Management of Environmental Safety and Cleaning in Hospitals

Recommendations

Clean housekeeping surfaces (e.g., floors, tabletops) on a regular basis, when spills occur, and when these surfaces are visibly soiled (Good practice statement)

Clean and disinfect environmental surfaces on a regular basis (e.g., daily, three times per week) and when surfaces are visibly soiled (Good practice statement)

Follow manufacturers’ instructions for proper use of disinfecting (or detergent) products -such as recommended use-dilution, material compatibility, storage, shelf-life, and safe use and disposal (Good practice statement)

Clean walls, blinds, and window curtains in patient-care areas when these surfaces are visibly contaminated or soiled. (Good practice statement)

Prepare disinfecting (or detergent) solutions as needed and replace it with fresh solution frequently (e.g., replace floor mopping solution every three patient rooms or hourly), according to the facility’s policy (Strong recommendation)

Decontaminate mop heads and cleaning cloths regularly to prevent contamination (e.g., launder and dry at least daily). (Good practice statement)

Detergent and water are adequate for cleaning surfaces in nonpatient-care areas (e.g., administrative offices). (Good practice statement)

Do not use high-level disinfectants/liquid chemical sterilant for disinfection of non-critical surfaces. (Strong recommendation)

Disinfect noncritical surfaces with an EDA and/or MoHP -registered hospital disinfectant according to the label’s safety precautions and use directions(Conditional recommendation)

Do not use disinfectants to clean infant bassinets and incubators while these items are occupied. If disinfectants are used for the terminal cleaning of infant bassinets and incubators, thoroughly rinse the surfaces of these items with water and dry them before these items are reused. (Strong recommendation)

Promptly clean and decontaminate spills of blood and other potentially infectious materials. (Strong recommendation)

For site decontamination of spills of blood or other potentially infectious materials (OPIM), implement the following procedures. Use protective gloves and other PPE (e.g., when sharps are involved use forceps to pick up sharps and discard these items in a puncture-resistant container) appropriate for this task. Disinfect areas contaminated with blood spills using an EDA and/or MoHP -registered tuberculocidal agent, (Conditional recommendation)

If sodium hypochlorite solutions are selected use 1000 ppm to decontaminate nonporous surfaces after a small spill (e.g., <10 mL) of either blood or OPIM. If a spill involves large amounts (e.g., >10 mL) of blood or OPIM, or involves a culture spill in the laboratory, use 5000 ppm chlorine for the first application of hypochlorite solution before cleaning in order to reduce the risk of infection during the cleaning process in the event of a sharp injury. Follow this decontamination process with a terminal disinfection, using 1000 ppm of sodium hypochlorite. (Strong recommendation)

If the spill contains large amounts of blood or body fluids, clean the visible matter with disposable absorbent material, and discard the contaminated materials in appropriate, labeled containment. (Conditional recommendation)

Use protective gloves and other PPE appropriate for this task (site decontamination of spill). (Conditional recommendation)

An EDA and/or MoHP-registered sodium hypochlorite product is preferred, but if such products are not available, generic versions of sodium hypochlorite solutions (e.g., household chlorine bleach) can be used. (Good practice statement)

Do not perform disinfectant fogging for routine purposes in patient-care areas. These refer to spraying or fogging of chemicals (e.g., formaldehyde, phenol-based agents, or quaternary ammonium compounds) as a way to decontaminate environmental surfaces or disinfect the air in patient rooms. (Strong recommendation)

Other Disinfection Methods

Hydrogen peroxide vapour disinfection  is not recommended as a routine  adjunct in healthcare facilities as the evidence of added value compared with conventional cleaning and disinfection is not well established (Strong recommendation)

Ultraviolet light disinfection, ultraviolet light in combination with sodium hypochlorite and other novel approaches to healthcare environment disinfection are not recommended as routine adjuncts in healthcare facilities as the evidence of added value compared with conventional cleaning and disinfection is not well established. (Strong recommendation)

The use of surfaces, fittings or furnishings containing materials with antimicrobial properties in healthcare facilities is not recommended as the evidence of added value compared with conventional cleaning and disinfection is not well established. (Strong recommendation)