The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [106]
6. Cleaning solutions must be freshly made up each day and the container emptied and cleaned daily. Disinfectants may lose activity over time; cleaning solutions can easily become contaminated (Dharan et al. 1999).
7. After use, the bucket must be cleaned and dried. Contaminated cleaning equipment and solutions will spread bacteria over surfaces being cleaned (Dharan et al. 1999).
8. Mop heads should be laundered in a hot wash daily as they become contaminated easily (Wilson 2006).
9. Furniture and fittings should be damp-dusted daily using a disposable cloth and a detergent or disinfectant solution by nursing or cleaning staff as dictated by local protocol, in order to remove dirt and a proportion of any organisms contaminating the environment (Wilson 2006).
10. The toilet, shower and bathroom area must be cleaned at least once a day and if they become contaminated, using a non-abrasive hypochlorite powder, cream or solution. Non-abrasive powders or creams preserve the integrity of the surfaces.
Cleaning the room after a patient has been discharged
1. The room should be stripped. All bedlinen and other textiles must be changed and curtains changed (reusable curtains must be laundered and disposable curtains discarded as infectious waste). Dispose of any unused disposable items. Curtains and other fabrics readily become colonized with bacteria (Patel 2005, E); paper packets cannot be easily cleaned.
2. Impervious surfaces, for example locker, bedframe, mattress cover, chairs, floor, blinds, soap dispenser, should be washed with soap and water, or a combined detergent/chlorine disinfectant if sporicidal activity is required, and dried. Relatively inaccessible places, for example ceilings, may be omitted. Wiping of surfaces is the most effective way of removing contaminants; spores from, for example, Clostridium difficile will persist indefinitely in the environment unless destroyed by an effective disinfectant; bacteria will thrive more readily in damp conditions; inaccessible areas are not generally relevant to any infection risk (Wilson 2006).
3. The room can be reused as soon as it has been thoroughly cleaned and restocked. Effective cleaning will have removed infectious agents that may pose a risk to the next patient.
Discharging the patient from isolation
If the patient no longer requires isolation but is still to be a patient on the ward, inform them of this and the reasons why isolation is no longer required before moving them out of the room. Also inform them if there is any reason why they may need to be returned to isolation, for example if enteric symptoms return.
If the patient is to be discharged home or to another health or social care setting, ensure that the discharge documentation includes details of their condition, the infection control precautions taken while in hospital and any precautions or other actions that will need to be taken following discharge. Suitable accurate information on infections must be supplied to any person concerned with providing further support or nursing/medical care in a timely fashion (DH 2010a).
Procedure guideline 3.10 Source isolation: preparing an isolation room
Essential equipment
Single-occupancy room
Patient equipment
Personal protective equipment
Hand hygiene facilities
Patient information material
Preprocedure
Action Rationale
1 Identify the most suitable room available for source isolation, taking into account the risk to other patients and staff and the patient’s other nursing needs. To ensure the best balance between minimizing the risk of cross-infection and maintaining the safety and comfort of the isolated patient. E
Procedure
2 Remove all non-essential furniture and equipment from the room. The remaining furniture should be easy to clean. Ensure that the room is stocked with any equipment required for patient care and sufficient but not excessive numbers of any disposable items