is rarely implicated in disease transmission,
except among patients who are immunocompromised.
Nonetheless, the Centers for Disease Control
says, inadvertent exposures to environmental or airborne
pathogens can result in adverse patient outcomes and cause
illness among health-care workers. Environmental
infection-control strategies and engineering controls can
effectively prevent infections, and the incidence of health-care
associated infections and pseudo-outbreaks can be minimized by
the following:
• Appropriate use of cleaners and disinfectants;
• Appropriate maintenance of medical equipment;
• Adherence to water-quality standards for
hemodialysis, and ventilation standards for specialized care
environments; and
• Prompt management of water intrusion into the
facility.
To control pathogens like methicillin-resistant
Staphylococcus aureus (MRSA) on environmental surfaces, the CDC
recommends the following:
Clean surfaces with a detergent/disinfectant.
This may be followed by an application of an
EPA-registered hospital disinfectant with or without a
tuberculocidal claim (depending on the nature of the surface and
the degree of contamination). Do not use alcohol to disinfect
large environmental surfaces.
Use barrier protective coverings as appropriate
for noncritical surfaces that are touched frequently
with
gloved hands during the delivery of patient care, or likely to
become contaminated with blood or body substances.
Keep housekeeping surfaces (e.g., floors, walls,
tabletops) visibly clean on a regular basis and clean up spills
promptly. Use a one-step process and an EPA-registered hospital
detergent/disinfectant designed for general housekeeping
purposes in patient-care areas where 1) uncertainty exists as to
the nature of the soil on the surfaces (e.g., blood or body
fluid contamination versus routine dust or dirt); or 2)
uncertainty exists regarding the presence of multidrug resistant
organisms.
Detergent and water are adequate for cleaning
surfaces in nonpatient-care areas, such as administrative
offices. But clean and disinfect high-touch surfaces (e.g.,
doorknobs, bed rails, light switches, and surfaces in and around
toilets in patients’ rooms) on a more frequent schedule than
minimal-touch housekeeping surfaces.
Clean walls, blinds, and window curtains in
patient-care areas when they are visibly dusty or soiled.
The CDC recommends against performing
disinfectant fogging in patient-care areas, and avoid
large-surface cleaning methods that produce mists or aerosols,
or disperse dust in patient-care areas.
Follow proper procedures for effective uses of
mops, cloths, and solutions. Prepare cleaning solutions daily or
as needed, and replace with fresh solution frequently, according
to facility policies and procedures. Change the mop head at the
beginning of each day and also as required by policy, or after
cleaning up large spills of blood or other body substances.
Clean mops and cloths after use and allow to dry
before reuse; or use single use, disposable mop heads and
cloths. For operating rooms, the CDC recommends the following:
After the last surgical procedure of the day or
night, wet vacuum or mop operating room floors with a single-use
mop and an EPA-registered hospital disinfectant. Do not use mats
with tacky surfaces at the entrances to operating rooms or
infection-control suites.
Use appropriate dusting methods for patient-care
areas designated for immunocompromised patients. Wet-dust
horizontal surfaces daily by moistening a cloth with a small
amount of an EPA-registered hospital detergent/disinfectant, and
avoid dusting methods that disperse dust, such as
feather-dusting.
Vacuums
