5 steps of cleaning blood and body fluid spillage

Examples include: Proceed in a Methodical, Systematic Manner, Figure 10. This will ensure that you can use all of the surface area efficiently (generally, fold them in half, then in half again, and this will create 8 sides). a respiratory protection device, for protection against inhalation of powder from the disinfectant granules or aerosols (which may be generated from high-risk spills during the cleaning process). (For larger spills:) 1. Remove visible organic material with absorbent material. Remove and dispose of gloves, paper towel and cleaning cloth in a sealed plastic bag after use. step 5. First, it is important to identify the source of the spillage and contain it if possible. These three elements combine to determine low, moderate, and high riskmore frequent and rigorous (with a different method or process) environmental cleaning is required in areas with high risk. It is best practice to perform routine, standardized assessments of environmental cleaning (i.e., practices, level of cleanliness) in order to: This section includes an overview of the available methods, as well as their advantages and disadvantages. Best Practices for Environmental Cleaning in Healthcare Facilities: in RLS. Disinfect the Area - Use a household disinfectant to clean the area where the spill occurred. Dried body fluids or small spill with low splash potential: Use absorbent material to soak up and contain spill with absorbent powder/ paper towels if necessary. PPE should always be put on and removed following the indications posted / recommended by IPC. Recommended Frequency, Method and Process for Terminal Cleaning of Inpatient Wards. Allow the area to dry. Clean Thrice. immunosuppressed patients (e.g., bone marrow transplant, chemotherapy), patients undergoing invasive procedures (e.g., operating theatres rooms), patients who are regularly exposed to blood or body fluids (e.g., labor and delivery ward, burn units), after the last procedure (i.e., terminal cleaning). n3kGz=[==B0FX'+tG,}/Hh8mW2p[AiAN#8$X?AKHI{!7. Step One: Fully Train Cleaners And Ensure They Are Wearing The Appropriate Clothing For Their Safety If the material has spilled on your clothing and soaked through so that there is skin contact, the clothes must be removed. endstream endobj 931 0 obj <>stream Develop detailed SOPs and checklists for each facility to identify roles and responsibilities for environmental cleaning in these areas. Perform assessments and observations of workflow in consultation with clinical staff in each patient care area to determine key high-touch surfaces. Clean and disinfect all low- and high-touch surfaces, including those that may not be accessible when the room/area was occupied (e.g., patient mattress, bedframe, tops of shelves, vents), and floors. counters where medications and supplies are prepared, patient monitoring equipment (e.g., keyboards, control panels), transport equipment (e.g., wheelchair handles), general inpatient wards with patients admitted for medical procedures, who are not receiving acute care (i.e., sudden, urgent or emergent episodes of injury and illness that require rapid intervention), disposable personal care items are discarded, patient care equipment is removed for reprocessing. A full list of pathogens/infections requiring these precautions are included in CDCs Guideline for Isolation Precautions. Pour a broad spectrum disinfectant such as a 10% bleach solution onto the body spill and leave on for 10-30 minutes before clean-up. . *B:jH>]P`H|UD|v #I7dv#o^Gv=m?uu(. Use fresh cleaning cloths for every cleaning session, regularly replacing them during cleaning and never double-dipping them into cleaning and disinfectant solutions. Hb``$WR~|@T#2S/`M. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. All equipment should include detailed written instructions for cleaning and disinfection from the manufacturer, including pictorial instructions if disassembly is required. Granular formulations that produce high available chlorine concentrations can contain the spilled material and are useful for preventing aerosols. Table 11. Table 9. Once visibly finished, saturate with sodium hypochlorite 0.5% (10,000 ppm available chlorine). Cleaning spots or small spills Spots or drops of blood or other small spills (up to 10 cm) can easily be managed by wiping the area immediately with paper towels, and then cleaning with warm water and detergent, followed by rinsing and drying the area. Cleaning blood and body fluid spillage can be a challenging task, but following these 5 steps will ensure that you are cleaning the area safely, effectively, and efficiently. Steam cleaning may be used instead. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Recommended Frequency and Process for Burn Units, Last clean of the day: clean and disinfect entire floor and low-touch surfaces, Table 21. Leave the bleach solution on the contaminated surface (s) for 20 minutes. 5_6~_:"I`-{8 Remember to always use protective gear when dealing with any bodily fluids and dispose of hazardous material in the appropriate containers for your safety and health. Where large spills (more than 10 cm) have occurred in a wet area, such as a bathroom or toilet area, the spill should be carefully washed off into the sewerage system using copious amounts of water and the area flushed with warm water and detergent. Portable or stationary noncritical patient care equipment incudes IV poles, commode chairs, blood pressure cuffs, and stethoscopes. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. It is recognised, however, that some healthcare workers and members of the public may feel more reassured that the risk of infection is reduced if sodium hypochlorite is used. Cleaning Procedure Summaries for Spills of Blood or Body Fluids +qoX=kG3 all surfaces (high- and low-touch) and the floor inside of the surgical field, including: horizontal surfaces (high- and low-touch) and fixed equipment in the room, including booms and wheels of any equipment (e.g., carts), vertical surfaces such as walls and windows as needed to remove visible soiling, handwashing sinks, scrub and utility areas/sinks, take care to move the operating table and any mobile equipment to make sure to reach the floor areas underneath. Dry the area, as wet areas attract contaminants. increase the probability of contamination of the environment from infectious agents or blood and body fluids, make them more susceptible to infection (e.g., trauma patients), high-touch surfaces and floors with focus on the patient zone and low-touch surfaces, any surface (e.g., walls) that is visibly soiled with blood or body fluids, all surfaces of the dialysis station/area (e.g., bed/chair, countertops, external surfaces of the machine) and floors in the patient zone, high-touch surfaces (e.g., light switches, door handles, handwashing sinks), entire floor (move procedure table and other portable equipment), high-touch surfaces and floors with focus on the patient zone, high-touch and low touch surfaces and floors, last clean of day: entire floor and low-touch surfaces, high-touch surfaces and floors in the patient zone/ procedure table; any surface visibly soiled with blood or body fluids, last clean of the day: other high-touch surfaces and low-touch surfaces, handwashing sinks and scrub/sluice areas and the entire floor, toys; for toys that may be put into mouth of infant or toddler ensure that they are cleaned, disinfected and rinsed thoroughly after each use, high-touch surfaces (e.g., procedure table/station, countertops, external surfaces of fixed equipment) and floors with focus on the patient zone, any surface that is visibly soiled with blood or body fluids, environmentally hardy pathogens (e.g., resistant to disinfectants). This will give you a 1 to 10 ratio of chlorine disinfectant. ,:z6rl3>xoWY8{c$J )-B"g{`tX% 88] 3. HW[o6~#U4X2,[+b${I-1?\yao/'Lo',O$bl5[ Unless otherwise indicated, environmental surfaces and floors in the following sections require cleaning and disinfection with a facility-approved disinfectant for all cleaning procedures described. This chapter provides the current best practices for environmental cleaning procedures in patient care areas, as well as cleaning for specific situations (e.g., blood spills) and for noncritical patient care equipment; see summary in Appendix B1 Cleaning procedure summaries for general patient areas and Appendix B2 Cleaning procedure summaries for specialized patient areas. ,vcIOR5[H]Zk+]cHOA .W%5vTsYC:P #! Clean patient areas (e.g., patient zones) before patient toilets. )U!$5X3/9 ($5j%V*'&*r" (,!!0b;C2( I8/ Control access to the area by blocking off the area of spill from others until clean up and disinfection is complete. Protective eyewear 3. Place the towels in the biohazard bag. Confine the spill and wipe it up immediately with absorbent (paper) towels, cloths, or absorbent granules (if available) that are spread over the spill to solidify the blood or body fluid (all should then be disposed as infectious waste). Proceed in a systematic manner to avoid missing areasfor example, left to right or clockwise (Figure 10). If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. wG xR^[ochg`>b$*~ :Eb~,m,-,Y*6X[F=3Y~d tizf6~`{v.Ng#{}}jc1X6fm;'_9 r:8q:O:8uJqnv=MmR 4 If you develop any symptoms during this time period, it is important to notify your healthcare provider immediately so that you can be tested for other infections such as hepatitis C or syphilis. Reprocess all reusable (noncritical) patient care equipment; see. hbbd``b` 1 $X Fe $rD#H1#n?_ # Train the staff responsible for cleaning equipment on procedures before the equipment is placed into use. Recommended Selection and Care of Noncritical Patient Care Equipment, Clean and disinfect heavily soiled items (e.g., bedpans) outside of the patient care area in dedicated 4.7.2 Sluice rooms. Recommended Frequency and Process for Medication Preparation Areas. All Rights Reserved. Blood spillage is defined as any exposure to blood or body fluids that could potentially cause harm. Then, any loose materials should be removed from the area and disposed of properly. Read more to discover how to properly act on a spillage of blood or other body fluids. The plastic bag may then be thrown away with household waste. Immerse the mop or floor cloth in the bucket with environmental cleaning solution and wring out. The affected area must be cleaned with a disinfectant solution to kill any remaining germs. Spills of blood or body fluids. Take care to allow the disinfectant to remain wet on the surface for the required contact time (e.g., 10 minutes), and then rinse the area with clean water to remove the disinfectant residue (if required). Table 8. Disposable towels used for wiping up blood or other body fluids . %I':zu~>S{;+ With this information about cleaning spills of bodily fluid in mind, now youre ready to tackle any mess with confidence. Table 6. Disposable gown (depending on the severity of the spill), Disinfectant with a broad spectrum kill claim, Brush and dustpan, or tongs and forceps as appropriate. In some cases, more than twice daily cleaning and disinfection may be warranted. Splashes of blood or body fluids to the eyes, nose or mouth must be treated as potential exposure to a blood-borne virus. Saving Lives, Protecting People, General environmental cleaning techniques, Methods for assessment of cleaning and cleanliness, Appendix B1 Cleaning procedure summaries for general patient areas, Appendix B2 Cleaning procedure summaries for specialized patient areas, Appendix A Risk-assessment for determining environmental cleaning method and frequency, 2.4.3 Cleaning checklists, logs, and job aids, Appendix C Example of high-touch surfaces in a specialized patient area, Appendix D Linen and laundry management, Appendix E Chlorine disinfectant solution preparation, Decontamination and Reprocessing of Medical Devices for Health-care Facilities, 4.2.3 Terminal or discharge cleaning of inpatient wards, Areas with Contact and Droplet Precautions, 4.4.2 Routine cleaning of inpatient wards, WHO 2019: Implementation manual to prevent and control the spread of carbapenem-resistant organisms at the national and health care facility level, WHO: Infection prevention and control guidance for care of patients in health-care settings, with focus on Ebola, WHO | Ebola virus disease: Key questions and answers concerning water, sanitation and hygiene, 4.7.1 Material compatibility considerations, Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP), Antibiotic Resistance & Patient Safety Portal, Data Summary: Assessing Progress 2006-2016, Central Line-associated Bloodstream Infections, Catheter-associated Urinary Tract Infection, Carbapenem-resistant Enterobacterales (CRE), Occupationally Acquired HIV/AIDS in Healthcare Personnel, Vancomycin-resistant Enterococci (VRE) in Healthcare Settings, Patients with Indwelling Urinary Catheter, Patients without Indwelling Urinary Catheter, Options for Evaluating Environmental Cleaning, Appendices to the Conceptual Program Model for Environmental Evaluation, Basic Infection Control and Prevention Plan for Outpatient Oncology Settings, Infection Prevention and Control Assessment Tool for Nursing Homes Preparing for COVID-19, Environmental Cleaning in Resource-Limited Settings, Environmental Cleaning Supplies and Equipment, Appendix B2: Cleaning specialized areas, Appendix C: Examples of high-touch surfaces, Appendix E: Chlorine disinfectant preparation, Healthcare Environmental Infection Prevention, Antibiotic Resistance Laboratory Network (AR Lab Network), HAI/AR Program Successes & Public Health Impact, Interim Local Health Department (LHD) HAI/AR Strategy, Modeling Infectious Diseases in Healthcare Network (MInD Healthcare), Multiplex Real-Time PCR Detection of KPC & NDM-1 genes, Detection of Imipenem or Meropenem-resistance in Gram-negative Organisms, Labs Role in the Search and Containment of VRSA, Inferred Identification of Pulsed Field Types based on MLST clonal complex, Microscopic Gallery of Pathologic Results, Outbreak Resources for State Health Departments, U.S. Department of Health & Human Services, At least once daily (e.g., per 24-hour period), Procedural (minor operative procedures; e.g., suturing wounds, draining abscesses), Before and after (i.e., between [Footnote e]) each procedure, High-touch surfaces and floors, with an emphasis on the patient zone, procedure table, Scheduled basis (e.g., weekly, monthly) and when visibly soiled, Scheduled basis (e.g., weekly) and when visibly soiled, High surfaces (above shoulder height) such as tops of cupboards, vents, At least once daily (e.g., per 24-hour period), after routine cleaning of patient care area, High-touch and frequently contaminated surfaces in toilet areas (e.g., handwashing sinks, faucets, handles, toilet seat, door handles) and floors, Public or shared toilets (e.g., patients, visitors, family members), Floors in general inpatient and outpatient areas, always cleaned last after other environmental surfaces, At least once daily (e.g., per 24-hour period) or as often as specified in the specific patient care area, Clean (unless otherwise specified within specific patient care area), Any spill in any patient or non-patient area. The method for cleaning spills will depend on the volume of the spill and where it occurs. Thoroughly clean and disinfect portable patient-care equipment that is not stored within the operating room before removal from the operating room. Therefore, under normal circumstances they should be cleaned daily, but the use of a disinfectant is not necessary. Thoroughly clean and disinfect portable patient-care equipment that is not stored within the operating room, such as suction regulators, anesthesia trolley, compressed gas tanks, x-ray machines, and lead gowns, before introduction into the operating room. See Appendix C Example of high-touch surfaces in a specialized patient area. x? Prevent access to the area 3. 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Wash hands thoroughly after cleaning is completed. Cookies used to make website functionality more relevant to you. Explore more workplace safety resources from the EHS Insight Blog. PPE should be used for all cleaning procedures, and disposed of or sent for cleaning after use. A scraper and pan should be used to remove the absorbed material. Toilets in patient care areas can be private (within a private patient room) or shared (among patients and visitors). Recommended Frequency and Process for Intensive Care Units, Clean floors with neutral detergent and water, If a neonatal incubator is occupied, clean and disinfect only the outside; only clean (neutral detergent) on inside, Ensure that cleaning schedules details responsible staff (e.g., nursing or cleaning staff) for environmental cleaning of surfaces of noncritical patient care equipment, Last clean of the day: also clean low-touch surfaces; see 4.2.4 Scheduled cleaning, Change filters in incubators according to manufacturers instructions, when wet or if neonate was on contact precautions (during terminal clean), Pay special attention to terminal cleaning of incubators, Pay special attention to ensure reprocessing of noncritical patient care equipment, Environmental Cleaning Supplies and Equipment for the ICU. This preliminary clean just utilizes a disinfectant to ensure that the space is fully decontaminated before the first procedure. #Om 3. multidrug-resistant pathogens that are highly transmissible and/or are associated with high morbidity and mortality. Emergency departments are moderate to high-risk areas because of the wide variability in the condition of patients and admissions, which can: Because emergency departments are specialized and high-throughput areas, clinical staff (e.g., nurses) might play an active role in performing environmental cleaning, particularly in examination and procedural areas. Recommended Frequency and Process for Sterile Service Departments (SSD), Additional Best Practices for Sterile Service Departments (SSD). %PDF-1.5 % Put the soiled wipe back into the pack Remove a disinfectant wipe from sachet. Concentration should not exceed 1000 ppm or 0.1%, Rinse equipment with clean water after disinfection, Good for disinfecting small equipment or devices that can be immersed (e.g., stethoscopes, thermometers), a door that is kept closed at all times and ideally has hands-free operation, a work counter and sluice/utility sink with a hot and cold faucet, space for washers/disinfectors (if resources allow), PPE available to protect staff during cleaning and disinfecting procedures, be distinctly separate from (by workflow) soiled areas to prevent confusion regarding reprocessing status, have shelves that are smooth, non-porous and easy to clean, be protected from water and soil, dirt, and dust, be as close as possible to patient areas and easily available to staff, ensure that environmental cleaning procedures are being performed according to best practices and facility policy, use results to inform program improvement (e.g., training, resource allocation), measuring the residual bioburden (i.e., ATP), taking a bacteriological culture of the surface itself using a swab or contact agar plate method. After the final procedure (i.e., terminal clean). The basic principles of blood and body fluid/substance spills management are: Using these basic principles, the management of spills should be flexible enough to cope with different types of spills, taking into account the following factors: Standard cleaning equipment, including a mop, cleaning bucket and cleaning agents, should be readily available for spills management. These high-touch items are: Note: Critical and semi-critical equipment requires specialized reprocessing procedures and is never the responsibility of environmental cleaning staff. Alternatively, there may be central depots where these procedures are performed. For all environmental cleaning procedures, always use the following general strategies: Conduct Visual Preliminary Site Assessment. Explore hundreds of health and wellness topics such as diet and nutrition, weight loss or weight gain, depression, and more. There are situations where there is higher risk associated with floors (e.g., high probability of contamination), so review the specific procedures in 4.2 General patient areas and 4.6 Specialized patient areasfor guidance on frequency of environmental cleaning of floors and when they should also be disinfected. Recommended Material Cleaning and Disinfectant Compatibility Considerations. Clean all equipment using the methods and products available at the facility. generation of aerosols from spilled material should be avoided. SSDs have two distinct areas, the soiled area (also called dirty area or decontamination area) and the clean area. General outpatient or ambulatory care wards include waiting areas, consultation areas, and minor procedural areas. These are the best practices for environmental cleaning in transmission-based precaution areas: Table 24. Centers for Disease Control and Prevention. This will help to protect you from coming into contact with any harmful substances. The areas in this section are higher risk because of: Nursing and cleaning staff might be responsible for cleaning certain areas/items in these areas, so there must be clearly defined cleaning responsibilities for all surfaces and equipment (stationary and portable). If you have come into contact with blood or body fluids, it is important to take steps to prevent infection. Routine cleaning of inpatient areas occurs while the patient is admitted, focuses on the patient zones and aims to remove organic material and reduce microbial contamination to provide a visually clean environment. do not use combined detergent-disinfectant product. This includes contact with intact skin, mucous membranes, or broken skin. Clinical and nominated staff members should deal with blood and body fluid spillages.11 Intensive care units (ICUs) are high-risk areas due to the severity of disease and vulnerability of the patients to develop infections. The responsibility for cleaning noncritical patient care equipment might be divided between cleaning and clinical staff, so it is best practice to clearly define and delineate cleaning responsibilities for all equipment (stationary and portable). You will be subject to the destination website's privacy policy when you follow the link. Do not use disinfectant. Therefore, they pose a higher risk of pathogen transmission than in general patient areas. What is Blood Spillage? All cleaners should wash their hands and put on disposable cleaning gear before attending the spill.

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