Cleaning and Disinfection of the Long Term Care Facility-Part 2

The 3-Legged Stool: People, Process and Technology

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

Expert Trainer @ GCI Certified


In Part 1 of this three-part blog, I discussed the all-important role people play in delivering a safe, clean and disinfected environment in which residents of LTC facilities can thrive. Although I was writing with long-term care facilities in mind, I didn’t intend to exclude the importance that sanitation plays in schools, early childcare facilities, corporate space, vacation rentals and, especially, hospitals.

The vast majority of microorganisms pose no threat to human kind. In fact, we need them to support life on earth. But a small subset of microorganisms can cause disease and death. A pathogen is any disease-producing agent, especially a virus, bacterium or other microorganism. Pathogens are not limited to the four walls of a LTCF, they are virtually in every public space and making people sick.

In Part 2, I want to discuss the second leg of this 3-legged stool, the PROCESS that will prevent infections as they relate to contaminated environmental surfaces. By definition a process is a series of actions or steps taken in order to achieve a particular end (i.e., a safe, clean and disinfected room, object or area).

You probably thought I would be discussing cleaning steps in this blog. You won’t be disappointed.

Before I talk about the PROCESS of reducing the numbers and types of pathogens from a room or surface, let me warn you that the consequences of performing the Process poorly:

1.   If the facility is using anything but micro-denier (microfiber) wipers and flat mops, the soil and biofilm will promote the proliferation of pathogenic microorganisms.

2.   If the facility does not adhere to a true color-coded system of micro-denier wipers and mops, the same cloth that is cleaning toilets, might be used on a table top where residents eat their meals.

3.   If the cleaning cloth and/or mop were used in a previous room, there is danger of cross-transmission of disease from one room to the next.

4.   If the Certified Environmental Services Technician (CEST) (see Part 1 for explanation) is not given enough time to process the room, improperly cleaned surfaces will remain a source of possible transference of pathogens from surface to hands or gloves.

5.   If a cleaning cloth is used improperly, the CEST might be picking up the soil from the first surfaces wiped and transferring the soil (e.g., pathogens) to other surfaces being wiped. If the CEST starts with the “dirtiest” part of the room and ends up with the “least soiled” part of the room, he or she has created fomites (definition-an object [such has a hand-touched surface] that may be contaminated with infectious organisms and serve in their transmission).

6.   Mal-odors may still be present from one of these sources: a. Urine in the rest room on grouted ceramic floors around toilets are not routinely removed; b. The carpet is dirty and in need of extraction; c. Waste receptacles where adult diapers are placed need to be routinely and thoroughly cleaned and deodorized; d. Waste remains unattended.

7.   Floors, horizontal and vertical surfaces have visible soil remaining. Visible soil might include: a. Trash remaining on the floor, behind doors and under furniture; b. Liquids (such as urine, blood or other body fluids) dried on rest room walls, fixtures or furniture; c. Television is streaked and or dusty appearing; d. Outsides of trash receptacles don’t appear to be clean; e. Privacy curtains, blinds, shades and furniture upholstery have spots and stains that could possibly be blood, urine, BM or other body fluids.

8.   Although the room is odor-free and appears to be surface cleaned, neat and orderly, there are items needing cycle or project cleaning: a. Carpet or upholstery need to be shampooed or extracted; b. VCT or other finished flooring needs to be buffed or refinished; c. Privacy curtains need to be replaced with clean and spot/stain-free curtains; d. Grouted tile or wax-free floors need to be machine-scrubbed to restore them to “like new” condition; e. Windows and glass need to be washed; f. Ceiling tiles, grid work (for suspended ceilings), recessed lighting, painted ceilings and HVAC vents in the ceiling need to be vacuumed and/or washed; g. Wall surfaces need to be vacuumed and/or washed.

By now you are getting the picture that a properly processed room, no matter where is in your facility, should be sanitized, orderly and have a clean appearance. While a clean room isn’t necessarily a sanitized room, a SANITIZED ROOM IS A CLEAN ROOM.

Finding the one best way to process a room, department or building means analyzing the facility’s needs and the tasks involved in meeting those needs. It means assessing methods and equipment options and available workforce and then putting it all together in a systematic program that runs like a finely crafted watch.

Just as every wheel or gear in a fine watch performs a specific integrated function, so should every part of a viable cleaning and disinfection program. By designing a plan, selecting the finest parts and fitting them all together in a synchronized fashion, the watchmaker creates an accurate timepiece. Finding the one best way to clean begins much the same way—with a carefully devised plan.

A needs analysis, including the desired level of clean and the frequency of cleaning necessary to reach that level, can serve as the groundwork for such a plan. This often keys on the building’s use, traffic flow and outside influences such as weather conditions.

In conclusion, the process should entail daily and terminal disinfection, removing mal-odors, placing things in a prescribed orderly appearance and cycle or project cleaning.

In Part 3, I will discuss the TECHNOLOGY leg of the three-legged cleaning and disinfection stool.

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

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, processing rooms, micro-denier wiper, micro-denier mop,

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