Infection Control Manual by liaoqinmei


									           University of Connecticut Health Center                                            Page 1 of 4
           John Dempsey Hospital
           Infection Control Manual

SECTION: PATIENT RELATED INFECTION CONTROL                                                         NUMBER: 2.5


     PURPOSE:    To maintain a clean and safe environment regardless of a patient's diagnosis and to assure
                 personnel safety.

       SCOPE:    Inpatient hospital room: room which patient is assigned to and remains in during the

                 Temporary Room: any room or area where a patient’s use of the room requires a limited stay
                 and/or where there is a succession of patients using the same room/area. Examples include, but
                 are not limited to, the Emergency Department, Ambulatory Clinics, and PACU.

       POLICY:   1.   Patients and employees are entitled to a clean and safe environment.

                 2.   Inpatient hospital rooms and temporary rooms shall be cleaned at least daily and in
                      accordance with Facilities Management policies and procedures.

                 3.   Temporary rooms require cleaning in between patient use only when visibly soiled or when
                      contaminated with blood/body substances.

                      a. Stretcher and exam table mattresses require cleaning between patients only when visibly

                      b. Linen and exam paper, when changed between each use, provides a clean contact
                         surface for each patient.

   PROCEDURE:    1.   The cleaning of a patient's room should be performed daily by Housekeeping staff with
                      emphasis on bathrooms, sinks, showers, bed, bed rails and patient touch areas such as bed,
                      bed rails, door knobs, faucet handles, monitoring equipment, knobs/buttons/controls, cables
                      and commode. Soap and paper towel dispensers should be refilled as needed.

                 2.   Gross contamination with blood or other body fluids should be promptly contained and
                      discarded by nursing personnel. This should be accomplished by using a blue pad with
                      plastic backing face up for maximal absorbency and health-care worker protection.
                      Housekeeping will clean residual and disinfect by applying a hospital-approved EPA
                      registered disinfectant-detergent. Gloves should be worn during this procedure.

                 3.   Rooms should be cleaned as soon as the patient has been discharged. All used disposable
                      items should be discarded in accordance with the hospital's regulated medical waste policy
                      by nursing personnel e.g., IV tubings, suction canisters and tubings. This must be done prior
                      to cleaning conducted by housekeeping personnel. Disinfection should be directed toward
                      those items which have had direct patient contact or had been in contact with the patient's
                      blood or body fluids.

                 4.   Disinfectant/detergent should be freshly prepared.

                 5.   Housekeeping personnel should use the same precautions to protect themselves during
                      routine cleaning that they would use if the patient were still in the room. Workers who perform
                      the cleaning should wear the appropriate personal protective equipment when contact with
                      body substances is anticipated.

                 6.   All non-disposable items that are contaminated or are likely to be contaminated with infective
                      material will be placed in a plastic bin and sent to Central Sterile Supply for decontamination
            University of Connecticut Health Center                                           Page 2 of 4
            John Dempsey Hospital
            Infection Control Manual

                       and processing.

                  7.   Stretcher and exam table mattresses should be cleaned with a hospital-approved EPA
                       registered disinfectant-detergent if visibly soiled. Linen and/or exam paper should be
                       changed between each patient.

                  8.   All horizontal surfaces of furniture and mattress covers and all floors should be
                       cleaned/washed with a hospital-approved EPA registered disinfectant-detergent.

                  9.   For the room of patient who is on isolation precautions daily room cleaning must include and
                       have high attention to: all high-touch areas such as: bed, bed rails, door knobs, faucet
                       handles, monitoring equipment, knobs/buttons/controls, cables, commode.

                  10. When contact/droplet and or enteric isolation precautions are discontinued/or the patient is
                      discharged, the precaution sign must remain posted and precautions followed until the room
                      is terminally cleaned per Environmental services protocol.

                  11. If precautions are discontinued but patient will remain hospitalized the patient should be
                      moved to a clean room and a clean bed. If this is not possible, the room and bed should be
                      thoroughly cleaned at a time when the patient is not in the room (i.e. when patient is off the
                      unit at a test or procedure). Contact Precautions sign should remain posted until room
                      including high touch areas and the bed are thoroughly cleaned.

                  12. Routine washing of walls, blinds, and curtains is not indicated, however, these should be
                      washed if they are visibly soiled. Cubicle curtains, blinds and window curtains should be
                      changed if visibly soiled, or may be spot cleaned if appropriate.

                  13. Cubicle curtains will be taken down and cleaned on a routine basis.

                  14. The Hospital Epidemiologist should be consulted about the cleaning of a room of a patient
                      who has suspected smallpox, Lassa fever, Ebola fever, or other hemorrhagic fevers, such as
                      Marburg disease.

   REFERENCES:    Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control Practices
                  Advisory Committee, 2007 Guideline for Isolation Precautions: Preventing Transmission of
                  Infectious Agents in Healthcare Settings, June 2007

                  Transmission-Based Isolation, Infection Control Manual, John Dempsey Hospital Section: 02,
                  Policy Number 2.18

     APPROVAL:    Infection Control Committee

REVISION DATES:   8/08, 12/08, 2/09

                  University of Connecticut Health Center                                  Page 3 of 4
                  John Dempsey Hospital
                  Infection Control Manual

                                     ROOM CLEANING QUICK REFERENCE
                                              APPENDIX A

1.   Nursing removes all gross contamination if applicable.

2.   Nursing staff must discard all used disposable items such as:

     a. IV tubings

     b. Suction canisters and tubing

3.   Linen is removed by nursing or housekeeping.

4.   Housekeeping cleans the bed surface including under the mattress with disinfectant.

5.   Housekeeping makes the bed with proper linen.

6.   Housekeeping cleans the bathroom with disinfectant.

7.   Housekeeping cleans the floors with disinfectant.

8.   Housekeeping will replace the privacy curtains if they are visibly soiled.

     * The Housekeeping Department must follow the 7 steps of Housekeeping.

Developed: August 29, 2008
Revised December 2, 2008
                  University of Connecticut Health Center             Page 4 of 4
                  John Dempsey Hospital
                  Infection Control Manual

                               EQUIPMENT CLEANING QUICK REFERENCE
                                           APPENDIX B


Mobile Equipment including but not limited to:

Blood pressure cuffs

Pulse oximeters

Disposal of contaminated canisters and/or buckets

Commode buckets that contain any patient body fluids


High Touch Areas in Patient Rooms including but not limited to:

Light switches


Bed rails

Bedside table

Overbed table

IV poles

IV pumps (without tubing and IV bags and not in use)

Television controls

Call lights

Shower chairs

Commode chairs (not buckets containing any patient body fluids)

Developed: December 2008
Revised: February 2009

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