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and the patient provided with normal cutlery. Cutlery and crockery should be washed in a dishwasher able to thermally disinfect items, that is, with a final rinse of 80°C for 1 minute or 71°C for 3 minutes. Disposable cutlery and crockery should only be used if specifically instructed by the infection prevention and control team. Disposables and uneaten food should be discarded in the appropriate bag.

Contaminated crockery is a potential vector for infectious agents, particularly those causing enteric disease, but thermal disinfection will minimize this risk (Fraise and Bradley 2009).

Urine and faeces

Wherever possible, a toilet should be kept solely for the patient’s use. If this is not available, a commode should be left in the patient’s room. Gloves must be worn by staff when dealing with body fluids. Bedpans and urinals should be bagged in the isolation room and taken directly to the sluice for disposal. They should not be emptied before being placed in the bedpan washer or macerator unless the contents volume needs to be measured for a fluid balance or stool chart. Gloves and apron worn in the room should be kept on until the body waste is disposed of and then removed (gloves first) and discarded as infected waste.

This will minimize the risk of infection being spread from excreta, for example via a toilet seat or a bedpan (Pratt et al. 2007) and the risk of hands or clothing being contaminated by body waste.

Spillages

As elsewhere, any spillage must be mopped up immediately, using the appropriate method for the fluid spilt, and the area dried. This removes the risk of anyone slipping and removes and disinfects any contaminated fluid that may carry a risk of infection.

Bathing

If an en-suite bathroom is not available, the patient must be bathed elsewhere on the ward. The patient does not need to use the bathroom last but the bathroom must be thoroughly cleaned after use so bathing them last will minimize any delays to other patients that this may cause. However, if the patient requires an early bath, for example because they are leaving the ward for an examination elsewhere, this must be catered for.

Thorough cleaning and disinfection of the bathroom will minimize the risk of cross-infection to other patients.

Linen

Place infected linen in a red water-soluble alginate polythene bag, which must be secured tightly before it leaves the room. Just outside the room, place this bag into a red linen bag which must be secured tightly and not used for other patients. These bags should await the laundry collection in the area designated for this.

Placing infected linen in a red alginate polythene bag confines the organisms and allows laundry staff to recognize the potential hazard and avoid handling the linen (NHSE 1995).

Waste

Orange waste bags should be kept in the isolation room for disposal of all waste generated in the room. The top of the bag should be sealed and labelled with the name of the ward or department before it is removed from the room.

Cleaning the isolation room

1. Domestic staff must be instructed on the correct procedure to use when cleaning an isolation room, including an explanation as to why isolation is essential to reduce the risk of cross-infection, the materials and solutions used, and the correct colour coding for these materials. This will reduce the risk of mistakes and ensure that appropriate precautions are maintained (DH 2001).

2. Isolation rooms must be cleaned last, to reduce the risk of the transmission of contamination to ‘clean’ areas (NPSA 2009).

3. Separate cleaning equipment must be used for isolation rooms. Cross-infection may result from shared cleaning equipment (Wilson 2006).

4. Cleaners must wear gloves and plastic aprons while cleaning isolation rooms to minimize the risk of contaminating hands or clothing. Some PPE may also be required for the safe use of some cleaning solutions.

5. Floor (hard surface: carpeted rooms should not be used as isolation rooms). This must be washed daily with a disinfectant as appropriate. All excess water must be removed. Daily cleaning