Controlling CDI Emergency Department Cleaning Procedure

Controlling CDI —
Emergency Department Cleaning Procedure

Policy statement

The hospital will make reasonable and continuing efforts to minimize the need for nurses to perform housekeeping functions.

Definitions

Room turnover: ED staff wipes down cart and all high touch areas with the alcohol-free wipes between every patient.

Terminal clean: EVS cleans all high touch areas with quat, high dusts and mops the floor. Done at least once every 24 hours as rooms are available.

Cycle clean: EVS washes walls, ceilings, all fixtures, washes all curtains and cleans all glass, floors are scrubbed, and poly reapplied as necessary. Done at least once a year and as needed.

Purpose

To maintain a clean environment and reduce the possibility of cross-contamination between patients and employees.

Procedure

All room turnover cleaning is done using AF wipes with the exception of the cardiac leads, which are cleaned with bleach wipes.

ED rooms must be cleaned after every patient, following the procedure below.

Any item with visible soil:

·  Clean item before disinfection using AF wipe and friction to remove soil. No dry time required after cleaning step.

·  Disinfect surface using a second AF wipe and allow to dry for three minutes following procedures below:

Room turnover / 1.  Remove dirty linen from cart and put into nearest soiled laundry bin.
2.  Wipe cart using a minimum of five AF wipes: three for mattress, two for side rails and cart handles. Allow to dry for minimum of three minutes.
3.  Dispose of trash in proper receptacles.
4.  Wipe down counter top with AF wipes. Allow to dry for a minimum of three minutes.
5.  Wipe down dash monitor cables, not including cardiac leads, with AF wipes. Allow to dry for a minimum of three minutes.
6.  Wipe down dash monitor cardiac cables with bleach wipes. Allow to dry for a minimum of four minutes then replace cables on holder.
7.  Chairs used by patients or family members should be wiped down with AF wipes and placed in chair holder.
8.  Wipe down computer keyboard.
9.  Shut cabinet doors.
Room turnover of isolation rooms / 1.  Same as above and staff to wear personal protective equipment as appropriate for isolation type (e.g., gown and gloves for contact or enteric precautions). If a room had a patient with diarrhea, use PDI bleach wipes to clean room instead of AF wipes and allow four minute dry time. Leave isolation sign at room entry until room is dry from cleaning and ready for patient.
Stab room clean / 1.  Performed by EVS staff (preferred) when large volumes of blood and body fluids, bloody trash or linens are present. Use microfiber cloths and quat instead of disposable disinfectant wipes.
2.  If no large volumes of blood or body fluids are present, the same procedure should be used as stated in room turnover with the exception of extra detail to equipment including, but not limited to:
a.  Ultrasound unit, probes and cords
b.  Top of crash cart
c.  Cardiac monitor and cables
d.  Glidescope
e.  Acrylic airway case
f.  Mayo stands
g.  Countertops
h.  Computer keyboards
Terminal clean / 1.  Performed by EVS staff following standard procedures
Cycle clean / 1.  Performed by EVS staff following standard procedures
Patient care equipment / 1.  Equipment to be wiped down after each use (see Appendix A):
·  EKG machines
·  Bladder scanner
·  Dopplers
·  Thermometers
·  Commodes with AF wipes
·  Portable cardiac monitors (cardiac leads with bleach wipes)
·  Nitrous machine
·  Mayo stands
·  Bedside tables
·  Infant crib
Appendix A
Item / Who / Frequency / Cleaning products
Keyboards and phones throughout nursing units and lounge areas, except patient rooms / EVS - once per day
Unit staff - other shifts / Once per shift / 3M Quat - EVS
AF wipes - unit staff
Dynamap / Unit staff / After each use / AF wipes
(Consider not using)
Glucometers, oximeters, scales, bladder scanner, Doppler, Mayo stand / Unit staff / After each use / AF wipes
Portable tele boxes / Unit staff / After each patient / AF wipes
Glide scope, ultrasound unit, portable EKG unit / Unit staff / After each use / AF wipes
Tube system (Control panel) / EVS- once per day
Unit staff- other shifts / Once per shift / 3M Quat - EVS
AF wipes – unit staff
Safe patient moving equipment (EZ stands, mobile lifts, slip sheets, etc.) / Unit staff / After each use / AF wipes
Wheelchairs / User / After each use / AF wipes
Check and refill alcohol hand foam / Unit staff / Change as needed
Items in patient rooms or procedure rooms
Monitoring equipment that stays in room (thermometers, ceiling lift remote, wall panel, leads, cardiac monitors) / EVS – once per day
Unit staff after each pt / On terminal room clean
Room turnover / 3M Quat – EVS
AF wipes – unit staff
Discard/disinfect patient supplies / Unit staff- remove or clean before terminal room clean / On terminal room clean- precaution patients only / AF wipes
Discard items that cannot be cleaned
Items to be returned to soiled utility room / Unit staff / Clean commodes with AF wipes before taking from room
Clean all equipment removed from precautions room / AF wipes
Isolation cart / CME – weekly clean
Unit staff – after each patient / To be rotated weekly
Wipe down after each patient use / AF wipes
Cardiac lead wires / Unit staff / After each use, wipe each individual wire separately / Bleach wipes
AF wipes= three minute contact time
Bleach wipes= four minute contact time

Content courtesy of Allina Health