• Ensure that the EVS team can identify which patient rooms are under transmission-based precautions , variations in cleaning and disinfection protocols that may be required , and necessary PPE .
• Establish the minimal cleaning time ( MCT ) for routine and discharge / transfer cleaning for each major patient-care room type or area . Define a process to establish MCTs , for example by observing standardized cleaning protocols performed by experienced personnel . Align MCTs with staffing plans to ensure that effective cleaning and disinfection can be completed and sustained . Disseminate MCTs so that others who are responsible for patient flow , such as bed control and nursing , are aware of them for each patient-care area . Enforce MCTs and empower EVS staff to require adherence to MCTs .
• Track cleaning times to identify factors that influence them and assess the need for mitigating those factors or revising the MCT .
• Monitor effectiveness and adherence to cleaning and disinfection protocols
• Develop and implement a monitoring strategy for adherence to , and effectiveness of , cleaning and disinfection procedures . Include who should do the monitoring ; what type of monitoring will be used ( direct observation , fluorescent gel , adenoside triphosphate ( ATP ); how frequently the monitoring will occur ; how monitoring data will be validated ; which rooms will be
monitored ; and which surfaces will be assessed .
• Incorporate methods for monitoring cleaning adherence and effectiveness in addition to direct observation ( fluorescent markers , ATP assays ).
• Perform routine audits of adherence to cleaning and disinfection procedures .
• Provide feedback on adequacy and effectiveness of cleaning and disinfection to staff and stakeholders
• Use monitoring data to improve facility cleaning and disinfection policies and procedures and patient safety .
• Present audit data to EVS personnel regarding their adherence to cleaning and disinfection procedures . Determine the best method to disseminate the information and foster shared accountability ( all staff , including EVS personnel , management , facility leadership , and clinical personnel take responsibility for consistent and successful adherence to protocols ).
• Present audit data to leadership to identify active issues and strategies to mitigate these issues and validate the effectiveness of the overall cleaning strategy .
References :
Centers for Disease Control and Prevention ( CDC ). Core Components of Environmental Cleaning and Disinfection in Hospitals . 2021 .
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