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Chapter Five
CLEAN ENVIRONMENTAL
SURFACES
By Mubarek M
Outline
Definitions of Key Terms
Weare Personal protective equipment (PPE)
Clean work surfaces
Maintain and storing equipment
Definitions of Key Terms
Biofilm: is an accumulated, thin layer of bacteria and
extracellular material that tightly adheres to surfaces (e.g.,
skin drains, urinary catheters) and cannot be easily
removed.
Cleaning: is the removal of visible dirt from objects and
surfaces, normally accomplished manually or mechanically,
using water with detergents or enzymatic cleaners.
Cleaning Solution: is any combination of soap or detergent
and water, with or without a chemical disinfectant used to
wash or wipe down surfaces such as floors, chairs, bench
tops and walls.
Definitions of Key Terms…
Contact time: is the length of time a cleaning product
must remain wet on the surface being cleaned for the
disinfectant to kill the targeted microorganisms.
Detergent (soap): is a cleaning product that lowers
surface tension of water, thereby helping to remove dirt
and debris.
Disinfectant Cleaning Solution: is a product that is a
combination of detergent (soap) and a chemical
disinfectant. It is true, that not all detergents and
disinfectants are compatible.
Definitions of Key Terms…
Disinfectants: are chemicals that destroy or inactivate
microorganisms.
Environmental cleaning: It is the general cleaning of
surfaces and equipment to reduce the number of
microorganisms present and providing a clean and
pleasant atmosphere.
Environmental Controls: activities of keeping standards
specifying procedures to be followed for the routine care,
cleaning and disinfection of surfaces, beds, bedrails and
bedside equipment
Definitions of Key Terms…
Frequently touched surfaces: are surfaces in patient care
areas in the health care facility with frequent hand contact.
Non-critical items: for the purposes of cleaning and
disinfection, are items that come into contact with intact
skin but not mucous membranes (e.g., blood pressure cuffs,
stethoscopes, and crutches).
Sanitizer: a chemical that reduces the number of bacterial
contaminants on inanimate objects to safe levels based on
public health requirements.
Sterilant: these are Chemicals used to destroy all forms of
microorganisms including endospores.
Wearing Personal Protective
Equipment (PPE)
When cleaning environmental surface it is highly
recommended to wear personal protective
equipment.
Under the current Covid-19 risk, the essential
cleaning PPE will be gloves and aprons, ideally
simple disposable ones,
Other personal protective equipment like mask,
shoes, eye ware also required.
Apron
General Principles For Cleaning
Scrubbing(Frictional cleaning) is the best way to
remove dirt, debris and microorganism.
Cleaning is required prior to any disinfection
process because dirt, debris and other materials can
decrease the effectiveness of many chemical
disinfectants.
Cleaning should always progress from least soiled
area to the most highly soiled areas.
Dry sweeping, mopping and dry dusting should be
avoided.
Cleaning Work Surfaces
Prepare a Disinfectant Cleaning Solution
The disinfectant cleaning solutions contain both
disinfectants for decontamination and detergents (soap) for
cleaning.
When we use Chlorine solution, we should be very
cautious. although chlorine-containing solutions (sodium
hypochlorite) are excellent and inexpensive disinfectants,
they should not be mixed with cleaning solutions
containing an acid like Ammonia or Ammonium chloride.
Cont…
To find out if a cleaning solution contains
ammonia, first check the label.
If it is not mentioned among the
ingredients, you may still be able to
detect ammonia when opening the
product by its pungent and burning smell.
Cleaning Methods
Wet Mopping Method (Preferable for Floor
Cleaning)
Single-Bucket (Basin) Technique: one bucket of
cleaning solution is used here. The solution,
however, needs to be changed when dirty. (The
killing power of the cleaning product decreases
with the increased load of soil and organic material
present).
Cont…
Double-Bucket Technique: two different buckets are
used here-one containing a cleaning solution and the other
containing water for rinsing. The double-bucket technique
extends the life of the cleaning solution (fewer changes
are required) saving both labor and material costs.
Triple-Bucket Technique: the third bucket is used for
wringing out the mop before rinsing which extends the
life of the rinse water.
Cont…
Flooding Followed by Wet Vacuuming Method
It is preferable for surgical suits.
It eliminates mopping and minimizes the spread of
micro-organisms.
It increases the contact time of the disinfectant and
the area to be cleaned.
Preferably, it should be done at night when the
traffic flow of the facility is low.
Cont…
Dusting: Should be used for cleaning walls, ceilings,
doors, windows, furniture and other environmental
surfaces.
Dry Vacuuming: This is recommended only for
cleaning carpets.
Maintaining & Storing
Equipment
Storing Equipment
All sterile items should be stored appropriately to
protect them from dust, dirt, moisture, animals and
insects.
The storage area should be located next to the place of
sterilization or connected to it in a separately enclosed
area with limited access that is used just to store sterile
and clean patient care supplies.
In smaller clinics, this area may be just a room close to
the Central Supplies Department or in the Operating
Room.
Maintaining & Storing
Equipment…
Instructions for Storing Sterile Items
Keep the storage area clean, dry, dust-free.
Control temperature and humidity (approximate temperature 24 oC)
Packs and containers for items should be stored 20 to 25cm off the
floor, 45 to 50cm from the ceiling and 15 to 20cm from an outside
wall.
Date and rotate the supplies (first in/first out). This process serves as
a reminder, but does not guarantee sterility of the packs.
Distribute sterile and high-level disinfected items from this area.
Maintaining & Storing
Equipment…
Shelf Life
The shelf life of an item (how long items can be
considered sterile) after sterilization is event-
related.
To make sure items remain sterile until you need
them, prevent events that can contaminate sterile
packs and protect them by placing them in plastic
covers (thick polyethylene bags).
Maintaining & Storing
Equipment…
Shelf Life…
Before using any sterile item, look at the package
to make sure that the wrapping is intact and the
seal is unbroken, clean and dry (as well as having
not water stains).
If the quality of wrapping clothes is poor and
plastic bags are not available, limiting the shelf life
is a reasonable option to resort to and secure the
sterility of the instruments.