Infection control

For example, surfaces that are touched directly after people wash their hands and/or use hand sanitizers will have a lower likelihood to become a source than an object touched frequently by a symptomatic patient. While this evaluation process might initially appear cumbersome, the huge benefit is the documented knowledge gained for your facility. It will now serve as an ‘inventory’ for any future processes. Step 3. Prioritization of risks and classifying them from low to high. This determines which efforts come first in the cleaning and disinfection process and which may need higher frequencies or more specific chemicals or techniques. For example, doorknobs are more likely to be touched by hands before people touch their faces than, say, floors. Leading to doorknobs being cleaned more frequently than the floor. Yet, floors cannot be ignored, as residents, staff or visitors may drop things onto the floor and shoes can track the virus from room to room. Step 4. Determination of the cleaning and disinfection processes, frequencies, the determination of the correct PPE as well as any other relevant administrative processes and procedures, e.g. training requirements, verification of the cleaning and disinfection process, and waste disposal. In addition, you need to evaluate if the desired outcomes require more staffing to accomplish the tasks. Step 5. After the cleaning and disinfection has been completed, any lessons learned and next steps should be taken into consideration for continuous improvement.

According to Olinger, the site risk assessment is a critical step not to be missed. “It assists you in gathering critical incident data. By identifying the hazards, and the risks associated with these hazards, you will be able to develop the risk mitigation steps and strategies that allow for a safe and effective process,” she adds.

Proper risk assessment helps define needs prior to entering a resident’s room where an infection may be present, or in addressing any areas where a potentially

sick employee has been present, and then continues through to what is needed during the actual work and afterwards. It should be noted that not all outbreak situations are created equal. The specific situation and associated processes and protocols in your care facility will define the PPE, the disinfectant to be used, the equipment that will be required and the training that needs to take place.

Common mistakes to avoid Sometimes, finer points can be missed when addressing cleaning during an outbreak. It is best to retrain staff on nuances they need to know when increasing cleaning and disinfecting tasks or frequencies. The risk assessment will help identify these areas.

In addition, employees need to be trained in ways the specific virus can travel and how long it can survive on what surfaces, so they understand how their precautionary measures make an impact, including what mistakes can increase resident and employee health risk. Common overlooked items include:

l Cross-contaminating surfaces by using the same cleaning cloth or tool for multiple areas, such as the resident’s main room and restroom, or between rooms. Colour-coding the mops and

Employees need to be trained in ways the specific virus can travel and how long it can survive on what surfaces, so they understand how their precautionary measures make an impact


cloths for different areas can help.

l Failure to properly remove, bag and dispose soiled cleaning materials and the employee’s own PPE and clothing, or laundering in the case of linens.

l Failure to wash hands regularly between tasks.

l Failure of staff to remove their uniform and shoes before leaving work to avoid tracking infection agents outside the building.

Another topic that the risk assessment should consider is employee-only areas where unwitting carriers could bring the virus into the building. This has been the case in multiple facilities during the Covid-19 outbreak.

There also may be a need to adjust what products are used for cleaning and disinfecting during an outbreak. Due to the higher risk of cross-contamination between rooms, or even between a resident’s room and restroom, administrators may want to consider moving to disposable microfiber cloths and mops.

They may want to evaluate the chemicals used as well. For instance, a dual-purpose cleaning and disinfecting agent can replace a common cleaning chemical for certain high-risk areas or critical touch points.

Pre-treated disinfecting wipes may be considered in lieu of reusable cloths, to reduce cross contamination risk. Vacuums with HEPA filters also can help further capture and remove contaminants from surfaces. Similarly, if certain products are not available, due to a shortage, it is advisable to adjust cleaning tasks to find the next- best solution with lowest risk to residents, employees and others. • July 2020

Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48