Guidelines have been published regarding cleaning strategies for isolation areas and operating rooms. The basic strategies for areas housing immunosuppressed patients include
a. wet dusting horizontal surfaces daily with cleaning cloths pre-moistened with detergent or an EPA-registered hospital disinfectant or disinfectant wipes;
b. using care when wet dusting equipment and surfaces above the patient to avoid patient contact with the detergent/disinfectant;
c. avoiding the use of cleaning equipment that produces mists or aerosols;
d. equipping vacuums with HEPA filters, especially for the exhaust, when used in any patient-care area housing immunosuppressed patients; and
e. regular cleaning and maintenance of equipment to ensure efficient particle removal.
When preparing the cleaning cloths for wet-dusting, freshly prepared solutions of detergents or disinfectants should be used rather than cloths that have soaked in such solutions for long periods of time. Dispersal of microorganisms in the air from dust or aerosols is more problematic in these settings than elsewhere in health-care facilities. Vacuum cleaners can serve as dust disseminators if they are not operating properly. Doors to immunosuppressed patients’ rooms should be closed when nearby areas are being vacuumed. Bacterial and fungal contamination of filters in cleaning equipment is inevitable, and these filters should be cleaned regularly or replaced as per equipment manufacturer instructions.
Mats with tacky surfaces placed in operating rooms and other patient-care areas only slightly minimize the overall degree of contamination of floors and have little impact on the incidence rate of health-care– associated infection in general. An exception, however, is the use of tacky mats inside the entry ways of cordoned-off construction areas inside the health-care facility; these mats help to minimize the intrusion of dust into patient-care areas.
Special precautions for cleaning incubators, mattresses, and other nursery surfaces have been recommended to address reports of hyperbilirubinemia in newborns linked to inadequately diluted solutions of phenolics and poor ventilation. These medical conditions have not, however, been associated with the use of properly prepared solutions of phenolics. Non-porous housekeeping surfaces in neonatal units can be disinfected with properly diluted or pre-mixed phenolics, followed by rinsing with clean water. However, phenolics are not recommended for cleaning infant bassinets and incubators during the stay of the infant. Infants who remain in the nursery for an extended period should be moved periodically to freshly cleaned and disinfected bassinets and incubators. If phenolics are used for cleaning bassinets and incubators after they have been vacated, the surfaces should be rinsed thoroughly with water and dried before either piece of equipment is reused. Cleaning and disinfecting protocols should allow for the full contact time specified for the product used. Bassinet mattresses should be replaced, however, if the mattress cover surface is broken.
Tuesday, May 31, 2022
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