Element 4

CLEAN ENVIRONMENT

Contamination: The presence of microorganisms on an item or surface.

Cleaning: The process of removing all foreign material (i.e., dirt, body fluids, lubricants) from objects by using water and detergents or soaps and washing or scrubbing the object

Decontamination: The use of physical or chemical means to remove, inactivate, or destroy blood borne pathogens on a surface or item to the point where they are no longer capable of transmitting infectious particles.

Disinfect (Sanitize): The use of a chemical procedure that eliminates virtually all recognized pathogenic microorganisms but not necessarily all microbial forms (e.g., bacterial endospores) on inanimate objects.

Clean, Rag, Cleaning Rags, Household

Environmental Cleaning Housekeeping

Follow manufacturers’ instructions for cleaning and maintaining noncritical medical equipment. In the absence of a manufacturer’s cleaning instructions, follow certain procedures.

Inform personnel involved in handling and disposal of potentially infective waste of possible health and safety hazards; ensure that they are trained in appropriate handling and disposal methods.

 

 Cleaning Spills of Blood and Body Substances

Promptly clean and decontaminate spills of blood or other potentially infectious materials. Follow proper procedures for site decontamination of spills of blood or blood-containing body fluid. Use protective gloves and germicide.

Bleach is one of the most common cleaning solutions.  Always purchase bleach 6 – 6.15% sodium hypochlorite.  Bleach solutions should be made fresh each day it becomes weak when exposed to sunlight and air.

Practice routine cleaning of frequently touched surfaces. High touch surfaces include:

  • Tables,
  • doorknobs,
  • light switches,
  • countertops,
  • handles,
  • desks,
  • phones,
  • keyboards,
  • toilets,
  • faucets,
  • sinks, etc

Cleaning, Service, Cleaner, Business

How to Clean and Disinfect for COVID-19

Hard (Non-porous) Surfaces

Wear disposable gloves when cleaning and disinfecting surfaces. Gloves should be discarded after each cleaning. If reusable gloves are used, those gloves should be dedicated for cleaning and disinfection of surfaces for COVID-19 and should not be used for other purposes. Consult the manufacturer’s instructions for cleaning and disinfection products used. Wash hands immediately after gloves are removed.

  • If surfaces are dirty, they should be cleaned using a detergent or soap and water prior to disinfection.
  • For disinfection, most common EPA-registered household disinfectants should be effective.
    • A list of products that are EPA-approved for use against the virus that causes COVID-19.
  • Follow manufacturer’s instructions for all cleaning and disinfection products for (concentration, application method and contact time, etc.). For example, Lysol All Purpose Cleaner kills the human coronavirus in 2 minutes, Lysol Neutra Air® 2 in 1 kills human coronavirus in 30 seconds or half a minute; Clorox QS kills human coronavirus in 2 minutes (EPA, 2020)
    • Additionally, diluted household bleach solutions (at least 1000ppm sodium hypochlorite) can be used if appropriate for the surface. Follow manufacturer’s instructions for application, ensuring a contact time of at least 1 minute, and allowing proper ventilation during and after application. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against coronaviruses when properly diluted.
  • Prepare a bleach solution by mixing:
    • 5 tablespoons (1/3rd cup) bleach per gallon of water or
    • 4 teaspoons bleach per quart of water
  • Bleach solutions will be effective for disinfection up to 24 hours. (CDC, 2020)

Kitchen, Interior Design, Indoors, Room

Soft (Porous) Surfaces

  • For soft (porous) surfaces such as carpeted floor, rugs, and drapes, remove visible contamination if present and clean with appropriate cleaners indicated for use on these surfaces. After cleaning:
    • Launder items as appropriate in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely.
      • Otherwise, use EPA-approved products for COVID-19 (or whatever organism is infectious at the time) and that are suitable for porous surfaces. (CDC, 2020)

 

Electronics            Free Gagdets on Wooden Surface Stock Photo

  • For electronics such as cell phones, tablets, touch screens, remote controls, and keyboards, remove visible contamination if present.
    • Follow the manufacturer’s instructions for all cleaning and disinfection products.
    • Consider use of wipeable covers for electronics.
    • If no manufacturer guidance is available, consider the use of alcohol-based wipes or sprays containing at least 70% isopropanol alcohol to disinfect touch screens. Dry surfaces thoroughly to avoid pooling of liquids. (CDC, 2020)

Clothes, Laundry Bag, Basket, Household

Linens, clothing, and other items that go in the laundry

  • Wear disposable gloves when handling dirty laundry from an ill person and then discard after each use. If using reusable gloves, those gloves should be dedicated for cleaning and disinfection of surfaces for COVID-19 and should not be used for other household purposes. Wash hands immediately after gloves are removed.
    • If no gloves are used when handling dirty laundry, be sure to wash hands afterwards.
    • If possible, do not shake dirty laundry. This will minimize the possibility of dispersing virus through the air.
    • Launder items as appropriate in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely. Dirty laundry from an ill person can be washed with other people’s items.
    • Clean and disinfect clothes hampers according to guidance above for surfaces. If possible, consider placing a bag liner that is either disposable (can be thrown away) or can be laundered. (CDC, 2020)

 

Other considerations       Paper Plate, Bavaria, Bavarian, Stack

  • The ill person should eat/be fed in their room if possible. Non-disposable food service items used should be handled with gloves and washed with hot water or in a dishwasher.  Wash hand after handling used food service items.
  • If possible, dedicate a lined trash can for the ill person. Use gloves when removing garbage bags, handling, and disposing of trash. Wash after handling or disposing of trash.
  • Consider consulting with your local health department about trash disposal guidance if available.

 

Free Person in glove rinsing sponge with cleaning agent under running water Stock Photo

Clean

  • Wear reusable or disposable gloves for routine cleaning and disinfection.
  • Clean surfaces using soap and water, then use disinfectant.
  • Cleaning with soap and water reduces number of germs, dirt and impurities on the surface. Disinfecting kills germs on surfaces.
  • Practice routine cleaning of frequently touched surfaces. High touch surfaces include:
    • Tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, sinks, etc.

 

Plastic, To Clean

Disinfect     

  • Recommend use of EPA-registered household disinfectant external icon.
    Follow the instructions on the label to ensure safe and effective use of the product. Read EPA’s infographic on how to use these disinfectant products external icon safely and effectively.
    Many products recommend:

    • Keeping surface wet for a period of time (see product label)
    • Precautions such as wearing gloves and making sure you have good ventilation during use of the product
  • Diluted household bleach solutions may also be used if appropriate for the surface.
    • Check the label to see if your bleach is intended for disinfection, and ensure the product is not past its expiration date. Some bleaches, such as those designed for safe use on colored clothing or for whitening may not be suitable for disinfection.
    • Unexpired household bleach will be effective against coronaviruses when properly diluted.
      Follow manufacturer’s instructions for application and proper ventilation. Never mix household bleach with ammonia or any other cleanser.

Check your Personal Protective Equipment  – If they are visibly worn or torn.  Don’t wear them!

 Well done! Follow safety precaution and information. Let us keep work together and keep each other safe!

 

 

References

CDC (2002) MMWR October25, 2002/ 51/No. RR-16. Guideline for Hand Hygiene in Health Care Setting. http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf

CDC. (2007) Guidance for the Selection and Use of Personal Protective Equipment (PPE) in Healthcare Settings. http://www.cdc.gov/ncidod/dhqp/pdf/ppe/PPEslides6-29-04.pdf

CDC, (2016). Transmission-Based Precautions. Retrieved from https://www.cdc.gov/infectioncontrol/basics/transmission-based-precautions.html

CDC. (2020b). Hand Hygiene Recommendation. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/hcp/hand-hygiene.html

CDC. (2020). Coronavirus disease 2019 (COVID-19) and you

CDC. (2020). Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Persons for Coronavirus Disease 2019 (COVID‐19). Retrieved from https://www.cdc.gov/coronavirus/2019‐nCoV/lab/guidelines‐clinical‐specimens.html

CDC. (2020). Interim Infection Prevention and Control Recommendations for Patients with

Suspected or Confirmed Coronavirus Disease 2019 (COVID‐19) in Healthcare Settings.

Retrieved from https://www.cdc.gov/coronavirus/2019‐ncov/infection‐control/controlrecommendations.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019‐ncov%2Fhcp%2Finfection‐control.html

CDC. (2020). Respirator Fact Sheet. Retrieved from https://www.cdc.gov/niosh/npptl/topics/respirators/factsheets/respsars.html

CDC. (2020). Symptoms of Coronavirus. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

CDC. (2020). What to do if you are sick with coronavirus disease 2019 (COVID-19).

Cleveland Clinic. (2020). Skin Rashes: An Emerging Symptom of COVID-19

EPA. (2020). List of N: Disinfectants for Use Against SARS-COVID-19. Retrieved from https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2

EPA. (2020). List N: Disinfectants for Use Against SARS-CoV-2 (COVID-19). Retrieved from https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2

Lysol. (n.d.). Products. Retrieved from https://www.lysol.com/products/

Mayo Clinic. (2020). Coronavirus disease (COVID-19). Retrieved from https://www.mayoclinic.org/diseases-conditions/coronavirus/symptoms-causes/syc-204799

MNDOH. (2020). Airborne Precautions. Retrieved from https://www.health.state.mn.us/facilities/patientsafety/infectioncontrol/pre/airborne.html

National Jewish Health. (2020). COVID-19 (Coronavirus) and your lungs. Retrieved from https://www.nationaljewish.org/patients-visitors/patient-info/important-updates/coronavirus-information-and-resources/health-tips/about-covid-19/covid-19-and-your-lungs

NYC Health. (2020). COVID-19: Coping and Emotional Well-being. Retrieved from https://www1.nyc.gov/site/doh/covid/covid-19-mental-health.page

NYC Health. (2020b). Coronavirus Disease 2019 (COVID-19). Retrieved from https://www1.nyc.gov/site/doh/covid/covid-19-main.page?utm_source=Google_Search&utm_medium=English&utm_campaign=Coronavirus

NYS Department of Health. (May 20, 2020). Health Advisory: COVID-19 Updated Guidance for Hospital Operators Regarding Visitation.

NYS Department of Health. (May 30, 2020). Health Advisory: Symptom-based strategy to discontinue isolation for persons with COVID-19.

NYS Department of Health. (May 31, 2020). Updated Interim Guidance: Protocol for COVID-19 Testing Applicable to All Health Care Providers and Local Health Departments.

Peachman, R. (2020). What to Know About Fever and COVID-19. Retrieved from https://www.consumerreports.org/medical-symptoms/fever-and-covid-19-what-to-know/

University of Michigan. (2020). Seeking Medical Care During COVID-19. Retrieving from https://www.uofmhealth.org/coronavirus/seeking-medical-care-covid-19

What clinicians need to know about cutaneous manifestations of COVID-19. Retrieved from https://consultqd.clevelandclinic.org/skin-rashes-an-emerging-symptom-of-covid-19/

WHO. (2020a). Q & A on Coronavirus (COVID-19). Retrieved from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/q-a-coronaviruses

WHO. (2020b). Public Advice. Retrieved from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

WHO. (2020c). Rolling Updates on Coronavirus Disease (COVID-19).  Retrieved from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen