Environmental cleaning is a difficult, yet critical aspect of healthcare settings

A core aspect of hygiene in any healthcare setting is the aspect pertaining to environmental cleaning.  A proper environmental cleaning program should consist of a plan in which the healthcare unit ensures that the possibility of risk of infection is minimized. Prevention of infection is the main purpose of environmental cleaning. This is because hospitals are a very likely source of infections, given that people with almost all kinds of contagious diseases visit or stay in them. Since hospitals or other healthcare settings are highly vulnerable to spreading disease; it is necessary for them to have a thorough environmental cleaning regimen in place.

An environmental cleaning program should commence from thoroughly disinfecting all the areas, points and surfaces, as well as apparatuses and equipment that patients, as well as the healthcare staff who come into contact with them, touch. While this much is agreed upon, this is a broad set of activities into which it is difficult to build compliance guidelines.

The problem of creating standards

Environmental cleaning becomes complicated by the fact it is not possible to assess effectiveness in all settings. There is no uniform set of principles that can be applied, because infection is highly subjective. It varies in relation to patient resistance and the ability of the staff to handle it. Also, prescribing a list of disinfectants is difficult because the irrefutable evidence of their effectiveness is impossible to establish. In many cases, disinfectants are not powerful enough depending on the patient’s exposure threshold, while in other cases, it may not be necessary to use disinfectants beyond a point.

Some general steps

Given this situation, some broad steps can be prescribed for ensuring environmental cleaning:

  • A first layer of cleaning includes using a broad range of surface cleaners and disinfectants such as chlorine, sodium hypochlorite and quaternary ammonium compounds
  • A second layer of environmental cleaning should be carried out by fortifying the environment with substances that are less likely to cause infections. Just as electrical shocks are weakened to an extent with the use of insulation material; all the likely places that come into contact with patients and healthcare staff should be made of substances that are likely to neutralize the effect of bacteria and other infection-causing agents. These include coating them with germicidal substances, silver or copper.
  • Environmental cleaning should also be about maintaining a constant, high state of alert at every stage after the healthcare setting becomes operational. An environmental cleaning program should consist of cleaning the healthcare setting from time to time in accordance with set standards.



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