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Unit 18: Cleaning, Decontamination and Waste Management

Course: Level 2 Diploma in Care
Awarding Body: Pearson
Level: Level 2 Diploma
Contributor:

1.1 State the general principles for environmental cleaning

Cleaning, sterilisation, and disinfection of the environment—which includes both indoor and outdoor environments—are essential steps in preventing the spread of disease and infection. Environmental cleaning includes removing dirt and germs from all of the facility’s surfaces. In order to rid the facility of dangerous disease-causing microorganisms, it is crucial to choose and maintain an efficient environmental cleaning routine.

Depending on what and where needs to be cleaned, you can choose an efficient cleaning method and material to use.

As a result, the general philosophy of encouragement is to keep everything as clean as possible and to minimise the risk of infection, ensuring that all precautionary measures are followed in accordance with applicable laws, company policies, and guidelines.

Environmental cleaning starts with the physical removal of trash, dirt, and other materials. Manual labour, as well as the use of mechanical or electrical tools, are all viable options. This will guarantee that the area to be disinfected is free of any tangible items that could obstruct the procedure or result in recontamination. By removing dirt and preventing the formation of biofilms with a neutral detergent solution, the effectiveness of chemical disinfectants is increased. Utilising a disinfectant requires preparation and dilution in accordance with the manufacturer’s instructions because an ineffective low concentration or a high concentration that could cause corrosion and damage to the cleared area or surface

Disinfectants and/or detergents must be thrown away after each use, including any leftovers.

It is crucial to avoid using techniques like spraying, dusting, or dry sweeping that produce or spread dust, moisture, or aerosol.

1.2 Explain the purpose of cleaning schedules

The phrase “cleaning schedule” refers to routinely timed cleaning and decontamination of a space, its components, and its infrastructure. The establishment of a cleaning schedule is crucial because it helps to ensure that the facility and its surroundings are always kept clean. Maintaining a regular cleaning schedule is crucial for maintaining good hygiene practices and minimising the risk of infection. Depending on the employer’s preferred method of operation, a cleaning schedule may be completed hourly, daily, weekly, or monthly.

A cleaning schedule should list the things that need to be cleaned and can take the form of an operation manual based on the employers’ preferred method of operation. Based on a pre-assessment test that had been conducted, this would be noted on the cleaning schedule as needing cleaning. It would include information on how to clean the item, how frequently, and how to clean it. This would specify how frequently the item should be cleaned as well as how long cleaning should take. The cleaning interval needs to be closely followed.

Procedure: This is a step-by-step activity outline that explains how to thoroughly clean an item so that it is well-sanitised and free of contamination.

The kind of cleaning agent to be used and the concentration level specified in the cleaning schedule will also be strictly followed, as doing otherwise could compromise the cleaning’s intended outcome.

The cleaning schedule would also include the name of the person or division in charge of the cleaning procedure. It is anticipated that the employers’ agreed-upon method of cleaning will be strictly followed because the person or department mentioned would be responsible for any situation that arises as a result of the cleaning process.

The cleaning schedule must be signed by the person who performed the cleaning task as evidence.

1.3 Describe how the correct management of the environment minimises the spread of infection

Cleaning is typically the first step in sanitation because it rids the object’s surface of debris and other impediments to efficient sanitation. If you try to sterilise or disinfect something that hasn’t been thoroughly cleaned, the process won’t be as effective as it could be because the dirt prevents the bacteria from being destroyed. Therefore, cleaning, disinfecting, and sterilisation is done in tandem to achieve maximum effectiveness when it comes to environmental sanitation. Bacteria and microorganisms are everywhere, both outside of us and inside of us.

Since some of these bacteria are quite safe and necessary for some regular bodily processes, the use of disinfectants must be moderate because excessive disinfectants harm these important bacteria. Maintaining good hygiene by washing hands with mild soap and water is one of the first steps to good sanitisation.

Using basic tools like a brush, mop, and vacuum cleaner, cleaning is done to remove dirt, microorganisms, and dust. In order to get rid of some bacteria or their surviving components like water and nutrients, cleaning methods also include the use of suitable detergent and warm water. To make things like fat, grease, and oil soluble in water so they can be easily removed, detergents are used.

In order to maintain a safe and bacteria-free environment, remove elements that can aid the growth of bacteria leading to infection, reduce the likelihood of accidents, and provide a safe working environment, cleaning is effective in removing offensive odours, reducing the cross-contamination of objects and people, maintaining a safe and bacteria-free environment. Cleaning is beneficial for adhering to the regulatory agencies’ legal requirements.

Employees must receive adequate training on proper cleaning techniques, including how to use cleaning equipment safely and effectively, use warning signs while cleaning, and transfer and move furniture and equipment both during and after cleaning.

1.4 Explain the reason for the national policy for colour coding of cleaning equipment

In order to prevent cleaning tools from being used in multiple locations within the facility, it is required for them to be colour coded. If these cleaning tools are moved while in use from one area to another, there is a very high risk of contamination.

The National Patient Safety Agency introduced a colour coding mandate in September 2007 that requires all cleaning tools, including mops, buckets, brooms, brushes, cleaning clothes, and dustpans, to have the proper colour codes on their heads and handles. The colour code may be on hand gloves and scrub brushes as well.

These steps are taken to make sure that each cleaning tool can be easily identified if it is brought into another section and is only to be used there. This is done to stop infection and cross-contamination from spreading within the facility. According to the guidelines for colour coding, blue-coded cleaning tools should be used in common areas like offices, wards, departments, basins, and sinks in public places. Green codes are intended for the kitchen, canteen, and catering areas, as well as the food services area. Catering tools like knives, ladles and cutting boards are not included in the colour code.

The red codes apply to sinks, floors, showers, bathrooms, and restrooms. Bleaches, disinfectants, and other cleaning supplies don’t need to be colour-coded.

Areas with a yellow code, such as hospitals and medical facilities, are infectious areas.

In order to stop infection from spreading and cross-contamination between spaces, colour coding is crucial. All employees should receive sufficient training to ensure familiarity with and adherence to the colour coding system. To guarantee complete compliance, proper monitoring and supervision must also be carried out.

2.1 Describe the three steps of the decontamination process

Decontamination is the process of getting rid of contaminants that have built up on something, somewhere, or someone. Eliminating these contaminants is crucial for good health and productive workplace practices because they can spread infection or disease. Cleaning, disinfection, and sterilisation are the three stages of decontamination.

Cleaning is the first stage of decontamination and entails removing contaminants and any other foreign substances from the object, the floor, and the doorknob using basic cleaning equipment and water and soap. Excreta, blood, and other organic matter like secretions are also removed through cleaning. These organic materials contain a lot of microbes that can spread infections and diseases.

The second and ultimate stage of decontamination is disinfection. It is the elimination of microbes using heat or chemicals. Disinfection helps to lessen the effectiveness of microorganisms while also decreasing their potential to infect humans or cause disease. Disinfection may not completely eradicate all microorganisms.

The third step in the process of eliminating all the microorganisms that cleaning and disinfecting left behind is sterilisation. Chemicals, irradiation, steam, dry heat, or wet heat (steam) are all methods of sterilisation. After the first two processes, it guarantees complete microorganism removal and significantly lowers the likelihood of infection and cross-contamination.

2.2 Describe how and when cleaning agents are used

To remove dirt, debris, and stains, cleaning agents like detergents, soaps, or powders are typically used. They are employed to eliminate bacteria, stop the spread of germs, get rid of offensive odours, and stop the spread of diseases. The kind of cleaning process and the intended materials to be cleaned are taken into consideration when choosing the cleaning agents to be used.

Employer-provided working instructions must be followed in order to perform cleaning effectively. Initial cleaning, also known as the initial sweep, is the process of removing loose dirt with the help of basic cleaning implements like brushes and brooms. The second step, known as the main clean, comes next. At this stage, numerous cleaning tasks are carried out in an effort to remove surface bacteria as well as major dirt from the body. This is accomplished by scrubbing, scraping, and applying high water pressure while pressure washing, using the right detergent to wash in order to get grease, oil, and fats off.

Rinsing is the third step, which is carried out with warm water to completely remove all detergent residue and all loose dirt.

Drying is the fourth and final step, and there are two methods for doing so: conventional/cold drying (air drying) or hot drying (sun drying or autoclaving). Scrapers, brushes, and brooms are examples of abrasive tools that are used manually by rubbing and scrubbing. For maximum effectiveness, they can be used in conjunction with detergents and water, but caution should be exercised so as not to scratch or otherwise harm the floor or surface.

Water is an excellent cleaning and rinsing agent. They are also used to dilute acids and detergents.

2.3 Describe how and when disinfecting agents are used

Disinfectants are antimicrobial substances that are used on surfaces and objects to eradicate any microorganisms that may be present. Typically, disinfection comes after the three cleaning steps. Cleaning should always come first, then disinfection. When using disinfectants, caution should be taken to ensure that the concentration is just right. Too much concentration can waste product and damage skin, whereas too little will have no effect. Detergent and disinfectants shouldn’t be combined.

Following the removal of stains and dirt from an object’s surface, disinfectants are used to kill and stop the spread of bacteria.

Acids are poisonous and dangerous if not handled properly, so they should only be handled carefully by trained individuals or under supervision. To avoid direct contact with the skin while applying, care should be taken to ensure that the product is diluted to the proper concentration. They are typically employed to remove rust and mineral deposits.

Degreaser: These solvent cleaners are used to get rid of oil and grease. They work by dissolving the grease and oil on the surface.

Detergents can be used to sanitise or disinfect surfaces in addition to cleaning and removing dirt from them. They are used to clean a variety of surfaces. The majority of detergents are concentrated and must first be diluted with water before use. Detergents can be used to sanitise or disinfect surfaces in addition to cleaning and removing dirt from them. They are used to clean a variety of surfaces. The majority of detergents are concentrated and must first be diluted with water before use.

2.4 Explain the role of personal protective equipment (PPE) during the decontamination process

The primary purpose of personal protective equipment (PPE) is to protect the user from infection caused by hazardous substances like bacteria, viruses, and environmental hazards. Helmets, protective clothing, face shields, gloves, respirators, and goggles are all examples of personal protection equipment (PPE). To prevent injury and the recontamination of already sterile surfaces or objects, PPE is used during decontamination and fumigation.

Following the manufacturer’s instructions, PPE must be properly decontaminated or disposed of after each use. PPE needs to be durable, able to withstand washing at high temperatures, and easily recognisable.

Masks are worn to protect the user from airborne pathogens, smoke, and other contaminants that are inhaled during decontamination. Additionally, they shield the wearer from splashes and spills.

Gloves shield the wearer’s hands from contamination and other injuries. Additionally, they shield the wearer from contamination and stop sterile areas from becoming contaminated again.

Foot protection: These can take the form of disposable shoe covers, which are used to keep sterile areas clean. Safety boots and shoes, as well as other foot protections, shield the wearer from harm.

The purpose of eye protection (goggles) is to shield the eyes from radiation, flying objects, splashes, and shrapnel.

Protective suits and gowns are used to keep the wearer and others from contracting an infection.

2.5 Explain the concept of risk in dealing with specific types of contamination

Risk refers to the likelihood that people, individuals, or the environment will suffer harm or endanger others. When handling contaminants and performing decontamination procedures, there is a high risk of contamination. In addition to the individual, the larger community, coworkers, and visitors to the facility are all at risk.

The number of people who will be affected, the potential extent of the damage, and the likelihood that the contamination will result in the spread of the infection all affect the risk level.

The number of people who will be affected, the potential extent of the damage, and the likelihood that the contamination will result in the spread of the infection all affect the risk level.

Cleaning and caring responsibilities like trash removal and linen and clothing changes are dangerous and expose people to high levels of contamination risk. To lessen or eliminate these risks, it is necessary to recognise these risk factors and activities and take the necessary precautions. Such actions are referred to as control measures and ought to be covered by the employer’s code of conduct.

Prior to cleaning, disinfecting, and sterilising any area or item, a risk assessment is required. This would make it possible to thoroughly plan the cleaning of the area or object, choose the right cleaning tools and supplies, PPE, and other chemicals, and implement the necessary cleaning techniques.

2.6 Explain how the level of risk determines the type of agent that may be used to decontaminate

A proper risk assessment is the first step in this process, which will help you choose the best cleaning supplies and decontamination techniques. All employees must have the necessary training and knowledge to understand the level of contamination risk. Following the completion of the risk assessment, the risk level—low risk, medium risk, or high risk—as well as the appropriate materials and procedure, are determined.

Surfaces, furniture, floors, bathroom fixtures, and mobility aids are examples of low-risk items.

Bedpans, urinals, toilets, and lavatories all pose medium risks.

Instruments used in cutting and surgical procedures, as well as reusable equipment, are high risks.

Items used in routine facility operations are referred to as low-risk or general equipment, and they must be thoroughly cleaned according to the employer’s established working practices using the right detergent and hot water. All of this equipment needs to be kept in good working order to avoid contamination and user injuries.

Cleaning and disinfecting medium- and high-risk items should be done in accordance with the manufacturer’s instructions and with strict adherence to the employer’s established working practises and code of procedure.

2.7 Describe how equipment should be cleaned and stored

Equipment must be cleaned and stored in accordance with the manufacturer’s instructions. These instructions can be found in the user manual for the relevant equipment on the device’s container, body, or packaging. These instructions can be translated for better understanding and are typically written in a language that the user can understand based on the preferences of the country of manufacture and the country of import.

All aspects of health and safety regulations must be followed when cleaning and storing things. To avoid contaminating and infecting users as well as bacterial growth and spread, all equipment must be kept clean. Safe storage is crucial to maintaining a secure working environment and avoiding accidents in the building. Cleaning supplies shouldn’t be left lying around or in the way, and the equipment storage area should be away from the general access area.

Acids and chemicals must be kept on the shelf or cabinet inside the storage area in their original containers. As recommended by the manufacturer, storage conditions for temperature, humidity, and lighting should be followed. The COSHH regulations must be followed for all equipment cleaning and storage procedures. Additionally, workers must ensure complete adherence to this and the employers’ established working practises by receiving thorough training in cleaning and storage tasks.

3.1 Identify the different categories of waste and the associated risks

In healthcare facilities, a variety of wastes are produced, some of which include chemical waste, clinical waste, and infectious waste, putting people at risk of infection or cross-contamination. Therefore, it is crucial to put in place an efficient waste management system to make sure that waste is properly collected and disposed of without running the risk of doing so in a way that could contaminate, infect, or pollute the environment.

It is crucial to correctly identify and classify such waste in order to handle and manage it properly. Clinical waste and sharps, specific waste, household waste, and confidential waste are the four categories of waste in social health care. As it lessens contamination and the potential for hazardous materials to cause harm or injuries, proper,

The use of colour coding to identify the type of waste being disposed of is crucial in health facilities during the waste collection and disposal process. On the lids of the sack holders, the colour coding chart must be prominently displayed and easily accessible. Labels must identify the waste source and type, and bags should be tied.

Waste categories

1. Infectious waste is any solid or liquid waste that contains pathogens (disease-causing microorganisms) and can potentially infect humans or animals. This type of waste includes items like used needles, lab cultures, and animal carcasses.

2. Pathological waste is any human tissue or body fluid that has been removed during surgery or autopsy, as well as anything contaminated by these tissues or fluids. This type of waste can include items like amputated limbs, biopsy specimens, and blood-soaked dressings.

3.. Pharmaceutical Waste is unused drugs or chemicals from health care facilities, including hospitals, pharmacies, nursing homes and veterinarians, that are no longer needed because they are expired, damaged beyond repair/useable condition OR were never used due to a patient’s death before the drug could be administered.

4. Sharps are any medical devices that can puncture or cut skin, such as needles, syringes, and lancets. This type of waste also includes items like needles, scalpels and IV catheters.

5. Cytotoxic waste is any solid or liquid waste that contains chemicals that are poisonous to cells (cyto = cell; toxic = poison). This type of waste includes items like chemotherapy drugs, empty containers that held these drugs, and absorbent materials used to clean up spills of these drugs.

3.2 Explain how to dispose of the different types of waste safely and without risk to others

General domestic waste and medical waste are two of the various types of waste that must be taken into account in this case. All of this waste needs to be collected correctly, colour-coded and disposed of appropriately.

According to health and safety executive regulations, all wastes in this category must be incinerated.

Waste handlers must always wear protective gear and follow approved procedures when collecting and disposing waste. They should also make an effort to file formal reports of incidents, accidents, or equipment failure. Additionally, they should watch out that no trash is dumped in unattended public spaces. The waste bags and sharp boxes must be filled, sealed, and identified properly, and they must be handled with the proper level of professionalism.

Body fluids include mucus, urine, blood, vomit, semen, saliva, respiratory secretions, and faeces.

They should be handled carefully and disposed of properly. Although this depends on the type of body fluid and the likelihood that it is infected or not, all contacts with body fluid pose a risk of infection.

Strict precautions must be taken to prevent contamination or infection when handling contaminated materials or coming into contact with bodily fluids.

Taking precautions

  • Utilising the proper PPE when handling and getting rid of waste and bodily fluids.
  • Disposal of contaminated materials safely in accordance with local laws.
  • Ensuring that all employees receive the necessary training in waste handling and disposal.

Staff members who are ill or injured need to be properly cared for with the right water resistance dressings, and they should report any such incidents to their supervisor and doctors for the right guidance.

Clinical waste is waste produced by healthcare facilities and is typically packaged in disposable yellow-coded bags for disposal.

Domestic waste includes packaging materials, paper, food scraps, plastic, and plant waste. This type of waste is produced within the home. Given the low risk of infection, this kind of waste needs to be routinely collected and tightly tied in black plastic bags for disposal by local authorities in landfills.

3.3 Explain how waste should be stored prior to collection

In order to stop an infection or disease outbreak, waste storage is crucial and must be done correctly. Waste should be kept in locked containers that are out of the reach of animals, the environment, and the general public. Only the regulatory body in charge of waste collection and disposal should perform this, and only in accordance with the policies and procedures of the institution.

All collected waste must be kept in bags and containers that are completely enclosed, lockable, rigid, leak-proof, and weatherproof. To avoid spills and contamination, rigid waste containers must be handled, stored, and handled in an upright position while being sealed and in good condition. The site’s and the containers’ maximum storage capacities must be determined and not exceeded.

Waste must be stored in a location that is far from sensitive areas, such as sensitive perimeters around homes, schools, and waterways.

To avoid unauthorised entry and vandalism, all storage facilities must be secured. Waste that is known to be delicate to light, heat, and water must be shielded from these elements by making sure the storage is covered.

If possible, infectious waste must be kept in a secure building. If it must be kept outside of a building, a proper assessment of the environmental risks must be done before storage can begin. Infectious waste must also be kept in secured bulk containers and kept in locations with impermeable surfaces and sealed drainage.

To avoid physical contact or leaks, make sure that different types of healthcare waste are stored in separate storage areas or containers. Bulk waste containers must be stored in a way that permits safe access into and exit from the storage areas as well as easy access and movement for inspection. Waste must be properly handled and removed from the storage location as soon as possible.

3.4 Identify the legal responsibilities in relation to waste management

Hazardous waste regulations 2011

Under the Hazardous Waste regulations 2011, these waste types are categorised as the most hazardous waste because they are harmful to human health and can seriously harm the environment. These regulations place a duty of care on businesses to ensure that their hazardous waste is disposed of safely and correctly. Organisations producing hazardous waste must:

– Keep accurate records of the types and quantities of hazardous waste they produce

– Use a registered hazardous waste carrier to transport their hazardous waste to a licensed disposal site

– Ensure that their Waste Transfer Note is completed correctly

The Environmental Protection Act 1990 also requires businesses to take all reasonable steps to prevent or minimise pollution from their activities. This means that businesses need to consider the environmental impacts of their waste and how they can reduce these impacts.

The Health and Social Care Act 2008

A code of conduct for infection control and prevention is established by this legislation. Additionally, it provides guidelines for the standards that each facility must take into account when developing its infection control policies and procedures.

It requires that staff members be protected from contamination and illness while performing their jobs. Additionally, it demands the implementation of measures for the control and prevention of infections.

It promotes the use of PPE, good hygiene habits, and the safe handling and storage of sharp objects. Additionally, it requires the appointment of an infection control lead officer and the development of an effective management system to address infection control issues.

3.5 State how to reduce the risk of sharps injury

Due to accidental skin penetration or larger wounds, individuals are at risk of contracting a blood-borne infection. Blood and blood products can be used to spread a variety of infections. HBV, HCB, HIV, and CJD are a few blood infections.

Sharp injuries:

  • Puncture wounds from sharps that are either contaminated with the patient’s blood or other body fluids
  • Cuts from sharp edges on devices such as scalpels
  • Grazes or scratches from contact with sharp points

The following safety measures must be followed in the event of any sharp injuries;

  • Encourage the wound to bleed as much as possible
  • using warm water and soap to clean the wound
  • Covering this with the proper, sterile, water-proof dressing is necessary.

Also, the manager or responsible supervisor needs to be informed of the accident.

It is important to pinpoint the accident’s cause and work to eliminate it. The injury should receive immediate medical attention, and appropriate steps should be taken to arrange for testing and treatment.

Reducing the potential for sharps injuries

  • Syringe needles should be disposed of as a one-time item rather than being recovered after being used or unused in order to lower the risk of accidents and infection from sharps.
  • Never leave sharp objects unattended or unattended while lying around.
  • Never fill sharp boxes too full.
  • The facility should always have sharp boxes available, but hands must never be placed inside of them.
  • Sharp boxes need to be emptied as soon as they are full.
  • Needles and other sharp objects must be discarded right away after use.

 

References:

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“Toward a Safer and Cleaner Way: Dealing With Human Waste in Healthcare – PubMed.” PubMed, 1 July 2016, pubmed.ncbi.nlm.nih.gov/26747841.

“For Greener, Cleaner and Safer Hospitals.” World Bank Blogs, 3 June 2015, blogs.worldbank.org/eastasiapacific/greener-cleaner-and-safer-hospitals.

Wright, R.N., CIC, Paula J. “Managing Flow of Waste and Materials in Hospitals.” Managing Flow of Waste and Materials in Hospitals | Health Facilities Management, 29 Apr. 2021, www.hfmmagazine.com/articles/4164-managing-flow-of-waste-and-materials-in-hospitals.

“Health Care Waste: Avoiding Hazards to Living and Non Living Environment by Efficient Management.” Health Care Waste: Avoiding Hazards to Living and Non Living Environment by Efficient Management, 18 Apr. 2019, www.fortunejournals.com/articles/health-care-waste-avoiding-hazards-to-living-and-non-livingnbspenvironment-by-efficient-management.html.

Nwankwo, C. “Knowledge and Practice of Waste Management Among Hospital Cleaners.” OUP Academic, 1 Aug. 2018, academic.oup.com/occmed/article/68/6/360/5035162.

Mariam, Finot Admassu, and Zewdie Aderaw Alemu. “Medical Waste Handling Practice and Associated Factors Among Cleaners in Publicn Hospitals Under Addis Ababa Health Bureau, Addis Ababa, Ethiopia | Open Access Journals.” Medical Waste Handling Practice and Associated Factors Among Cleaners in Publicn Hospitals Under Addis Ababa Health Bureau, Addis Ababa, Ethiopia | Open Access Journals, www.rroij.com/open-access/medical-waste-handling-practice-and-associated-factors-among-cleaners-in-publicn-hospitals-under-addis-ababa-health-bureau-addis-a.php?aid=87246.

“Cleaning and Waste Management in a Hospital.” Supply This, smartmedicalbuyer.com/blogs/smb-blog/cleaning-and-waste-management-in-a-hospital. Accessed 23 Nov. 2022.

 

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