Routine daily cleaning of treatment areas includes: The procedure for routine and general cleaning of premises
The procedure for carrying out routine cleaning in each room of a department or office of a healthcare facility depends on the specific requirements of the sanitary regime for this room.
It should be remembered that in departments and offices where parenteral interventions are not carried out, during routine cleaning, as a rule, you can use a soap-soda solution.
When cleaning using aqueous solutions of detergents, up to 80-90% of bacteria located on the surface of walls, floors, and equipment can be removed. In this case, 10 liters of cleaning solution should be used on no more than 20 m2 of surface.
Where these interventions are carried out in accordance with Orders M3 of the USSR No. 288, 720 and 1230 (Appendix No. 1), routine cleaning is carried out at least 2 times a day using a wet method using disinfectants. The use of disinfectants can reduce bacterial contamination by 93-97%, but after 2-3 hours the contamination of the hearths, for example, approaches the original level.
Cleaning equipment (buckets, rags, brushes, etc.) are marked and used separately for toilets, wards, bathrooms and other rooms.
Marked cleaning equipment is stored strictly in designated places and used only for its intended purpose.
After use, cleaning equipment is disinfected.
In the case of quarantine in the department, as well as in infectious diseases, tuberculosis, etc. departments, aseptic blocks, etc., special requirements for the disinfection regime are imposed on routine cleaning.
More on the topic Routine cleaning of health care facilities:
- Regulatory documents for general and routine cleaning in health care facilities
- Current municipal health planning
- Hygienic standards for the microclimate of sports premises of various specializations. Natural and artificial lighting of sports facilities, taking into account hygienic standards.
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State Budgetary Educational Institution of Higher Professional Education Volga State Medical University of the Ministry of Health of Russia
Department of Childhood Diseases, Faculty of Pediatrics
on the topic “Requirements and procedure for general cleaning”
Completed by: Maria Semchenko
Volgograd 2016
- Introduction
- Features of general cleaning in medicine
- Equipment
- Algorithm for general cleaning in the operating room
- General cleaning of the treatment room
- Features of general cleaning in the treatment room
- General cleaning technique in the treatment room
- The first stage of general cleaning in the treatment room
- The second stage of general cleaning in the treatment room
- Own research
- Conclusion
- Bibliography
Introduction
In medicine, the health and sometimes the lives of people directly depend on the cleanliness of premises. The order in them is maintained in accordance with strict standards and regulations. General cleaning will be no exception - it is always carried out according to clear instructions. This guarantees the level of cleanliness and sterility that is necessary for treating patients and maintaining the health of medical facility staff.
General cleaning is one of the methods of combating nosocomial infections and is a preventive measure to destroy germs.
Purpose: To study the algorithm for carrying out general cleaning. Know the disinfectants and tools used for general cleaning.
Tasks: Conduct general cleaning of the premises of the health care facility. Perform a sequential algorithm for general cleaning.
Basic definitions and concepts
Nosocomial infection is any clinically significant disease of microbial origin that affects a patient as a result of his hospitalization or visit to a medical institution for the purpose of treatment, as well as hospital personnel due to their activities, regardless of whether symptoms of this disease appear or do not appear at the time the data is found persons in hospital.
Disinfection is a set of measures aimed at destroying pathogens of infectious diseases and destroying toxins in environmental objects. It is one of the types of disinfection.
A bactericidal irradiator is an open type device that is designed for quartzization (disinfection) of air and surfaces in a room with direct ultraviolet rays with a bactericidal effect.
Frequency of current wet cleaning
Routine and general cleaning in health care facilities is a necessary measure aimed at preventing the development of infections and the spread of nosocomial diseases among its patients and medical staff. In addition, Rospotrebnadzor authorities periodically monitor the implementation of these procedures.
* minimizing the number of microbes;
* reducing the risk of cross-contamination.
General cleaning of UZ premises should be carried out:
At least once every 7 days:
In the premises of the operating unit and the centralized sterilization department, in the maternity room, dressing, manipulation, examination, vaccination, treatment and dental rooms, in the dairy room of the maternity hospital, intensive care and surgical wards;
In wards for patients with burns, in wards for patients with infectious diseases, including in wards for patients with purulent-septic infections, tuberculosis, in aseptic wards after the immediate discharge of patients, as well as when repurposing wards;
At least once a month:
In therapeutic rooms, halls, corridors, at the nurse's station and other rooms.
Every 3 days:
In obstetric hospitals.
Features of general cleaning in medicine
As a rule, routine and general cleaning in wards, offices and other premises of medical institutions is carried out by their own staff - full-time cleaners, orderlies and even nurses. The process consists of cleaning windows, doors, walls, floors, furniture and equipment from dust and dirt. In addition to washing, during cleaning, surfaces must be disinfected with special compounds that provide the required level of sterility and do not harm the health of patients and staff. The list of detergents and antiseptics approved for use in medical institutions is provided by the sanitary and epidemiological authorities. All washing and disinfection work is carried out according to the approved schedule.
Equipment
* schedule indicating the date and hours of cleaning, approved by the head of the department;
* disinfectant and cleaning solutions;
* sterile rags (for ceilings and walls, furniture, manipulation or sterile tables, refrigerators, 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, cap with elastic band, safety glasses, technical gloves, rubber shoes) two sets;
* containers for detergents and disinfectant solutions. Containers must be clearly marked (see routine cleaning).
general cleaning medical staff
General algorithm for performing general cleaning
Before you start cleaning:
Record in a special journal the date of cleaning, the disinfectants used, and the exposure time.
Dispose of disinfected medical waste and send it to the central waste disposal center.
Remove group A waste
· Wash your hands.
Wear special clothing: gown, cap, respirator, gloves, and use safety glasses if necessary.
Prepare sterile rags, containers “for surfaces” and “for floors”.
Prepare a disinfectant solution following the dilution instructions;
Move equipment and furniture away from the walls.
Cleaning algorithm:
1. On the eve of general cleaning, the rags are sterilized.
2. On the day of cleaning, cabinets, bedside tables, and shelves are emptied. Furniture is moved away from the walls. The refrigerator is defrosting.
3. Wear protective clothing...
4. Prepare a 0.5% soap-soda cleaning solution (25 g of laundry soap shavings + 25 g of soda ash and up to 10 liters of hot water).
5. The cleaning 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 processing premises with an aseptic regime (treatment rooms, postoperative wards, etc.)
6. Disinfectant is prepared. The disinfection mode is indicated in methodological recommendations on the use of a specific disinfectant.
7. Use a cleaning product to clean sinks.
8. Use a cleaning agent to clean the baseboards with a brush, then use a rag marked “for baseboards” to wash off the cleaning agent.
9. 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.
10. With this cleaning equipment we wet the walls from the door from top to bottom (from the ceiling to the baseboard).
11.Use a rag marked “for furniture” to 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. Upon completion of irrigation of the furniture, the untreated parts of the furniture are then moistened with a rag moistened with a disinfectant solution. 12. The batteries are moistened with a disinfectant solution using a brush.
13. Using a mop with a “floor” rag, moisten the floor with a disinfectant solution in one direction towards the door.
14. Turn on the bactericidal lamp.
15. Disinfection exposure for 60 minutes (room closed).
16. Ventilate the room and wash off the remaining disinfectant solution with a sterile rag when treating rooms with asepsis (procedure rooms, dressing rooms, operating rooms and postoperative wards, etc.) and clean rags in general somatic wards and other rooms.
17. Surfaces are wiped dry with a rag in accordance with the aseptic procedure.
18. Turn on the bactericidal lamp, exposure 60 minutes.
19. Ventilate the room for 20-30 minutes.
20. 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 with a lid in a special cabinet and a designated place.
Algorithm for general cleaning in the operating room
General cleaning of the OPERATING ROOM is carried out once a week.
Before general cleaning, it is necessary to move all furniture away from the walls and close the window. Disinfectant solution (with detergent- Ecobreeze oxy 0.5%) is applied to all surfaces (walls, ceilings, windows, window sills, furniture, sinks, door handles, floors, etc.) by wiping to a height of at least 2 meters or by irrigation.
After the disinfection and ventilation time has ended, first one half of the office is washed and wiped and the furniture is installed, then the other.
IN last resort washing the floor. Cleaning rags are disinfected. solution and dry. The completion of general cleaning is confirmed by an entry in the “general cleaning” log book.
Stage 1.
- wear a clean special gown, cap, mask, gloves.
Close the window, TURN OFF THE AIR CONDITIONER!!!;
Apply a disinfectant solution to all surfaces and furniture with a clean rag.
Time - 60 minutes + 30 minutes irrigation with a hydraulic remote control (gun) with a disinfectant with a detergent effect (Ecobreeze oxy 0.5%); - close the office door
Exposure to disinfectant for 60 minutes.
Stage 2.
- put on a clean robe, mask, rubber gloves, wipe your shoes with disinfectant. solution (you can wear disposable shoe covers);
Wash the floor with the same disinfectant solution. Arrange furniture and equipment 30 min
Turn on the bactericidal lamp based on the volume and cleanliness class of the room ON A WET SURFACE
30 min (clause 7.4 GUIDE R 3.5.1904-04 “USE OF UV BACTERICIDAL RADIATION FOR DISINFECTION OF INDOOR AIR”)
Ventilate the office for 20 minutes
All work on disinfection and washing of surfaces in the operating room is carried out in special clothing, a mask, and rubber gloves.
Used cleaning equipment is disinfected in a disinfectant solution, then rinsed in water and dried.
If it is not possible to use disposable cloth napkins, reusable napkins must be washed. Cleaning equipment for floors and walls must be separate, clearly marked indicating the premises and types of cleaning work, used separately for corridors, offices, bathrooms, and stored in a specially designated place.
The instructions were developed on the basis of: SanPiN 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations engaged in medical activities”, order of the USSR Ministry of Health dated July 31, 1978 No. 720 “On improving medical care for patients with purulent surgical diseases and strengthening measures to combat nosocomial infection."
TOTAL MINIMUM TIME FOR GENERAL CLEANING 230 MIN(3h50min)
Features of general cleaning in the treatment room
It is most important to maintain order in those areas where an aseptic environment is needed. Treatment rooms also fall into this category. Their sanitary treatment has certain differences:
· cleaning includes thorough disinfection;
· work is carried out in protective uniform;
· detergents and equipment must comply with the approved list;
· during cleaning, sterile wipes and special clothing are used;
· general cleaning is carried out in the treatment room according to the established schedule (according to SanPiN, at least once a week).
Necessary cleaning equipment
To carry out regular general cleaning in the treatment room you will need:
· freshly prepared disinfectant solution (part of it is poured into a spray bottle for convenient treatment of hard-to-reach places);
· two sets of overalls (sterile and non-sterile);
· three containers (for treating floors, walls and furniture);
· two mops (one each for walls and floor);
· napkins or rags for washing surfaces, applying disinfectants and wiping dry;
· container with disinfectant solution for used napkins and dirty work clothes.
General cleaning technique in the treatment room
To achieve maximum effect, all sanitary and hygienic treatment in the room is carried out according to a certain algorithm. General cleaning of the treatment room is carried out in stages. During the preparatory stage, it is necessary to check the availability of equipment, detergents and disinfectants and protective clothing. It is necessary to disconnect electrical appliances from the network - lamps and UV irradiators. The room itself and furniture should, if possible, be freed from medical instruments, medicines, and small equipment.
After this, you can begin the actual cleaning. It consists of two stages - before and after disinfection.
The first stage of general cleaning in the treatment room
Put on non-sterile clothing and pour the disinfectant solution into the required containers. Next, follow the algorithm:
· take out waste and garbage;
· using napkins and a sprayer, treat all surfaces of furniture, equipment, windows, doors, radiator radiators with an antiseptic;
· wipe lamp lamps with 70% alcohol and then with a dry cloth;
· disinfect the floor of the room with the solution;
· close the office for the period of disinfection;
· remove dirty protective clothing, wash your hands and disinfect them.
The second stage of general cleaning in the treatment room
Wash your hands, put on sterile clothing and wipe your shoes with a disinfectant solution. The second stage of general cleaning is carried out in the following order:
· fill containers treated with disinfectant with tap water; Using sterile wipes, wash all disinfected surfaces;
· wipe glass and tables dry;
· wash the floor;
· disinfect the air with UV irradiators.
Upon completion of work in the room, disinfect all equipment, rinse and dry. Napkins (except for floor rags) along with overalls are handed over to the laundry, and then (if necessary) for sterilization.
The role of medical personnel during general cleaning
The nurse carries out measures to maintain the sanitary and hygienic regime in the premises, carries out systematic sanitary and hygienic control of the premises, and also instructs junior medical staff and controls their work.
The nurse is also responsible for general cleaning. However, she is assisted by junior medical staff, whom she “instructs and supervises.” In fact, general cleaning in rooms with special treatment purity consists of work of two levels of complexity. Some of the work requires nursing qualifications: cleaning cabinets, turning off and moving equipment, monitoring processing modes. After this is done, it is time for unskilled labor - washing walls, ceilings and floors. It is performed by a nurse who, according to her qualification description, “cleans premises in a medical organization.” At the same time, her work should be supervised by a nurse.
Own research
At State Healthcare Institution Clinical Hospital No. 7, I did an internship in the maternity ward. During my internship as an assistant to junior medical staff, I was able to conduct my own research into general cleaning in health care facilities:
I did a general cleaning of the treatment room. I put on a special one. clothes and gloves. She moved all the furniture away: the couch, tables, medicine cabinets. Next, I washed the walls and ceilings. Washing was carried out with a marked mop, separate for the walls and separate for the ceiling. After starting surface treatment (couches, tables, tables for medicines, cabinets for storing medicines) with specially marked rags soaked in a 1% solution of Clindemezin Extra. The sink was treated with sanitary and a brush. Afterwards, rinse off the toilet with running water. I washed the batteries with a brush and disinfectant. solution. I wiped the window sills with a surface rag. I scrubbed the floor from the windows and walls to the middle and to the door with a rag moistened with a disinfectant solution. Disinfected the air with UV irradiators.
Conclusion
Perhaps the most sensitive places to clean are hospitals. Since the requirements for keeping them clean and sterile are very high, and the health of patients depends on cleanliness and sterility. In medical institutions, much is built on the hierarchy and precise description of the functions of each type of personnel - housekeepers, nurses, and senior nurses. Technologies have stepped forward, now you can do cleaning much faster, better and cheaper, and do cleaning at times more modern technologies. Now daily, general cleaning of hospital premises can be made easier with the help of high-speed technologies and professional detergents.
Bibliography
1. Federal law Russian Federation dated November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation”
2. Federal Law of March 30, 1999 No. 52-FZ “On the sanitary and epidemiological welfare of the population”
3. SanPiN 2.1.3.2630 -10 “Sanitary and epidemiological requirements for organizations engaged in medical activities”
4. SanPiN 2.1.7.2790-10 “Sanitary and epidemiological requirements for the management of medical waste”
5. Assistant to junior medical staff of a children's somatic hospital: educational and methodological manual on production practice / Malyuzhinskaya N.V., Polyakov O.V., Khalansky A.N.-Volgograd: VolgSMU Publishing House, 2015.
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Routine cleaning of health care facilities. It is allowed to involve employees of specialized services (firms) who have permission for this type of work in cleaning medical institutions.
Frequency of current wet cleaning:
1. In surgical and maternity institutions - at least 3 times a day, including 1 time using disinfectants.
2. In ward general somatic departments - at least 2 times a day, with disinfectants -> after changing linen, as well as for epidemic indications.
3. Premises with a special regime of sterility, asepsis and antiseptics (intensive care wards, newborn and premature babies, treatment rooms, infectious disease boxes, bacteriological and virological laboratory boxes, dairy rooms, etc.) should be disinfected after each cleaning.
4. Common areas (halls, corridors, information desks, etc.) must be cleaned when dirty.
Routine cleaning according to the type of preventive disinfection. Sequence of current disinfection.
1. Put on overalls for cleaning (robe, cap, apron, gloves, slippers).
2. Prepare a 2% soap-soda solution (100.0 soap, 100.0 soda). Apply detergent to all surfaces to be treated. Wash it off with water.
3. Apply a working disinfectant solution.
4. Rinse off with clean water.
5. Disinfect cleaning equipment: soak a rag or rags in a disinfectant solution in separate containers, rinse and dry.
6. Remove the used special. clothes.
7. Carry out hygienic hand antiseptics.
8. Put on clean overalls.
9. Turn on the quartz for 30 minutes, ventilate for 15 minutes.
The procedure for performing general cleaning:
1. In ward departments, in offices and premises of functional departments, general cleaning must be carried out according to the approved schedule at least once every day. per month:
· with washing and disinfection of walls, floors, and all equipment
· with wet wiping of dust from furniture, lamps, blinds, etc.
2. General cleaning, including washing and disinfection of operating rooms, dressing rooms, treatment rooms, postoperative wards of the intensive care unit, and maternity ward premises, is carried out once a week.
3. In obstetric hospitals, general cleaning and final disinfection of maternity rooms is carried out every 3 days.
Technology for general cleaning - carried out according to the type of final disinfection:
1. put on special clothes for cleaning (robe, slippers, apron, gloves, cap);
2. free the room from furniture as much as possible and move it to the center;
3. Windows are washed with warm water and window detergent;
4. using separate cleaning equipment, apply a cleaning solution to the walls, wipe surfaces, equipment, furnishings, floors, following the sequence - ceiling, window, walls from top to bottom, equipment, floor from the far wall to the exit;
5. wash off with clean water using a rag;
6. re-treat all surfaces with a disinfecting working solution, maintaining exposure according to the virucidal regime;
7. wash their hands with soap;
8. change overalls to clean ones;
9. wash off with clean water;
10. arrange furniture and equipment in places;
11. turn on the bactericidal lamps for 2 hours;
12. ventilate the room for 1 hour;
13. disinfect cleaning equipment.
Infectious diseases hospital (department). Placement and layout features. Hygienic requirements to the conditions of reception, sanitation, placement and maintenance of patients. Principles of individual and group isolation.
Infectious diseases department located in a separate building. Features of layout and sanitary regime:
1. On the territory of an infectious diseases hospital (building) there must be designated “clean” and “dirty” zones, isolated from each other by a strip of green space. At the exit from the “dirty” zone, a site must be provided for disinfection of vehicles.
2. The main feature of infectious diseases hospitals or departments is the arrangement of boxes and half-boxes in them.
3. availability of reception and inspection boxes (16 m2),
4. a sanitary checkpoint is provided for personnel,
5. discharge rooms for patients discharged from half-boxes and wards, for each section separately (8 m2),
6. there are no common premises for patients (canteens, day rooms).
7. Infectious diseases departments must be located in separate buildings in order to isolate patients.
8. A feature of the layout of the infectious diseases department is the need to separate the flow of patients and staff, as well as those entering and leaving.
9. conditions for receiving and keeping patients
1. Upon admission to inf. hospital patients must comply with the following requirements:
· flow of movement entering the information. hospital patients should be provided with direction from the reception and examination box of the admission department to the medical departments;
· Reception of patients with infectious pathology should be carried out strictly individually. Waiting for two or more patients in the same room at the same time is not permitted;
· patients in need of resuscitation measures can be hospitalized in intensive care units, bypassing the infectious diseases emergency department. hospitals.
2. In the reception and examination rooms of an infectious diseases hospital, additional sets of protective equipment and personal protective equipment for medical workers should be provided.
3. In the reception and examination rooms of the infectious diseases hospital after receiving each patient:
4. all objects that came into contact with the patient must be disinfected;
5. Wet cleaning of the floor should be carried out using chemical disinfection agents. The sanitary facility should be wet cleaned last;
6. Air disinfection should be carried out after wet cleaning.
7. Washing clothes in an infectious diseases hospital should be carried out in its own laundry.
8. Used patient care products, linen, bedding, furniture, equipment must be disinfected before removal from the department of an infectious diseases hospital (for use in other departments, write-off, disposal).
9. In infectious diseases hospitals, unauthorized movement of patients from ward to ward, unauthorized movement of patients outside departments is prohibited.