Effective Surface and Environment Cleaning
Published: 12 April 2023
Published: 12 April 2023
It’s crucial to ensure surfaces and environments in healthcare settings are cleaned thoroughly and properly in order to prevent infection transmission and keep patients, staff and visitors safe and healthy.
Healthcare-associated infections (HAIs) can be transmitted in any healthcare setting, with approximately 165,000 cases occurring per year. HAIs can potentially lead to poor patient outcomes, increased healthcare costs and longer patient stays in hospital (NHMRC 2022).
HAIs also pose a risk to staff or any other people who enter a healthcare facility (NHMRC 2022).
Therefore, the effective implementation of infection prevention and control is crucial to ensure that high-quality healthcare is provided to patients and a safe working environment is maintained for staff (NHMRC 2022).
Successful infection prevention and control relies on a sound understanding of the modes of transmission and when preventative measures should be taken. This is the responsibility of not only healthcare staff but also visitors, patients, carers and administrators (NHMRC 2022).
Many infectious agents, comprising bacteria, viruses, fungi and parasites, exist in healthcare settings, usually originating from human sources (patients and staff). They are most commonly transmitted to others through contact (direct or indirect), droplet or airborne routes (NHMRC 2022).
The spread of these infectious agents between susceptible ‘hosts’ is a process known as the chain of infection, and preventing transmission relies on breaking the chain at any of its six links:
(NHMRC 2022)
For more information about infectious agents and the chain of infection, refer to Infectious Diseases: How Do You Break the Chain?.
Successful infection prevention and control involves the implementation of the following two-tiered approach:
(NHMRC 2022)
(NHMRC 2022)
Note: Transmission-based precautions must be used in addition to, not instead of, standard precautions.
Environmental surface cleaning relates to the cleaning of surfaces and objects in order to reduce contamination from infectious agents that may be present and as a result, prevent cross-infection (SA Health 2023).
The act of cleaning aims to remove foreign materials, including dust, soil, blood, secretions, excretions and micro-organisms from surfaces and objects. This is achieved through a combination of water, detergent and friction (SA Health 2021).
According to the Australian Guidelines for the Prevention and Control of Infection in Healthcare (2022), it’s good practice to clean as follows:
(NHMRC 2022; ACSQHC 2021)
Additionally, wet areas such as toilets, sinks, baths, showers and basins should be cleaned at least daily, and more frequently if needed (Health.vic 2021).
There are two types of chemicals used for cleaning in healthcare settings:
(SA Health 2021; ACSQHC 2021)
Cleaning solutions should be prepared immediately before use (Health.vic 2021).
Remember to follow workplace health and safety instructions and the manufacturer’s recommendations before using a disinfectant (Health.vic 2021).
Generally, the following principles apply to equipment used for cleaning:
(SA Health 2021; Health.vic 2021)
It’s important to adhere to appropriate cleaning techniques, as incorrect cleaning may encourage the spread of microorganisms rather than remove them (SA Health 2021). The following principles generally apply:
(SA Health 2021; ACSQHC 2021)
There are generally two processes used for environmental cleaning in healthcare that you can choose from: the two-step process and the two-in-one-step process (ACSQHC 2021).
(ACSQHC 2021)
Clean all surfaces using a single cleaning solution that contains both a natural detergent and a disinfectant. Allow the surfaces to dry completely.
(ACSQHC 2021)
Standard clean: | The minimum amount of cleaning that should be routinely conducted regardless of whether surfaces appear visibly dirty or not. |
Transmission-based clean: | Conducted when there are patients on transmission-based precautions.
|
Discharge (terminal) clean: | Cleaning of specific elements after the permanent vacation of a patient (e.g. due to discharge, transfer, death).
|
Spot and spill clean: | To be performed whenever a surface is visibly soiled or there is a body fluid spillage. |
(SA Health 2021)
Remember to refer to your organisation’s policies and procedures for environmental cleaning.
Question 1 of 3
True or false: Standard precautions should be in place all the time.