ENVIRONMENTAL SERVICES PATIENT ROOM DISCHARGE CLEANING PROCEDURE PROVIDING A CLEAN AND SAFE ENVIRONMENT FOR PATIENTS, VISITORS AND STAFF. OUR CAUSE IS HEALTH, OUR PASSION IS SERVICE WE ARE HERE TO MAKE LIVES BETTER. 1
MATERIALS REQUIRED 1. Personal Protective Equipment as Needed. *Gloves *Safety Glasses 2. Housekeeping Cart stocked and ready ( Please refer to the cart setup Procedure) 3. Assorted Forms 4. Pens 5. Disinfectant cleaner 6. Glass Cleaner 7. Multi-Purpose Degreaser 8. Cream Cleaner 9. Neutral Cleaner 10. Quantamary Ammonium 11. Micro Fiber Cleaning Cloths 12. Cleaning Pail 13. Putty Knife 14. High Duster Tools 15. Plastic liners for waste containers, linen and bio hazard waste 16. Paper Towels 17. Toilet Seat Covers 18. Toilet Tissue 19. Endure 50 cartridge soap 20. Antimicrobial Hand Gel and Lotion 21. Broom 22. Dust pan and small counter brush 23. Bowl Mop or Bowl Brush 24. Micro Fiber mops and mop bucket and wringer 25. Wall Washer 26. Wet Floor Caution Signs 27. Tongs for picking up needles 28. Adhesive Remover 2
PREPERATION 1. Inspect your uniform for general cleanliness and appearance. If your uniform is excessively soiled, change into a clean article of clothing. 2. Attach name badge to your lapel and remember that your badge must be worn and in sight at all times during working hours. 3. Wear appropriate personal protection equipment. 4. Stock your housekeeping cart with required equipment and supplies. 5. Always start your day with fresh Disinfectant Cleaner. 18 REQUENTLY TOUCH POINTS 1. Toilet Seats 2. Flush Handles 3. Toilet Hand Rails 4. Commodes 5. Shower Faucets 6. Sink Top and Handles 7. Bathroom Light Switches 8. Pull Cords 9. door Knobs and Door Levers 10. Bed Rails 11. Bedside Table and Tray Table 12. Telephones 13. Call Boxes 14. Patient Chairs 15. Patient Room Door Knobs, Door Levers and area surrounding Levers and Knobs 16. Patient Room Thermostats and Light Switches 17. Soap Dispensers 18. Computer Work Stations 3
PROCEDURE 1. Enter the room carefully. A. Call into Dispatch and give room number. B. Look for infection control signs that indicate the need for special precautions. These signs may be printed or there may be evidence of isolation gowns in waste containers. If this is the case call dispatch for clarification of cleaning requirements. C. Follow protocol for hand hygiene and use of alcohol based hand rubs. Wash hands and then put on gloves, and any other personal protective equipment that may be necessary. D. ALWAYS knock and announce yourself Hello Housekeeping to make sure that the room is unoccupied. E. Leave your cleaning cart in the hallway as close as possible to the wall. Take only the supplies and equipment you need in the room as you need them. 2. Do a visual inspection of the room A. Reset the thermostat to the appropriate temperature so the room can adjust prior to the arrival of the next patient. B. Survey the area and pick up any loose trash. 4
C. Survey the area for leftover tape. Remove tape with adhesive remover if necessary. D. Be alert for needles and other sharp objects. Pick up sharps using a mechanical device such as tongs, forceps or brush and dustpan and place them into a sharps container. Be sure to document any discovery of any loose needles. 3. Soiled Waste Removal A. Use caution and look for protruding objects in the waste containers. NEVER reach into or push on the bag to compress the trash. B. Check for heavy objects in the container that would prevent safe removal. C. Close, twist and tie a knot in the top of the plastic trash liner while it is still in the container. D. Remove and place for disposal. Emptied waste will be disposed of in the appropriate container: Red waste bags will be placed in bio hazard waste receptacles and clear bags in waste receptacles. E. Wipe inside and outside of container with micro fiber cleaning cloth from disinfectant solution pail. Let stand for 10 minutes. Replace liner. 5
4. Remove Soiled And Used Linen A. Check for heavy objects in container that would prevent safe removal. B. Use caution and look for protruding objects in the linen container. NEVER reach into or push on the bag to compress the linen in its container. C. Close, twist and tie a knot in the top of the linen bag. Place the linen in the appropriate container for proper transport to the laundry. D. Remove gloves and follow protocol for hand hygiene and use of alcohol based hand rubs after handling any waste from the room. 5. High Dust Wall Articles A. High dust the tops of items along the patient room and restroom walls (picture frames, clocks, etc.) that are at or above your shoulder height. B. Use a long handled high dusting tool and make long slow strokes. 6. Disinfect Computer Workstations A Computer work stations are frequently touched points and are to be cleaned both daily and upon discharge. B. Hand hygiene should be performed between room cleaning and the cleaning of the computer as well as putting on clean gloves. 6
C. Computer keyboards and mice with or without covers should be cleaned and disinfected using the standard quaternary ammonium compound impregnated wipe. D. Monitors should be wiped with a dry microfiber cloth. 7. Change Or Inspect Privacy Curtains And Window Treatments. A. Inspect the privacy curtains for spots or stains. B. If soiled set up the stepladder if needed, be sure to place it squarely on a level surface and locking it open before climbing on to it. C. Remove and bag the curtains for laundering or dry cleaning. Be aware of the presence of blood and body fluids and use proper precautions such as gloves. Hold the soiled curtain away form your body to prevent contamination of your clothing. Place the bag in appropriate area for pickup D. Damp wipe the tracks. E. Hang the clean curtain and ensure that it is working properly. 8. Dust mop the floor A. Place the micro fiber on the floor dusting cloth holder. B. Inspect the floor for debris and wet spots. Dry all wet spots. You cannot dust mop a wet floor 7
C. Remove any gum or other sticky residue form the floor by gently prying it loose with the putty knife (be careful not to scratch the floor finish). D. Use the swivel motion of the frame and wrist action to change direction. Don t lift the cloth off the floor once you have started. E. Move furniture to one side of the floor, dust and then repeat. F. After dust mopping the entire area, gently sweep the pile of litter and dirt into the dustpan using the small broom. Dispose of the soil into an appropriate trash container. Never leave a pile of debris in a corner for later pick-up. 9. Clean the patient bed A. Clean the mattress with a clean cloth and disinfectant cleaner. Clean the top and sides of the mattress then fold the mattress in half and clean the exposed bottom of the mattress. B. Clean the exposed bed springs and frame. C. Fold the mattress to the other side of the bed and clean the exposed bottom of the mattress, bedsprings and frame. D. Unfold the mattress and re-wipe the top and sides of the mattress. Check for any soiled spots that you may have missed. E. Clean the headboard, footboard, side rails, and bed controls with disinfectant cleaner. Pay particular attention to the areas that are visibly soiled and surfaces frequently touched by the staff and patients. 8
10. Damp dust the doors and wall features. A. Damp clean the door and wall features in the patient room. Pay extra attention to the door knob, hand plate, door frame and chart holder. Use stainless steel cleaner on the face of the doors. Remember that elbow grease applying friction and removing the spores is the #1 defense in disease control. B. Begin cleaning at the entrance door and work around the room. Damp clean the top of an object first and work down to avoid soiling surfaces you have just cleaned. C. Fold the micro fiber cloth in a series of squares to provide a number of potential cleaning surfaces. A wadded cloth does not clean efficiently. D. Remove micro fiber cloth from disinfectant and wring out the excess solution to avoid drips. When using the disinfectant cleaner, wet the surface you are cleaning and allow to air dry. E. Clean items such as thermostats, light switches and ledges F. Spot clean visible soil from doors, walls windows and blinds. Pay particular attention to heavily soiled and frequently touched points. G. Use a scotch brite pad to clean stubborn spots then re-wipe the area the micro fiber cloth. H. Never shake the cloth. When it becomes soiled simply refold it so a clean surface is available or replace it with a clean one. 9
H. Never shake the cloth. When it becomes soiled simply refold it so a clean surface is available or replace it with a clean one. 11. Clean the room furnishings A. Clean all furnishings in the patient room including the bedside table, over bed table, closet, and chairs. B. Fold the micro fiber cloth in a series of squares to provide a number of potential cleaning surfaces. Wadded cloth does not clean as efficiently. C. Remove micro fiber cloth from disinfectant cleaning solution pail and wring out excess solution to avoid drips. When using disinfectant cleaner, wet the surface you cleaning and allow to air dry. D. Clean the top of an object first and work downwards to avoid soiling surfaces you have just clean Use the damp cloth on soil. Use an abrasive hand pad to clean stubborn soil then re-wipe surface with the cleaning cloth. E. Clean the interior and exterior of all furnishings. Be sure to open up and clean all drawers. On furnishings with cushions be sure to pull up any and all cushions and wipe under and around where the cushions sit. F. Pay particular attention to soiled or frequently touched surfaces such as bed controls, bed rails, and TV control as well as any hospital provided information that could be in the room. 10
12. Clean the telephone A. Clean the phone, cord and dial plate using the disinfectant cleaner. B. Thoroughly clean the hand piece and push buttons. 13. Clean and refill the soap dispenser A. Inspect soap dispensers to ensure that there is an adequate supply of soap. B. If a soap dispenser is a disposable unit and the soap level is low, replace the unit. C. If a soap dispenser is a reusable unit follow the instructions for opening, cleaning, filling and replacing the dispenser. Be sure to wash and dry the inside of the dispenser before adding fresh solution. D. Clean the exterior of the dispenser with a damp cloth and disinfectant cleaner. E. Report any broken or malfunctioning units to the Dispatcher who will then contact maintenance or other appropriate person for repairs. 14. Clean and refill the paper towel dispenser A. Open or unlock the dispenser. Be careful not to let it fall open as it can scratch the wall or hurt you. 11
B. As needed remove any paper towels and clean the inside of the dispenser using a damp cloth and disinfectant cleaner in order to remove loose paper dust. C. Replace paper towels. For folded paper towels, be sure to place them folded side down and interweave the bottom of the new sheets with the top of the existing sheets. Add as necessary in order to fill the unit. Do not overfill as this will make it difficult to pull the towels out. Check to be sure the towels release easily. Report broken dispensers to Dispatcher. D. Close and lock the dispenser making sure it is secure and will not fall open and hurt someone. E. Clean the outside of the dispenser with a damp cloth and disinfectant cleaner. 15. Clean and refill the toilet tissue dispenser A. Unlock the dispenser. B. Remove the tissue rollers. C. Clean the inside and outside of the dispenser to remove paper dust using a damp cloth and disinfectant cleaner. D. Install the new roll of tissue. Be sure the tissue unwinds over the top of the roll and not from underneath since this allows it to be pulled out more easily and avoids unrolling and wasted product. Be sure to start the tissue by pulling the first sheet loose for the convenience of the patient. E. Report any broken or malfunctioning units to the Dispatcher. 12
16. Clean the restroom walls and wall features A. Fold the cloth in a series of squares to provide a number of potential cleaning surfaces. A wadded cloth does not clean as efficiently. B. Dampen the cloth in disinfectant cleaner and wring out all excess solution to avoid drips. when using the disinfectant cleaner wet the surface you are cleaning and allow to air dry. C. Begin cleaning at the door and work around the room in one direction. D. Clean the top of an object first and work down to avoid contaminating surface just cleaned. E. Use a damp cloth on soil. Use an abrasive hand pad on stubborn soil then rewipe the surface with the cleaning cloth. F. Pay particular attention to soiled and frequently touched surfaces such as towel bars, grab rails, pull cords, light switches and ledges. 17. Cleaning the toilet A. Flush the commode. B. Apply disinfectant bathroom cleaner to the bowl mop. C. Clean the inside of the toilet with the bowl mop paying particular attention to the underside of the flush rim where bacteria can accumulate and cause unpleasant odors. 13
D. Let the disinfectant bathroom cleaner remain on the toilet and continue to the restroom sink 18.Cleaning the restroom sink A. Apply disinfectant to the interior surfaces of the sink. When using disinfectant cleaner, wet the surface and allow to air dry. B. Clean the inside of the sink, the exterior surface Of the sink, and all metal handles and faucets using a clean micro fiber cloth dampened with the disinfectant or bathroom cleaner. C. When the sink is visibly soiled use a white hand pad with the multi surface cream cleaner to remove stubborn soil. Always follow the manufacturer s recommendations for stain removal, especially on specialty surfaces. D. Clean any surfaces around the sink such as vanities or countertops with a damp cloth and disinfectant cleaner. E. Clean the plumbing underneath the sink using a dampened cloth with disinfectant cleaner. F. Wipe all metal fixtures to avoid spotting. G. Rinse the sink and dry with a clean cloth. H. Wipe up any spills. 14
19. Cleaning the tub and shower A. Apply disinfectant bathroom cleaner to a cleaning cloth and clean the interior surfaces of the tub and shower including the curtain or door tracks, doors, walls, soap dish, faucets and shower head. B. Use a white hand pad if necessary to remove soap scum especially from the walls and floors of a tiled shower stall and from doors. If the unit is fiberglass, be sure to follow all manufacturers recommendations regarding both general cleaning and stain removal. C. Rinse thoroughly using the shower spray if possible. D. Dry all surfaces carefully to prevent slips and falls. E. Clean all chrome handles and fittings and dry with a clean dry cloth to prevent spotting. F. Wipe up any spills. G. Inspect vinyl shower curtain for stains and or damage. Replace stained or damaged curtains with a new one. Bag the soiled curtain according to hospital procedure. Inspect fabric shower curtains for soil or damage removing any such curtains according to hospital procedure for laundering or dry cleaning. H. Hang new curtain. 15
20. Cleaning the pull cord A. Apply disinfectant bathroom cleaner to a cleaning cloth. Starting at the top of the pull cord, wrap the cleaning cloth around the pull cord. Hold top of the pull cord while gently wiping in a downward movement. Slight friction will remove debris, too much friction can set off the call light. 21. Finish cleaning the toilet A. Clean all exterior surfaces of the fixture with a clean cloth and disinfectant bathroom cleaner. Pay close attention to the toilet seat and lid. B. Clean all chrome flush handles, grab rails, etc, then dry with a clean dry cloth to prevent spotting. C. Flush the toilet. D. Dry the exterior, seat and lid of the commode carefully. E. Wipe up any spills on the toilet, floor, or walls. F. Clean the bedside commodes, take them apart and clean all sides and underneath. 16
22. Clean the mirror. A. Apply glass cleaner to the cloth B. Clean the entire mirror removing all visible dirt. Polish and inspect for spots and streaks. 23. Make the bed. C. Put the fitted sheet on the bed, tucking all corners securely under the mattress. Be sure it is absolutely smooth. D. Place the top sheet on the bed with the wide hem even with the top of the mattress-seam side should be up so that the finished side will touch the patient. Be sure the sheet is centered and that the drop of both sides of the bed is the same. Do not tuck in the foot at this time. E. Place the spread on the bed even with the top of the mattress-the seam side should be down so that the finished side shows. Be sure the spread is centered and the the drop on both sides of the bed is the same. Tuck both the spread and the sheet smoothly under the mattress fat the foot of the bed. F. Miter both corners at the foot of the bed, but allow the sides of the spread to hang loose. G. Turn the pillow case wrong side-out. Reach into the case and grab the center bottom seam. Using the same hand, grab the center end of the tagged end of the pillow. The case should now be correctly placed on the pillow. Smooth the case over the pillow making sure there are no bulges 17
H. Place the pillow on the bed with the seam of the case toward the head of the bed and the open end of the pillow away from the door of the room. Place a second clean pillow in the closet on the top shelf. I. Inspect the bed for neatness and smooth all wrinkles out of the spread. 23. Leave card and or forms A. Welcome cards- This small card, signed and dated by the person who has cleaned the room is placed on the bedside table. B. Concierge sign- This small sign informs The patient of a number they can call for immediate attention if they have a complaint or a concern. It is placed by the telephone. 24. Cleaning Baseboards A. Using a clean cloth with disinfectant cleaner beginning at the top, using friction, wipe all baseboards. The top ledge, the face, as well as the bottom. B. Pay close attention to the corners and heavily soiled areas. 25. Wet mop the floor A. Place the Wet Floor caution sign outside the room. B. To enable the reduction of cross contamination use a clean micro fiber mop head from the mop bucket. C. Push the mop around the baseboards first paying particular attention to removing 18
soil from the corners. Avoid splashing the walls and furniture. In open areas, use the figure eight stroke, overlapping each stroke. D. Use only one mop head per room. E. Repeat these steps until the entire floor has been mopped. F. Allow the floor to air dry 26. Clean the room entrance A. Spot clean visible soil from the room door with a clean cloth and disinfectant cleaner. Pay extra attention to the door knob, hand plate, and chart holders. B. Look over the room carefully and mentally check that you have performed all the required steps and that the room meets your standards. C. Leave the wet floor sign at the room entrance while you clean the next room. By the time you need the sign for the next room, the floor in this room should be dry. 27. Clean up after each room A. Remove all cleaning supplies form the room. B. Wash your hands. C. Notify the appropriate person that the room is clean and ready for the next admission. 19
Safety 1. Follow all the safety precautions explained in each procedure step. 2. Always read patient door signage. 3. Always use the cleaning chemicals exactly as directed by the label following all recommended safety precautions 4. Always practice standard precautions when handling articles soiled with blood or body fluids. Using PPE. 5. Always make sure the floor is dry before removing Wet Floor signs. 6. Always wash your hands before and after cleaning. 7. Be careful not to hurt yourself when moving furniture or other heavy objects. Always practice proper lifting techniques and ask for assistance when needed. 8. Always report all maintenance concerns to appropriate person for repairs. 20