5.8 Safe Management of the Care Environment

During this ongoing pandemic, cleaning frequency of the environment should be increased across all pathways. A minimum of 4 hours should have elapsed between the first daily clean and the second daily clean.  Where a room has not been occupied by any staff or patients since the first daily clean was undertaken, a second daily clean is not required.

It is the responsibility of the person in charge to ensure that the care environment is safe for practice (this includes environmental cleanliness/maintenance). The person in charge must act if this is deficient.

The care environment must be:

The use of general purpose detergent for cleaning in the Low Risk pathway is sufficient with the exception of isolation/cohort areas where patients with a known or suspected infectious agent are being nursed.  These areas require to be cleaned twice daily with a chlorine releasing agent containing 1000ppm av chlorine. 

Environmental cleaning in the Medium and High Risk COVID-19 Pathways should be undertaken using either a combined detergent/disinfectant solution at a dilution of
1000 ppm available chlorine or a general purpose neutral detergent in a solution of warm water followed by a disinfectant solution of 1000 ppm.

Cleaning across the pathways is summarised in table 5. It is recognised that NHS boards will have local protocols in place to determine the staff groups who have responsibility for cleaning different items and areas. 

Table 8: Environmental cleaning determined by pathway

 

Low risk pathway
(green)

Medium risk pathway
(amber)

High risk pathway
(red)

First daily clean

Full clean

Full clean

Full clean

Second daily clean

High Risk Touch Surfaces* within clinical inpatient areas

High Risk Touch Surfaces within clinical inpatient areas

High Risk Touch Surfaces within clinical inpatient areas

Product

General-purpose detergent.

Note that cleaning in the low-risk pathway should be carried out with chlorine-based detergent for patient rooms where the patient is known to have any other known or suspected infectious agent.

Combined detergent/disinfectant solution at a dilution of 1000 ppm av chlorine or general-purpose neutral detergent in a solution of warm water followed by a disinfectant solution of 1000ppm av chlorine.

Combined detergent/disinfectant solution at a dilution of 1000 ppm av chlorine or general-purpose neutral detergent in a solution of warm water followed by a disinfectant solution of 1000ppm av chlorine.

*High risk touch surfaces as a minimum should include door handles/push pads, taps, bed heads/bed ends, cotsides, light switches, lift buttons.  Clinical inpatient areas should include the patient bedroom and treatment areas and staff rest areas.

Any areas contaminated with blood and body fluids across any of the three pathways require to be cleaned as per Appendix 9.