedures To reduce the risk of cross infection, all toys and equipment must be made of a material that allows for effective cleaning and decontamination All equipment and toys must be cleaned, on minimum of a weekly basis, however toys must be cleaned when visibly soiled and between each session (It is recognised that some sessions include more than one child, cleaning is only necessary at the end of these sessions). All wipeable toys must be decontaminated with a detergent which will remove soiling combined with a disinfectant to remove microorganisms Clinell Universal wipe. This must be undertaken a minimum of daily. The entire surface of the toy must be wiped methodically with the Clinell Universal wipe and then allowed to dry. If the wipe begins to dry out discard into the clinical waste and replace with a fresh wipe Do not use the wipe for more than 1 toy/game /piece of equipment. Wash weekly with hot soapy water. Hospital toys must be washed with detergent and hot water, rinsed and dried on removal from the room of an infectious child who has been isolated. For patients where Clostridim Difficile or CPE has been identified, a sporicidal agent must be used. Should any toy or piece of equipment become contaminated with blood or body fluids these will require disinfecting using a chlorine based solution (Haz Tabs), followed by rinsing and drying (see guidance below). Toys awaiting cleaning must be stored in a box labelled as dirty toys and kept in an area that children/patients cannot access Each practitioner who comes into contact with play equipment must ensure that play equipment and storage are cleaned and checked a minimum of weekly, cleaned when necessary in between and compliance documented in (the appropriate place) Consider providing detergent wipes for parents/carers to use if they would like to clean toys prior to their use. Cleaning of specific toys Patient s own Toys/Games Mechanical/Electrical Toys These must be stored in their locker when not in use or other appropriate covered storage area e.g. toy box. If shared with other patients, the toy/games must be cleaned after use A Toy Information sheet (see appendix 2) is available within the ward booklet and there are posters around each cubicle and bay Mechanical/electrical toys must have the surface wiped a minimum of weekly using a damp colour coded cloth that has been rinsed in warm soapy water or detergent wipes followed by thorough drying.
Books Books must be inspected a minimum of weekly and the surfaces wiped using a disposable cloth that has been rinsed in warm soapy water/detergent wipes followed by thorough drying. As they have a potential of soaking up water, books with signs of dampness or mildew must be discarded. They may require frequent replacement. Dressing up clothing Dressing up can form an important part of a child s therapy or rehabilitation, however, only use when necessary for therapy. However, there is no facility to wash dressing up clothing at East Cheshire NHS Trust. Therefore, the Trust will not provide such items. Distraction box These are the responsibility of all staff and must be checked and cleaned as described earlier following each individual use or on a minimum of a weekly basis (if not in use). These must not be stored with other general toys. Preparation toys These toys must be regularly inspected and cleaned using an appropriate cleaning method as described earlier in this document. Play dough This can transmit infection. This must be for single patient use only. Play sand Outdoor Sand pits must be covered when not in use. The sand must be replaced regularly as it becomes discoloured. Blood-stained sand and sand that has come into contact with bodily fluids or faeces, should be discarded immediately. Sand must be discarded during any outbreaks. Individual Play Therapy Prior to use children s hands must be cleaned before and after use and skin lesions must be covered with a moisture impermeable dressing. Group Play/Therapy Where children/patients may benefit from sharing toys/play equipment, staff have a responsibility to support safe play this may require a documented risk assessment All toys/equipment must be cleaned at the end of all communal use sessions before placing back into storage this should also be recorded/documented Appendix 1: Cleaning Checklists Appendix 2: Information for Parents and Carers
Appendix 1: Cleaning Record Home Corner Small World Area Book & Music Corner Cleaning Rota Cupboard Toys Large Toybox Toddler Toys Creative & Construction Tables Please Tick, Initial and date when cleaning has been completed. The Playroom is thoroughly cleaned daily from 3-3.30pm.
Appendix 2: Parent Information Sheet for In-Patients Toys Information for parents and carers On the Children s ward we know how important toys are to all of our patients. We know they can play a critical role to their recovery and how bringing a favourite toy into hospital can make all the difference. Unfortunately toys that have not been cleaned properly can become a source of infection. To help us minimise the risk of infection we ask you to: Ensure any toys you bring into hospital are clean. All soft toys should be machine washed before bringing them into hospital. If your child is here for a long stay please wash their toys each week. Keep the number of toys brought into hospital to a minimum. This will allow us to effectively clean your child s bed area. Don t share your child s toys with other children unless they are group toys such as games. If your child has played with any hospital toys in their bed space, please give them back to ward staff to clean rather than putting them back into the general store. Please inform ward staff/ Play Leader if you are concerned about the cleanliness or condition of any Hospital toys. This fact sheet only gives general information. Please discuss any questions or concerns with a member of staff. Please help us to keep infections to a minimum.
Likeli-hood Impact Risk Score Initial Appendix 3: Risk assessment of cleaning toys Area being assessed: Decontamination of toys Name of assessor: Joanne Shippey / Nicola Rodman Contact number: 01625 661080 Date of initial assessment: 11/08/2015 Reviewed and Updated 30 th June 2017 Significant hazard Risk(s) Persons at risk Children on the ward like to play with toys. These could potentially harbour infection. -Toys need to be cleaned regularly to prevent the risk of spreading infection -Full guidelines about toy cleaning are based in the Trust s Infection Control policy Patients Visitors Current controls in place 1 3 3 The play team complete regular toy cleaning and have a checklist for the cleaning of toys in the play room The play team regularly check that toys are in fully working and in a good state of repair. There is a risk assessment for the outside toys which is completed daily There are guides on the Additional controls required to eliminate risk or reduce as far as practicable If any staff member sees a toy that looks dirty or in a poor state of repair they will either clean/repair it or discard it. Any toys donated to the ward are isolated until there is time to Estimated completion date Ongoing JS
ward to advise parents about bringing in toys from home. All toys that have been played with in isolation rooms are thoroughly cleaned before putting back into the playroom. clean/sort and repair them. All toys on the ward are assessed for their suitability for cleaning eg no soft toys.