Free Membership.....

See What the FSSA can do for you.

 Cleaning/Disinfection of LTC Facilities

Cleaning and Disinfection of the Long Term Care Facility, or

The 3-Legged Stool: People, Process and Technology- Part 1

The cleaning of hard surfaces in Long-term Care (LTC) facilities is critical for reducing healthcare-associated infections (HAIs). Long-term care facilities continue to send many of their residents to hospital emergency departments and the majority of them end up becoming inpatients. In those LTC facilities, “…between 1 and 3 million residents get an HAI and up to 380,000 succumb to those infections.”

After being in the business of providing a safe, clean and disinfected environment in healthcare facilities of all sizes, I have come to the conclusion that the best cleaning/disinfection program involves three basic elements: 1. People; 2. Process; and, 3. Technology. In this three-part blog, my goal is to whet your appetite for all three elements. Hopefully, when you have read all three parts you will feel as passionate as I do about saving lives through better, more thorough cleaning.

Let’s start with the most crucial element of the three-legged stool: People (Process and Technology comprise the other two legs). The BEST process and Technology will ultimately fail if the person expected to deliver them struggles with low self-esteem, poor training, too little time for the task, low pay and poor management.

The person on the front-line of the battle could be called “Housekeeper”, “Cleaning Tech”, or numerous other titles that do little to convey their essential role of preventing or controlling the spread of infections in LTCs. The time has come to turn cleaning professionals into Certified Environmental Services Technicians (CESTs).

Infection prevention and control will only become a reality when the CEST is properly regarded, educated, equipped and compensated. Until then, the system will remain broken, or at the very least, in need of improvement.

Simple cleaning and disinfection (two separate tasks) of the environmental surfaces may be one of our key defenses in the future battle against multi-drug resistant organisms (MDROs) or a pandemic exposure of some super bug. With MDROs proliferating on common touch-points for 56 days or longer, the role of the cleaning professional cannot be left to uneducated, untrained people who come from some of the most disadvantaged areas of our society.

We cannot wait until the pandemic is upon us to raise up a legion of CERTIFIED ENVIRONMENTAL SERVICES TECHNICIANS; there simply won’t be enough time. On the other hand, according to the CDC website, there are 380,000 LTC residents who succumb to Healthcare-Associated Infections (HAIs) every year in America. The time to educate, train, equip and compensate Certified Environmental Services Technicians is NOW!

The Certified Environmental Services Technician must be:

·       Well trained (a national or international accredited training program);

·       Equipped with the “best in class” tools to clean, sanitize and disinfect;

·       Allotted time to do the necessary tasks;

·       Educated about the prevention and transmission of disease.

The CEST needs partners in providing a safe, clean and disinfected environment in which residents can thrive. The cleaning staff is in the resident’s room 15 minutes out of a 24-hour period. Who maintains the environmental hygiene of the room or area the other 23 hours and 45 minutes out of the day?

Infection prevention doesn’t (or shouldn’t) rely solely on the cleaning professional or CEST at your facility. Infection prevention must be a partnership and joint effort between the cleaning staff, resident, nursing staff, doctors and anyone else who enters the resident’s room.

For example, the environment can be maintained throughout the day by using disinfectant wipes to clean common touch points, removing spills immediately, removing waste (both general and medical or “red bag”) routinely, posting isolation signs and verbally reminding others to wash their hands.

Because nursing staff enter resident rooms most frequently, asking them to assist in this process will help in reducing surface-mediated transmission of disease.

Without a doubt, PEOPLE are the most important element in infection prevention. Without their full engagement, the 3-legged stool of cleaning and disinfection cannot stand.

In part 2, we will look at the Process of cleaning and disinfecting the resident’s room.

Tags: cleaning and disinfection, infection prevention, infection control, cleaning professionals, Certified Environmental Services Technician, HAI, Healthcare-associated Infections, MDRO, touch point cleaning, touch points, LTC, Long Term Care facilities, disinfectant wipes

Copyright© 2015. All rights reserved


GCI offers a certification program for cleaning professionals in LTC Facilities. For information about the Certified Environmental Services Technician  program, you can go here:


By J. Darrel Hicks, BA, MREH, CHESP,

Expert Trainer @ GCI Certified
- See more at:

See What the FSSA can do for you.

Free Membership.....

Florida Sanitary Supply Association

State Governing and Advocacy Association for Contractors, Distributors and Manufacturers of Cleaning and Maintenance Supplies