1. Proceed from cleaner to dirtier areas to avoid spreading dirt and microorganisms.

2. During terminal cleaning, clean low-touch surfaces before high-touch surfaces.

3. Clean patient areas (e.g., patient zones) before patient toilets.

4. Within a specified patient room, terminal cleaning should start with shared equipment and common

surfaces, then proceed to surfaces and items touched during patient care that are outside of the patient

zone, and finally to surfaces and items directly touched by the patient inside the patient zone.

5. High-touch surfaces outside the patient zone should be cleaned before the high-touch surfaces inside

the patient zone.

6. Clean general patient areas not under transmission-based precautions before those areas under

transmission based precautions.

Proceed from high to low to prevent dirt and microorganisms from dripping or falling and contaminating

already cleaned areas.

• cleaning bed rails before bed legs

• cleaning environmental surfaces before cleaning floors

• cleaning floors last to allow collection of dirt and microorganisms that may have fallen

1. Proceed in a systematic manner to avoid missing areas—for example, left to right or clockwise

2. Immediately Attend to Body Fluid Spills

1. Bedrails.

2. IV poles.

3. Sink handles.

4. Bedside tables.

5. Counters where medications and supplies are prepared.

6. Edges of privacy curtains.

7. Patient monitoring equipment (e.g. keyboards, control panels).

8. Transport equipment (e.g. wheelchair handles).

9. Call bells.

10. Doorknobs.

11. Light switches.

Environmental cleaning supplies and equipment quickly become contaminated during their use

regularly reprocess all reusable items (i.e., thoroughly clean, disinfect, and dry). These are the best

practices for reprocessing reusable cleaning supplies and equipment.

1. All reusable supplies and equipment (e.g.buckets, rubbergloves) should be reprocessed directly after

use in atransmission-based precaution area or when soiled with blood or body fluids.

2. Thoroughly clean, disinfect, and rinse equipment such as buckets and containers whenever solution is

replaced or daily. Store them upside down to allow complete drying.

3. Launder mop heads, floor cloths, and soiled cleaning cloths at least daily (e.g., at the end of the

day/shift) and allow them to fully dry before storage and reuse.

4. Reprocess all reusable supplies and equipment in a dedicated area that is not used for other purposes

(i.e. reprocessing of cleaning equipment should never be conducted in handwashing sinks).

5. Reprocess reusable supplies, equipment, and PPE as:

• Immerse in detergent solution and use mechanical action (e.g scrubbing) to remove soil.

• Disinfect by: fully immersing the items in disinfectant solution for the required contact time and rinsing

with clean water to remove residue.

• Allow to fully dry. Lay items to dry in a clean and dry area to prevent recontamination, Position mops

with the head up to allow the mop head to fully dry.

1. Thoroughly clean all surfaces with detergent and water.

2. Thoroughly wet (soak) a fresh cleaning cloth in the environmental cleaning solution.

3. Fold the cleaning cloth in half until it is about the size of your hand. This will ensure that you can use all

of the surface area efficiently (generally, fold them in half then in half again, and this will create eight

sides).

4. Wipe surfaces using the general strategies as above (e.g., clean to dirty, high to low, systematic

manner), making sure to use mechanical action (for cleaning steps) and making sure to that the surface

is thoroughly wetted to allow required contact time (for disinfection steps).

5. Regularly rotate and unfold the cleaning cloth to use all of the sides.

6. When all of the sides of the cloth have been used or when it is no longer saturated with solution,

dispose of the cleaning cloth or store it for reprocessing.

7. Repeat process from step 1:

1. Use fresh cleaning cloths at the start of each cleaning session (e.g., routine daily cleaning in a general

inpatient ward).

2. Change cleaning cloths when they are no longer saturated with solution, for a new, wetted cloth. Soiled

cloths should be stored for reprocessing.

3. For higher-risk areas, change cleaning cloths between each patient zone (i.e., use a new cleaning cloth

for each patient bed). For example, in a multi-bed intensive unit, use a fresh cloth for every

bed/incubator.

4. Ensure that there are enough cleaning cloths to complete the required cleaning session.

Never double-dip cleaning cloths into portable containers (e.g. bottles, small buckets) used for storing

environmental cleaning products (or solutions).

1. Never shake mop heads and cleaning cloths—it disperses dust or droplets that could contain

microorganisms.

2. Never leave soiled mop heads and cleaning cloths soaking in buckets.

1. Immerse the mop or floor cloth in the bucket with environmental cleaning solution and wring out.

2. Mop in a figure-eight pattern with overlapping strokes, turning the mop head regularly (e.g. every 5-6

strokes).

3. After cleaning a small area (e.g. 3m x 3m), immerse the mop or floor cloth in the bucket with rinse

water and wring out.

4. Repeat process from step 1:

5. Use wet floor or caution signs to prevent injuries.

6. Mop from cleaner to dirtier areas.

7. Change mop heads/floor cloths and buckets of cleaning and disinfectant solutions as often as needed

(e.g. when visibly soiled,after every isolation room, every 1-2 hours) and at the end of each cleaning

session.

Chlorine in liquid bleach comes in different concentrations. Any concentration can be used to make a

dilute chlorine solution by applying the following formula:

Example:To make a 0.1 % chlorine solution from 1% bleach:

[1% / 0.1%] − 1 = 10 − 1 = 9 parts water for each part bleach

Therefore, you must add 1 part 1% bleach to 9 parts water to make a 0.1% chlorine solution.