General cleaning technique. Cleaning in a medical room and its features

General and current cleaning of premises in medical institutions (HCIs) are necessary measure, the purpose of which is to prevent the spread of infections and other diseases within the hospital among medical staff and patients. These procedures need to be given the most serious attention, since it directly affects human life and health, especially since Rospotrebnadzor bodies and various sanitary commissions regularly monitor these procedures in medical institutions.

Requirements for inventory and cleaning products

The first thing you should pay attention to when cleaning rooms in healthcare facilities is a competent and optimal selection supplies and detergents. Namely, these two main aspects guarantee the high-quality performance of cleaning operations in hospitals. When selecting equipment and detergents, it is also necessary to take into account the factor that, as part of the cleaning of premises in health facilities, one will have to face not only household dust and ordinary dirt, but also potential sources of various infections. Consequently, standard wet cleaning, when a full-time cleaner simply wipes the dust with a cloth, will obviously not be enough here, it is necessary to use only professional equipment and only professional chemicals. All personnel involved in cleaning work in the hospital must receive appropriate training.

The procedure, as well as the procedure for conducting the current and general cleaning in modern organizations health care are regulated by the relevant documents:

• SanPiN 2.1.3.2630-10 "Sanitary and epidemiological requirements for organizations engaged in medical activities." In particular, these requirements contain very voluminous and precise recommendations for the implementation various kinds cleaning in medical premises, depending on the profile of this hospital department.
• SP 3.5.1378-03 "Sanitary and epidemiological requirements for the organization and implementation of disinfection activities."

Features of current and general cleaning

In the premises of the healthcare facility, as in any other premises, with the exception of disinfection procedures, two types of cleaning are carried out - current cleaning and general cleaning.

CURRENT CLEANING OF PREMISES OF HCI

Current cleaning- a set of measures that is aimed at the effective and timely elimination of pollution of all types within the premises and is carried out during working hours.

The procedure for conducting routine cleaning in a hospital and other medical organizations necessarily includes the processing of furniture, equipment, work surfaces and floors. At its core, it is a regular wet cleaning, with the only difference that this cleaning is carried out at least twice a day and for its implementation it is necessary to use special cleaning and disinfecting agents. Its main difference from the general one is the frequency and volume of work performed.

The frequency of cleaning may vary in each case, depending on the profile of the medical institution or even its individual premises. For example, dressing rooms should be cleaned at least twice a day, including floors, sinks, door handles and walls. At the same time, radiators, windows, doors, window sills and cabinets where medical instruments are stored are cleaned at least once a day. A similar cleaning procedure is implied in recovery rooms and intensive care units. In turn, cleaning of such premises as a regular therapeutic ward is carried out at least once a day, etc.

GENERAL CLEANING OF PREMISES OF HCI

General cleaning is a complex of disinfection and sanitary-hygienic measures aimed at creating an aseptic regime in the room for the safe conduct of the required medical procedures.

To carry out these activities, it is necessary to use only professional disinfectants and detergents, as well as to use equipment designed for cleaning this particular room.

General cleaning is carried out according to the schedule agreed by the administration of the medical organization, taking into account all the required disinfection regimes suitable for the hospital department of the corresponding profile.

In functional premises, in doctors' offices and hospitals, planned general cleaning should be carried out at least once a month, including the treatment of walls and ceilings, work equipment and lighting devices. Operating rooms, maternity rooms, dressing rooms, as well as sterilization, procedural and other rooms with an aseptic regime are subject to scheduled general cleaning at least once a week. At the same time, it is important to understand that on the day of the general cleaning, surgical operations in the operating unit are not allowed. Unscheduled general cleaning may be carried out as a result of obtaining unsatisfactory indications of sterility and microbial contamination external environment during the inspection of the hospital premises.

Stage 1. Freeing the premises from objects, equipment, tools, medicines, etc. Preliminary cleaning with a 0.5% soap and soda solution (50 g of soap, 200 g of soda per 10 liters of water) to remove mechanical and other contaminants in order to increase efficiency exposure to treated surfaces with disinfectants, followed by rinsing with clean drinking water.

2 stage. The disinfectant solution is applied to all surfaces (walls, windows, window sills, doors, surfaces, floors) and left for 60 minutes, at the same time turn on germicidal lamp.

Zap. Switch off the bactericidal lamp. They make a change of special clothing, working rags. All surfaces wetted with disinfectant are washed thoroughly and abundantly. clean water using sterilized rags. Disinfected furniture and equipment are brought in.

4th stage. Bactericidal irradiation of the room for 30 minutes, after which airing is carried out for 15-20 minutes.

When using modern disinfectants that combine the properties of disinfectant and washing solutions, the general cleaning scheme changes:

Stage 1- Free the room from items of equipment, etc. Apply to everything
surfaces (walls, windows, window sills, doors, surfaces, floors) working solution and
turn on a bactericidal lamp for the duration of the disinfectant exposure.

Stage 2- Switch off the germicidal lamp. They change special clothes and rags.
Rinse thoroughly with clean water using sterilized rags.
Bring disinfected furniture, etc.

Stage 3- Bactericidal irradiation up to 90 minutes, taking into account the operating time of the lamp at
the first stage, followed by airing for 15-20 minutes.

When using disinfectants for general cleaning, it is necessary to follow the recommendations given in the instructions for the product used. So, the use of lyzafin does not provide for the subsequent washing off of the drug. Surfaces treated with lyzafin-special after exposure are simply wiped with a clean, dry rag. (see Attachment)

Procedure room cleaning rules.

The treatment room, like a clean dressing room or a small operating room, is designed to carry out manipulations related to the regular condition of the office - compliance with the rules of asepsis, maintenance of the skin by cutting (injections, infusions, blood transfusions), therefore not cleanliness and order.

The work begins with the morning pre-cleaning - removing the dust that has settled overnight on furniture, window sills, appliances, on the floor and others. horizontal surfaces with the use of disinfectant solutions.

Current cleaning is carried out during work: accidentally dropped balls, napkins and other items are removed from the floor.

At the end of the shift, cleaning is carried out, including wet wiping of walls, window sills, furniture and floors using disinfectants. After cleaning, the room is irradiated with ultraviolet light, ventilated.

General cleaning is carried out once a week (fixed day).

Extracts of the order from 720 Ministry of Health of the USSR "Regulations on the work of the treatment room."

1. Cover the sterile table 4 times a day (after 6 hours).

2. Change bathrobes, caps, towels daily, masks every other 3 hours.

3. Treat hands before starting: 2-fold washing with soap; swab dipped in
It is good to treat hands with 70% alcohol for 2 minutes.

4. Have a schedule for general cleaning.

5. Have a schedule for quartzing the treatment room - 1 time per 4 hours (6 times a day)

6. Have an emergency kit for anaphylactic shock.

7. Every day, the procedural sister should put azopyram and fenlphthalein samples, the older sister - once a month.

8. Report all cases of post-injection complications to the head of the department.

9. Responsibility for compliance with the sanitary and epidemiological regime lies with the head of the department, senior nurse and sister of the treatment room.

Airing

Target: Health improvement, air disinfection mechanically. Providing a barrier for the reproduction of pathogenic flora and the spread of nosocomial infections by airborne droplets. Enrichment of air with oxygen Indications: All premises of medical institutions. The necessary conditions:

regularity of airing (at least 4-5 times a day);

the presence of vents, opening sashes

P/No.	PREPARATION PROCESS FOR PROCEDURES	RATIONALE
1.	Warn patients in the ward about the upcoming manipulation and obtain consent to it.	Motivating the patient to cooperate. Respect for the rights of the patient.
2.	Determine the most appropriate method of ventilation (it depends on the season, the presence of vents, the patient's condition).	Ensuring the technicality and correctness of the manipulation.
3.	Ask patients who can walk to leave the room	Ensuring the effectiveness of manipulation
4.	Provide critically ill patients reliable protection from hypothermia: - cover with a blanket - cover your head	Maintain the body's defenses of weakened patients
5.	Open windows, sashes (depending on the season) for 20 minutes. IN summer period they can be kept open 24/7.	Provision of ventilation, air disinfection.
6.	Close windows, shutters.	end of manipulation.
7.	Invite patients to the room.	Ensuring the comfort of patients.

QUARTZING

Purpose: Destruction of pathogenic flora as a result of exposure to the rays of a bactericidal lamp

Indications: All regime rooms of health care facilities Frequency and duration of quartzing depends on the area of ​​the room (1 watt per 1 cubic meter), as well as on the functional load of the room (in treatment rooms, dressing rooms every 4-6 hours).

The necessary conditions:

regularity of quartzing,

the presence of a stationary or mobile ultraviolet irradiator,

the absence of patients and medical staff in the room during quartzization.

P/No.	PREPARATION PROCESS FOR THE PROCEDURE	RATIONALE
1.	Warn patients and medical staff about the upcoming manipulation and ask them to leave the room.	Avoidance of possible complications. Respect for the rights of the patient.
2.	For patients who are forced to be indoors during quartzization, provide eye protection.	Avoid damage to eyes sensitive to UV exposure
3.	Turn on the bactericidal lamp (time is regulated)	Air disinfection
4.	Turn off the lamp when finished.	Completeness of manipulation
5.	Invite patients to the ward, medical staff to their workplaces.	Ensuring the comfortable condition of patients. Continued work of the medical staff.

The date and time of quartzization is recorded in special documentation.

Questions for self-control

1. The problem of nosocomial infection, definition, structure. Factors affecting the growth of nosocomial infections. The most common VBI.
2. Epidemiology of nosocomial infections. The concept of the infectious process.
3. Properties of pathogenic microorganisms.
4. Sources and reservoirs of WBI. causative agents of nosocomial infections.
5. Risk groups for the development of nosocomial infections among patients and medical staff.
6. Methods of transmission of infection in hospitals.
7. Human susceptibility factors to infection.
8. Measures for the prevention of nosocomial infections and the control of nosocomial infections.
9. current regulatory documents.
10. Requirements for personal hygiene and medical clothing of personnel.
11. Hand washing levels.

Literature

1. Lecture No. 5

2. " Theoretical basis nursing. pp. 83 - 95

3. T.P. Obukhovets “Fundamentals of nursing. Practicum» p.83 - 95

Purpose of disinfection: removal or destruction of pathogens from the objects of the external environment of the wards and functional premises of the departments of healthcare facilities, on medical equipment and tools, patient care items.

All disinfection measures are distinguished by type:

- focal (current and final);

- preventive (current)

Preventive disinfectionis carried out in order to prevent nosocomial infections (in the absence of a focus of infection) in all medical diagnostic and auxiliary units of medical facilities regardless of the fact of the diagnosis of an infectious disease. Modes of preventive disinfection are determined according to the profile of health facilities.

Spot disinfectionis carried out in an established epidemiological center (if an infectious disease or complication is suspected or diagnosed).Focal - divided on the focal current disinfection, which is carried out in the focus of infection, at the bedside of an infectious patient, is carried out repeatedly. AND focal final after isolation, hospitalization in the infectious diseases department, recovery or death of the patient in order to completely free the infectious focus from pathogens.

Scope of preventive disinfection measures depends on the profile

medical institution And determined by the requirements of the main regulatory

documents on the prevention of nosocomial infections and the sanitary and anti-epidemic regime - Orders of the Ministry of Health of the USSR:

No. 720 dated 07/31/78« About improvement medical care patients with purulent

surgical diseases and strengthening measures to combat nosocomial infections”;

No. 408 dated 12.0789"On measures to reduce the incidence of viral hepatitis in the country";

No. 916 dated 04.07. 83g "On the approval of instructions for sanitary

anti-epidemic regime and labor protection of personnel of infectious diseases hospitals”;

SP 3.5.675-97"Hygienic requirements for institutions, organizations,

enterprises and persons engaged in disinfection activities”;

Industry standard 42-21-2-85,determining the methods, means and mode of disinfection and sterilization of medical devices (syringes, needles, instruments);

SAN ePiN 5 179-90 MZ, M., 1990,defining sanitary content various premises hospital, equipment, inventory, personal hygiene of patients and attendants.

Methods and methods of disinfection

methods	ways	application
mechanical	ventilation	Chambers, corridors, functional, auxiliary premises and offices
shaking, knocking out, knocking out, using a vacuum cleaner, whitewashing, coloring	Currently unjustifiably forgotten and not used. The effectiveness of these methods is more than 80%, and at the same time, the risk of developing allergic reactions in patients and staff to the disinfectants used is eliminated.
Wet cleaning, washing incl. hands	Surfaces of the room, equipment, hands
physical	heating, boiling	Products made of glass, metals, heat-resistant materials
Ironing with a hot iron, calcination, burning, burning	Items of little value Infectious waste, rubbish
exposure to dry hot air	Products made of glass, metals, heat-resistant polymer materials(without packaging, in a dry oven at t-120°C, exposure 45 minutes from the moment the set temperature is reached)
steam exposure	Products made of glass, metals, heat-resistant polymeric materials under overpressure at 0.5 atm. and temperature 110°C, exposure time is 20 minutes. Rarely used.
UFO (guideline R 3.1 683-98)	Disinfection of air and surfaces of wards, functional rooms and offices
The use of sunlight	Blankets, mattresses, pillows
chemical using chemical substances(antiseptics and disinfectants)	Immersion (soaking)	medical devices, patient care items, cleaning equipment, dishes
falling asleep	biological material
irrigation	large appliances, large surfaces(walls, furniture)
Rubbing	Equipment, furniture, surfaces, medical supplies
Combined (steam-air, steam-formalin) combine several methods ( wet cleaning premises with subsequent UVI	chamber processing: t o - 110 about C, p-0.5 atm. ex.20` t o - 90 o C, p-0.5 atm. Ex.30`	bedding

When conducting disinfecting measures, the correct use of disinfectants, in legal terms, is of no small importance. This means: the fulfillment of the requirements for both the disinfectant itself and the persons using them. The difficulty in organizing and carrying out disinfection measures in health facilities lies in the fact that they should be carried out mainly in the presence of patients and with the uninterrupted activity of medical and attendant personnel.

General cleaning involves the treatment of walls with a disinfectant solution up to the ceiling, ceiling, floor, working and hard-to-reach surfaces, equipment, windows, including internal surfaces window glass (according to the schedule). Windows are being washed warm water with the addition of 1 tablespoon ammonia per 1 liter of water or permitted special detergent for windows.

Sequencing:

I stage:

Put on special clothes;

Move furniture and equipment away from the walls to clean the walls and floor behind them;

Carry out mechanical cleaning of the walls and floor from dirt, using a clean rag (1st rag) and a cleaning solution, the space behind heating batteries and between them, treat sequentially with 2 ruffs moistened with disinfectant;

Rinse off the cleaning solution tap water;

Apply a disinfectant solution to all surfaces with a clean rag (2nd rag), withstand exposure.

II stage:

Remove apron, change gloves;

Wash all surfaces with tap water using a sterile cloth

(3rd rag);

Wipe the washed surfaces with a clean rag (4th rag);

Wash the floor according to the "two buckets" method;

Wiping the floor is carried out using the “two buckets” method (Fig. 20). For this purpose, two containers (buckets) are distinguished, which are marked "1" and "2". Pour into container "1" required amount(3 - 4 l) disinfectant solution; into container "2" - clean tap water. Moisten the cleaning rags in the solution of the container "1" and thoroughly wipe the surface to be treated. Then the rags are rinsed in container "2", squeezed out and re-moistened in the solution of container "1" and the untreated floor surfaces are washed. The solution in container "1" is changed

after disinfection 60 m², the water of the container "2" -

as it becomes contaminated.

Disinfect cleaning equipment disinfectant solution, rinse and

be sure to dry in a special room;

Take off overalls, send to the laundry;

Make a note in the Journal of General Cleaning, Journal

registration and control of ultraviolet bactericidal installation.

Note: When using a disinfectant solution with a detergent effect, mechanical cleaning can be combined with disinfection. If the disinfectant does not require rinsing, the treatment consists only of wiping the surfaces with the disinfectant, followed by irradiation with a germicidal lamp.

Weekly (during general cleaning) the lamp of the bactericidal irradiator is wiped from dust and grease deposits with a gauze cloth (the presence of dust on the lamp reduces the efficiency of air and surface disinfection by 50%). To do this, it is necessary to unfold the napkin in length, moisten it with 96% alcohol, wring it out, throw one end of the napkin to the other side of the lamp, wrapping it in a ring. Then pinch both ends of the napkin with one hand and rub the lamp along. The screen is treated with a swab with 96% alcohol, pre-squeeze.

Cleaning technology

By type of current disinfection

The current cleaning of the wards is carried out in the morning and in the evening, rooms, aseptic rooms - before starting work and at the end of work, as it gets dirty during work by junior medical personnel in special clothes under the supervision of a nurse.

Current cleaning includes:

Processing of working surfaces, equipment, doors, sinks by wiping with a rag moistened with a disinfectant solution, followed by rinsing with tap water using a clean rag;

Irradiation of the room with a bactericidal lamp. The exposure time is calculated based on the data of the passport of a particular bactericidal lamp and the area of ​​the treated room. It is recommended to record the operating time of the bactericidal lamp in the register of the operation of bactericidal lamps.

Sequencing:

I stage:

Put on special clothes;

Treat work surfaces, equipment, doors, sinks in sequence with a disinfectant solution (use a container for surfaces and clean rags).

II stage:

Rinse off the disinfectant solution with clean tap water using clean

Wash the floor using the "two buckets" method (use a bucket for mopping and rags for

Turn on the bactericidal lamp, withstand the exposure;

Turn off the bactericidal lamp;

Ventilate the room until the smell of ozone disappears;

Disinfect rags, cleaning equipment in a disinfectant solution, rinse and

be sure to dry in a special room.

Note: during the operation of the procedural (manipulation, dressing) room, the disinfection of the roller, tourniquet, oilcloth, the surface of the couch - after each procedure, the surface of the desktop - as it gets dirty. With a rag moistened with a disinfectant solution, the roller under the arm, tourniquet, oilcloth, and the surface of the couch are processed. In case of contamination of working surfaces during procedures with blood, they should be carefully treated with a rag moistened with a disinfectant solution, then rinse the disinfectant solution with tap water using a clean rag. After use, disinfect the rags in a disinfection container.

Ventilation of the wards

To maintain a constant temperature and ensure the purity of the air, the ward must be regularly ventilated: open vents, transoms, and in the summer, windows.

The frequency and duration of airing depends on the time of year. IN winter time ventilation of the wards is carried out regardless of the adopted ventilation system at least 4 times a day for 15 minutes.

In summer, windows with nets should be open around the clock.

During ventilation, the nurse should cover the patients well, make sure that there are no drafts. Ventilation is a mandatory measure and is not subject to discussion by patients.

The use of germicidal lamps

Germicidal lamps are widely used to disinfect indoor air, fence surfaces (ceilings, walls and floors) and equipment in rooms with an increased risk of spreading airborne and intestinal infections.

They are effectively used in operating rooms of hospitals, in delivery rooms and other premises of maternity hospitals, as well as in bacteriological and virological laboratories, at blood transfusion stations, in dressing hospitals and polyclinics, in vestibules of boxes of infectious diseases hospitals, in emergency clinics, dispensaries, first-aid posts.

Air disinfection modes are set out in the relevant regulatory and methodological documents and instructions for the use of specific disinfection equipment and disinfectants.

In order to reduce air contamination to a safe level, the following technologies are used (Fig. 21):

Impact ultraviolet radiation using open and combined bactericidal irradiators used in the absence of people;

The impact of closed irradiators that allow air disinfection in the presence of people.

The required number of irradiators for each room is determined by calculation, in accordance with applicable standards. When calculating the operating mode of the lamp, one should take into account the area of ​​\u200b\u200bthe room, the number and power of the lamps, and also that as the lamps work, the bactericidal flux decreases, in order to compensate for this, it is necessary to increase the exposure time by 1.2 times after 1/3 of the nominal service life, 2/3 of the term - 1/3 times.

In order to reduce the level of ozone concentration, the use of “ozone-free” germicidal lamps is preferable. "Ozone" lamps can be used indoors in the absence of people, while it is necessary to ensure thorough ventilation after the irradiation session.

Lamp operation is logged.

Control of the sanitary condition of the wards, bedside tables, refrigerators(fig.22)

In the places of reception of transfers and in the branches, lists of products allowed for transfer (with an indication of their maximum quantity) should be posted.

It is allowed to store soap in the bedside tables, toothpaste, a toothbrush in a case, a comb in a case or in a plastic bag, magazines, newspapers. Sweets, jam, cookies are stored on another shelf of the bedside table. Fruit and perishable foods are stored in refrigerator.

Sour, dairy products are stored in the refrigerator for no more than 2 days. Do not store canned food in the refrigerator

meat, fish products.

Daily duty nurse department checks compliance with the rules and expiration dates (storage) of food products stored in the department refrigerators. If food products are found in the refrigerators of the department with an expired shelf life, stored without packaging, without indicating the name of the patient, and also showing signs of spoilage, they should be removed as food waste. The patient should be informed about the rules for storing personal food products upon admission to the department.

Handling dirty laundry

Dirty linen is collected in closed containers (oilcloth or plastic bags, specially equipped and marked linen trolleys, etc. (Fig. 23) and transferred to the central pantry for dirty linen. Temporary storage of dirty linen in compartments (no more than 12 hours) is allowed in dirty laundry rooms waterproof finish surfaces equipped with a washbasin, a device for air disinfection. The room and inventory are washed and disinfected daily.

In hospitals and clinics, central pantries are provided for clean and dirty linen. In medical organizations low power clean and dirty linen can be stored in separate closets, including built-in ones.

Washing of linen should be carried out in special laundries or laundry as part of a medical organization.

Transportation of clean linen from the laundry and dirty linen to the laundry should be carried out in a packaged form (in containers) by specially designated vehicles.

Transportation of dirty and clean linen in the same container is not allowed. Washing of fabric containers (bags) should be carried out simultaneously with linen.

Fig. 24 Disinfection chamber

After the discharge (death) of the patient, as well as in the process of contamination, mattresses, pillows, blankets should be subjected to disinfection chamber processing (Fig. 24). In the case of using covers to cover mattresses, from a material that allows wet disinfection, chamber processing is not required. The patient's bed and bedside table are subject to disinfection.

Hand treatment before and after manipulation

The microflora of the skin of the hands consists of both permanent and transient (temporary) microorganisms. Permanent ones live and multiply on the skin, while temporary ones appear only as a result of hand contamination. In the superficial layers of the skin is 80-90% of permanent microorganisms, the rest can live in the deep layers of the skin.

Most of the permanently living microorganisms are non-virulent and do not cause any infections other than skin infections. With deep penetration into tissues during surgical interventions, injections and other penetrating procedures, as well as in immunocompromised patients, they become a pathogenic factor and cause nosocomial infection.

Temporary microorganisms often present on the skin of the hands of personnel, as well as obtained from contaminated or infected patients, can also cause nosocomial infections.

Scheme of general cleaning.

Stage 1 - room preparation.

Stage 2 - washing all surfaces.

Stage 3 - disinfection of all surfaces + air disinfection .

Stage 4 - flushing disinfectant + re-disinfection of air .

Stage 5- ventilation of the room.

Stage 6 - disinfection of rags and cleaning equipment.

Option number 1.

General cleaning with chlorine-containing preparations.

More than 100 drugs belong to the group of chlorine-containing drugs and are approved for use for general cleaning in sensitive rooms. Consumption rates of a solution of chlorine-containing preparations - 150 - 200 ml of solution per 1 sq.m of surfaces when processed by wiping or spraying with the Kvazar apparatus.

Stage 1. Room preparation. The room is freed from medicines, sterile packing and materials, Supplies, waste. All equipment is turned off. The staff puts on overalls and protective equipment (gloves, mask, apron). Working solutions are being prepared: 2% soap and soda solution (per 10 l hot water add 50g laundry soap and 200 g of soda ash) and a disinfectant solution according to the regime that ensures the destruction of bacteria, viruses, fungi.

Stage 2. Purpose: mechanical cleaning of surfaces from mechanical impurities.

A 2% soap-soda solution is applied to all surfaces in two directions - “top-down” and “window-to-door”. At the same time, the surfaces are thoroughly washed. Then the soap-soda solution is washed off with drinking (tap) water.

Stage 3. Purpose: disinfection of surfaces.

The disinfectant solution is applied to all surfaces by wiping, observing the directions “from top to bottom” and “from window to door”. Then, turn on the germicidal lamp for 60 minutes.

Stage 4. After 60 minutes of exposure exposure, the personnel change overalls and rags for sterilized ones (after its sterilization, the storage time is not limited). The bactericidal lamp is turned off, and all surfaces are washed from the disinfectant with drinking (tap) water. Then, the bactericidal lamp is turned on again for 30 minutes.

Stage 5. Airing for about 20 minutes (until the ozone smell disappears).

Stage 6. Disinfection of rags and cleaning equipment. Rags after disinfection are washed and sterilized.

Stage 7. Paperwork.

Option number 2.

General cleaning with preparations of combined disinfecting and washing action.

Many modern disinfectants are products of combined action - disinfection + washing, so the stages of washing and disinfection are combined into one.

Stage 1. Room preparation. The room is freed from medicines, sterile packing and materials, consumables, waste, documentation. All equipment is turned off. The staff puts on overalls and protective equipment (gloves, mask, apron). A working solution of a disinfectant is prepared according to the regime that ensures the destruction of bacteria, viruses, fungi.

Stage 2. Purpose: disinfection of surfaces and cleaning from mechanical contamination.

A solution of a combined disinfectant is applied to all surfaces by wiping, observing the directions “from top to bottom” and “from window to door”. The drug is applied and at the same time thoroughly washed from mechanical contamination. Then, turn on the germicidal lamp for 60 minutes.

Stage 3. After 60 minutes of exposure exposure, the personnel change overalls and rags for sterilized ones (after its sterilization, the storage time is not limited). The bactericidal lamp is turned off, and all surfaces are washed from the disinfectant with drinking (tap) water. Then, the bactericidal lamp is turned on again for 30 minutes.

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Algorithm for cleaning
medical and preventive organizations

1. Purpose

Cleaning is carried out to ensure preventive / anti-epidemic measures, prevent the spread of infections, comply with the sanitary and hygienic regime, provides both the aesthetic appearance of the room and the removal of microorganisms.

2. Definition

Cleaning in the premises of medical and preventive organizations is one of the links in the chain of sanitary and anti-epidemic measures aimed at preventing nosocomial infections. At the same time, dirt, dust, substrates of biological origin are cleaned and disinfected, i.e. destruction on surfaces of microorganisms - causative agents of infectious diseases.

Exist the following types cleaning:

I. Wet cleaning;

II. Spring-cleaning;

III. Cleaning according to the type of final disinfection.

3. Scope

The rules apply to the middle and junior medical staff of clinical units. Cleaning personnel must undergo qualified documented training on the types of cleaning.

Supervision of the cleaning is carried out by senior nurses and sisters of the mistress of the departments.

The control and monitoring of cleaning is carried out by the infection control service.

4. List of equipment

4.1. special clothing (robe, cap, mask, gloves);

4.2. a set of cleaning equipment (rags, brushes, mops, ruffs, spray guns);

4.3. detergents and disinfectants permitted for use in the Republic of Kazakhstan;

4.4. containers for cleaning behavior must be labeled and used for their intended purpose.

5.1. Decree of the Government of the Republic of Kazakhstan No. 87 dated 17.01.2012 " Sanitary regulations"Sanitary and epidemiological requirements for healthcare facilities".

6. Document

6.1. Journal for recording cleaning and quartzing.

6.2. Instructions for the disinfectant;

6.3. The procedure for disinfecting the indoor air.

I. Wet cleaning algorithm

1. Definition

Wet cleaning - floors, furniture, equipment, window sills, doors is carried out at least twice a day (in operating rooms between operations) and as it gets dirty, using detergents and disinfectants approved for use in the Republic of Kazakhstan.

Cleaning is carried out daily at least 2 times a day:

1st time with the addition of detergent (50 gr. Detergent per 10 liters of water).

2nd time - using a disinfectant of an approved concentration.

2. Procedure

2.1. Wipe the bed, window sills, and other furniture with a damp cloth;

2.2. After feeding the patients, the distributor wipes the bedside tables and tables;

2.3. cleaning is completed by washing the floor with a disinfectant solution;

2.4. then quartz treatment is carried out (according to the list) according to the volume of the premises, followed by ventilation;

2.5. after cleaning, the rags are disinfected in a disinfectant solution according to the instructions for diluting the disinfectant, washed under running water until the smell of the disinfectant disappears and are dried;

2.6. The nurse notes about quartzing in the Journal of general cleaning and quartzing.

II. General cleaning algorithm.

1. Definition

2. General cleaning is carried out once a week according to the approved schedule with the processing and disinfection of equipment, furniture, inventory in the following rooms:

3. Operating blocks;

4. Dressing rooms;

5. Delivery rooms;

6. Treatment rooms;

7. Manipulation rooms;

8. Sterilization;

9. Intensive care units;

10. Examination rooms;

11. Invasive cabinets;

12. Premises with aseptic regime.

13. General cleaning once a month according to the approved schedule and according to epidemiological indications is carried out with the treatment of walls, floors, equipment, furniture and inventory in the following rooms:

14. Chambers;

15. Ancillary premises;

16. Cabinets.

2. Procedure

2.1. Preparation for general cleaning:

a) put on special clothes (robe, cap, mask, gloves);

e) prepare working solutions (cleaning and disinfecting) according to the instructions for preparing solutions;

f) take out medical waste and disinfect containers.

2.2. General cleaning:

a) ceilings, walls, beds, bedside tables, tables and other furniture, as well as cabinet equipment, should be treated with a 0.5% cleaning solution (50 g of powder per 10 liters of water or a disinfectant with a cleaning effect *) and washed off with clean water;

b) ceilings, walls, beds, bedside tables, tables, and other furniture, as well as cabinet equipment, should be treated by spraying or wiping with rags moistened with a disinfectant of an approved concentration;

c) after which the room is closed for a certain exposure of the disinfectant solution;

d) after exposure, the room is ventilated;

e) all surfaces are washed off with water and dried (walls, ceiling, furniture, apparatus, equipment) with a clean rag;

f) cleaning is completed by washing the floor with a disinfectant solution;

g) then quartzization is carried out (according to the list) according to the volume of the premises, followed by ventilation;

g) after cleaning, the rags are disinfected in a disinfectant solution, washed under running water until the smell of the disinfectant disappears and dried;

h) special clothes are rented to the laundry;

i) the nurse notes about the general cleaning and quartzing in the Journal of general cleaning and quartzing.

III. Cleaning algorithm according to the type of final disinfection

1. Definition

Final disinfection - after discharge, transfer, death of the patient, cleaning is carried out in the vacated ward according to the type of final disinfection.

2. Procedure

2.1. Preparation for cleaning according to the type of final disinfection:

a) put on special clothes (robe, hat, masks, gloves);

b) bedding (mattresses, pillows, blankets) is subjected to chamber disinfection or treatment with disinfectant solutions;

c) free the room as much as possible from the furniture or move it to the center of the room, to ensure free access to the treated surfaces and objects;

d) prepare working solutions according to the instructions for preparing solutions;

e) take out medical waste and disinfect containers.

2.2. Carrying out cleaning by the type of final disinfection:

a) by spraying or wiping, treat ceilings, walls, beds, bedside tables, tables and other furniture moistened with a disinfectant solution with a damp rag of an approved concentration for final cleaning;

b) after which the room is closed for the exposure time;

c) after exposure, the room is ventilated;

d) all surfaces are washed off with water and dried (walls, ceiling, furniture, apparatus, equipment) with a clean rag;

e) cleaning is completed by washing the floor with a disinfectant solution;

f) then quartzization is carried out (according to the list) according to the volume of the premises, followed by ventilation;

g) after cleaning, the rags are disinfected in a disinfectant solution, washed under running water until the smell of the disinfectant disappears and dried;

g) special clothes are rented to the laundry;

h) the nurse notes the final disinfection and quartzing in the Journal of general cleaning and quartzing.

2. List of quartzization of premises

Quartz treatment is carried out after each cleaning according to the volume of the room, followed by ventilation in the following rooms:

· Operating blocks;

· dressing rooms;

· delivery rooms;

· treatment rooms;

· manipulation rooms;

· Sterilization;

· Intensive care units;

· Observation rooms;

· Invasive cabinets;

· Aseptic rooms.

Note:

All cleaning in high-security rooms is carried out together with the nurse, the nurse starts cleaning from a clean area, i.e. manipulation table, dressing table, medical cabinets, refrigerator, couch, nurse's desk, and the nurse wipes the window sill, chair, door, door handles, sanitary facilities and finishes by mopping the floor.

In the wards, the nurse starts with beds, window sills, doorknobs, sanitary facilities and ends with mopping the floor.

dining tables, bedside tables and a food refrigerator is handled by a distributor.

Washing of window glass is carried out at least once a month from the inside, at least once every 3 months from the outside and as it gets dirty.

* when cleaning is carried out with a disinfectant with a washing effect, the 1st stage of treatment with a 0.5% cleaning solution is canceled.