CLEANLINESS OF THE WARD
AND ITS ANNEXES
HAMENU VAVA CYRIL
Environmental Management /
Controls (Housekeeping and
Waste Disposal)
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Environmental controls are practices
that are performed to render the
health care facility environment safe
from infections or reduce the
infections to the barest minimum.
General cleanliness and hygiene of a
facility (housekeeping) are vital to the
health and safety of staff, clients,
visitors and the community at large.
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General cleanliness and hygiene are vital
for safety
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General cleanliness and hygiene are vital for safety
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General Cleaning Guidelines
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Ward/Unit supervisors shall draw up
cleaning schedules for the different
areas of the ward and post them
where all housekeeping staff can see
them.

To reduce the spread of dust and
microorganisms, use a damp or wet
mop or cloth for walls, floors and
surfaces instead of dry-dusting or
sweeping.
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General Cleaning Guidelines

Scrubbing is the most effective way to
remove dirt and microorganisms

Wash surfaces from top to bottom so
that debris falls to the floor and is
cleaned up last. Clean the highest
fixtures first and work downwards e.g.
from shelves to tables, lockers and then
the floor.

Change cleaning solutions whenever
they appear to be dirty as a solution is
less likely to kill infectious
microorganisms if it is heavily soiled
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General Cleaning Guidelines

Clean and disinfect surfaces that are
likely to be contaminated with
pathogens that are touched frequently
such as bed rails, bed tables, door
knobs frequently compared to other
surfaces such as walls that are not
touched.

Clean from less contaminated area to
heavily contaminated area.
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General Cleaning Guidelines

Use separate equipment (brushes and
cloths) for high risk areas which are
more likely to be contaminated e.g.
toilets

Housekeeping staff shall have regular
in-service training.
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Immediate Physical Environment
of the Patient
Cleaning Procedures for
Different Clinic Areas
Non-patient Care Areas: Low Risk
Areas (waiting rooms, administrative
areas) where clinical services are not
provided. These areas are not usually
heavily contaminated with infectious
microorganism and so the risk of
infection is very minimal.

Routine cleaning (daily, or when the
area is dirty) is good enough.
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Toilets and sluice Rooms
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Cleaning Schedule: Toilets and sluice Rooms
Task
Clean walls
Clean ceilings
Clean counter and
other surfaces
Schedule
Wipe with a disinfectant
cleaning solution each
day (or more often if
necessary)
Wipe with a disinfectant solution
each week
Wipe with disinfectant solution
each day
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Cleaning Schedule: Toilets and sluice Rooms
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Clean floors

Use mop and disinfectant cleaning solution
each day or more often
Scrub with a disinfectant cleaning solution
and rinse with clean water each day or
more often.

Clean sinks and
toilets
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Empty waste
containers
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Each day or more often
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scrub to remove soil or organic material
with disinfectant cleaning solution each day
or more often

Clean waste
containers
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Cleaning Schedules
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Client Care Areas (operating
theatres, procedure rooms,
laboratories, areas where
instruments are processed,
wards, toilets, sluice rooms etc.).
In these area, there is greater
potential for contamination with
infectious materials hence needs
special care using a disinfectant
cleaning solutions.
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Cleaning Schedule for Client-Care Areas
A the
beginning
of each
day
Between
Clients
Clean operating/procedure tables, examination
couches, chairs, trolley tops, Mayo stands,
lamps, counters with disinfectant solutions to
remove dust that has accumulated overnight.
Clean operating/procedure tables, examination
couches, trolley tops or Mayo stands, counters,
lamps and any other potentially contaminated
surfaces in operating theatres and procedure
room with a cloth dampened with a
disinfectant cleaning solution. Alternatively,
spray the solution onto the surfaces and wipe
off with a damp cloth.
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Cleaning Schedule for Client-Care Areas
Clean spills of blood or other body fluids
with 0.5% chlorine solution immediately
 Clean visibly soiled areas of the floor; walls,
or ceiling.
 Put waste in a leak-proof container and
empty the container when it is ¾ full.
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Between
Clients
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At the end
of each
clinic
session or
day
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Wipe down all surfaces including counter,
tables, sinks, lights, door handles and wall
with a cloth dampened with a disinfectant
cleaning solution or spray the solution.
Always wipe from top to bottom paying
particular attention to the base, sides and
legs. Rinse sinks with clean water.
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Cleaning Schedule for Client-Care Areas

At the end of
each clinic
session or day
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Each week
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Mop the floors with a mop soaked in
disinfectant cleaning solution
 Check sharp-disposal containers:
remove and replace when ¾ full
Remove medical or hazardous chemical
waste and burn or bury as soon as
possible to limit contact.
 Wash containers with a disinfectant
cleaning solution and rinse with water
Clean ceilings with a mop dampened
with a disinfectant cleaning solution.
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Cleaning of Spills
If spill is small, wipe it with a cloth that
has been saturated with a disinfectant
(0.5% chlorine) solution immediately.
 If the spill is large, cover or flood the
area with a disinfectant (0.5%)
solution, mop up the solution, and
then clean the area with a disinfectant
cleaning solution immediately.
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Supplies and equipment used for
cleaning (mops, buckets, and cloths)
should be decontaminated with a
disinfectant 0.5% chlorine solution
cleaned in detergent and water,
rinsed in clean water and dried
before reuse
Types of Cleaning Solutions
Three kinds of cleaning solutions are
used during housekeeping at a health
facility:
1. Detergent or Plain Soap and
Water
This is used for low-risk areas and
general tasks. Detergents remove
dirt and organic material and
dissolve or suspend grease, oil and
other matter for easy removal by
scrubbing
Types of Cleaning Solutions
Disinfectant (0.5% Chlorine
Solution
The disinfectant rapidly kill or
inactivate infectious
microorganisms during the cleaning
process. Disinfectants are used to
clean up spills or blood or other
body fluids.
2.
Types of Cleaning Solutions
3.
Disinfectant Cleaning Solutions
This solution contains detergent,
disinfectant and water is used for cleaning
areas that may be contaminated with
infectious materials e.g. OT rooms, sluice
room, toilets etc. The disinfectants
kill/inactivates the microorganisms while
the detergents remove dirt and organic
material.
To constitute a disinfectant cleaning solution,
prepare 0.5% chlorine solution and add
liquid/powdered detergent until foamy
Types of Cleaning Solutions
Other equally good disinfectants that
can be used include
 Phenol
 Lysol
 Quaternary ammonium compounds
Preparation of 0.5% Chlorine
Solution
Chlorine is commonly used for
disinfection because it
1. Is a powerful killer of
microorganisms
2. Deordourises
3. Is not poisonous to humans in the
accepted concentrations used
4. Leaves no poisonous residues
5. Colourless, easy to handle and
economical to use.
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Preparation of 0.5% Chlorine
Solution
Chlorine may be supplied in the
following forms:
1. Liquid (sodium hypochloride)
2. Powder (calcium hypochloride or
chlorinated lime)
3. Chlorine Releasing Tablets (Sodium
dichlorocyanurate)
Preparation of 0.5% Chlorine
Solution
The amount of active chlorine in a
chlorine containing compound is
usually described in percentage (or
in degrees chlorum in some
francophone countries). Chlorine in
the various preparations comes in
different concentrations.
When the solution is prepared, the
active chlorine available should be
0.5%.
Preparation of 0.5% Chlorine Solution
1.
Using the liquid household bleach
Parts of water = % of active chlorine in liquid bleach -1
0.5%
Or
Parts of water = 2X – 1
Where X is the figure/numeral in the expressed percentage
indicating the active chlorine in the stock solution
Preparation of 0.5% Chlorine Solution
2. Using Bleach Powder; calculate the ratio of
bleach to water as follows
Grams of powder =
0.5% (desired strength
active chlorine in bleach powder X 1000
Preparation of 0.5% Chlorine Solution
Using Chlorine-Releasing Tablets
Since the percentage of active chlorine in these
products varies, the manufacturer’s instructions
should be followed
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