Best Practices for Environmental Cleaning
Module 4 – General Cleaning
Part C - Other Considerations
Learning Objectives
1. To identify factors that determine frequency of cleaning.
2. To correctly sequence tasks for cleaning.
3. To demonstrate proper procedures for different cleaning
applications.
4. To describe other considerations in environmental
management (e.g. waste handling, sharps safety, biological
spill cleaning)
2
Categories of Waste
• Biomedical
 Includes:
 Anatomical
 Microbiological
 Fluid (e.g. blood)
 Sharps
• General
• Cytotoxic
• Chemical
• Pharmaceutical
3
Storage of Waste
• Placed in appropriate container at or near point of origin
• Store in a designated enclosed room with access only by
authorized staff
• Biomedical waste

Placed in a locked area

Refrigerated space (4°C) if stored > 4days
• Contingency plan needed for:

Excess waste

Disruption of refrigerated area

Disruption of waste removal services
4
Transportation of Waste
• ALL waste should be transported within the health care setting
incorporating the following procedures:

Clearly define transport routes

Minimize manual handling of waste

Avoid crossing through clean zones, public areas or
patient/resident care units

If dedicated elevator not available – avoid transporting on same
elevator as patients/residents or food serving carts

Waste should not be transported at same time as
patients/residents are transported

Transport waste in leak-proof carts which are cleaned
daily
5
Cleaning of Biological Spills
• Assemble materials required for dealing with the spill prior to
putting on PPE
• Inspect the area around the spill thoroughly for splatters or
splashes
• Restrict the activity around the spill until the area has been
cleaned and disinfected and is completely dry
• Put on gloves; if there is a possibility of splashing, wear a gown
and facial protection (mask and eye protection or face shield)
• Confine and contain the spill
• Wipe up any blood or body fluid spills immediately using either
disposable towels or a product designed for this purpose
6
Cleaning of Biological Spills
• Dispose of materials by placing them into regular waste
receptacle, unless the soiled materials are so wet that blood can
be squeezed out of them, in which case they must be
segregated into the biomedical waste container (i.e., yellow
bag).
• Disinfect the entire spill area with a hospital-grade disinfectant
and allow it to stand for the amount of time recommended by
the manufacturer.
• Wipe up the area again using disposable towels and discard
into regular waste.
• Care must be taken to avoid splashing or generating aerosols
during the clean up.
• Remove gloves and perform hand hygiene.
7
Sharps Handling
• Sharps are devices that are capable of
causing a cut or puncture wound
• All sharps must be handled with care to
prevent injury
8
Sharps Handling
• Prevention of sharps injuries may be achieved by:

Using safety engineered medical devices, such as needle-less
devices;

Never re-capping a used needle;

Never reaching into waste or sharps containers;

Providing rigid, puncture-resistant sharps containers at or near the
point-of-use to permit safe one-handed disposal;

Replacing sharps containers when they are three-quarters full or
the sharps have reached the fill line and securely closing the lid;

Handling laundry with care; and

Educating staff about the risks associated with sharps, including
safe disposal of sharps in puncture-resistant containers if found in
the environment (e.g. sharps in laundry, waste, bedside, floor).
9
Safe Disposal of a Sharp
• Put on a pair of gloves
• Ideally, take a sharps container to the needle and syringe
• NEVER re-cap a needle and syringe even if a cap is available
• Use tongs/forceps, or similar implement, to pick up the needle
and syringe. If no implement is available, carefully pick up the
needle and syringe with the needle furthest away from your
fingers and body
• Carefully place the needle and syringe into the sharps container
• Report the incident to your supervisor or manager
10
Non-critical Equipment
• Non-critical medical equipment within the client/patient/resident
environment and that is used between clients/patients/residents
requires cleaning and disinfection after each use
• Policies and procedures should clearly define the frequency and
level of cleaning required for each piece of equipment plus
assign responsibility for cleaning
Examples:

Person taking the equipment to use must clean prior to using or;

Person using the equipment cleans after use
• Selection of new equipment must include considerations for
cleaning and disinfection
11
Non-critical Equipment
• Low-level disinfection should be used for all non-critical
equipment
• Examples of non-critical equipment include:

Bath seat and raised toilet seat

Resuscitation cart

Blood pressure cuff

Commode chairs

IV pumps

ECG machine and cables

Transfer boards

Stethoscope
12
Learning Checkpoint
13
Learning Checkpoint
True or False
1. Waste may be transported on an elevator at the same time as
patients/residents.
2. To neutralize a blood spill, apply the disinfectant before wiping
up.
3. Laundry should be handled with care to avoid a sharps injury
due to sharps being left in the laundry.
4. Commodes within the patient/resident environment and that are
used between patients/residents require cleaning and
disinfection after each use
14
Learning Checkpoint Answers
1. False – waste should not be transported on an elevator at the
same time as patients/residents to minimize the risk of
contamination.
2. False – blood spills should be contained and material wiped up
before applying the disinfectant. Disinfectants will be ineffective
if applied before cleaning the spill.
3. True – Sharps, accidentally left in bedding, may pose a risk to
healthcare workers. Care should be taken when handling all
linen.
4. True – All non-medical equipment that is shared between
patients/residents should be cleaned and disinfected before
being used with another patient/resident.
15
When you return to your job, what will you
do differently as a result of this session?
16
Thank You!
17
Image Sources –
Module 4C
• Getty Images used in slide 12
• Microsoft Office Clipart used in slide 13
• Images in slides 9 & 19 are © PHO 2013