Instructions for routine cleaning of ward departments. Stages of general cleaning in health care facilities. General cleaning technology

Examples of calculating the concentration of active substances in working solutions of products

Example 1. The concentration of active ingredients in the product (M) is 25%, the concentration of the working solution for the drug (C) is 0.5%. To obtain the desired concentration (X), it is necessary to perform the following calculations: (25×0.5):100=0.125%. Thus, the concentration of DV in the working solution is 0.125%.

If the product contains several active substances (for example, a polymer derivative of guanidine and QAS), then the concentration for each active substance is first calculated, and then these concentrations are summed.

Example 2. The concentration of one active substance (M 1) in the product is 25%, the concentration of the working solution for the drug (C 1) is 0.5%, the other active substance (M 2) is 4%, with the concentration of the working solution for the drug (C 2) – 0.5%. Then: X 1 =(25×0.5):100=0.125%, X 2 =(4×0.5):100=0.02%. The final total concentration of two active substances in the working solution is 0.125 + 0.02 = 0.145%.

Table 1

Hazard classification of disinfestation agents

table 2

Hazard Class	Biocidal action zone	Conclusion on the possibility and scope of use of drugs in disinfection
acute	subacute
consumption rate	consumption rate
Class 1 – extremely dangerous	< 10	< 1	Not recommended for use
Class 2 - highly dangerous	10-30	1-5	Recommended for use only by professional contingent with respiratory, eye, and skin protection in the absence of people with regulated conditions of use (product consumption, ventilation and wet cleaning).
Class 3 - moderately dangerous	31-100	5,1-10	Recommended for use by professional contingents and the population in everyday life with regulated conditions of use (consumption of funds, ventilation mode, cleaning) in premises of any type
Class 4 – low-hazard	> 100	> 10	Can be used without limiting the scope of application

Containers with working solutions of disinfectants must be equipped with tight-fitting lids, have clear labels indicating the product, its concentration, purpose, date of preparation, deadline suitability of the solution.

MARKING OF CLEANING EQUIPMENT

Inventory	Purpose	Marking	Marking method
Buckets	for cleaning toilets	UB
Buckets		For floors	applied oil paint on the outer surface of the bucket.
Buckets		For sofas	applied with oil paint to the outer surface of the bucket.
Brushes	for sweeping floors in toilets;	UB
Brushes	for sweeping floors of passenger and office premises.	For floors	applied with oil paint or burned onto the brush handle
Sackcloth	for cleaning toilets	red patch
Sackcloth	for cleaning the floors of passenger and service areas	green patch	the flaps are sewn onto the corner of the burlap
Flannel	for washing benches, sofas, walls and balustrades of passenger premises	not marked

spring-cleaning

General cleaning of the premises of ward departments and other functional offices is carried out according to a schedule of 1 time per month with the treatment of walls, equipment, inventory, and lamps.

General cleaning (washing and disinfection) of the operating unit, dressing room, delivery rooms, treatment rooms, vaccination room, manipulation rooms, sterilization rooms is carried out once every 7 days with treatment and disinfection.

Tasks:

minimizing the number of microbes;
reducing the risk of cross-contamination.

Equipment:

a schedule indicating the date and hours of cleaning, approved by the head of the department;
disinfectant solutions with detergent;
clean rags (for the ceiling and walls, furniture, manipulation or sterile tables, refrigerator, etc.) two sets. Mops for the floor and with a long handle for the ceiling and walls, two brushes for radiators;

protective clothing for medical personnel (waterproof gown, respirator, elastic cap, safety glasses, technical gloves, rubber shoes) two sets;
containers for detergents and disinfectant solutions. Containers must be clearly marked (see carrying out current cleaning).

Cleaning algorithm

On the eve of general cleaning, the rags are washed, if the rag is reusable, it is possible to use a clean disposable rag.
On the day of cleaning, cabinets, bedside tables, and shelves are emptied. Furniture is moved away from the walls. The refrigerator is defrosting.
Protective clothing is worn.
A detergent-disinfectant solution is being prepared. Currently, new generation disinfectants with detergent properties are used as detergents. Then the washing solution is prepared according to the methodological instructions for this preparation. The disinfection mode (concentration of the drug and exposure time) is indicated in the guidelines for the use of a specific disinfectant. The solution should be changed after cleaning 80-100 m² of surface - in general somatic wards and administrative, utility and other premises that do not require a special regime and no more than 60 m² when treating premises with an aseptic regime (procedure rooms, postoperative wards, etc.).
The sinks are cleaned with a cleaning product.
Use a cleaning agent with a brush to clean the baseboards, then use a rag marked “for baseboards” to wash off the cleaning agent.
Using a mop with a long handle and a rag marked “for walls,” moisten the ceiling with a disinfectant solution. Apply the solution in one direction.
With this cleaning equipment we wet the walls from the door from top to bottom (from the ceiling to the baseboard).
Using a rag marked “for furniture”, wet the furniture, starting from the lid, and then the legs from top to bottom, but not reaching the floor 5-7 cm, so as not to contaminate the treated surface. Once the furniture has been irrigated, the untreated parts of the furniture are then moistened with a rag moistened with a disinfectant solution.
The batteries are moistened with a disinfectant solution using a brush.
Using a mop with a “floor” rag, moisten the floor with a disinfectant solution in one direction towards the door.
Turn on the bactericidal lamp, exposure according to the passport or according to the calculation for the given room.
Disinfection exposure is 60 minutes (room closed).
Ventilate the room and wash off any remaining disinfectant solution with a clean rag.
Surfaces are wiped dry with a clean rag in accordance with asepsis.
Turn on the bactericidal lamp for 1 hour.
After the bactericidal irradiator has finished operating, it is necessary to ventilate the room for 20-30 minutes.
After cleaning, cleaning equipment is disinfected in the same disinfectant solution that was used for cleaning, rinsed until the smell disappears, dried on special racks and stored dry in a clean, dry container, closed lid in a special closet and designated area. Mops are wiped with a working disinfectant solution - first the handle is wiped from top to bottom, then the crossbar, twice with an interval of 15 minutes.

Current cleaning.

Routine cleaning of premises (cleaning floors, furniture, equipment, window sills, doors) must be carried out at least twice a day using detergents and disinfectants. Routine cleaning of premises is carried out in the morning and evening.

Tasks.

Creating a safe, clean environment for patients and medical personnel

Destruction and minimization of most microorganisms on the surface of non-living objects

Reducing the risk of cross-contamination

Equipment:

Protective clothing for honey. personnel (oilcloth apron, respirator, cap, technical gloves, leatherette shoes)

Cleaning equipment: clean rags for walls, furniture, floors, mop. All cleaning equipment must be clearly marked (for cleaning what room and object in the room, type of cleaning). containers for disinfection solutions. The containers are clearly marked (for disinfection of which room, object in the room - walls, furniture, floor, etc.) disinfection. solution, mode. There should be a horizontal line on the inner surface of the container, which indicates how much disinfectant solution is needed for the object being treated (calculation is made by multiplying the area of the object by the consumption of the disinfectant, which is indicated in the guidelines for the use of this disinfectant). The disinfection regime depends on the profile of the department.

Cleaning algorithm:

Wear protective clothing.
Inspect the room (determine the level of contamination).
Prepare a disinfectant solution.
The sink is cleaned with a cleaning product.
Take a rag marked “for the baseboard” and wet the baseboards from the door around the entire perimeter.
Use a rag marked “for walls” to wipe the walls at arm’s length, but not less than 1.5 m in height from the floor. The walls are wiped from top to bottom. At the same time, the window sills and radiators are wiped with the same rag in one direction.
Using a “furniture” rag, wipe the furniture, starting from the lid and then the legs from top to bottom, not reaching 5-7 cm to the floor, so as not to contaminate the surfaces. After wiping the furniture with a rag, apply a disinfectant solution to the treated parts of the furniture.
A mop with a “floor” rag is used to wipe the disinfectant floor. solution in one direction towards the door.

Routine cleaning is a regular event that consists of effective elimination of all contamination of the premises and is carried out during working hours. Its main task is to maintain cleanliness in the room to prevent the accumulation of microorganisms and other contaminants that can cause harm. Routine cleaning of premises must be carried out in accordance with all established rules to achieve maximum efficiency. So, how exactly is the current cleaning carried out, and also what algorithm is used to carry out the general cleaning, which is no less important?

Rules for routine cleaning

Routine cleaning should be carried out at least twice a day, it is carried out by junior medical staff, whose work is coordinated by the operating nurse. The minimum number of routine cleanings per working day is regulated as follows:

Before starting work with the operating room.
After the end of each new operation/at the end of the working day after all operations.

The option of routine cleaning after each operation is more preferable in terms of cleaning efficiency, but may require more resources, including temporary ones, compared to twice-time cleaning. If resources allow, cleaning can be done more frequently.

What is routine cleaning? This is a complex that consists of the following individual actions:

Wiping walls to a height of up to 1.5 meters with a special solution containing 0.5% - 1% detergent for effective disinfection.
Wiping with the designated solution all surfaces, floors and equipment in the operating room with exposure for 30-60 minutes for greater effect.
Ultraviolet disinfection of air and all surfaces for 60 minutes.

Only those products that can be used in accordance with the conclusions of the State Sanitary and Epidemiological Supervision Service of Russia should be used as disinfectants. The use of other means cannot guarantee a positive result and the absence of consequences, therefore you should use cleaning products recommended by the government service.

General cleaning - how is it done?

How routine cleaning is carried out has already become clear, however, both routine and general cleaning are among the irreplaceable activities. The latter is carried out by the operating nurse with the help of junior medical staff. To carry out such cleaning you must have:

Sterile rags for cleaning surfaces.
Containers for detergents and disinfectants.
A set of work clothes.
A set of equipment needed for the event.

How often is general cleaning of the premises carried out? The frequency of this procedure is at least once every seven days, however, with active use of the operating room, cleaning can be carried out twice a week at equal intervals.

The rules for general cleaning in the operating room are as follows:

Medical personnel wear special work clothes.
The room is completely cleared of furniture and other disturbing objects.
The window sill and windows are washed with a warm solution ammonia in water.
Ceilings and walls are treated with an approved disinfectant.
Surfaces, the space behind radiators and other hard-to-reach places are also treated with rags soaked in a disinfectant solution.
The room is left for exposure for 60 minutes, after which wet cleaning is carried out - all the disinfectant solution is washed off using a sterile rag.
The floor is disinfected with further exposure for 60 minutes.
The air in the operating room is treated with ultraviolet irradiation for 60 minutes. Ultraviolet irradiation should be carried out twice during cleaning.

After the cleaning is completed, the equipment is disinfected, and the operating nurse makes a note in the journal about the cleaning. At this point the event ends, the countdown to the date of the next general cleaning begins, the waiting period should not exceed 7 days.

What is the difference between routine cleaning and general cleaning? The main difference lies in the approach - the current one is aimed at eliminating small pockets of contamination to maintain cleanliness during work, while the general one is focused on complete disinfection of the room. The frequency and rules for routine and general cleaning also differ.

Instructions

for general cleaning

Basic provisions

This instruction introduces the rules for organizing and conducting general cleaning of the treatment room, dressing room, examination room, manipulation room and operating room.
The requirements of the instructions are aimed at reducing the risk of the occurrence and spread of nosocomial infections by improving the organization and carrying out general cleaning of premises.
The requirements set out in the instructions apply to all categories of premises.
This instruction clarifies and clarifies certain provisions of SanPin 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations engaged in medical activities”, SP 3.5.1378-03 “Sanitary and epidemiological requirements for the organization and implementation of disinfection activities.”
Responsibility for compliance with the provisions of the instructions rests with the senior nurses (laboratory assistants) of the departments.
Control over compliance with the instructions is assigned to the chief nurse and epidemiologist.

^ Cleaning equipment and workwear

Cleaning equipment includes: a marked container for processing furniture and equipment, a marked container for walls (basin, bucket), a marked bucket for floors.
Two labeled mops (for walls and for floors).
Clean, marked rags for removing disinfectants from furniture, equipment, walls (several cloths to replace if dirty).
Clean rags for washing floors.
Wipes for treatment of UV irradiators.
Clean rags for wiping dry and polishing surfaces (furniture, mirrors).
Container for soaking used rags (with lid).
Two sets of overalls (gown, mask, cap, gloves). One of the sets of overalls is used when cleaning the office (sterile, in a bag).
Working solution of disinfectants, hand sprayer for treating hard-to-reach places.

^ General cleaning technology

Stage one

The nurse (nurse, laboratory assistant) should prepare the office for cleaning, empty it of objects, equipment, instruments, and medications. Tables and cabinets must be free and accessible for processing.
Disconnect electrical appliances from the network.
In accordance with the waste management plan, the cleaning worker must remove class B waste and used disposable medical products from the office.
Pour the prepared working solution into cleaning containers and bring the cleaning equipment into the office.
Wash your hands and put on protective clothing: gown, cap, mask, rubber gloves.
Use a clean rag (for applying the solution to furniture and walls) moistened with a disinfectant solution from a furniture container to wipe the interior surfaces of cabinets and other furniture.
If possible, move furniture away from the walls.
Using a clean rag (for applying the solution to furniture and walls), moistened with a disinfectant solution from a container for walls, wipe the walls (to a height of at least 2 meters), windows, window sills, radiators and doors with smooth movements from top to bottom. Special attention pay attention to switches, door handles, trims, taps and sinks for washing hands, as well as places in close proximity to them. Treat hard-to-reach areas with a hand sprayer.
With a clean rag (for applying the solution to furniture and walls), moistened with a disinfectant solution from a furniture container, wipe the horizontal surfaces of furniture and equipment, starting from the top. Then move on to processing vertical surfaces. If there is visible contamination, the rags should be replaced.
Wipe UV irradiators that are disconnected from the network with napkins moistened with a disinfectant solution from a furniture container; lamp with a napkin moistened with 70 percent ethyl alcohol and wrung out well, and then with a dry napkin.
Lastly, treat garbage and waste collection containers with a rag soaked in a disinfectant solution from a furniture container, then immediately throw the rags into a special container.
At the end of cleaning, before pouring the used disinfectant working solution out of containers for furniture and walls, moisten a rag with it to treat the inner and outer surfaces of these containers. Then treat both containers emptied of the working solution.
Moisten a rag for cleaning the floor with a disinfectant solution from the floor bucket and wipe the floor.
Throw the rags used during cleaning into a container with a disinfectant intended for its collection and take it to the sanitary room.
Remove the gown, cap and mask and place them in a laundry bag.
Remove gloves, wash your hands and treat them with antiseptic.
Close the treated area for the duration of disinfection.

Stage two

After disinfection is completed, wash your hands, put on a clean sterile gown, cap, mask, gloves and wipe your shoes with a disinfectant solution.
Furniture and wall containers treated with disinfectant should be rinsed and then filled tap water. Using a clean rag for furniture and walls, soaked in tap water, wash all surfaces in the same sequence as when applying the disinfectant solution.
Window glass on the inside, as well as other glass surfaces and mirrors, after removing the disinfectant solution, wipe dry and polish.
Lastly, use a clean scrub rag to spray the floor with clean tap water from the floor bucket.
At the end of general cleaning, disinfect the air with a bactericidal lamp for two hours.
Disinfect cleaning equipment, rags, and rags for cleaning the floor with a disinfectant solution (disinfection time is indicated in the instructions for use of the disinfectant). Upon completion of disinfection, rinse and dry cleaning equipment and rags for washing the floor. Put the rags in the wash.
Take off your overalls and put them in a bag.
Make an entry in the “Journal of general cleaning and accounting” and in the “Recording journal bactericidal lamps» with clear filling of all columns.
In case of unsatisfactory results of air sowing and washouts from environmental objects in the offices, carry out general cleaning outside the schedule with a note in the appropriate registration log.
Before the onset of the autumn-winter season, include in the general cleaning the mandatory washing of glass on both sides and checking the tightness of the frames.

^ Requirements for medical personnel.

Medical personnel cleaning premises must undergo preliminary and periodic medical examinations. Persons with hypersensitivity to chemicals, used when cleaning the premises, are suspended from work.
Persons at least 18 years of age who have undergone appropriate training are allowed to work. functional responsibilities, safety precautions, precautions when working with disinfectants.
Medical personnel cleaning premises must know the rules for providing first aid in case of accidental poisoning with a disinfectant.
After finishing the work you should hygienic treatment hands

^ General first aid measures for accidental poisoning

If precautions are not observed, acute poisoning may occur, which is characterized by signs of irritation of the respiratory system, eyes, skin and mucous membranes.
If the product gets on your skin, rinse the area immediately. running water within 10 minutes. Lubricate with emollient cream. If necessary, consult a doctor.
If it gets into the eyes, the product causes burns to the mucous membrane and damage to the cornea. Needed immediately!!! Rinse them with running water for 10-15 minutes (keep your eyelids open) and immediately consult an ophthalmologist.
If the product is accidentally ingested through the mouth, pain and burns of the oral mucosa occur. You should immediately rinse your mouth with water, then take 10-15 crushed tablets activated carbon with several glasses of water. Do not induce vomiting!! If necessary, consult a doctor.
If the respiratory system is irritated (sore throat, nose, cough, difficulty breathing, lacrimation), the victim is removed from the work area to fresh air or a well-ventilated area. The mouth and nasopharynx are rinsed with water. Give warm drink (milk). If necessary, consult a doctor.

Routine cleaning of premises is carried out for the purpose of prevention, prevention of infectious contamination, as an anti-epidemic measure, as well as to achieve and comply with the accepted sanitary and hygienic regime. Carrying out routine cleaning ensures the removal of dangerous microorganisms; in addition, routine cleaning of the room maintains its aesthetic appearance.

General definition

Routine cleaning of wards, routine cleaning of the office and other premises is one of the items on the list of measures and sanitary measures carried out for anti-epidemic purposes. First of all, routine cleaning of the ward and routine cleaning of other areas is aimed at preventing infection that may spread within the hospital.

The schedule and frequency with which routine cleaning of offices is done may vary - in addition to the two mandatory ones, additional cleaning and disinfection must be done between operations. In all cases when routine routine cleaning of premises is carried out, the following types of work must be completed:

Cleaning from various passive contaminants. Dirt, dust, and other surface contaminants.
Removal of biological waste, especially carefully - if routine cleaning of the operating room is carried out.
Use of disinfectants. This is done without fail if all premises are being routinely cleaned; for operating rooms and wards, additional disinfection can be carried out in several stages.

Routine cleaning of hospital wards has the main goal of destroying microorganisms that can multiply on various surfaces and be pathogens various diseases, including serious ones.

Algorithm for current cleaning

Routine cleaning of premises is carried out at least 2 times a day, including cleaning and disinfection of floor surfaces, window sills, doors, furniture, and all equipment. Operating rooms undergo additional routine cleaning between surgeries. The use of only certified and safe cleaning and disinfectants is permitted.

When carrying out routine cleaning of premises, you must follow the principle:

The first cleaning is done using detergents to thoroughly clean the surfaces from dirt and dust. The consumption rate of detergent additives is 50 grams per standard ten-liter bucket of water.
The second cleaning includes the use of disinfectants. The concentration and composition are approved by the regulatory documents in force for the hospital.

Carrying out routine cleaning includes the following steps:

Surface cleaning. To do this, you need to wipe all window sills, headboards, tables, other furniture and surfaces with a damp cloth or rag.
A cleaning procedure is carried out in canteens or food centers for patients. After feeding, the distributor must wipe all tables, bedside tables and other surfaces.
After cleaning the furniture and window sills, the floor is washed. In this case, the addition of a disinfectant solution is used.
If necessary, additional quartzing is performed. This procedure is mandatory for routine cleaning of operating rooms.
The final stage includes ventilation.

The used cloth used to wipe the surfaces is disinfected. To do this, the composition of the disinfectant solution is diluted in accordance with the approved hospital standards. After disinfection, the fabric or rags are rinsed or washed with running water until the smell of the disinfectant disappears. After this it is dried.

Registration logs for current cleaning

The log of current cleanings includes an approved schedule for their implementation. After cleaning, a recording is made. The log indicates the planned date and time, actual data, who carried out the cleaning, what detergent the disinfectant solution used, its quantity and concentration. This must be followed by the name of the person who controlled the process and effectiveness. Paintings are put up of those who did and supervised the cleaning.

Compiled separately normative document, which indicates the number of cleanings for each specific type of room and lists separate rooms, for which there is a personal schedule.

Regulatory documents and instructions

The procedure for carrying out current cleanings, their quantity and methodological requirements are regulated by orders of the health committees of the administration of individual regions. The use of quartz irradiators for air disinfection is regulated by guidelines approved by the country's chief sanitary doctor.

In health care facilities (medical and preventive institutions) - mandatory procedures carried out according to a certain algorithm and in accordance with the rules and instructions. Not only the cleanliness of the premises, but also the protection of patients and staff from the spread of infections depends on the quality of their implementation.

Equipment and cleaning products

Since the purpose of cleaning in health care facilities is not only to remove contaminants, but also to disinfect surfaces, the work will require professional cleaning products and special disinfectant solutions that have antimicrobial and antibacterial effects. Besides, For each type of work, special equipment is required:

Reusable items should be labeled to indicate their purpose. As for sterile rags, they will be required for general cleaning of aseptic and sensitive rooms.

When working with disinfectant solutions You must follow the safety rules according to the instructions on the packaging. The preparation of solutions must be carried out in accordance with the standards and recommendations specified in the instructions. On average, the consumption of such products is 100-150 ml per 1 square meter surfaces.

Current cleanup

Current cleaning in health care facilities consists of wet cleaning of all surfaces using special means. The frequency of the procedure depends on the purpose of the room. Thus, in postoperative wards, dressing rooms and intensive care wards, routine cleaning should be performed 2 times, in therapeutic wards - 1 time, and in wards for newborns - 3 times a day. Work should be performed in the specified order. The algorithm for carrying out routine cleaning in health care facilities is as follows:

For cleaning the floor the “two buckets” technique you will need two containers. The first is filled with water with an antiseptic, the second with ordinary tap water. The work begins with washing the floor with a cleaning rag soaked in the first container, then the rag is rinsed in the second container and used to wash the same area of the floor again.

To monitor the operation of bactericidal lamps, it is necessary to keep a logbook. After completion of quartzing, ventilation is carried out. You can close the windows (vents) only when the smell of ozone completely disappears.

General cleaning technology

General cleaning should be carried out according to a schedule drawn up by the head nurse and approved by the administration of the health facility. The schedule is developed with a focus on the organization’s profile and disinfection regime. For example, in wards for newborns, dressing rooms and treatment rooms, the procedure must be performed at least once a week, in therapeutic wards and doctors’ offices - at least 1 time per month.

The procedure involves treating all surfaces with disinfectant solutions, including radiators and internal window glass. The work is carried out sequentially, and the stages of general cleaning in health care facilities are followed. Before starting the procedure itself, it is advisable to empty cabinets and work surfaces and turn off existing refrigerators. The algorithm for carrying out general cleaning in a healthcare facility consists of the following steps:

The rules for general cleaning in health care facilities provide for the use of cleaning and disinfectants included in the list of recommendations of sanitary and epidemiological authorities. The day before the scheduled procedure, it is necessary to sterilize the rags.

Carrying out routine and general cleaning in health care facilities is an integral part of the work in organizations of this type. Medical staff must strictly follow all instructions, because proper cleaning helps preserve people’s health.