Transcript Cleaning products and tools

Best Practices for Environmental Cleaning
MODULE 3 –Cleaning Products and Tools
Learning Objectives
1. Define and describe cleaning and disinfection
2. Explain the difference between detergents and
disinfectants and indicate their appropriate use.
3. Describe the importance of proper chemical
dilutions.
4. Explain the need for dedicated equipment/space and
care of equipment.
5. Have an increased awareness of new technologies.
2
Glossary of terms
• Cleaning – The physical removal of foreign material
(e.g. dust, soil) and organic material (e.g. blood,
secretions, excretions, microorganisms). Cleaning
physically removes rather than kills microorganisms.
It is accomplished with water, detergents and
mechanical action.
• Detergent – A synthetic cleaning agent that can
emulsify oil and suspended soil.
• Disinfection – The inactivation of disease-producing
microorganisms. Disinfection does not destroy
bacterial spores. Equipment must be cleaned
thoroughly before effective disinfection can take
place.
3
Glossary of terms
• Disinfectant – A product that is used on surfaces or
medical equipment/devices which results in
disinfection of the surface. Some products combine
a detergent with a disinfectant.
• Hospital-grade disinfectant – A low-level
disinfectant that has a drug identification number
(DIN) from Health Canada indicating its approval for
use in Canadian hospitals
4
Glossary of terms
• Hotel Clean: A measure of cleanliness based on
visual appearance that includes dust and dirt
removal, waste disposal and cleaning of windows
and surfaces. Hotel Clean is the basic level of
cleaning that takes place in all areas of a health care
setting.
• Hospital Clean: A measure of cleanliness routinely
maintained in client care areas of the health care
setting. Hospital Clean is “Hotel Clean” with the
addition of disinfection, increased frequency of
cleaning, auditing and other infection control
measures in client care areas.
5
Cleaning and Disinfectant Agents
• Hospital Grade Disinfectants
• Alcohols (60-90% ethyl or isopropyl)
• Chlorine - sodium (bleach) and calcium
hypochlorite
• Phenolics
• Quaternary Ammonium Compounds (Quats)
• Iodophors
• Accelerated Hydrogen Peroxide (AHP)
6
Hospital-grade
Disinfectants and Sporicides
Process Option Uses/Comments
Quaternary
ammonium
compounds
(QUATs)
- Floors, walls and
furnishings
- Blood spills prior to
disinfection
Advantages
Disadvantages
-Non corrosive
-Non-toxic,
low irritant
- Good cleaning
ability,
usually have
detergent
properties
- May be used on
food
surfaces
-Not to be used to
disinfect
instruments
- Limited use as
disinfectant
because of narrow
microbicidal
spectrum
- Diluted solutions
may support
the growth of
microorganisms
- May be neutralized
by various
materials (e.g.,
gauze)
7
Hospital-grade
Disinfectants and Sporicides
Process Option
Uses/Comments
Advantages
Disadvantages
Accelerated
Hydrogen
Peroxide 0.5%
(7% solution diluted
1:16)
- Isolation room
Surfaces
- Clinic and procedure
room surfaces
Low level disinfection is
achieved after 5
minutes of contact at
20°C.
- Safe for environment
- Non-toxic
- Rapid action
- Available in a wipe
- Active in
organic materials
- Excellent cleaning
due to detergent
properties
- Contraindicated for use
on
copper, brass, carbontipped
devices and some
aluminum
Accelerated
Hydrogen
Peroxide 4.5%
- Disinfection of
washrooms/commodes
C.difficile patients
Following cleaning,
sterility is achieved with
a 4.5% solution after 10
minutes of contact.
- Sporicidal
- Available in a gel
format
- Safe for environment
- Non-toxic
- Expensive
- Contraindicated on
surfaces as above
-Do not use on monitors
Hydrogen peroxide
3%
- home health
care equip
- Floors, walls,
furnishings
Disinfection after
30 minutes of contact
- Rapid action
- Safe for the
environment
- Non-toxic
- Contraindicated for use
on
copper, zinc, brass,
aluminum
- Store in cool place,
protect from light
8
Hospital-grade
Disinfectants and Sporicides
Process Option Uses/Comments
Advantages
Disadvantages
-Non-critical equipment
-Hydrotherapy tanks
- Blood spills
Low cost
Rapid acting
Readily available
Sporicidal
- Corrosive
- Irritant to mucous
membranes
- Use immediately
after diluted
- Need good
ventilation
Chlorines
Dilution
Undilute 5.25%
Blood spill -1:10 (major)
or 1:100 (minor)
Surface cleaning 1:50
9
Hospital-grade
Disinfectants and Sporicides
Process
Option
Uses/Comments Advantages
Disadvantages
Alcohols (7095%)
- External equipment
surfaces
(e.g., stethoscopes)
- Noncritical equipment
used for home health
care
- Disinfection is after 10
minutes contact.
- Fire code
restrictions for storage
- Evaporates quickly not a
good surface
disinfectant
- Evaporation may
diminish
concentration
- Flammable storage of
large volumes
problematic
-Coagulates protein; a
poor
cleaner
-May harm or
deteriorate some
materials and surfaces
- Inactivated by organic
material
- Contraindicated in the
O.R.
- Non-toxic
- Low cost
- Rapid action
- Non-staining
- No residue
- Effective on clean
equipment/devices
that can
be immersed
10
Hospital-grade
Disinfectants and Sporicides
Process Option
Uses/Comments
Advantages
Disadvantages
Iodophors
(Non-antiseptic
formulations)
Hydrotherapy tanks
Thermometers
Hard surfaces
• Rapid action
Non-toxic
Corrosive to metal unless
combined with inhibitors
 Inactivated by organic
Phenolics
- Floors, walls and
furnishings
- Hard surfaces and
equipment that do not
touch mucous
membranes (e.g., IV
poles, wheelchairs,
beds, call bells)
- Leaves residual film
on
environmental surfaces
- Commercially
available
with added detergents
to
provide one-step
cleaning
and disinfecting
- Slightly broader
spectrum
of activity than QUATs
- Cannot use is some
settings (nurseries,
food contact surfaces)
-May be absorbed
through skin
- May be toxic if inhaled
- Corrosive
-Some synthetic flooring
may become sticky
DO NOT use
phenolics in nurseries
11
Importance of chemical
dilutions
For effective cleaning and disinfecting ensure that:
• Manufacturer’s instructions for dilution
and contact time are followed
• Disinfectant solution is frequently
changed to reduce contamination
and maintain the proper dilution
• Cloths do not re-enter the disinfectant solution once
removed (i.e. no “double dipping”)
12
Learning Checkpoint
13
Learning Checkpoint
What are the key components of cleaning and
disinfection?
a) mechanical action / friction
b) contact time / dwell time
c) proper chemical dilution
d) all of the above
14
Learning Checkpoint Answer
• The answer is all of the above
Chemical
Contact / Dwell time
Action / Friction
15
Storage and cleaning of
housekeeping equipment
• Cleaning equipment requires attention to avoid
cross-transmission of microorganisms and growth of
microorganisms in dirty environments
• Tools and equipment used for cleaning and
disinfecting must be cleaned and dried between
uses (e.g. buckets, mop handles, squirt bottles,
wet floor signs)
• Mop heads and cloths should be laundered daily and
dried thoroughly before storage
16
Storage and cleaning of
housekeeping equipment
• Cleaning equipment shall be well maintained, clean
and in good repair
• Cleaning carts:
 Should have a separation between clean and
soiled items;
 Should never contain personal clothing or
grooming supplies, food or beverages;
 Should be thoroughly cleaned at the end of the day;
 In long-term care homes, cleaning carts shall be equipped
with a locked compartment for storage of hazardous
substances and each cart shall be locked at all times when
not attended.
17
Storage and cleaning of
housekeeping equipment
• All cleaning products should be appropriately labeled
and stored safely
• Chemicals must be clearly labeled with Workplace
Hazardous Materials Information System (WHMIS)
information and MSDS must be readily available for
each item
• Housekeeping Rooms/Closets should never contain
personal clothing or grooming supplies, food or
beverages
18
New Technologies
Microfibres:
•
•
•
Densely constructed polyester and nylon fibres
Positively charged microfibres attract dust and bacteria
and hold it tightly so that it is not redistributed around
the room during cleaning
Available as cloths, floor mops and high dusters
19
New Technologies
Air Disinfection/Fogging:
• Not currently in general use in Canada
• Vapourized Hydrogen Peroxide (VHP) – vapour is
delivered by computer-controlled distribution system
that ensures even distribution throughout the room
• Ozone Gas – should only be used in areas that may
be completely sealed off for the duration of treatment
• Super-oxidized Water – use as a disinfectant fog
shows promise but requires more study before
applying it to the health care environment
20
New Technologies
Steam Vapour
• Portable steam generators may be used to clean
kitchens, bathrooms, floors, walls and other surfaces
using steam delivered with a nozzle brush
• Steam vapour effectively travels through biofilm to
kill microorganisms that may be unreachable by the
surface application of disinfectants
21
New Technologies
Anti-microbial impregnated Supplies and
Equipment:
• Treated surfaces and equipment have not been well
studied and little data exists to show how these
antimicrobial chemicals will endure after exposure to
hospital-grade cleaners and disinfectants or whether
they will prevent disease
• These products are not recommended
22
Learning Checkpoint
23
Learning Checkpoint
1. Things that belong in a housekeeping closet are:
(check all that apply)
a) Properly labelled cleaning products
b) A cup of coffee and bottle of water
c) Cleaning tools
d) Personal clothing
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Learning checkpoint answer
1. Correct answer is: a and c
 The PIDAC best practice document and the
Occupational Health and Safety Act state that
personal clothing, beverages and food should not
be on a housekeeping cart. This is to protect the
housekeeper and other
staff/clients/residents/patients from transfer of
microorganisms.
25
Learning checkpoint
2. How often should the housekeeping cart be
cleaned?
a) Weekly
b) Daily
c) Does not need routine cleaning
26
Learning checkpoint answer
2. Correct answer is b
 The PIDAC best practice document recommends
that housekeeping carts are cleaned daily to
reduce the risk of contamination with
microorganisms.
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When you return to your job, what will you
do differently as a result of this session?
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Thank You!
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Image Sources – Module 3
• Microsoft Clipart used in slides 13 & 23
• Images in slides 16 & 17 are © PHO 2013