TITLE
INFECTION PREVENTION AND CONTROL
(IPC) GUIDELINES FOR PRINCIPLES OF
ENVIRONMENTAL CLEANING AND
DISINFECTION
October 28, 2013
SOURCE: INFECTION
PREVENTION AND CONTROL
RELATED DOCUMENTS
ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES CLEANING STANDARDS
ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES CLEANING FREQUENCY TABLES
ALBERTA HEALTH SERVICES HAND HYGIENE POLICY AND PROCEDURE
APPROVING AUTHORITY
PRACTICE SUPPORT DOCUMENT SPONSOR
Infection Prevention and Control Leadership
Infection Prevention and Control
If you have any questions or comments regarding the information in this guideline, please contact Infection Prevention & Control
infectionpreventioncontrol@albertahealthservices.ca
OBJECTIVES
Environmental cleaning practices are important in minimizing the spread of microorganisms.
The purpose of this guideline is to describe Infection Prevention and Control (IPC) principles to
be used when cleaning the environment where care is provided.
This document is intended to support existing Alberta Health Services protocols, procedures
and standards related to environmental cleaning.
APPLICABILITY
This guideline applies to all AHS staff, medical staff, volunteers, students and other persons
acting on behalf of AHS.
GUIDELINE
Basic IPC Principles
1.1
Before cleaning
a) use best practices for hand hygiene
perform hand hygiene:
o before entering a patient/client/resident space, or
(before contact with a patient or patient’s environment)
o prior to performing cleaning activity if already in the patient/client/resident
space;
o before leaving a patient/client/resident space, or
(after contact with a patient or patient’s environment)
o prior to commencing a non-cleaning activity if remaining in the
patient/client/resident space;
o following removal of disposable gloves and between changing disposable
gloves;
o before donning and after doffing reusable gloves. If reusable gloves, as per
Linen Environmental Services (LES) policy, are used they must be cleaned as
per facility procedure when moving from a dirty activity (for example cleaning
GUIDELINE
October 28, 2013
PREVENTION AND
CONTROL CLEANING AND DISINFECTION
PRINCIPLES: GUIDELINE
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a blood or body fluid spill) to a cleaner activity (for example wiping a high
shelf) or when entering a new patient/client/resident space; and
o when moving from one activity to another activity (including dirty to a clean
activities;)
used gloves must not be worn when walking from room to room or through other
areas of the health care facility.
b)
Alcohol-Based Hand Rub (ABHR) is the product of choice for performing hand
hygiene except:
when hands are visibly soiled with food, dirt, blood or body fluids;
following glove removal when cleaning space occupied by
patients/clients/residents with diarrhoea and/or vomiting;
c)
assume all blood and body fluids from all patients/clients/residents are infectious.
Follow routine IPC practices:
follow information on additional precautions signage posted on the door, use the
specified personal protective equipment (PPE) indicated on the signage.
wear gloves when cleaning spills of blood and body fluid. Additional personal
protective equipment (PPE) such as gowns, eye protection and mask may be
necessary when cleaning large spills (large spills are those larger than 23 cm but
less than 150 cm in diameter.)
wear PPE for protection from exposure based on the task to be performed.
do not overstock patient/client/resident care supplies.
PPE must not be worn outside the patient/client/resident space.
1.2
a)
b)
Cleaning Methods
Before cleaning:
gather materials for cleaning before entering the room.
remove unnecessary items from surfaces to be cleaned before starting to clean.
re-usable equipment removed from the patient/client/resident space must be
cleaned first.
collect waste by removing waste bags and handling plastic bags from the top.
check sharps containers, replace sharps containers once they are ¾ full or once
they have reached the fill line. Do not overfill.
Cleaning is a two-step process that involves the removal of soil and debris with
the first wipe followed by a second wipe with a clean cloth or mop for disinfection
(the deactivation of microorganisms.)
Proceed from:
clean areas to dirty areas. Toilet rooms should be cleaned last.
low frequency touch to high frequency touch surfaces.
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PRINCIPLES: GUIDELINE
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high surfaces to low surfaces.
NOTE: If there is visible soil, use a two-step process. First, remove the soil and then,
using a clean cloth, disinfect.
c)
During Cleaning:
change cloths/mop heads when:
o visibly soiled.
o no longer wet enough to moisten surfaces.
o moving from a dirty area to a clean area.
Follow manufacturer’s instructions for contact time when disinfecting.
do not dip cleaning equipment such as cloths or mops into the cleaning solution
more than once (double dipping).
change cleaning solutions when visibly soiled.
minimize shaking of items such as cleaning cloths, mops and linen to prevent
scattering or spreading of dust that may contain microorganisms.
observe your cleaning equipment and environmental surfaces for cracks,
breakdown, wear and damage and report to appropriate supervisor.
d)
After cleaning:
avoid overstocking patient/client/resident rooms.
do not top-up liquid dispenser products, for example soap or hand rub.
do not top-up cleaning and disinfectant solutions. Empty existing contents, then
clean and dry container (including buckets and flip-top bottles) before refilling with
fresh product.
Cleaning equipment/tools:
o must be cleaned and disinfected after use, using AHS approved solutions.
Equipment and tools used in additional precaution rooms must be cleaned
and disinfected on removal from the room. This includes small brushes or
other “detail” cleaning tools. If disinfection cannot be accomplished they are to
be discarded.
o Any cleaning equipment labelled as single-use is to be discarded after use.
o should be well maintained and in good repair
o are to be stored so as to prevent cross contamination.
1.3
a)
Minimum Cleaning Frequency:
Factors to consider for cleaning frequency are:
frequency of touch.
likelihood of contamination based on usual or expected activities.
patient population.
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PREVENTION AND
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PRINCIPLES: GUIDELINE
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b)
Cleaning is to be done on a regular and consistent basis, and as needed.
Minimum cleaning frequencies are outlined in LES Cleaning Frequency Table
(see Appendix 1).
Areas are classified as high, medium and low risk depending on patient
populations, activities being performed and microbial load.
High risk areas require more frequent cleaning than medium risk areas.
Medium risk areas require more frequent cleaning than low risk areas.
Risk areas are listed in the definitions and in Appendix 1: Alberta Health
Services Environmental Services Cleaning Frequency Expectations Table.
c)
High touch surfaces should be cleaned more frequently. High touch surfaces
include, but are not limited to; door knobs, bed rails, call buttons, light switches.
d)
Patient/client/resident spaces and toilet rooms should be cleaned at least daily
and as per site requirements.
IPC Principles for Product Preparation and Equipment:
2.1
When preparing cleaning products
Prepare fresh cleaning and disinfectant solutions using:
o manufacturer’s instructions for intended use
o the proper dilution
o appropriate PPE
Check solution concentration as per facility policy and manufacturer’s instructions
using manufacturer’s recommended test strips at least daily or more frequently as
per site requirements.
Cleaning and disinfectant products should be dispensed into clean, dry,
appropriately sized containers that are clearly labelled and dated and discarded
after expiry date.
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DEFINITIONS
Additional Precautions (AP) – Precautions (i.e. Contact Precautions, Droplet Precautions,
Airborne Precautions or combination of precautions) that are necessary in addition to Routine
Practices for certain pathogens or clinical presentations. These precautions are based on the
method of transmission (e.g. contact, droplet, airborne).
Clean - the state of a surface that has undergone physical removal of foreign material (e.g.
dust, soil) and organic material (e.g. blood, secretions, excretions, microorganisms). It is
accomplished through use of water, detergents and mechanical action.
Clean activity - any activity that involves contact with a clean surface or item (e.g. bed making,
restocking clean dispenser.)
Cleaning – The physical removal of foreign material (e.g. dust, soil) and organic material (e.g.
blood, secretions, excretions, microorganisms). Cleaning physically removes rather than kills
microorganisms. It is accomplished with water, detergents and mechanical action.
Dirty - the state of a surface in the absence of cleaning where contamination with foreign
material (e.g. dust, soil) and or organic material (e.g. blood, secretions, excretions,
microorganisms) has occurred, or has possibly occurred.
Dirty activity - any activity that involves contact with a dirty surface or item (e.g. cleaning blood
spills, emptying garbage.)
Disinfectant – A chemical agent used on inanimate objects to destroy virtually all recognized
pathogenic microorganisms, but not all microbial forms (e.g. bacterial spores).
Disinfection – The inactivation of disease-producing microorganisms. Disinfection does not
destroy bacterial spores. Medical equipment/devices must be cleaned thoroughly before
effective disinfection can take place.
Double dipping – is when used or soiled cloth or mop is re-dipped into a cleaning/disinfecting
solution(s).
High touch (surface area) - High touch surfaces are those that have frequent contact with
hands. Some of the examples include doorknobs, call bells, telephone, bedrails, light switches,
wall areas around the toilet and edges of privacy curtains.
Patient/Client/Resident Space- The immediate space around a patient that may be touched by
the patient and may also be touched by the health care worker when providing care. There may
be multiple patient spaces within a room or care area.
Personal Protective Equipment (PPE) – Clothing or equipment worn by staff for protection
against hazards. For example; gloves, masks, gowns or eye protection.
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October 28, 2013
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Routine Practices - a four-step process including hand hygiene, assessing the risk of
transmission reducing the risk of transmission (includes appropriate use of PPE, cleaning and/or
disinfecting the environment and equipment, proper handling of linen & waste, sharps injury
prevention, and appropriate resident placement or accommodation) and education
Two-Step Clean – A two-step, or “wipe twice” is the process to clean and then disinfect
surfaces. Organic materials must be removed during the first step, then disinfectant used in the
second step. A new cleaning cloth or mop is to be used between the steps.
High Risk Areas - OR Theatres, Invasive Procedure Rooms, OR Sterile Core, OR Recovery,
OR Nursing Station, OR Hallways, Burn Unit, Intensive Care Units, NICU, Emergency Room
Trauma & Cubicles, Labor Delivery, Hemodialysis, SPD Sterile Areas, Pharmacy Ad-Mix Room,
Transplant Units, Oncology.
Medium Risk Areas - Acute and Continuing Care Units, Outpatients, Clinic Rooms, Exam /
Treatment Rooms, Laboratory, O/T, P/T, Pharmacy, SPD Decontamination areas, Facility
Kitchens, and Client Dining Rooms, Long Term Care, Nursing Home, Auxiliary, Supportive
Living, Designated Assisted Living.
Low Risk Areas - All other areas not captured in medium and high risk charts such as, but not
limited to: Diagnostic Imaging, Materials Management, waiting areas, lobbies, offices, library,
Day Room, administrative areas, cafeterias, conference/board/meeting rooms.
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PREVENTION AND
CONTROL CLEANING AND DISINFECTION
PRINCIPLES: GUIDELINE
October 28, 2013
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REFERENCES
1. Alberta Health Services. Hand Hygiene Policy PS-02, October 2011.
2. Alberta Health Services. Hand Hygiene Procedure PS-02-01, October 2011.
3. Alberta Health Services, Infection Prevention and Control Resource ManualRecommendations for Management of Acute Care Patients with Known or Suspected
Diseases, May 2012.
4. Alberta Health Services, Linen and Environmental Health Services Environmental Services
Cleaning Frequency Standard ES-STD-CLN-002.
5. Health Canada. Hand Washing, Cleaning, Disinfection and Sterilization in Health Care.
Canada Communicable Disease Report, December, 1998. Vol. 24S8
REVISIONS
APPENDIX 1: ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES
CLEANING FREQUENCY EXPECTATIONS TABLE
High Risk Areas
OR Theatres, Invasive Procedure Rooms, OR Sterile Core, OR Recovery, OR
Nursing Station, OR Hallways, Burn Unit, Intensive Care Units, NICU, Emergency
Dept. Trauma & Cubicles, Labor Delivery, Hemodialysis, SPD Sterile Areas,
Pharmacy Ad-Mix Room, Transplant Units, Oncology
Medium Risk Areas
Acute and Continuing Care Units, Outpatients, Clinic Rooms, Exam / Treatment
Rooms, Laboratory, O/T, P/T, Pharmacy, SPD Decontam areas, Facility Kitchens,
and Client Dining Rooms, Long Term Care, Nursing Home, Auxiliary, Supportive
Living, Designated Assisted Living.
Low Risk Areas
All other areas not captured in medium and high risk charts such as, but not
limited to: Diagnostic Imaging, Materials Management, waiting areas, lobbies,
offices, library, Day Room, administrative areas, cafeterias, conference / board /
meeting rooms.
ALTHOUGH THESE ARE STIPULATED FREQUENCIES, THERE WILL BE TIMES WHEN ADDITIONAL CLEANING IS REQUIRED.
Best Practices for Environmental Cleaning in All Health Care
Settings - Draft, PIDAC-March 10, 2009,
(2) ORNAC 2006
(1)
Task
Frequency
Notes
High
Risk
Medium Risk
Low
Risk
ATM Machines
D
D
D
e-People Kiosks
Baseboard
Bassinets
D
D
D
A
A
A
D/C
D/C
n/a
D
D
D
D/C, W
D/C, W
D/C, W
D/C
D/C
n/a
D
D
Clean thoroughly
n/a
M
N/A
Damp wipe hand rails, railing latches and foot board
D
D
D
Clean thoroughly
n/a
BC
BC
Clean thoroughly
D
D
D
Clean thoroughly
D/C
D/C
D/C
Clean thoroughly
Bathtub & fixtures
(Including the lifting device) - Env. Services
(Nursing Staff between clients)
Common Use Tubs
Private Use Tubs
As required if there is a gap between when it is first cleaned and then used.
The user needs to clean the tub between patients; in many sites
housekeeping only cleans the exterior of the tub/fixtures and surrounding
area.
Bed
Thorough Clean - all mattress surfaces, foot and headboards, bed rails mattress pan, all
Acute Care Discharge mechanisms underneath mattress pan and wheels
Acute Care occupied Damp wipe hand rails, railing latches, and foot board
LTC/Continuing Care
Continuing Care, occupied
For family overnight stay
On call rooms
Resident Suites / Border Rooms
ES-STD-CLN-002-Att A – Last Updated Jul 5, 2013
Frequency Codes - e.g. Policing a Washroom 4 times per day = D4; M2=2 times per month
D-once per day; D/C-upon discharge; BC-between case; W-once weekly; BW - Bi-weekly;
M-once monthly; M2-twice per month; Q-once quarterly;
B-Bi-annually; A-once annually; AR-as required.
Page 1 of 12
APPENDIX 1: ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES
CLEANING FREQUENCY EXPECTATIONS TABLE
Best Practices for Environmental Cleaning in All Health Care
Settings - Draft, PIDAC-March 10, 2009,
(2) ORNAC 2006
(1)
Task
Frequency
Notes
High
Risk
Medium Risk
Low
Risk
n/a
M
M
D
D
D
D/C
D/C
D/C
D/C
D/C
n/a
D
D
n/a
D, D/C
D, D/C
D, D/C
Spot clean and restock
D
D
D
Clean thoroughly
W
W
W
D
D
D
1
B, AR
AR, A
AR, A
1
B, AR
AR, A
AR, A
1
B, AR
AR, A
AR, A
D
D
n/a
Not always a housekeeping task – sometimes Nursing Attendant responsibility.
D/C
D/C
n/a
Not always a housekeeping task – sometimes Nursing Attendant responsibility.
D
D
n/a
D/C and D
D/C and W
W
D
D
D
M,AR
M,AR
M,AR
D/C
D/C
n/a
Clean inside weekly
n/a
A
n/a
Must be emptied by nursing
n/a
n/a
n/a
Not a housekeeping responsibility
Acute Care awaiting placement to Continuing Care Clean thoroughly
Thorough wipe
Bedpan flusher/hopper exterior
Wall mounted blood pressure cuffs, and other wallThorough wipe (do not change).
mounted equipment at headboard (suction) etc.
Between clients for clinical staff, multi-use equipment
Bumper guards for beds - wall mounted damp wipe
Inpatient
Outpatient
Call bell and cord
Cart, housekeeping
Waste carts
Ceiling (other than OR)
Acoustical Clean, vacuum or brush
Miscellaneous Clean, vacuum or brush
Painted Clean, vacuum or brush
Chair
Commode Quick damp wipe - arms, seat, & back
Clean thoroughly
Geriatric Damp wipe arms, seat, back, leg supports, tray
In Patient/Client Room, with hard surface & fabric
Wheelchair Facility Owned - Damp wipe arms, seat, and back
Client Owned
Not ES responsibility unless specifically requested
Closet
Acute Care Closet, patient/client Clean inside/out thoroughly
Closet, continuing care patient/client
Computers
ES-STD-CLN-002-Att A – Last Updated Jul 5, 2013
Frequency Codes - e.g. Policing a Washroom 4 times per day = D4; M2=2 times per month
D-once per day; D/C-upon discharge; BC-between case; W-once weekly; BW - Bi-weekly;
M-once monthly; M2-twice per month; Q-once quarterly;
B-Bi-annually; A-once annually; AR-as required.
Page 2 of 12
APPENDIX 1: ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES
CLEANING FREQUENCY EXPECTATIONS TABLE
Best Practices for Environmental Cleaning in All Health Care
Settings - Draft, PIDAC-March 10, 2009,
(2) ORNAC 2006
(1)
Task
Frequency
Notes
High
Risk
Medium Risk
Low
Risk
?
n/a
n/a
W
W
W
D
D
D
Exterior Damp wipe
Handles, knobs
M
A
A
D
D
M
Top Damp wipe
M
M
M
Interior w/sterile products Damp wipe
n/a
n/a
n/a
B
B
A
When emptied / requested
Request that low risk be cleaned annually
Cubicle, change Regular Discharge
B
B
B
NOTE: Also changed if visibly soiled
Regular Occupied
AR
AR
AR
Isolation Discharge
D/C
D/C
D/C
Isolation Occupied
AR
AR
AR
A
A
A
NOTE: Also changed if visibly soiled
A,DC
A,DC
A,DC
NOTE: Also changed if visibly soiled
B
A
A
W, D/C
M
M
W
M
M
Q
Q
n/a
Emergency
W
N/A
N/A
Conference Damp wipe
Office Damp wipe
W
W
W
M2
M2
M2
Couch
Hard surface & fabric - staff lounges. Damp wipe
Hard surface & fabric – patient/client Damp wipe
Cupboards
Cupboard, interior w/non-sterile products
Not a housekeeping responsibility.
Curtain
Window, change/clean
Isolation Discharge, Wiped upon D/C
Blinds/Shades/Verticals Damp wipe
Curtain Track (bedside) Damp wipe
Curtain Track (window)
Shower Clean
Or more often if required
Desk
ES-STD-CLN-002-Att A – Last Updated Jul 5, 2013
Frequency Codes - e.g. Policing a Washroom 4 times per day = D4; M2=2 times per month
D-once per day; D/C-upon discharge; BC-between case; W-once weekly; BW - Bi-weekly;
M-once monthly; M2-twice per month; Q-once quarterly;
B-Bi-annually; A-once annually; AR-as required.
Page 3 of 12
APPENDIX 1: ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES
CLEANING FREQUENCY EXPECTATIONS TABLE
Best Practices for Environmental Cleaning in All Health Care
Settings - Draft, PIDAC-March 10, 2009,
(2) ORNAC 2006
(1)
Task
Multi-Station Damp Wipe
Dispensers
(cup, paper towel, toilet paper, soap, waterless hand
sanitizer)
Wipe, including underneath and refill
Frequency
Notes
High
Risk
Medium Risk
Low
Risk
D
D
D
D
D
D
D, DC
D
D
W
W
M
M
M
B
M
n/a
D/C and W
D/C and W
M
D
D
D
A
A
A
D
D
D
D
W
W
n/a
BC
BC
Door
Door handle/knob/push area Damp wipe
Door kick plate Damp wipe
Door Full wash thoroughly
Dresser
(outside / exterior)
Dusting
high places and hard to reach
Electric switch/cover
Elevators
Lights (ceiling) Vacuum/clean/wipe
High touch areas
Doors, tracks, frames, walls
Equipment, Community Use and/or Loaner
Site Specific Requirement
Responsible department is site specific.
Exam table
Eyewash station
D
D
n/a
W
W
W
File cabinet exterior, damp wipe
M
M
B
D
W
W
Hepa filter vacuum in high risk areas
A
A
A
Spot clean as required
Floors
Carpet Vacuum
Steam Clean
ES-STD-CLN-002-Att A – Last Updated Jul 5, 2013
Frequency Codes - e.g. Policing a Washroom 4 times per day = D4; M2=2 times per month
D-once per day; D/C-upon discharge; BC-between case; W-once weekly; BW - Bi-weekly;
M-once monthly; M2-twice per month; Q-once quarterly;
B-Bi-annually; A-once annually; AR-as required.
Page 4 of 12
APPENDIX 1: ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES
CLEANING FREQUENCY EXPECTATIONS TABLE
Best Practices for Environmental Cleaning in All Health Care
Settings - Draft, PIDAC-March 10, 2009,
(2) ORNAC 2006
(1)
Task
Frequency
Notes
High
Risk
Medium Risk
Low
Risk
D
D
n/a
D
W3
n/a
D
D
D
W3
W2
W
n/a
D
D
Responsible department is site specific.
Clean thoroughly / Autoscrub
n/a
D
W
Responsible department is site specific.
Pull out heavy items & scrub underneath
n/a
D
W
Dependent on use and size of kitchen; responsible department is site
specific.
Lounge, patient/client Damp Mop thoroughly including under furniture
D
D
D
Lounge, staff Damp Mop thoroughly including under furniture
D
W
W
M2
M2
M2
W
M2
M2
Washrooms Damp Mop
Wood (Auditorium, Gymn) Dry Mop
D
D
D
D
D
W
Only if gym is used daily.
Damp Mop
D
D
W
Only if gym is used.
Clean thoroughly
D
D
D
Move where possible and clean behind, user assists by emptying bookcases, desks
A
A
A
Or as requested.
A
A
A
Advise all departments that vinyl is recommended
Floors, hard surface
Client room Dry mop thoroughly
Damp mop thoroughly, including under bed & other furniture
Corridor Spot Clean
Clean thoroughly / Autoscrub
Food Service Dry mop
Office Dust Mop
Clean thoroughly , including under furniture
Fountain, water
Furniture
Office, heavy
(e.g., desk and bookcase cabinets)
Furniture, upholstered Steam clean
ES-STD-CLN-002-Att A – Last Updated Jul 5, 2013
Frequency Codes - e.g. Policing a Washroom 4 times per day = D4; M2=2 times per month
D-once per day; D/C-upon discharge; BC-between case; W-once weekly; BW - Bi-weekly;
M-once monthly; M2-twice per month; Q-once quarterly;
B-Bi-annually; A-once annually; AR-as required.
Page 5 of 12
APPENDIX 1: ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES
CLEANING FREQUENCY EXPECTATIONS TABLE
Best Practices for Environmental Cleaning in All Health Care
Settings - Draft, PIDAC-March 10, 2009,
(2) ORNAC 2006
(1)
Task
Frequency
Notes
High
Risk
Medium Risk
Low
Risk
D
D
D
Clean thoroughly
B
B
B
Exterior clean Clean thoroughly
Partitions, doors Spot clean
A
A
A
D
D
D
Clean thoroughly
W
M
M
AR
AR
AR
D
W
M
D
D
D
AR
M
n/a
n/a
n/a
D
D
D
W
W
W
W
W
W
BC, D/C, W
D/C, W
n/a
D
D
Touch
surfaces BC
D
M2
M
M
Site specific responsibility.
A
A
A
Site specific responsibility.
W
M
M
Site specific responsibility.
W
M2, AR
M2, AR
Site specific responsibility.
W, D/C
M2, D/C
M2,D/C
Site specific responsibility.
Glass
Inside Spot clean
Broken Clean up on request
Site Specific Responsibility; may be contracted or FME.
Hand Rails
Hallways Wipe
Washrooms Clean thoroughly
Hood
Exhaust kitchen Clean exterior only
Lab check lab standards
Housekeeping (Janitor) Room
Spot clean
Equipment Clean thoroughly
Hopper/Sink Clean thoroughly
I.V. pole
Ice machine
Damp wipe exterior
Touch
surfaces BC
Lifts – patient/client
Site specific
Not done by Housekeeping at all sites
Site specific equipment cleaning
Lights
Ceiling High dust
Clean outside and inside
Desk & floor Damp wipe
Half globe - wall Vacuum or damp wipe
Light - overbed Vacuum or damp wipe
ES-STD-CLN-002-Att A – Last Updated Jul 5, 2013
Frequency Codes - e.g. Policing a Washroom 4 times per day = D4; M2=2 times per month
D-once per day; D/C-upon discharge; BC-between case; W-once weekly; BW - Bi-weekly;
M-once monthly; M2-twice per month; Q-once quarterly;
B-Bi-annually; A-once annually; AR-as required.
Page 6 of 12
APPENDIX 1: ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES
CLEANING FREQUENCY EXPECTATIONS TABLE
Best Practices for Environmental Cleaning in All Health Care
Settings - Draft, PIDAC-March 10, 2009,
(2) ORNAC 2006
(1)
Task
Frequency
Notes
High
Risk
Medium Risk
Low
Risk
A
A
A
Site specific responsibility.
W
M2
M2
Site specific responsibility.
W
M2
M2
Site specific responsibility.
BC, D/C
D/C
n/a
Clean inside weekly
Clean in/out
A
A
A
Staff to empty contents
Clean thoroughly
D
D
D
Clean thoroughly
D
D
n/a
Damp mop
D
D
n/a
Damp wipe
D
n/a
n/a
Clean in/out
D
D
D
Damp wipe
D
D
D
DC
M
M
Wipe top and high touch areas
D
D
Clean thoroughly inside and out
D/C
D/C, M
n/a
D
D
D
BC
n/a
n/a
M
n/a
n/a
M
n/a
n/a
M, AR
n/a
n/a
D
n/a
n/a
D
n/a
n/a
Recessed hallway, reflective Vacuum
Spotlight Vacuum
Wall mounted Vacuum or damp wipe
Lockers
Bedside locker
Closet/Lock, staff - joint owners
Locker, Patient/Client (change room DI Area)
Locker, medication (site-specific)
Matting, fatigue
Mayo stand/table
Microwave, patient/client-specific
Mirror, patient/client
Wall
Pull out type Pull out and dust the back
Night Stand / Bedside Stand
Nourishment Centre
Operating Room Frequencies, CSR,SPD,MDR
Clean counter, sink, floor
Ceiling Spot clean
Clean thoroughly
Ceiling in areas outside of OR Theatre
Vacuum, brush or wash according to type of surface
(i.e. Surgical Suite)
Diffuser/vent Damp wipe
Door, OR Theatre Clean thoroughly
Door, kick plate Damp wipe
Site specific
ES-STD-CLN-002-Att A – Last Updated Jul 5, 2013
Frequency Codes - e.g. Policing a Washroom 4 times per day = D4; M2=2 times per month
D-once per day; D/C-upon discharge; BC-between case; W-once weekly; BW - Bi-weekly;
M-once monthly; M2-twice per month; Q-once quarterly;
B-Bi-annually; A-once annually; AR-as required.
Page 7 of 12
APPENDIX 1: ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES
CLEANING FREQUENCY EXPECTATIONS TABLE
Best Practices for Environmental Cleaning in All Health Care
Settings - Draft, PIDAC-March 10, 2009,
(2) ORNAC 2006
(1)
Task
Frequency
Notes
High
Risk
Medium Risk
Low
Risk
Door, handle/knob/push plate Damp wipe
BC
n/a
n/a
Door frames / tops outside OR (Surgical Suite) Damp wipe
W
n/a
n/a
Dumbwaiter, for clean supplies
Clean thoroughly
between OR,MDR and SPD
W
n/a
n/a
Site specific responsibility.
Dumbwaiter for soiled materials
Clean thoroughly
between OR,MDR, and SPD
D
n/a
n/a
Site specific responsibility.
BC
n/a
n/a
Site specific responsibility.
D
n/a
n/a
Dictated by site need (i.e., size, equipment, etc.)
BC, D
n/a
n/a
Site specific responsibility.
D
n/a
n/a
B
n/a
n/a
D, AR
n/a
n/a
End of day, unless visibly soiled
B
n/a
n/a
Maintenance cleans interior; Housekeeping exterior.
D
n/a
n/a
BC
n/a
n/a
If visibly soiled, clean 3' to 4' around perimeter of table. More cleaning done as
required (ORNAC 3.9.4)
D
n/a
n/a
Autoscrubbing dictated by site need (i.e., size, equipment, etc.)
D
n/a
n/a
Equipment in OR (table, supply table,
stands, other equipment, etc.)
Floor, Recovery Area Autoscrub or damp mop
Horizontal surfaces, OR and surfaces/equipment in
Between case clean
immediate contact with patient/client body fluids
Light, Recovery Room, over-bed Damp wipe
Lights, overhead SPD Clean
Light, surgical Damp wipe
Remove and clean lens
1
1
Linen hamper
OR Theatre Damp Mop
OR Theatre End of Day Autoscrub or flood, then wet vac or mop up with microfibre
Refrigerator - Drug, Sterile Core/Holding Area Damp wipe exterior
Refrigerator
Refrigerator
Stretcher
Vents, Ceiling (OR theatre and Sterile Core)
Vents, wall (OR Theatre and Sterile Core)
Pull out, clean behind
1
M
n/a
n/a
Defrost & clean interior
1
M
n/a
n/a
Between case clean
BC
n/a
n/a
Damp wipe exterior
W
n/a
n/a
Damp wipe exterior
D
n/a
n/a
Site-specific responsibility
ES-STD-CLN-002-Att A – Last Updated Jul 5, 2013
Frequency Codes - e.g. Policing a Washroom 4 times per day = D4; M2=2 times per month
D-once per day; D/C-upon discharge; BC-between case; W-once weekly; BW - Bi-weekly;
M-once monthly; M2-twice per month; Q-once quarterly;
B-Bi-annually; A-once annually; AR-as required.
Page 8 of 12
APPENDIX 1: ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES
CLEANING FREQUENCY EXPECTATIONS TABLE
Best Practices for Environmental Cleaning in All Health Care
Settings - Draft, PIDAC-March 10, 2009,
(2) ORNAC 2006
(1)
Task
Frequency
Vents ceiling / wall all other high risk areas Remove, clean
Walls OR Theatre and Sterile Core
Spot clean
(includes doors and frames)
Clean thoroughly
High
Risk
Medium Risk
Low
Risk
B
n/a
n/a
BC
n/a
n/a
W, AR
n/a
n/a
1
2
Notes
Site specific responsibility.
Walls, MDR,SPD (CSR) Sterile Processing
Clean thoroughly
includes doors and frames
1
B
n/a
n/a
Check new CSA standards when finalized
Walls, MDR,SPD (CSR) other areas
Clean thoroughly
includes doors and frames
1
B
n/a
n/a
Check new CSA standards when finalized
W
n/a
n/a
n/a
D
D
Damp wipe top, high touch areas
D
D
D
Clean thoroughly, including column and wheels
BC
BC
BC
D
D
W
D
D
D
Site specific responsibility.
M2
M2
M2
Site specific responsibility.
D
D
D
Site specific responsibility.
D/C
D
W
D
n/a
n/a
Warming cabinet in Sterile Core/Holding Area Clean exterior
Oven & stove
Overbed table
Pass through
Phones
Patient/Client and multi-use Damp wipe
Office / single use
Booth/stall
Radiant heat cover
Refrigerator
Wall mount – exterior only
Medical Damp wipe exterior
Pull out, clean behind
Q
D
n/a
Defrost & clean interior
Q
n/a
n/a
W
n/a
n/a
Pull out, clean behind
Q
Q, AR
AR
Defrost & clean interior
n/a
Q, AR
Q, AR
Staff Damp wipe exterior
Site specific responsibility.
May be site specific, due to differing equipment features
May be site specific, due to differing equipment features
ES-STD-CLN-002-Att A – Last Updated Jul 5, 2013
Frequency Codes - e.g. Policing a Washroom 4 times per day = D4; M2=2 times per month
D-once per day; D/C-upon discharge; BC-between case; W-once weekly; BW - Bi-weekly;
M-once monthly; M2-twice per month; Q-once quarterly;
B-Bi-annually; A-once annually; AR-as required.
Page 9 of 12
APPENDIX 1: ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES
CLEANING FREQUENCY EXPECTATIONS TABLE
Best Practices for Environmental Cleaning in All Health Care
Settings - Draft, PIDAC-March 10, 2009,
(2) ORNAC 2006
(1)
Task
Frequency
Notes
High
Risk
Medium Risk
Low
Risk
D
D
D
D
D
D
Nourishment Wipe high touch areas
Damp wipe exterior
Pull out, clean behind
1
M
Q, AR
Q, AR
Defrost & clean interior
n/a
Q
Q
Patient/Client Damp wipe
Bookshelves Damp wipe front ledge
D/C
W,DC
W,DC
M2
M2
M2
Generally in office or lounge areas
Clean thoroughly
A
A
A
If emptied
Multi-use Clean thoroughly
D
D
n/a
D
D
n/a
D/C
D/C
n/a
D
D
D
W
W
W
n/a
n/a
n/a
AR
AR
AR
May be site specific, due to differing equipment features
Shelves
Shower Stall and fixtures
Single room Damp wipe taps, dispenser, floor and seat
Clean thoroughly
Sink
Basin, fixtures, drain, and overflow Damp wipe
Sink stopper Brush clean
Spills
Patient messes, incl.blood and body fluid Initial clean-up
Follow-up cleaning
User department responsibility for initial cleanup; Housekeeping may be
responsible at some sites for Code Brown issues.
Chemical Initial clean-up
Stairwell
Stools
Storage Rooms
Clean
D
W
W
Damp wipe
D
D
M2
M
M
M
A
A
A
On-Unit Clean
Basement Clean
Nursing responsible for initial clean-up
Site specific responsibility.
Stretchers
ES-STD-CLN-002-Att A – Last Updated Jul 5, 2013
Frequency Codes - e.g. Policing a Washroom 4 times per day = D4; M2=2 times per month
D-once per day; D/C-upon discharge; BC-between case; W-once weekly; BW - Bi-weekly;
M-once monthly; M2-twice per month; Q-once quarterly;
B-Bi-annually; A-once annually; AR-as required.
Page 10 of 12
APPENDIX 1: ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES
CLEANING FREQUENCY EXPECTATIONS TABLE
Best Practices for Environmental Cleaning in All Health Care
Settings - Draft, PIDAC-March 10, 2009,
(2) ORNAC 2006
(1)
Task
Notes
High
Risk
Medium Risk
Low
Risk
B/C
D
n/a
BC – quick
wipe on top
B/C
n/a
W
W
n/a
Site specific responsibility.
D
D
W
If used.
D and BC
D,D/C
D, D/C
Site specific responsibility.
D
W,D/C
n/a
Site specific responsibility.
W
W
M
Site specific responsibility.
Clean thoroughly
D
D
D
Descale
AR
AR
AR
Site specific frequency
D/C
D/C
D/C
Site specific duty; may be other dept. responsibility
D, BC
Site specific; may be other dept. responsibility
Emergency/Exam/Treatment Clean thoroughly between mattress and bedrails
Morgue Quick Wipe
Thorough
Table - Conference
Television
Remote control, all areas Damp wipe
Screen, patient room Damp wipe
Screen in lounge/public areas Damp wipe exterior
Toilet & fixtures
Frequency
Site specific; housekeeping does not have D/C responsibility in all sites.
Toys
Dedicated (must be non-porous) Clean
Play area Clean
Plush
Shared electronics, high touch areas (i.e. joysticks,
Clean
keyboards
Urinal & fixtures
Utility Room, Clean or Soiled
n/a
1
D
1
D, BC
n/a
1
D
1
n/a
1
D
1
Must be sent home with client or discarded
Site specific responsibility.
D
D
D
D
D
D
D
D
All other tasks (walls, ceilings, lights), per risk area
D
D
D
Owner responsibility
Spot clean
D
D
D
Clean thoroughly
B
A
A
Remove, clean
B1
B
A
Vending machine
Vent/diffuser
D
D
Damp mop floor, clean counter, sink, dispensers
Walls
1
Site specific responsibility.
ES-STD-CLN-002-Att A – Last Updated Jul 5, 2013
Frequency Codes - e.g. Policing a Washroom 4 times per day = D4; M2=2 times per month
D-once per day; D/C-upon discharge; BC-between case; W-once weekly; BW - Bi-weekly;
M-once monthly; M2-twice per month; Q-once quarterly;
B-Bi-annually; A-once annually; AR-as required.
Page 11 of 12
APPENDIX 1: ALBERTA HEALTH SERVICES ENVIRONMENTAL SERVICES
CLEANING FREQUENCY EXPECTATIONS TABLE
Best Practices for Environmental Cleaning in All Health Care
Settings - Draft, PIDAC-March 10, 2009,
(2) ORNAC 2006
(1)
Task
Frequency
Notes
High
Risk
Medium Risk
Low
Risk
Waiting room
Clean tables and chairs touch areas, and floors
D
D
D
Warming cabinet
Washroom
Waste receptacle
Clean exterior
D
D
n/a
D
D
D
D
AR
AR
n/a
AR
AR
Mixed waste (wet and dry) Thoroughly damp wipe exterior and interior
Dry waste Thoroughly damp wipe exterior and interior
Windows - exterior
Window ledge
A
A
A
D1
D1
W
X-ray view screen
D
D
D
Where Hskg is responsible
Site specific responsibility.
Best Practices for Environmental Cleaning in All Health Care
Settings - Draft, PIDAC-March 10, 2009,
(1)
(2)
ORNAC, June 2006
ES-STD-CLN-002-Att A – Last Updated Jul 5, 2013
Frequency Codes - e.g. Policing a Washroom 4 times per day = D4; M2=2 times per month
D-once per day; D/C-upon discharge; BC-between case; W-once weekly; BW - Bi-weekly;
M-once monthly; M2-twice per month; Q-once quarterly;
B-Bi-annually; A-once annually; AR-as required.
Page 12 of 12