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Decontamination of Enviroment

1. Cleaning Methods

Cleaning of the environment around which the treatment takes place is also a very important component of good infection control.  All areas need to be kept in a clean condition at all times.  To achieve this, a sensible, planned approach is required.

Divide up the premises into each area, e.g.; the treatment room, the toilet, the waiting area etc.  Include all areas of the premises including hallways, storage areas etc...  Stand in each area and physically look around and record every item and area to be cleaned, e.g. the floor, walls, ceiling, bench, chair etc.

Then consider each item in turn and decide how often it requires cleaning.  Some items/areas require daily cleaning, some weekly and so on.

Then consider how the item/area is to be cleaned.  This is important, as this is when you decide whether cleaning alone; or cleaning and disinfection; or cleaning and sterilisation is required.  This leads to deciding on the most appropiate methods and chemicals to be used.  See definitions for these terms above.

This is called a cleaning program.  Once you have decided on the programme, you can devise simple checklists for cleaning.  These can be classed by ‘area’or by ‘frequency’ of cleaning, eg: ‘the waiting room’ or ‘the daily checklist’.

 The checklists act as both reminders and documentary evidence for cleaning.  It is useful to keep the ‘parent document’ with all the details of the cleaning program in the premises.  The checklists only need to have the item cleaned, the date and by whom.  If a chemical is to be used it is useful to name it and give the correct dilution, etc, on the checklist to help ensure that chemicals are used properly. 

All chemicals shall be used and handled and stored as per the manufacturers’ instructions.  Ensure that the chemicals safety data sheets and product descriptions are kept on the premises and are available to all who have to use them.  Store the chemicals in a specified area that is cool, dry and well ventilated that is also preferably lockable, this may be simply a press.  The area should not be accessible to the general public.  Store chemicals in their original containers and check  the expiry dates on a routine basis.

Detergent/disinfectant containers with spray nozzles should ideally be purchased for easy use over ‘home made’ squeeze bottles or containers with spray nozzles which can readily become contaminated during the ‘mopping up’ process.  If the latter are used they must be labelled and fresh solutions used daily as well as daily washing/drying of the containers.

Recommended Cleaning Agents for the Environment:

- Disinfectant Spray                Used for cleaning worktop surfaces between clients
- Detergent and hot water       Used for cleaning surfaces at the end of sessions/day
(e.g. floors)
- Cream Cleaner                      Used for cleaning surfaces, (wash hand basins etc)
-Hypochlorite e.g. Milton       For environmental cleaning: please follow dilution instructions on the manufacturer’s label.  Not for use on metal surfaces.

NB  GLUTARALDEHYDE (CIDEX) MUST NEVER BE USED.

The environment plays a relatively minor role in transmitting infection, but dust, dirt and liquid residues will increase the risk. They should be kept to a minimum by regular cleaning and by good design features in buildings, fittings and fixtures.
A written cleaning schedule should be devised specifying the persons responsible for cleaning, the frequency of cleaning and methods to be used and the expected outcomes:

  • Work surfaces and floors should be smooth-finished, intact, durable, of good quality, washable and should not allow pooling of liquids and be impervious to fluids
  • Carpets are not recommended in areas where tattooing/body piercing procedures will take place because of the risk of body fluid spills
  • Where carpets are in place, there should be procedures or contracts for regular steam cleaning and dealing with spills
  • Keep mops and buckets clean, dry and store inverted
  • Mop head should be removable for frequent laundering and replaced at least weekly, or single-use if this is not possible
  • Provide single-use, non-shedding cloths or paper roll for cleaning
  • Keep equipment and materials used for general cleaning separate from those used for cleaning up body fluids
  • Use general-purpose detergent (GPD) for environmental cleaning - follow the manufacturer’s instructions.

THE GOLDEN RULE: WORK FROM THE CLEANEST AREA TOWARD THE DIRTIEST AREA. THIS GREATLY REDUCES THE RISK OF CROSS-CONTAMINATION.

A Sample Daily Cleaning Schedule and Sample Cleaning Checklist are included below for reference purposes.

2. Sample Cleaning Schedule (Body Modification)

EQUIPMENT CLEANING/DECONTAMINATION MINIMUM FREQUENCY PERSON RESPONSIBLE
Floor Cleaning only, use detergent and hot water. sweep floor first and then mop. if blood splash or spillage see procedure for dealing with same. Daily  
Walls Cleaning only, use detergent and hot water. wash only up to extended hand height, higher up, remove cobwebs and dust. if blood splash or spillage, see procedure for same. Weekly  
Ceiling Cleaning, maintain dust and cobweb free. Weekly  

Light
Fittings

Cleaning, wipe clean and remove cobwebs. Weekly  
Wash Hand
Basin
Cleaning, use cream cleaner and hot water, including taps, rinse after cleaning.  include wiping clean the soap dispenser and the paper towel dispenser Daily  

Treatment
Work Top

Cleaning and disinfection.  use the sanitiser/alcohol spray and fresh paper towels.  spray on and wipe clean. if blood splash or spillage, see procedure for dealing with same.

After each
client

 

Detergent = Soap/cleaner which does not kill micro-organisms, e.g. washing-up liquid or floor cleaners.

Disinfectant = A chemical that can reduce numbers of micro-organisms to a level where they will not be harmful to health.

Sanitiser = Detergent plus disinfectant combined, a chemical that can remove dirt and reduce numbers of micro-organisms.

Sterilisation = (e.g. autoclaving), is a process that destroys all living organisms. 

Cleaning chemicals are available commercially and companies supplying these will be able to explain which of them are cleaning products only and which are disinfectants.  Always follow the manufacturer’s instructions.

This is a sample only and does not include all items that require cleaning and decontamination.

 

3. SAMPLE DAILY CLEANING CHECKLIST

THE TREATMENT AREA

AREA/EQUIPMENT

DATE

CLEANED BY

CHECKED BY

CORRECTIVE ACTION

TREATMENT CHAIR

 

 

 

 

TREATMENT WORK-TOP

 

 

 

 

FLOOR

 

 

 

 

WASH-HAND-BASIN

 

 

 

 

EQUIPMENT SINK

 

 

 

 

ULTRASOUND

 

 

 

 

AUTOCLAVE

 

 

 

 

OPERATOR CHAIR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE CHECKLIST ONLY.  DOES NOT INCLUDE ALL ITEMS/AREAS TO BE CLEANED

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