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Thorough environmental cleaning and disinfection of rooms where patients with multidrug-resistant organisms (MDROs) were hospitalized and treated is essential. The purpose of this cleaning and disinfection process is to remove bacterial contamination from environmental surfaces and equipment surfaces where patients receive care in order to prevent the transmission of the microorganism from patient to patient, from patients to healthcare workers, and from patients to visitors.
Environmental services (ES) personnel should receive proper training and education on patient room cleaning and disinfecting protocols, and they must use all barrier precautions (such as masks, gloves and gowns) when cleaning in rooms or units where surfaces may be contaminated with infectious microorganisms.
ES personnel should use Environmental Protection Agency (EPA)-approved, hospital-grade cleaning and disinfectant products and all horizontal surfaces and other surfaces in the room that may have become contaminated must be cleaned and disinfected.
Terminal cleaning of patient rooms should include the following steps:
• Using an EPA-approved, hospital-grade disinfectant, the following items should be cleaned:
> Top, front and sides of the bed’s headboard, mattress, bedframe, foot board and side rails, and between side rails
> TV remote
> Nurse-call device and cord
> All high-touch areas in the room including tabletops, bedside tabletop and inner drawer, phone and cradle, armchairs, door and cabinet handles, light switches, closet handles, etc.
• In the bathroom, start with the highest surface and clean the toilet last; clean the sink and counter area, including sink fixtures, and if there is a shower, the support bars and shower fixtures and surfaces
• Privacy curtains should be removed, placed in a plastic bag in the room and double bagged into a laundry bag with the assistance of another member of the ES staff standing at the door outside the room. The person outside the door should wear gloves. After completing the task this person should remove gloves, wash hands with an antimicrobial soap and water or apply an alcohol rub to their hands.
• Cleaning of window curtains, ceiling or walls is not necessary unless visibly soiled.
• Following patient discharge, clinical equipment must be cleaned and disinfected, moved to the door of the room for removal to central supply or to the sterile processing department.
• Following the terminal cleaning of a patient room, gloves should be removed so as to avoid touching the outside of the gloves. Hands should be washed with an antimicrobial soap and water or an alcohol rub applied to the hands prior to donning a new set of gloves.
Reference: “Practice Guidance for Healthcare Environmental Cleaning” from the American Society for Healthcare Environmental Services (ASHES).