Introduction
Cleaning and disinfection are essential practices in healthcare, food service, and everyday environments to prevent the spread of infections and maintain hygiene.
Asepsis is a state of being free from disease-producing organisms. It is important in the hospital environment to prevent cross-infection as well as to control infection.
Disinfection and sterilization are essential to ensure that medical and surgical instruments do not transmit infectious pathogens to patients.
Definitions
Cleaning is a form of decontamination by removing organic matter, salts, and visible soils. The physical action of scrubbing with detergents or surfactants and rinsing with water is called cleaning.
Disinfection is a process that eliminates many or all pathogenic microorganisms, except bacterial spores on inanimate objects.
Principles for Cleaning and Disinfection
- Cleaning should be done with a wet mop or vacuum cleaner.
- After cleaning, the area should be dry, as bacteria get naturally killed in dry areas.
- Cleaning of the roof is recommended only when there is accumulation of dust.
Cleaning and Disinfection Guidelines
The guidelines for cleaning and disinfection of the healthcare facility are;
| Guidelines for Cleaning and Disinfection | ||
| Area/item | Process for Disinfection | Method |
| Floors. | Detergent and 1% sodium hypochlorite. | (Use three buckets: one with plain water and one with detergent solution; one bucket for 1% sodium hypochlorite). First, mop the area with warm water and detergent solution. After mopping, clean the mop in plain water and squeeze it. Mop the area again using sodium hypochlorite 1% after drying the area. Mop the floor starting at the far corner of the room and work toward the door. |
| Ceiling and walls. | Detergent/1% sodium hypochlorite. | Damp dusting should be done in straight lines that overlap one another. |
| Doors and door knobs. | The doors should be washed with a brush. | |
| Isolation room. | Terminal cleaning. Three-bucket technique (as mentioned previously). | |
| All clinical areas/ laboratories where spill care is required. | 1% sodium hypochlorite. | As per spill management protocol. At the end, wash the mop with detergent and hot water and allow it to dry. |
| Stethoscope, BP cuffs and covers, Thermometer. | Alcohol-based rub/spirit swab. | Wipe with alcohol; rub in between each patient use. |
| Injection and dressing trolley. | Detergent and 70% alcohol. | Clean daily with detergent and water. After each use, the trolley should be disinfected with 70% alcohol-based reagent. |
| Refrigerators. | Detergent and water are used to clean the inside surface at least weekly once. Follow the surface cleaning schedule as mentioned for cleaning high-touch surfaces. | Empty the fridge and store things appropriately.Defrost, decontaminate, and clean with detergent.Dry it properly and replace the things. |
| Equipment (equipment need to be disinfected after every contact with the suspected patient). | All areas and surfaces of equipment: 1% sodium hypochlorite. Sensitive probes of equipment: 70% alcohol. CT/MRI-like machines: As per manufacturer’s instructions. | Whenever possible, portable radiographic equipment should be used to limit transportation of patients. |
Special Considerations
- Environmental services should be fully integrated into the hospital’s infection control strategy.
- Regular training and education for cleaning staff on best practices.
- Use EPA-approved disinfectants effective against healthcare-associated pathogens.
- Ensure compatibility with medical equipment and surfaces.
- Develop setting-specific protocols for different hospital areas (e.g., ICU vs. general wards).
- Implement risk-based cleaning schedules—high-touch surfaces require more frequent disinfection.
- Conduct routine audits to assess cleaning effectiveness.
- Use fluorescent markers or ATP testing to verify surface cleanliness.
- Operating rooms: Follow strict sterilization protocols.
- Isolation rooms: Use dedicated equipment and enhanced cleaning measures.
- Blood spills: Follow biohazard protocols for safe cleanup.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
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