3 - Safe management of the care environment

Isolation room/area cleaning

Staff must:

clean and decontaminate the isolation/cohort rooms/area at least daily or more if advised to do so. If you have been advised to clean more than daily this should be added into the environmental cleaning schedule;

clean frequently touched surfaces like door handles, bed frames and bedside cabinets at least twice daily;

make sure you are using the correct product which is:

a combined detergent/disinfectant solution at a dilution of 1,000 parts per million available chlorine (ppm available chlorine (av.cl.));

or

a general purpose neutral detergent in a solution of warm water followed by disinfection solution of 1,000ppm av.cl.

follow manufacturers guidance and instructions on how to use the product and what the recommended contact time is for the product to work. This may include rinsing off the disinfection solution to prevent damage to surfaces.

Do not use refillable spray container for cleaning products as there is a risk of contamination. 

Cleaning products which come in non-refillable spray containers may be used as long as they conform to EN standards.

Terminal clean

Important words and what they mean

A terminal clean is cleaning/decontamination of the environment to ensure it is safe for the next resident or when the current resident is no longer considered infectious.

A terminal clean is carried out by:

removing all healthcare waste and other disposable items from the room;

removing bedding, curtains (bagged before removal from the room) and then wash as infectious linen;

cleaning and decontaminating all reusable care equipment in the room (before removal from the room).

The room should then be decontaminated using either:

The room must be cleaned from the highest to lowest point and from the least to most contaminated point.

When an organisation uses cleaning and disinfectant products that differ from those stated in this IPCM CH these products need to meet BS EN standards. 

This means that the product has passed tests and is shown to reduce different viruses, bacteria, funguses, yeasts and spores. If you do not use an BS EN standard product you have no assurance that it will work effectively.

Manufacturers instruction and recommended contact times must be adhered to.

BS EN standards and what they mean

  • BS EN 13727 - quantitative test used to evaluate bactericidal activity of disinfectants intended for use in the MEDICAL area (e.g. surface disinfection, surgical and hygienic handrub and handwash). Products must achieve ≥ 5 log reduction (must kill 99.999%) against P. aeruginosa, S. aureus and E. hirae.
  • BS EN 14476 – quantitative test used to evaluate virucidal activity of disinfectants intended for use in the medical area. For surface disinfection, products must achieve ≥ 4 log reduction against Adenovirus, Norovirus and Poliovirus.
  • BS EN 13624 – quantitative test used to evaluate fungicidal and yeasticidal activities of disinfectants intended for use in the medical area. For surface disinfection, products must achieve ≥ 4 log reduction against A. brasiliensis, C albicans.
  • BS EN 17126 – quantitative test used to evaluate sporicidal activity of disinfectants in the medical area. For surface disinfection, products must achieve ≥ 4 log reduction against bacterial spores. (Used for C. diff). BS EN 13704 has also been used to test products against C. diff.