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Ministry of Health ~lo.)jJ
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TERMINAL CLEANING OF CRITICAL AREAS AND PATIENT ROOM

(ON ISOLATION PRECAUTIONS).
IPP-IPC-068 I Infection Prevention and I Medical, Nursing I 8 May 2018
Control Department and Ancillary staff

1.0 PURPOSE:
1.1 To ensure correct and appropriate cleaning of patient rooms after discharge, transfer or
death of patients on isolation precautions.

2.0 DEFINITION:
2.1 A terminal cleaning is defined as: "a procedure required to ensure that an area has been
cleaned/decontaminated following discharge of a patient with infection (Le. alert organism
or communicable disease) in order to ensure a safe environment for the next patient."

3.0 POLICY:
3.1 When a patient is discharged, transferred or dies, the room or bed shall be cleaned and
disinfected thoroughly before the next patient occupies the space.
3.2 Housekeeping staff shall follow correct methods for terminal cleaning of all patient
rooms.
3.3 Only hypochlorite shall be used for cleaning and disinfection of all patient care items in
isolation rooms.

4.0 MATERIALS:
4.1 Environmental checklist for monitoring terminal cleaning: Form.

5.0 PROCEDURE:
5.1 GENERAL GUIDELINES:
5.1.1 When a patient on isolation precautions is discharged, transferred or dies, the
room or bed space must be cleaned and disinfected thoroughly before the next
patient occupies the space. Use H202 fogging machine for disinfecting the
room as indicated in the user manual (Room Height X Length X Wwidth=
surface in in cubic meter= disinfection time in minutes).
5.1.2 Use hypochlorite solution in the correct dilution for cleaning and disinfecting
isolation rooms-D.1% for room and patient items; 0.5% for bathrooms.
5.1.3 Check for Isolation Precaution signs and follow nursing instructions as
indicated.
5.1.3.1 Gowns and Gloves-For Contact Isolation Precautions.
5.1.3.2 Surgical Masks-For Droplet Isolation Precautions. Gown, Gloves,
N-95 Respirator and Face shield-For Airborne infection Isolation
Precautions.
5.1,3.3 Mopping bucket must be thoroughly cleaned and disinfected with
0.1% hypochlorite before using for any other room.
TERMINAL CLEANING OF CRITICAL AREAS AND PATIENT ROOM (ON ISOLA TION PRECAUTIONS)

5.1.3.4 All items (e.g., cloths, mop heads/pads) used to clean the room
must be laundered or discarded; they must not be used to clean
any other room or bed space.
5.2 NURSING PERSONNEL -Responsibilities include:
5.2.1 Removal or discarding of medical supplies.
5.2.2 Emptying suction bottles.
5.2.3 Discarding IV bags and tubing.
5.2.4 Emptying bedpans/urinals.
5.2.5 Removing dirty linen.
5.2.6 Disinfection and removal of oxygen therapy equipment.
5.2.7 Disposal of personal articles left by the patient (lotions/cream; soaps; razors;
toothbrush, toothpaste, denture box; comb/hairbrush; toys).
5.3 HOUSEKEEPING PERSONNEL - Once nursing staff have completed their tasks,
terminal cleaning may be carried out by housekeeping.
5.3.1 ASSEMBLE SUPPLIES:
5.3.1.1 Take fully equipped cleaning cart outside room.
5.3.1.2 Ensure an adequate supply of clean cloths is available.
5.3.1.3 Ensure that disinfectant solution (hypochlorite) is freshly prepared
according to Housekeeping polices.
5.4 Assessment:
5.4.1 Check for Isolation Precautions signs and follow nursing instructions as
indicated.
5.4.1.1 Gowns and Gloves-For Contact Isolation Precautions.
5.4.1.2 Surgical Masks-For Droplet Isolation Precautions
5.4.1.3 Gown, Gloves, N-95 Respirator and Face shield-For Airborne
Infection Isolation Precautions.
5.4.1.3.1 Only immune staff may enter a room where airborne
precautions are in place for measles or varicella (chicken
pox)-an N-95 respirator is not required.
5.5 ENTER THE ROOM, CLEAN HANDS USING ABHR AND PUT ON GLOVES"
5.5.1 For negative pressure rooms-The door must be kept closed to maintain
negative pressure, even if the patient is not in the room.
5.6 Remove:
5.6.1 Old supplies (paper towels, toilet rolls).
5.6.2 Waste bags
5.6.3 Sharp container if % full (close lid before removing).
5.6.4 Privacy curtains and send for laundering.
5.7 Clean and disinfect room, working from clean to dirty and high to low areas of the room:
5.7.1 Use fresh cloth(s) for cleaning each patient room/patient bed space in general
ward.
5.7.2 Spray cleaning cloth with 0.1% hypochlorite till cloth is wet but not dripping.
Spray cloth repeatedly if required
5.7.3 Change the cleaning cloth if heavily soiled.
5.7.4 Start by cleaning doors, door 'handles and touched areas of frame including
outer surface of toilet doors.
5.7.5 Check walls for visible soiling and clean if required.
5.7.6 Clean light switches and thermostats.
5.7.7 Clean wall mounted items such as alcohol-based hand rub dispenser.
5.7.8 Check and remove fingerprints and soil from low level interior glass partitions,
glass door panels, mirrors and windows with glass cleaner.
5.7.9 If patient was on contact isolation precautions.
5.7.10 Clean all furnishing and horizontal surfaces in the room including tops of
shelves, chairs, windows sill, television, telephone, side table and other tables.
Lift items to clean the tables.
5.7.11 Wipe equipment on walls such as top of suction bottle, and IV pole.

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TERMINAL CLEANING OF CRITICAL AREAS AND PATIENT ROOM (ON ISOLA TION PRECAUTIONS)

5.7.12 Clean inside and outside of patient cupboard.

5.7.13 Clean bed controls and call bell.
5.7.13.1 Clean top and sides of mattress, turn over and clean underside.
5.7.13.2 Check for cracks or holes in mattress replaced as required.
5.7.13.3 Clean exposed bed springs and frame.
5.7.13.4 Inspect for pest control.
5.7.13.5 Clean headboard, foot board, bed rails, call bell and bed controls;
pay particular attention to areas that are visibly soiled and surfaces
frequently touched by staff.
5.7.13.6 Clean all lower parts of bed frame, including wheels.
5.7.13.7 Allow mattress to dry.
5.7.14 Clean out extra equipment in the room (Walker, extra chairs, etc.).
5.7.15 Damp dust top of sharps container.
5.7.16 Damp dust top of waste bin/wash if required.
5.7.17 Clean and wash handwashing sink.
5.7.18 Clean bathroom / shower-wash outer surface of soap dispenser (See bathroom
cleaning procedure).
5.7.19 Clean floors (see floor cleaning procedure).
5.8 Waste Issues:
5.8.1 Replace sharps container when % full.
5.8.2 Replace waste bag.
5.9 Removing PPE:
5.9.1 Remove gloves and clean hands with
5.9.1.1 Alcohol based hand rub.
5.9.1.2 Soap and water if hands are visibly soiled.
5.9.2 Remove other PPE-gown, mask and face shield and clean hands.
5.9.3 Return disinfected equipment (e.g., IV poles and pumps, walkers) to clean
storage area.
5.9.4 Leave the room, close the door and remove other PPE:
5.9.4.1 N-95 respirator-Airborne Infection Isolation Precautions.
5.9.5 Clean hands - soap and water / alcohol-based hand rub (ABHR).
5.9.6 Transfer in another patient:
5.9.6.1 Room can be immediately be used following terminal cleaning after
discharge of patients on contact and droplet isolation precautions.
5.9.6.2 Keep the door closed for 1 hour in case of airborne infection
isolation precaution and then use for the next patient.
5.9.6.3 Discard cleaning cloths.
5.9.6.4 Clean and disinfect supplies used for cleaning room.
5.9.7 Forms and Equipment:
5.9.7.1 Cleaning cart with supplies
5.9.7.2 Cleaning Agents
5.9.7.3 Disinfectants
5.9.7.4 Brushes
5.9.7.5 Mops
5.9.7.6 Measuring cups
5.9.7.7 Spray Bottles
5.9.7.8 Labels
5.9.7.9 PPE
5.9.7.10 Detergents
5.9.7.11 Cleaning cloths
5.9.7.12 Buckets
5.9.7.13 MSDS
5.9.7.14 Housekeeping policies and procedures Infection Control Policy on
Cleaning Agents, Antiseptics and Disinfectants in Patient Care
Areas

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TERMINAL CLEANING OF CRITICAL AREAS AND PA TlENT ROOM (ON ISOLA TION PRECAUTIONS)

6.0 RESPONSIBILITY:
6.1 Housekeeping.
6.2 Laundry.
6.3 Nursing.
6.4 Infection Control Practitioner.

7.0 REFERRENCE:
7.1 Kingdom of Saudi Arabia, Ministry of Health, General Directorate, Infection Prevention
and Control in Healthcare Facilities-Healthcare Housekeeping Policy-2009.
7.2 Guidelines for Environmental Infection Control in Health-Care Facilities-
Recommendations of CDC and Healthcare infection Control Advisory Committee
(HICPAC)-2003.
7.3 Ministry of Health-List of Chemical and Disinfectants.
7.4 William. Rutala, Ph.D., M.P.H.1, 2, David J. Weber, M.D., M.P.H.1, 2 and the Healthcare
Infection Control Practices Advisory Committee 9HICPAC): Guideline for Disinfection and
Sterilization in Healthcare Facilities, 2008.

Page 4 of5
TERMINAL CLEANING OF CRITICAL AREAS AND PATIENT ROOM (ON ISOLA TION PRECAUTIONS)

8.0 AUTHORIZED SIGNATURES:

APPROVAL:

Action Name Position Signature Date

Process Owner: Department of Infection Prevention and
Control /I
Reviewed by: MR. WALEED OTTAI Director of IPC ~- q, '1,/~
DR. MOHAMMAD MOMINUL Acting Consultanf L~ r-9,tt,. I'
ISLAM for IPC /~-
Reviewed by:
Mr. ALI OMRANI Head,Support
Services
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rt,,~; fl. .ct-1 f~
MS. HIND MOHAMED ALAIDAI Nursing Director .r+: t\...A-
MR. SALEM ALATAWI Director of TaM / ~-Q , ;-'_./
1 Z)._ ~
DR. SALEM AL BALAWI Medical Director '-: VJ~ ~ LO(£f-(~
Approved by: DR. TARIQ ALI AL BALAWI Hospital Dire_g1PF- ~ /O'flll~
~

REVIEW HISTORY
Name Position Signature Date

1
2

3
4

Page 50'5
 Kingdom of Saudi Arabia ~~I~yJl~1
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Directorate of Health Affairs in Tabuk ~~ ~I WJy:.t! 4..-WI~.):!~I
King Fahd Specialist Hospital
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Environmental checklist for monitoring terminal cleaning1

I Date:
Unit:

Eva uat e The Fo " oWing P"nonlt Y SOt

I es For Eac h Room:
High-touch Room Surfaces3 Cleaned Not cleaned Not Present in Room
Bed rails/ controls
Tray table
IV pole (grab area)
Call box! Button
Telephone
Bedside handle
Chair
Room sink
Room light switch
Room inner door knob
Bathroom inner door knob
Bathroom light switch
Bathroom handrails by toilet
Bathroom sink! basin
Toilet seat
Toilet flush handle
Toilet bedpan cleaner

Evaluate The Fo"owing additional sites if these equipment are present in the room:

High-touch Room Surfaces3 Cleaned Not cleaned Not Present in Room

IV pump control
Multi-module monitor control
Multi-module monitor touch
screen
Multi-module monitor cables
Ventilator control panel

Marks the monitorin method used:

o Direct observation o Swab culture

1Selection of detergent and disinfectants should be according to KFH, Tabouk policies and procedures.
2Hospitals may choose to include identifiers of individualenvironmental services staff for feedback purposes.
3 Sites most frequently contaminated and touched by patients and/or healthcareworkers (HCWs).

Form No: IPC:

 Kingdom of Saudi Arabia ~y.wJ1~yJl ~I
Ministry of Health ~lo)j.J
Directorate of Health Affairs in Tabuk ~~ ~I Luy:.!l4.-.WI ~.):l.l.J1
King Fahd Specialist Hospital 1..,;1,0,0.;,;11¥.ill.J1 ~
In Tabuk
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HYDROGEN PER OXIDE (H202): FUMIGATION LOG

STERILIZED ROOM NO. DATE & TIME NURSE'S

NAME & SIGNATURE

Head Nursel Link Nurse:

Signature:

IPC, KFH, Tabouk,