Bridging the Gap Health Care Environmental Services Study Guide Carts, Closets and Equipment Training Education and Developmental Series
Technology at work for you INTRODUCTION The Environmental Service Cart is the closest thing, other than the Environmental Service Supply Closet that the Environmental Service Technician has to a workstation, and they are the most visible piece of equipment that patients, staff and visitors will see, and because of the visibility, the Environmental Service Technician needs to be trained and educated on the importance of the cleanliness and organization process of their Environmental Service Cart. Table of Contents Introduction Overview Carts, Closets and Equipment Supply Closets Safety Cart Set Up Mixing Chemicals Preparation of Microfiber An Environmental Service Cart is both the workstation and office for the Environmental Service Technician and has a huge impact on overall productivity of the Environmental Service Tech. Not only does the Environmental Service Carts have to provide adequate storage for the supplies needed to stock restrooms and other areas of the Healthcare facility, but they also have to hold chemicals, charging buckets, cleaning tools such as microfiber flat mops and microfiber cloths, and waste and recycling. Without question, a messy Environmental Service Cart is going to produce a negative perception that extends to the Environmental Service Tech, the Environmental Service Department and the cleaning and disinfecting process itself. Charging Buckets Preparation of Specialty Tools and Supplies Prepare Collection/Trash Bags Preparation of Bowl Cleaner Final Steps The goal of this Module, Carts, Closets and Equipment, is to increase efficiencies in any way possible, and carts play an integral part when it comes to the productivity of the Environmental Service Technician. Best Practices 1
OVERVIEW When one is admitted to a hospital, there seems to be an air of quality and an air of quiet. People, who work in healthcare, appreciate the value of their service to mankind and their community. As a Professional Environmental Service Technician, when you come to work, always feel proud of the vital role you play in keeping your facility clean and disinfected. CARTS, CLOSETS and EQUIPMENT PREPARATION IS THE KEY TO EFFICIENCIES This Guide has three objectives: 1. To familiarize you with the proper care and upkeep of equipment and supplies. 2. To eliminate unnecessary damage or wear to equipment and facilities. 3. To encourage the proper use of supplies and eliminate unnecessary waste. This Guide will touch on each of these important objectives and how the Environmental Services Technician should implement them. 2 3
After reviewing this module you will be able to: 1. Properly maintain and organize the Housekeeping Supply Closet. 2. Put on and remove appropriate Personal Protective Equipment (PPE). 3. Inspect and clean the cart. 4. Prepare Chemicals. 5. Prepare the Charging Buckets with proper cleaning and Disinfecting Chemicals. 6. Prepare Microfiber Color Coded Cleaning System. 7. Prepare specialty tools and supplies. 8. Prepare the POCKET Mop System. 9. Install collection system for Solid Waste. SUPPLY CLOSETS It is the responsibility of the Environmental Service Technician to keep an adequate amount of supplies properly stored in the Environmental Service Supply Closet and also to care for, clean and store the various items of equipment that are used in your daily work. When you need supplies you should tell your supervisor what you need. 1. Don't wait until you run out or run so low that you will run out before fresh supplies arrive. 2. Anticipate when you are beginning to get low and tell your supervisor exactly what you need. 3. Your Supervisor will order it and inform you when the supplies have arrived. 3 4
CHECK SUPPLY CLOSET ONCE A WEEK This means you should schedule periodic checks of your supply closet, at least once a week, in order to make sure that you will always have adequate supplies on hand. Keep a list in your storage area of what you need. When the supplies have arrived you should take them to your Environmental Services Supply Closet. Take care to stock them in neat and orderly fashion with the items which are most frequently used nearest at hand. When you enter your storage area or closet you should know exactly where everything is located. You shouldn't have to search for anything. KEEP ENVIRONMENTAL SERVICES SUPPLY CLOSET NEAT & CLEAN The Environmental Service Supply Closet itself should also be kept neat, clean and orderly. This is very important. When management looks into your supply closet and finds a mess, you know who will be called to justify its appearance. So avoid trouble, and keep it clean. USE SUPPLIES EFFICIENTLY Supplies should be used efficiently and economically. Avoid wasting liners, paper towels, toilet paper, and so on. Treat the supplies as though they were your own, as though the money to pay for them was coming out of your own pocket. This does not mean that you should skimp in using supplies, but rather that you should use enough supplies to get the cleaning and stocking job done properly. 4 5
SAFETY FIRST Always think about your personal Safety First. You should always wear healthcare approved Personal Protective Equipment. You should always start your day with appropriate hand hygiene. This practice has long been recognized as the most important way to reduce the transmission of pathogens in healthcare settings. Hand Hygiene is the cornerstone of most Infection Control Programs Clinical Outcomes Studies have shown that effective Hand Hygiene reduced Infection Rates in Hospitals by 36%. For example, gloves are required any time an employee works with chemicals or infectious materials, such as blood and body tissues. Employees must also wear gloves if they are working in harmful extreme temperatures or if there is a risk of injury to the skin, such as burns or lacerations. Next, you should put on healthcare approved examination gloves. Medical gloves are used to prevent a wide variety of diseases to both patients and healthcare professionals. OSHA, Occupational Safety and Health Administration, is a Federal Agency that enforces and administers legislation regarding safety and health in the United States. As part of OSHA's regulations employees are required to wear gloves: 1. When their hands may be exposed to harmful substances. 2. When they may come in contact with infectious materials. 3. When gloves are needed to protect the skin from burns, cuts or other physical damage. 4. If an employee may be exposed to potential health hazards through the normal course of his or her work. This practice conforms with the OSHA, BLOODBORNE PATHOGEN STANDARD 29 CFR 1910.1030. 5 6
Once your task is completed, you should remove your gloves by grasping the palm of one glove near your wrist, carefully pull the glove off. Hold the glove in the palm of the still-gloved hand and slip two fingers under the wrist of the remaining glove. Pull the glove until it comes off inside out. The first glove should end up inside the glove just removed. Dispose of gloves safety and accordantly. Once again, wash your hands after removing gloves. Gloves can have holes in them that are too small to be seen. Always remember Safety First The Centers for Disease Control and Prevention (CDC) recommends eye protection for a variety of potential exposure settings where workers may be at risk. Eye protection provides a barrier to infectious materials entering the eye and is often used in conjunction with other Personal Protective Equipment (PPE). The eye protection chosen for specific work situations depends upon the circumstances of exposure, other PPE used, and personal vision needs. Unless eye protection is mandated, for example for Isolation Room Cleaning or mixing chemicals, it is not necessary to wear eye protection throughout your shift. Eye protection should be removed by handling only the portion of this equipment that secures the device to the head (i.e., plastic temples, elasticized band, ties), as this is considered relatively "clean." The front and sides of the device (i.e., goggles, face shield) should not be touched, as these are the surfaces most likely to become contaminated by sprays or splashes. There is wide variety in the types of protective eyewear, and appropriate selection should be based on a number of factors, the most important of which is the nature and extent of the hazard. 6 7
CART SET UP Start your shift by inspecting your cart. You should look for any damage to the cart first. If found you should report the damage to your supervisor. Inspect for any dirt, dust or stains. You should clean the cart with a GREEN microfiber cloth. The microfiber cloth can be used for wet and dry dusting. A well maintained cart will not only last longer, enhances the professionalism of your facility, but will help reduce the spread of dirt throughout your facility thus eliminating possible pathogens. Check the waste container for any remaining waste or linen. Always thinking Safety First, place a yellow safety sign on the cart.. MIXING CHEMICALS Chemical dilution rates and mixing process may vary from different Manufactures. Always follow Manufactures recommendations when mixing chemicals. Always follow Manufactures recommendations when measuring appropriate amounts of chemicals based on the number of microfiber mops or cloths to be diluted. When connecting chemical dilution systems up to the water source, always use PPE s as outlined on the Manufactures Safety Data Sheet. Always use the appropriate dilution system designed for that specific chemical for the correct dilution rates. When using a dilution system, according to OSHA standards, always use the proper Labeled Secondary Bottle from the dispensing system to the charging system. Never use the same Secondary Bottle for multiple chemicals. Up to date understanding of the hazards of handling and mixing chemicals is essential for safe use. 7 8
PREPARE THE COLOR CODED CHARGING BUCKETS For cleaning walls and floors, you need to prepare microfiber wet mops in the Charging Bucket. Start, by opening the leak-proof lid. Follow hospital protocol on the correct color coding of the mops. Next, you have two options as to how the Charging Bucket can be filled with the appropriate chemical. 1. You can either fill the 2.5 qt size container at the dilution station, or 2. Remove the charging bucket from the cart and bring to the sink for filling. Once filled, lock the leak-proof top on the Charging Bucket. If you choose to remove the charging bucket, be sure to use the proper lifting techniques while replacing the filled charging bucket back on the cart to avoid possible back injuries. Remember Safety First. Once the Charging Bucket is replaced on the cart, flip the charging bucket upside down on the cart as shown for a minimum of 15 minutes for proper charging of the microfiber mops with cleaning solution. Then the microfiber mops will be ready to be used. 8 9
NEXT, Prepare the Color Coded Charging Buckets with appropriate cleaning and disinfectant solutions. Color coded microfiber cloths are matched for specific tasks in the healthcare setting to help reduce the risk of cross contamination. Each color coded bucket has a closable lid to keep the microfiber cloths property saturated for maximum efficacy. There are three key elements that make the microfiber technology so extraordinary. 1. Microfiber technology provides longevity. 2. Backing material is a high performance fabric. 3. Loop design maintains Debris Channels. Measure the proper chemical in each color coded bucket as follows. 1. Place color coded microfiber cloths in matching color coded buckets. Each microfiber cloth has eight sides for non-contamination of surfaces. NOTE: First fold microfiber cloth in half. Next, fold microfiber in half again. After cleaning with one side, reverse the folding action so you will always have a non-contaminated side for cleaning and disinfecting. 2. Pour solution over cloths to assure saturation of product. 3. Place lid back on Bucket. Once the lid is attached, it will close automatically to assure safety and to contain the efficacy of the products used. 4. Let product sit for 15 minutes. 9 10
For Patient contact cleaning and disinfecting, the RED microfiber cloth is used wet with disinfectants such as hydrogen peroxide and peracetic acid or quaternary disinfectant cleaners. The RED microfiber cloth is used to disinfect the following direct patient contact areas: Patient Beds Wheel Chairs Stretchers Exam Beds Operating Room Table Procedure Table Gurneys Patient Equipment For General Surface Cleaning, the Green microfiber cloth is used wet with disinfectants such as hydrogen peroxide and peracetic acid or quaternary disinfectant cleaners for disinfecting the following high-touch items: Over-the-Bed Table Phone Nightstand Vertical and Horizontal surfaces Remotes, TV Medical Equipment Basins, High-Touch Areas Also Used for Wet and Dry Dusting 10 11
For Urinals and Commodes, The YELLOW microfiber cloth is used wet with disinfectants such as hydrogen peroxide and peracetic acid or quaternary disinfectant cleaners for disinfecting for the following areas: Commodes - inside and out Urinals - inside and out Commode Chairs - inside and out The YELLOW microfiber cloth is only used for these items and no other surface or equipment. For Windows and bright work, the BLUE microfiber cloth is used for bright work after being cleaned and disinfected with a GREEN microfiber cloth. The BLUE microfiber cloth can be used wet or dry to bring a shine to mirrors and bright work. You should always store additional supplies, chemicals, and properly labeled and additional microfiber cloths on the shelves in your housekeeping cart. This process will allow you to continue throughout the day without having to return to the utility closed for additional supplies. This procedure will help you become more efficient and in turn increase your productivity. The RED bucket or designated color coded bag on the cart is designed to store the used and contaminated cloths to be laundered. 11 12
PREPARE SPECIALTY TOOLS and SUPPLIES Preparing Specialty Tools starts with assembling the Pocket Microfiber Frame to the Microfiber Telescopic Mop Handle. The Pocket style microfiber mops are designed with a collapsible frame, disconnect fitting that easily slides into pocket mops for a no touch operation. The easy to use, light weight Pocket Mopping System reduces the risk of contamination and easily swivels around hard to reach areas and under furniture. Always store the mopping frame and mopping handle in one of the locking brackets with the frame down to prevent blocking your site while working. For high dusting, prepare a Flexible Wand and Microfiber Dusting Sleeve. Slide the sleeve over the wand and secure the dusting sleeve to the wand. Place the microfiber wand in one of the secure brackets on the Environmental Service Cart. For easy access to your cleaning supplies, and with safety in mind, the Environmental Service Cart has been designed with locking doors on both sides. Extra supplies can be safely stored so efficiencies in one work day can be met. For gathering large debris, a Duo-pan lobby dust pan along with an angle broom needs to be placed on the Environmental Service Cart. This can become useful for gathering larger debris from areas prior to mopping. This tool will also become very useful if and Medical waste, such as sharps, are found on the floor. 12 13
PREPARE THE SSS NEXGEN BUCKETLESS MOPPING SYSTEM For quick clean ups, it is recommended to have on the Environmental Service Cart a Bucketless Mopping System. The system allows fast and efficient clean ups without the use of a mop bucket. This innovative system has a heavy duty 16 inch frame with a 360 degree swivel head and designed to accommodate the hook and loop microfiber mopping pads. The system is designed with a Viton Seal to prevent leaks even with heavy duty chemicals. The 32 oz. bottle includes full level graduations in both liter and ounce. The translucent sight gage clearly identifies chemical level. Remove the chemical bottle, and attached top and fill with appropriate chemicals Be sure to properly label the bottle with supplied label according to OSHA Guidelines. Place a microfiber mop on the floor and connect to the frame of a microfiber mop. Place the mop on the front of the cart and secure the handle with the microfiber pad facing down. PREPARE COLLECTION BAGS There are several options for outfitting the appropriate waste collection bags on the Environmental Service Cart. Because some healthcare facilities use disposable pre-charged wipes for cleaning, a clear plastic liner would be used. The Environmental Service Cart has a closable lid to prevent orders from escaping and causing unfriendly scents while cleaning the patient units. This feature was designed for patient, staff and visitor comfort. Because some chemicals may have an unpleasant or unfamiliar order, a closable lid on the waste receptacle of the Environmental Service Cart diminishes this issue. 13 14
STOCK PAPER PRODUCTS and HAND SOAP Stock your cart with the appropriate paper products and hand soap. This is to include enough supplies to change out in each patient room. PREPARE BOWL CLEANER and CADDY Prepare the Impact Toilet Bowl Caddy and place on cart. Stock the caddy with the hospital approved, non-acid cleaner. FINAL STEP Now it is time to turn the Charging Mop Bucket upright and place on your Environmental Service Cart. After wiping down the lid of the charging bucket, and before exiting your Environmental Service Supply Closet, you should carefully remove your PPE s, and wash your hands according to standards. You are now ready to proceed to your first assigned Patient Room. 14 15
Health Care Environmental Services Training Programs It was the intent and goal of this Study Guide to train and educate you, as a Professional Environmental Service Technician on the objectives of: Preparation is the Key to Efficiencies 2 Executive Park Drive Billerica, MA 01862 (978) 667-7900 Training Education and Developmental Series 16