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House Keeping Role in Infection Prevention

The role of the housekeeper or environmental cleaning personnel is critical to the control and prevention of infections in the hospital. It is a team effort to which all hotel / hospital workers play a part – doctors, nurses at the bedside, surgery technicians in the Operating Rooms, cooks in the kitchen and housekeepers in the hotels or the maintenance personnel who work throughout the busy organization to maintain a clean environment.  

Bacteria are able to survive in dust and on bedrails, phones, nurse call buttons, curtains and other surfaces for long periods. Hand hygiene is important for all hygiene workers but without a clean environment, hands will quickly become recontaminated.
Antibiotic–resistant bacteria ("super bugs") have also been unleashed in hospitals and they can survive on common touch-points for up to 56 or more days. And  the mattress in a hotel which is said to be the unhygienic place in a hotel which comes before the water closet or the drainage areas.

Prevention of healthcare associated infections depends on a clean and properly disinfected area. In order to reduce the number of infections in the work area, it is extremely important that housekeepers understand their role, proper cleaning procedures and the soaps or chemical solutions they use for cleaning.  

In this column, my goal is to teach you the essential elements of your job with special attention to the infection prevention and control aspects.  

Definition of Terms

Before we can embark on this journey of preventing or controlling infections through better cleaning practices, we must understand some of the basic terms used by those in the field of cleaning and disinfecting healthcare facilities around the world.

Cide or Cidal
Cide or Cidal means to kill or murder. For instance, a bactericide is an agent that kills bacteria. Virucidal, fungicide, sporicide and tuberculocidal can kill the type of microorganism identified by the prefix.

Cleaning

Cleaning is not the same as disinfecting or sanitizing. It should occur before disinfecting or sanitizing surfaces. Cleaning is the removal of all foreign material from objects by using water and detergents, soaps, enzymes and the mechanical action of washing or scrubbing the object. Disinfection/sterilization cannot be accomplished if cleaning is inadequate.   

Cleaning involves the following ingredients:

• Water-must be clean, potable and kept clean. Once the water becomes visibly soiled, it must be changed for clean water.
• Soap, detergents or enzymes mixed at proper concentrations with water
• Time must be allotted in order to remove all soil from a surface
• Agitation-scrubbing with brushes, abrasive pads, or microfiber cloths is necessary to break through biofilm.

For those in the profession of cleaning, the best way to remember the definition of cleaning is:  NO Dust, NO Spots, NO Smudges, NO Odors=CLEAN

Disinfection

Disinfection describes a process that eliminates many or all pathogenic microorganisms — except bacterial spores — on inanimate (non-living) objects. In healthcare settings, objects usually are disinfected by liquid chemicals called disinfectants. 

Factors that affect the efficacy of disinfection include prior cleaning of the object; organic and inorganic soil load present; type and level of microbial contamination; concentration of and exposure time to the germicide; physical nature of the object (e.g., crevices, hinges and lumens); presence of biofilm. 

Unlike sterilization, disinfection is not sporicidal. A few disinfectants will kill spores with prolonged exposure times (3–12 hours); these are called chemical sterilants. Low-level disinfectants can kill most vegetative bacteria, some fungi and some viruses in a practical period of time (<10 minutes). Intermediate-level disinfectants might be cidal for mycobacteria, vegetative bacteria, most viruses and most fungi, but do not necessarily kill bacterial spores.

Infection Prevention  

Infection prevention is identifying and reducing the risks of infections from developing or spreading (infection control).  Because of diseases such as cholera, typhoid and Hepatitis B, the risk of acquiring infection is high in areas where people gather.

As a healthcare worker, you must recognize and understand that these threats are a reality and that universal precautions should always be implemented. This is considered one of your biggest job responsibilities.

Sanitizer

Sanitizers are a type of antimicrobial that kills or irreversibly inactivates at least 99.9 percent of all bacteria, fungi and viruses (called microbials, microbiologicals, microorganisms) present on a surface. Most sanitizers are based on chlorine, iodine, phenol, or quaternary ammonium compounds, and (unlike some antiseptics) may never be taken internally. Sanitizers are mainly used in food preparation areas such as kitchen counters where food-borne pathogens need to be kept to a safe level.

Tips for Speed and Efficient Cleaning your Home

1. Get your daily routines down.

If I keep up with my basic routines, things don’t get so out of control in the first place. My house will stay clean enough! Trust me on this, cleaning routines will change your life.

Try my 4 Daily Routines or make up your own! The important thing is that you get yourself in a simple rhythm of daily upkeep of your home. Once you do, all the other necessary homemaking tasks will not seem so overwhelming or take so long in a day. This is so important!

2. Dress for success!

Want to fly through your cleaning routine? What you wear just might affect the efficiency in which you clean! I certainly find that to be true. I actually do not clean well in my PJs. Sorry to disappoint you PJ loving people, but it just doesn’t work for me. My clothes tell me what I can accomplish. PJs and slippers tell me to be lazy and slow and maybe even crawl back in bed. I can do a quick load of laundry while still in my PJs, but anything else and I am good for nothing.

Shoes and clothes tell me it is time to get down to business and start the day. Too nice of clothes tell me I shouldn’t clean at all. Aprons tell me it is OK to tackle a quick cleaning job no matter what I’m wearing.

Moral of this story, I find I need to be dressed appropriately for cleaning or wear an apron in order to be efficient. Try it. Get dressed and I bet you’ll be more efficient. I dare you.

3. Stay focused.

It is so easy for me to get carried away when I start cleaning and end up spending way too much time on something I only intended to do for 15 minutes. Setting a short timer for the task at hand keeps me focused on completing a task (rather than getting bogged down in perfection or lost by distraction) and moving quickly through the process. Your timer is your housekeeping friend, use it!

4. Keep cleaning supplies in convenient location.

This is HUGE for me. If I have to run downstairs for a cleaning supply I need upstairs, I get distracted on my way down. Pretty soon I’m having a snack. Checking Facebook. Looking at old photos. And then I forget to finish cleaning. True story. So if I keep everything I need to clean the upstairs bathrooms handy right there in the bathroom, chances are I’ll finish cleaning without getting distracted!

5. Clean as you go.

Cleaning as I go through my day saves so much time! Even though at first it will seem like you are cleaning all the time, eventually it becomes second nature and you won’t even think twice about it!

Here are my best clean-as-you-go tips:

·         Clean out the shower while you are taking a shower.

·         Wipe out the sink after you brush your teeth.

·         Throw all the laundry in the wash before you start breakfast.

·         Set a timer for when it is time to move clothes to the dryer and again for when dryer will finish.

·         Pull clothes out of the dryer and hang immediately. Do not pile anything but socks, undies or towels in a laundry basket. I repeat, hang clothes immediately.

·         Empty dishwasher before you cook or eat.

·         Put dirty dishes directly in the dishwasher instead of piling them in the sink first.

·         Soak pots immediately after cooking.

·         Clear the table right after dinner.

·         Start the dishwasher right after the dinner dishes are put in.

Simple clean-as-you-go tips, yes, but if you use them they will save hours in a day! Hours you can use for fun in the summer sun.

6. Clean in a logical order.

If I need to clean an entire room or house top to bottom, it is helpful to think through the most logical order in which to complete the tasks. For instance, I always sweep and vacuum before I dust. If I do it the other way around, I end up having to dust all over again as the vacuum will kick up more dust.

In the kitchen, clean top to bottom. Wipe down your appliances and counters, sweep and then mop your floors. Always wash your floors last, as you back out of the room!

Think through the order of housekeeping will keep you from doubling your effort! It is worth a little planning in order to save time for things you’d rather do than clean! Like RELAX!

7. Lighten your load.

Less stuff means less to clean and organize and more space for what you really need. When all of your cabinets and closets are stuffed and overflowing, it is too frustrating to try to be organized. Summer is the perfect time to have that garage sale, donate items to charities and rid your home of excess!

Your daily cleaning routine will go so much faster when there is less to shuffle and clean around, and you’ll feel much happier and lighter all summer long! Set aside even just a few minutes every day to clean out a new drawer, a closet or a cabinet and say good-bye to stuff you don’t need

Bed Making

PURPOSES OF BEDMAKING

PROVIDES COMFORT AND PROTECTION FOR A PATIENT CONFINED TO BED

BED MUST BE FREE FROM ALL WRINKLES BECAUSE WRINKLES CAUSE DISCOMFORT AND CAN LEAD TO FORMATION OF DECUBITUS

MITERED CORNERS

PURPOSE IS TO HOLD LINEN FIRMLY IN PLACE ON BEDS, STRETCHERS, AND EXAM TABLES

A MITERED CORNER IS A SPECIAL FOLDING TECHNIQUE THAT SECURES THE LINEN UNDER THE MATTRESS

TYPES OF BEDS

CLOSED BED

MADE FOLLOWING DISCHARGE OF PATIENT

PURPOSE IS TO KEEP BED CLEAN UNTIL NEW PATIENT ADMITTED

OPEN BED

FANFOLD TOP SHEETS TO FOOT OF BED TO CONVERT CLOSED BED TO OPEN BED

FANFOLD MEANS TO FOLD SHEETS LIKE ACCORDIAN PLEATS

DONE TO WELCOME A NEW PATIENT OR FOR PATIENTS WHO ARE AMBULATORY OR OUT-OF-BED

OCCUPIED BED

BED IS MADE WHILE PATIENT IS IN IT

USUALLY DONE AFTER THE MORNING BATH

BED WITH CRADLE

CRADLE PLACED ON BED UNDER THE TOP SHEET

PREVENTS TOP SHEETS FROM TOUCHING PARTS OF THE PATIENTS BODY

USED FOR BURNS, SKIN ULCERS, LESIONS, BLOOD CLOTS,FRACTURES, OR SURGERY

SOME CRADLES HAVE LIGHT BULBS TO PROVIDE HEAT FOR SPECIAL TREATMENTS

DRAW SHEETS

HALF SHEETS FREQUENTLY USED ON BEDS

EXTENDS FROM PATIENT’S SHOULDERS TO THE KNEES

USED TO PROTECT THE MATTRESS

IF SOILED, IT CAN BE CHANGED WITHOUT CHANGING THE BOTTOM SHEET

DISPOSABLE BED PROTECTORS, ALSO CALLED UNDERPADS, ARE USED IN SOME AREAS INSTEAD OF DRAW SHEETS

BODY MECHANICS

ESSENTIAL TO USE CORRECT BODY MECHANICS WHILE BEDMAKING

ALSO IMPORTANT TO CONSERVE TIME AND ENERGY

KEEP LINEN ARRANGED IN ORDER OF USE

MAKE BED COMPLETELY ON ONE SIDE BEFORE DOING OTHER SIDE TO LIMIT UNNECESSARY MOVEMENT FROM ONE SIDE OF BED TO THE OPPOSITE SIDE

INFECTION CONTROL

IMPORTANT TO LIMIT MOVEMENT OF ORGANISMS AND SPREAD OF INFECTION WHILE IN BED

ROLL THE DIRTY OR SOILED LINEN WHILE REMOVING IT FROM BED

HOLD DIRTY LINEN AWAY FROM YOUR BODY

PLACE DIRTY LINEN IN  HAMPER/CART/BAG IMMEDIATELY

NEVER PLACE LINEN ON THE FLOOR

WASH YOUR HANDS AFTER HANDLING DIRTY LINEN

NEVER BRING EXTRA LINEN INTO A PATIENTS ROOM LINEN IS CONSIDERED

CONTAMINATED ONCE IT IS IN A ROOM AND CANNOT BE USED FOR ANOTHER PERSON

AVOID SHAKING CLEAN SHEETS TO PLACE THEM ON THE BED

UNFOLD THEM GENTLY TO INHIBIT THE FLOW OF MICROORGANISMS

PLACE THE OPEN END OF PILLOWCASE AWAY FROM THE DOOR

THIS LOOKS NEATER AND ALSO HELPS PREVENTS THE ENTRANCE OF ORGANISMS FROM THE HALL

UNIVERSAL PRECAUTIONS

OBSERVE UNIVERSAL PRECAUTIONS IF LINEN IS CONTAMINATED BY BLOOD OR BODY FLUIDS

WASH HANDS FREQUENTLY AND WEAR GLOVES WHILE HANDLING LINEN

FOLLOW AGENCY POLICY FOR PROPER DISPOSAL OF LINEN