Environmental cleaning in healthcare is a herculean task by any standards. Few doubt that hygiene in a healthcare setting is the fundamental requirement for helping the patients keep good health by minimizing risk of infection. Environmental cleaning is the means to bring about hygiene. So, the aim of any healthcare unit should be to ensure that it does environmental cleaning regularly, so that it is a place that is relatively free of infection.
But here is the rub -how does a healthcare unit carry out environmental cleaning that ensures that the risk of infection is eliminated? The entire challenge to environmental cleaning lies in the fact that contamination and infection can happen from the unlikeliest of sources. It is like waging a battle against all fronts all the time. There are innumerable sources of infection which the healthcare setting has to anticipate. But the sources are just so many and of such varied types that it is almost impossible to keep a thorough tab on each of these.
Given this fact, environmental cleaning can be made effective by preventing the occurrence of infection at the source of the problem to the extent possible. At best, a good environmental cleaning program can think of thoroughly disinfecting the areas that are likely to be sources of infection:
- Surfaces and points in the facility that are prone to touch by the patient or those accompanying or visiting the patient
- The objects and apparatuses that patients are likely to come into contact with, such as lab equipment or beds or dustbins
- All the healthcare staff that are likely to come into contact with the patients
Creating standards in environmental cleaning is almost impossible:
Why environmental cleaning is a challenge is because there are no methods or standards for testing the effectiveness of this practice. Healthcare settings may take the highest possible care, but could still end up causing infections because of factors that that are beyond its reach. A major aspect here is the patient’s threshold level of tolerance of endurance to infection or disease. Since this all-important parameter is subjective and varies from one patient to another; it is difficult for environmental cleaning to attain its intended objective. For instance, disinfectants may be used as a measure for environmental cleaning, but the difficulty is that these and other environmental cleaning agents may work to an extent, and its effectiveness becomes subjective.
A few general environmental cleaning tips:
In the light of these important factors, one can think of implementing a few broad guidelines for environmental cleaning:
- Generous use of surface cleaners and disinfectants like sodium hypochlorite, chlorine and quaternary ammonium compounds as a first line of defense
- Use of germicidal materials and silver and copper could be a sound second line of defense
- Constant monitoring at every stage is indispensable to environmental cleaning.