Procedure for routine cleaning. All disinfection measures are distinguished by type. General cleaning technology

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

Sequencing:

Stage I:

Wear special clothing;

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, space behind heating batteries and between them, treat sequentially with 2 brushes moistened with a disinfectant solution;

Rinse off the cleaning solution tap water;

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

Stage II:

Remove apron, change gloves;

Wash all surfaces with tap water using sterile rags.

(3rd rag);

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

Wash the floor using the “two buckets” method;

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

after disinfection 60 m², water container “2” –

as it gets dirty.

Disinfect cleaning equipment in disinfectant solution, rinse and

be sure to dry it in a special room;

Take off your overalls and send them to the laundry;

Make a note in the General Cleaning Log, Journal

registration and control of ultraviolet bactericidal installation.

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

Weekly (during spring cleaning) the lamp of the bactericidal irradiator is wiped from dust and fatty deposits with a gauze cloth (the presence of dust on the lamp reduces the efficiency of disinfection of air and surfaces by 50%. To do this, you need to unfold the napkin lengthwise, moisten it with 96 percent alcohol, squeeze it out, and throw one end of the napkin to the other side of the lamp, encircling it into a ring. Then hold both ends of the napkin with one hand and wipe the lamp lengthwise. The screen is treated with a swab with 96% alcohol, first wring it out.

Cleaning technology

By type of current disinfection

Routine cleaning of wards is carried out in the morning and evening, offices, aseptic rooms - before starting work and at the end of work, as they become dirty during work, by junior medical staff in special clothing under the supervision of a nurse.

Routine cleaning includes:

Treating work surfaces, equipment, doors, sinks by wiping with a rag soaked in a disinfectant solution, followed by rinsing with tap water using a clean rag;

Irradiation of the room with a bactericidal lamp. Exposure time is calculated based on the data in the passport of a specific bactericidal lamp and the area of the room being treated. It is recommended to record the operating time of the bactericidal lamp in the bactericidal lamp operation log.

Sequencing:

Stage I:

Wear special clothing;

Sequentially treat work surfaces, equipment, doors, and sinks with a disinfectant solution (use a container for surfaces and a clean rag).

Stage II:

Rinse off the disinfectant solution with clean tap water using a clean

Wash the floor using the “two buckets” method (use a bucket to wash the floors and a rag to

Turn on germicidal lamp, withstand exposure;

Turn off the germicidal lamp;

Ventilate the room until the ozone smell disappears;

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

Be sure to dry it in a special room.

Note: during the operation of the treatment (manipulation, dressing) room, disinfection of the roller, tourniquet, oilcloth, surface of the couch is carried out - after each procedure, surface of the work table - as it gets dirty. A rag moistened with a disinfectant solution is used to treat the roller under the arm, the tourniquet, the oilcloth, and the surface of the couch. If work surfaces are contaminated with blood during procedures, they should be thoroughly treated with a rag moistened with a disinfectant solution, then the disinfectant solution should be washed off with tap water using a clean rag. After use, disinfect the rags in a disinfection container.

Ventilation of wards

To maintain a constant temperature and ensure clean air, the room must be regularly ventilated: open the windows, transoms, and summer time window.

The frequency and duration of ventilation depend on the time of year. IN winter time The wards are ventilated, regardless of the ventilation system adopted, at least 4 times a day for 15 minutes.

In summer, if there are screens, windows should be open around the clock.

During ventilation, the nurse should cover the patients well and ensure that there are no drafts. Ventilation is mandatory and is not subject to discussion on the part of patients.

Application 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 the spread of airborne and intestinal infections.

They are used effectively in operating rooms of hospitals, in delivery rooms and other premises of maternity hospitals, as well as in bacteriological and virological laboratories, blood transfusion stations, dressing rooms in hospitals and clinics, in the vestibules of infectious disease hospitals, in the waiting rooms of clinics, dispensaries, and 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):

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

Exposure to closed irradiators that allow air disinfection in the presence of people.

The required number of irradiators for each room is determined by calculation, according to current standards. When calculating the operating mode of the lamp, one should take into account the area of the room, the number and power of lamps, and also that as the lamps operate, the bactericidal flow decreases; in order to compensate for this, it is necessary, after 1/3 of the nominal service life has expired, to increase the duration of irradiation by 1.2 times, 2/3 of the term - 1/3 times.

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

The operation of the lamps is recorded in a log.

Monitoring the sanitary condition of wards, bedside tables, refrigerators(Fig.22)

Lists of products allowed for donation (indicating their maximum quantity) must be posted at delivery reception areas and departments.

It is allowed to store soap in the nightstands, toothpaste, a toothbrush in a case, a comb in a case or in a cellophane bag, magazines, newspapers. Sweets, jam, and cookies are stored on another shelf of the nightstand. Fruits and perishable foods are stored in refrigerator.

Sour and dairy products are stored in the refrigerator for no more than 2 days. Canned food should not be stored in the refrigerator

meat and fish products.

Every day the nurse on duty of the department checks compliance with the rules and expiration (storage) dates. food products, stored in department refrigerators. If food products are found in refrigerator compartments that have expired, are stored without packaging, without indicating the patient’s name, and also have signs of spoilage, they must be removed as food waste. The patient should be informed about the rules for storing personal food upon admission to the department.

Handling dirty laundry

Dirty linen is collected in closed containers (oilcloth or plastic bags, specially equipped and labeled linen trolleys, etc. (Fig. 23) and transferred to the central pantry for dirty linen. Temporary storage of dirty linen in departments (no more than 12 hours) is allowed in rooms for dirty linen with waterproof surface finishes, equipped with a washbasin and an air disinfection device. The premises and equipment are washed and disinfected daily.

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

Laundry should be washed in special laundries or a laundry within a medical organization.

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

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

Fig.24 Disinfection chamber

After discharge (death) of the patient, and also as they become dirty, mattresses, pillows, blankets must be subjected to chamber disinfection treatment (Fig. 24). If covers made of material that allows wet disinfection are used to cover mattresses, chamber processing is not required. The patient's bed and bedside table must be disinfected.

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 dirty hands. In the superficial layers of the skin there are 80-90% of permanent microorganisms, the rest can live in the deep layers of the skin.

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

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

I. Planning general cleaning

For general cleaning ward departments By order of the hospital, a fixed day is established once a month (for example, the last Friday of each month), of which the administration of the hospitalization department is notified in advance.

On this day, the admission of planned patients to the departments is limited, only patients for emergency reasons are hospitalized.

To ensure rational placement of personnel, take into account the volume of work performed, and calculate the required amount of detergents, cleaning agents and disinfectants, it is recommended to develop annual schedule carrying out general cleaning, approved by the head of the department. The technology, cleaning schedule, list of detergents and cleaning products are periodically reviewed, but the reality of the plan’s implementation can only be assessed under the condition of strict monitoring of implementation in compliance with the rules sanitization all premises and equipment.

It is more convenient to draw up a schedule in the form of tables, indicating the complete set and area of the premises, as well as the number and approximate area of the processed surfaces of furniture, medical and sanitary equipment (baths, toilets, sinks, radiators, etc.) equipment, windows and glazed doors.

In the same table you can include the timing of washing windows, processing lighting fixtures, step-by-step processing of decontamination treatment of all bedding, changing curtains, etc.

Cleaning equipment

Procedural, manipulation, etc. with an aseptic regime (according to the number of rooms);

Therapeutic wards;

Postoperative wards for patients with immunodeficiency conditions receiving hormonal drugs, etc. (according to the number of wards);

Administrative and utility premises (doctors’ offices, nurses’ offices, etc.);

Bathrooms (by number of bathrooms);

Bathrooms (according to the number of toilets).

Cleaning equipment (cleaning equipment) must be easily disinfected. It is not recommended to use hair brushes and sorghum brooms in health care facilities, which are difficult to wash and practically cannot withstand disinfection, as a result of which they are a factor in the transmission of infection.

According to the number of groups of premises with the appropriate asepsis regime, sets of cleaning equipment are completed:

A set of a floor brush (mop) and a mop with a long handle for washing walls and ceilings;

Buckets or plastic bags for collecting and short-term storage of garbage during the cleaning period;

A set of 2 buckets (galvanized) for washing walls and ceilings with a detergent-disinfectant solution and then washing it with clean water to remove any residual detergents;

Set of 2 buckets - respectively for washing and rinsing the floor;

A set of brushes with handles of different lengths for washing radiators, hard-to-reach places, etc.;

Enameled containers (pans) for clean rags;

Brushes with stiff bristles or rags - for washing bathtubs and sinks;

Cleaning Brushes upholstered furniture(in the absence of a vacuum cleaner);

Round toilet brush (for cleaning bathrooms in separate ward sections),

Pump (kvach, plunger) - for eliminating small blockages sewer pipes toilets and sinks.

A set of rags consisting of:

A bag-cover made of cotton jersey, put on a mop for washing (sweeping) ceilings and walls: two burlap rags (preferably with trimmed edges) - respectively, for washing the floor with a solution and then washing it with clean water;

Cotton dust rag.

Regardless of the type of room treatment (washing with soap and soda or disinfectant solutions), all cleaning equipment and rags after cleaning the premises are subject to disinfection, washing and mandatory drying.

The rags must be dried, since in a humid environment and especially in a dark room, many microorganisms that cause nosocomial purulent-inflammatory diseases multiply very intensively.

Cleaning equipment cannot be stored in offices and wards. For this purpose it is allocated separate room or cabinets in which a complete set of labeled cleaning equipment for each category of premises is stored in separate sections.

It is better to hang floor brushes on wire or metal rings for better drying and to protect the bristles from bending. At the end of cleaning, brushes must be washed in a detergent-disinfectant solution, rinsed in clean water and periodically combed through the bristles with a comb or other device specially designated for this purpose.

It is advisable to coat the wooden handles of brushes and mops with waterproof paint or varnish to facilitate disinfection.

Cleaning technology

It is advisable to carry out cleaning of treatment and diagnostic rooms and wards with the windows open and in the absence of patients. Beds must be covered.

Cleaning of premises should begin with the removal of furniture, equipment, etc. or by moving it away to provide free access to the objects being processed.

When installing stationary equipment, it is recommended to seal the joints and contacts with the walls with sealants to prevent the leakage of liquids, the accumulation of dirt and dust.

General cleaning before the onset of the autumn-winter season should include mandatory double-sided washing of glass after completion of repair and glazing work on windows and restoration of putty. Then the cracks are sealed with cotton wool or other material and the second frames are pasted with special thick paper 4-5 m wide. Pasting is usually carried out with liquid starch paste.

If the frames do not fit tightly enough, it is recommended to nail thin wooden slats to them, covered with fleece or other sealing material, but not with felt, since moths and other insects breed in it. You can use special sealants.

To protect glasses from freezing, they are wiped with a mixture of 1 part glycerin and 3 parts alcohol, and some hygroscopic substance, for example a piece of charcoal, is placed between the frames.

Dirty glass absorbs up to 50% of transmitted light. Approximately once every 1-2 months they should be washed with warm water with the addition of ammonia (1 tablespoon per 1 liter of water) or with special glass cleaners.

In the absence of such conditions, upholstered furniture, mattresses, and pillows are covered with a dampened cloth and then cleaned by beating.

If disinfection treatment of upholstered furniture, curtains, and various surfaces is required, for which traditional treatment with aqueous solutions is not suitable, you can use “Solarsept” of the “Deconex” series of JSC Vita-Tour - ready solution for quick disinfection of hospital furniture, fabrics, mattresses, clothing ( outside hospital gowns, shoes), objects and areas of frequent touch (appliances, telephones, door and faucet handles, switches, toilet seats, etc.).

The advantage of the drug is that it does not destroy tissue structures, wets the treated surface well and dries quickly, and is non-toxic.

When carrying out general cleaning, it is somewhat difficult to wash the batteries and the space behind them, where a significant amount of dust accumulates. For this purpose, you can use hand-held sprayers filled with: one with a detergent-disinfectant solution, the other with clean water for final rinsing. It is more convenient to treat the space behind and under the battery using two brushes in succession (for washing and subsequent washing with clean water, respectively).

Beds, bedside tables, tables and other furniture are wiped with a damp cloth moistened with a disinfectant solution.

Finish cleaning the premises by washing the floors. Special attention requires washing the baseboards, which are wiped again with a rag moistened with a disinfectant solution after washing the floors.

It is recommended to treat any surfaces (by wiping, roughening) in small areas (2-3 m2).

The detergent-disinfectant solution should be changed after cleaning 80-100 m2 of surface - in general somatic wards and administrative and utility rooms and other premises that do not require a special regime, and no more than 60 m2 when treating premises with an aseptic regime (treatment rooms, postoperative wards, etc.). d.).

When carrying out general cleaning using spray equipment, personnel use respirators, safety glasses, and gloves.

Features of general cleaning in the treatment room

Once a week, general cleaning of treatment rooms, manipulation rooms, postoperative and intensive care wards is carried out.

A disinfectant solution (1% chloramine solution, 0.25% sodium hypochlorite solution, etc.) is applied to the surface and a bactericidal lamp is turned on for 60 minutes (its power, as in other high-security rooms, must be at least 1 W per 1 m3 volume of the room, and the period of use should not exceed the standard shown in the passport (no more than 2 years); control of timely replacement is the responsibility of the head nurse of the department. Then put on a clean gown and wash off the disinfectant solution with a sterile rag moistened with tap water. Upon completion of cleaning, the room is re-irradiated with ultraviolet light for 30 minutes. Then the office is ventilated. Cleaning equipment is disinfected in a 1% chloramine solution for 1 hour, then washed and dried.

General cleaning of bathrooms, bathrooms, sanitary rooms, etc. utility rooms should be carried out at least once every 10-15 days.

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, maternity 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.

General requirements.

All premises, equipment, medical and other supplies must be kept clean. Wet cleaning of premises (washing floors, wiping furniture, equipment, window sills, doors, etc.) must be carried out at least 2 times a day, and if necessary more often, using detergents and disinfectants approved for use in the prescribed manner .

Window drains should be washed at least once a month from the inside and when dirty, and at least once every 3 months from the outside (spring, summer, autumn).

General cleaning of the premises of ward departments and other functional rooms and offices should be carried out according to a schedule at least once a month with thorough washing of walls, floors, equipment, furniture, and lamps.

General cleaning (washing, disinfection) of treatment, manipulation, and sterilization rooms is carried out once a week. General cleaning is carried out according to a schedule approved by the head of the department. The person responsible for carrying out general cleaning is the head nurse of the department.

Ventilation of wards and other rooms that require access to fresh air through windows, transoms, and doors must be carried out at least 4 times a day.

For collecting household waste and other class A waste in corridors, toilets and other auxiliary premises Urns should be installed, and pedal buckets should be installed in treatment rooms and other similar rooms associated with the medical and technical process. The accumulated waste is collected and packed into plastic bags. It is disposed of in containers located on the territory of health care facilities.

Procedure for routine cleaning.

In all medical and treatment-diagnostic laboratory rooms where parenteral interventions are carried out, work is carried out with biological material from patients, cleaning is carried out daily only with a wet method at least 2 times a day (in the morning - before working day and at the end of the work shift) and, as necessary, using detergents (2% soap-soda solution (if prepared centrally) or 0.5% synthetic detergent solution (CMC) at the rate of 50 g . powder per 10 liters of water. The second wet wiping and washing of surfaces that are not contaminated with the patient’s secretions (blood, feces, urine, pus, etc.) is carried out using disinfectants -

3% chloramine solution, 0.5% bleach solution, 6% hydrogen peroxide solution with 0.5% CMC solution, neutral anolyte 0.05%, centodorforte 0.4.%

Working surfaces can also be wiped with new-generation disinfectants intended for these purposes, following the “Methodological Recommendations” for their use, approved by the head of Rospotrebnadzor (Sanitary and Epidemiological Supervision) and the manufacturer’s instructions. Cleaning is carried out with specially designated rags using marked equipment (buckets, basins, mops).

Cleaning equipment is stored in a strictly designated place. Cleaning equipment intended for work in epidemiologically significant rooms (treatment rooms, dressing rooms, delivery rooms, toilet rooms, etc.) is stored locally.

Before cleaning, a nurse or orderly puts on a gown specially designated for this purpose and gloves.

Clean rags for surface treatment are moistened in a container with a disinfectant solution and all surfaces are wiped twice with an interval of 15 minutes in strict sequence: table for sterile material, cabinets for sterile solutions, equipment, manipulation tables, chairs, couch for patients.

The floor is washed with a disinfectant solution. The current cleaning is completed by ultraviolet irradiation of the room and ventilation for 20 minutes.

Procedure for general cleaning

General cleaning of premises differs from the current one in the frequency of implementation, volume of work, concentration of disinfectants, duration of air disinfection, depending on the type of premises and its epidemiological category. In treatment and dressing rooms, the operating room, the delivery room, any surgical office of the clinic where parenteral manipulations are performed, as well as in the pantry, general cleaning is carried out once a week. General cleaning (similar to final disinfection) is carried out once a week according to the approved schedule, with an entry in the appropriate log.

If chloramine solutions and other chlorine-containing preparations are used for general cleaning, then before applying these solutions to surfaces, the latter are washed with a 2% soap-soda solution or 0.5

% CMC solution. Then the detergent is washed off with water and a disinfectant solution is applied. If peroxide preparations are used for general cleaning, then the detergent is added to the peroxide and steps mechanical cleaning and disinfection are combined. Commonly used products for general cleaning of medical premises (procedure rooms, dressing rooms, operating rooms) are a 5% chloramine solution and a 6% hydrogen peroxide solution with 0.5% detergent in accordance with the recommendations of the USSR Ministry of Health Order No. 720 dated July 31, 1978 on work surgical departments and departments, intensive care units. For general cleaning in treatment rooms, examination rooms

maternity and obstetric hospitals in accordance with the order of the Ministry of Health of the Russian Federation No. 345 dated

11/26/97. use a 3% concentration of chloramine solution with a 0.5% concentration of synthetic detergent (CMC).

Hydrogen peroxide or chlorine-containing agents are applied to the treated surfaces twice with an interval of 15 minutes and left for one hour, then washed off with tap water and wiped with sterile diapers.

In the room, all surfaces to be treated are wiped by generously moistening sterile rags in a disinfectant solution (walls, facing down, window sills, doors, furniture, equipment, surfaces, floor). Cleaning is carried out at behind closed doors and windows.

Cleaning is completed by ultraviolet irradiation of the room and ventilation for 20 minutes.

When carrying out general cleaning, medical personnel use a clean gown, shoes, mask, oilcloth apron, and gloves.

Requirements for cleaning equipment.

All cleaning equipment (buckets, basins, mops, etc.) must be clearly marked indicating the premises and types of cleaning work, and used strictly for their intended purpose. Cleaning equipment should be stored in separate cabinets, niches or other designated places with markings

"Cleaning equipment."

Cleaning equipment is kept clean and disinfected after each cleaning.

Cleaning equipment that cannot be disinfected (brushes, brooms, etc.) is prohibited from being used. Separate cleaning equipment is used for cleaning furniture and floors.

Cleaning of epidemiologically significant premises always ends with air disinfection using bactericidal irradiators. A bactericidal irradiator is an electrical device that contains: a bactericidal lamp, a reflector, a ballast and other auxiliary elements. Bactericidal irradiators are placed on the ceiling or wall, and bactericidal irradiators can also be mobile. They are divided into two groups: closed (shielded) and open (unshielded). Both types of irradiator must have separate switches, and the switch for the open irradiator is led out into the corridor. Closed irradiators can operate in the presence of people, while open ones can only operate in the absence of personnel and patients.

All premises in health care facilities to be equipped with bactericidal irradiators are divided into 5 categories:

Quartz time range in the absence of people open and

combined irradiators from 15 min. up to 120 or more min. When operating only a shielded lamp, the duration of its burning can be up to 8 hours a day, and every 2-3 hours the irradiator is turned off for 1.5-2 hours. After operation of bactericidal irradiators, the room is always ventilated to remove ozone and nitrogen oxides.

Personnel working with open irradiators must be provided with the means personal protection(face masks, gloves and goggles), direct rays from an unshielded illuminator are harmful to humans, causing photoophthalmia and skin erythema.

An important point The sanitary and hygienic regime in health care facilities is ventilation. With the help of through ventilation, dust and hospital strains of pathogens of nosocomial infections (HAIs) that are resistant to the used disinfectants, quartz treatment, and aerosols of antibacterial agents are removed into the external environment.

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 room 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 of 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.

Rules for routine cleaning

General cleaning - how is it done?

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