Room Turnover Times, Infection Control and Hygiene

Ever wonder how your facility's room turnover times stack up against other institutions, especially relating to environmental hygiene and infection control? We invite you to join a conversation in progress on the ICTalk online forum to share your thoughts and experiences: http://forum.infectioncontroltoday.com/f17/room-cleaning-times-206/

In the meantime, here's a reminder from the Centers for Disease Control and Prevention (CDC)'s "Guidelines for Environmental Infection Control in Health-Care Facilities" on cleaning and disinfecting strategies for environmental surfaces in patient-care areas:

Select EPA-registered disinfectants, if available, and use them in accordance with the manufacturer's instructions (270--272). Category IC (EPA: 7 United States Code [USC] § 136 et seq.)

Do not use high-level disinfectants/liquid chemical sterilants for disinfection of either noncritical instruments and devices or any environmental surfaces; such use is counter to label instructions for these toxic chemicals (273--278). Category IC (Food and Drug Administration [FDA]: 21 CFR 801.5, 807.87.e)

Follow manufacturers' instructions for cleaning and maintaining noncritical medical equipment. Category II

In the absence of a manufacturer's cleaning instructions, follow certain procedures.

1. Clean noncritical medical equipment surfaces with a detergent/disinfectant. This may be followed by an application of an EPA-registered hospital disinfectant with or without a tuberculocidal claim (depending on the nature of the surface and the degree of contamination), in accordance with germicide label instructions (274). Category II

2. Do not use alcohol to disinfect large environmental surfaces (273). Category II

3. Use barrier protective coverings as appropriate for noncritical surfaces that are 1) touched frequently with gloved hands during the delivery of patient care; 2) likely to become contaminated with blood or body substances; or 3) difficult to clean (e.g., computer keyboards) (265). Category II

Keep housekeeping surfaces (e.g., floors, walls, tabletops) visibly clean on a regular basis and clean up spills promptly (279). Category II

1. Use a one-step process and an EPA-registered hospital detergent/disinfectant designed for general housekeeping purposes in patient-care areas where 1) uncertainty exists as to the nature of the soil on the surfaces (e.g., blood or body fluid contamination versus routine dust or dirt); or 2) uncertainty exists regarding the presence of multidrug resistant organisums on such surfaces (272,274,280,281). Category II

2. Detergent and water are adequate for cleaning surfaces in nonpatient-care areas (e.g., administrative offices). Category II

3. Clean and disinfect high-touch surfaces (e.g., doorknobs, bed rails, light switches, and surfaces in and around toilets in patients' rooms) on a more frequent schedule than minimal-touch housekeeping surfaces. Category II

4. Clean walls, blinds, and window curtains in patient-care areas when they are visibly dusty or soiled (270,282--284). Category II

Do not perform disinfectant fogging in patient-care areas (270,285). Category IB

Avoid large-surface cleaning methods that produce mists or aerosols, or disperse dust in patient-care areas (37,48,51,73). Category IB

Follow proper procedures for effective uses of mops, cloths, and solutions. Category II

1. Prepare cleaning solutions daily or as needed, and replace with fresh solution frequently according to facility policies and procedures (280,281). Category II

2. Change the mop head at the beginning of each day and also as required by facility policy, or after cleaning up large spills of blood or other body substances. Category II

3. Clean mops and cloths after use and allow to dry before reuse; or use single-use, disposable mop heads and cloths (282,286--288). Category II

After the last surgical procedure of the day or night, wet vacuum or mop operating room floors with a single-use mop and an EPA-registered hospital disinfectant (114). Category IB

Do not use mats with tacky surfaces at the entrances to operating rooms or infection-control suites (114). Category IB

Use appropriate dusting methods for patient-care areas designated for immunocompromised patients (e.g., HSCT patients) (37,40,280). Category IB

1. Wet-dust horizontal surfaces daily by moistening a cloth with a small amount of an EPA-registered hospital detergent/disinfectant (37,40,280). Category IB

2. Avoid dusting methods that disperse dust (e.g., feather-dusting) (40). Category IB

Keep vacuums in good repair and equip vacuums with HEPA filters for use areas with patients at risk (37,40,280,289). Category IB

Close the doors of immunocompromised patients' rooms when vacuuming, waxing, or buffing corridor floors to minimize exposure to airborne dust (37,40,289). Category IB

When performing low- or intermediate-level disinfection of environmental surfaces in nurseries and neonatal units, avoid unnecessary exposure of neonates to disinfectant residues on these surfaces by using EPA-registered germicides in accordance with manufacturers' instructions and safety advisories (271,290--292). Category IB, IC (EPA: 7 USC § 136 et seq.)

1. Do not use phenolics or any other chemical germicide to disinfect bassinets or incubators during an infant's stay (271,290--292). Category IB

2. Rinse disinfectant-treated surfaces, especially those treated with phenolics, with water (290--292). Category IB

When using phenolic disinfectants in neonatal units, prepare solutions to correct concentrations in accordance with manufacturers' instructions, or use premixed formulations (271,290--292). Category IB, IC (EPA: 7 USC § 136 et seq.)