TEMA6 - TEMA7 - Hospital Cleaning and Maintenance Manual

REFERENCE: LN-300
Qualification
CLEANING MANUAL
MAINTENANCE
OF
HOSPITALS
GENERAL CLEANING MANUAL
SPANISH TECHNICAL INSTITUTE OF CLEANING

RESEARCH AND ADVICE CENTER FOR CLEANING
C/Cadí, 27- C/Moixeró, s/n – Pol. Ind. Riu d'Or
08272 Sant Fruitós de Bages (Barcelona)
Tel.: 93 877 41 01 / 93 877 40 79 – Fax: 93 877 40 78
e-mail: itel@itelspain.com – web: www.itelspain.com
CLEANING MANUAL
AND
MAINTENANCE
OF
HOSPITALS
RESEARCH AND ADVICE CENTER FOR CLEANING

C/ Cadí, 27 - C/ Moixeró, s/n - Polígon Industrial Riu d'Or
08272 Sant Fruitós de Bages - (Barcelona)
TEL.: 93-877 41 01 / 93-877 40 79 - FAX: 93-877 40 78

Email: itel @ itelspain.com
Website: http://www.itelspain.com
-2-
Introduction
The Technical Notebooks are an answer. They respond above all to a need of all those who work in
positions of responsibility or production, within the sector of Industrial Cleaning of Premises,
Buildings, Disinfestation and Deratization, etc......................................
This professional sector and particularly its service sector is little known, poorly known and often -if
everything must be said-, unknown. This ignorance of the general public, which nevertheless
concerns it, is deeply felt by all those who contribute their care to the place of work or leisure of
each citizen.
Ignorance does not mean lack of information. ITEL (Spanish Technical Institute of Cleaning) has
begun a few years ago work on public relations and heightened communications at all media levels.
But for the germ of information to develop, it takes time. A long time for our professional sector to
appear in the eyes of everyone as an important sector of the economic and active life of our society.
Information and training are two words that have the same deep resonance. And the
implementation of continuous training for the hygiene and maintenance of premises, buildings, etc.,
has given rise to the need to create basic documentation for our activities.
If the Limpieza-Inform magazine has allowed us to achieve part of these objectives, we have found
it necessary to gather in the technical notebooks, general documentation on specific topics that the
periodic analysis of the technical press cannot delimit with such precision.
Here is our purpose. We hope that the goal will be achieved even if our publication seems modest in
the eyes of some.
There are many nuances in our objectives: Inform and Train, Analyze and Disseminate, Inform and
Teach.
Valenti Casas
-3-
INDEX P.
Qualification................................................................................................................1
CLEANING MANUAL......................................................................................1
MAINTENANCE................................................................................................1
OF........................................................................................................................1
HOSPITALS........................................................................................................1
Introduction.............................................................................................................3
INDEX.............................................................................................................4
CLEANING AND MAINTENANCE OF HOSPITALS.................................6
Public areas, hallways and lobbies.................................................................10
Patient Rooms and Congested Areas.............................................................11
Utensils and Equipment Needed:...................................................................11
Utensils and Equipment Needed....................................................................16
Necessary Utensils and Equipment:...............................................................34
- Recurrent cleaning and disinfection:......................................................58
Terminal cleaning and disinfection:...............................................................58
- Recurrent:................................................................................................58
Precautions for nursing staff..........................................................................59
Disinfection:...................................................................................................61
Degermination:...............................................................................................61
Disinfectants:..................................................................................................61
Antiseptics:.....................................................................................................61
Bacteriostatic:.................................................................................................61
Bactericide:....................................................................................................62
GERMS..........................................................................................................62
PATHOGENIC GERMS...............................................................................63
GROWTH RATE...........................................................................................63
VULNERABILITY OF MAN.......................................................................63
IMPORTANCE OF CLEANING..................................................................64
CLEANING PROCEDURES........................................................................64
POST-OPERATIVE CLEANING.................................................................65
CHANGING THE MOP HEAD....................................................................66
MISCELLANEOUS CLEANING.................................................................66
OPERATIONS TO CARRY OUT DURING THE WEEKLY BREAK.......67
GENERAL CLEANING OF THE OPERATING ROOMS..........................67
CLEANING THE WALLS............................................................................68
FLOORING CLEANING..............................................................................68
WET SUCTION.............................................................................................68
CONDUCTIVE PAVEMENTS (CONDUCTIVE).......................................69
DO NOT USE THE SEALANT....................................................................69
FURNITURE AND APPLIANCES..............................................................70
SUBSTERILE STAYS..................................................................................70
RESUSCITATION ROOM...........................................................................71
INTRODUCTION..........................................................................................72
GOALS..........................................................................................................72
CLEANING AND DISINFECTION OF THE ENDOSCOPY AREA:........73
PRECAUTIONS FOR MEDICAL AND PARAMEDICAL PERSONNEL:74
EQUIPMENT CONSERVATION:...............................................................74
INTRODUCTION..........................................................................................75
STORAGE AREA.........................................................................................76
CHARACTERISTICS OF THE CONTAINERS..........................................77
- The returnables.......................................................................................77
-5-
- The disposable ones................................................................................78
WASTE TYPES.............................................................................................78
- Ordinary type waste:...............................................................................78
- Hospital-type waste:...............................................................................78
EFFECTS OF WASTE..................................................................................79
PRESENTATION OF WASTE.....................................................................80
SOLID WASTE RECOVERY.......................................................................80
HARVEST.....................................................................................................81
FREQUENCY................................................................................................81
EVACUATION..............................................................................................82
LIST OF NECESSARY EQUIPMENT.........................................................82
EQUIPMENT CARE.....................................................................................87
CLEANING AND MAINTENANCE OF HOSPITALS
<<In 22 Hospital Cleaning Procedures>>, the instructor supervisor will find

the most important methods of general cleaning of hospitals and institutions;
These methods are governed by very simple rules to follow and treated in
effective language. These procedures, or tasks to be carried out, form a set
of teaching aids of incalculable value.
Through graphic representations, the supervisor allows the employee to

immediately gain self-confidence and a sense of belonging, and all of this
has been because the trust that has been given to him has influenced him in
a way that he knows in at all times how to do a task quickly, correctly, safely
and consciously.
The Cleaning and Maintenance department of a Hospital is the center

around which all kinds of activities are carried out that imply a whole host of
responsibilities:
• Building maintenance
• Equipment
• Provide facilities for cleaning the Hospital
-6-
• Establishing an order of stillness and silence at all times
The degree of efficiency with which these responsibilities are carried out
directly reflects on the comfort, well-being, and morale of patients, visitors,
and hospital staff.
In the very nature of all the activity that takes place in them, there is a great
difference between the necessary degree of cleaning in a hospital and that
which is necessary in other institutions, whether in commercial or industrial
buildings. Furthermore, it is necessary that the surrounding The parts of the
hospital offer an attractive appearance and that the Cleaning and
Maintenance Department has the special mission of ensuring that the
cleaning of the entire floor is carried out with the highest degree of
acceptability.
In no other type of institution will you find such a variety of factors that
intervene in the direction of <<Cleaning and Maintenance>>. As an
example, we can say that under a simple roof you can find different types of
floors and walls, each of them having its own particular cleaning problems,
which implies the use of materials and procedures that are very different in
other types. of floors, walls or ceilings.
Due to a very careful effort of working 24 hours a day, 7 days a week, it is

vitally important for there to be flexibility in the scheduled work, that it be
meticulously detailed and consistent with the programming that has been
carried out. out with the other departments of the hospital. At the same time,
the current function of cleaning and maintenance should not interfere with
the main function of caring for the sick.
A good Cleaning and Maintenance program must be based on three basic

requirements:
• Good staff
-7-
• Proper equipment
• Modern cleaning procedures.
It is this combination that produces maximum efficiency. To achieve

unbeatable success in the task of Cleaning and Maintenance, we should
ensure that all department personnel are well selected, inspected and also
instigated with the desire to <<Do the Best>> or put their five senses, in the
work they do.
It is also of vital importance to try to raise the morale of the components of

the Cleaning and Maintenance Department to its highest level. No so Others
of us cannot force too much the value of our own pride and emphasize the
sense of importance that each of the employees has in the entire hospital
building and in the cleaning work.
We have highlighted the basic procedures that have been put into practice
and have been improved, both teaching tools for supervisors and a book of
procedures to follow for employees. two of Cleaning and Maintenance.
Although all hospitals can be considered with the same principles, there are
varieties in administrative policy, physical obstacles, in the structure of the
organization, types of hospitals, etc. Which, in short, means that there is
great diversity between each of the institutions. This is why it may be
necessary to make certain modifications to these basic procedures in very
specific cases. To allow in each case a practical application of these
methods, we include in the final part of this manual a <<Task Substitution>>
form, which may be useful when the procedure to follow cannot be carried
out in its entirety, then You can change the method to suit your needs. your
hospital, using copies of this blank form.
It should be noted that competent supervision and a good training program

for Housekeeping employees will allow you to obtain the best results along
-8-
with the procedures outlined in this manual.
-9-
PROCEDURES
1 .- REMOVE DUST WITH MOPS
Objectives: Remove debris, dust and dirt from the floor as a daily
maintenance task or in preparation for mopping with a mop and bucket.
Steps to perform:
Public areas, hallways and lobbies.
1. Area in which dust must be removed.
- Use 1.20 m impregnation mops.

- Hold the mop handle at approximately a 45-degree angle...
- Push the mop straight forward...
- Avoid lifting the mop off the floor or moving it from front to back...
- Carefully remove the gums with the tip of a knife or freeze them with
Freon and remove them with a knife.
- Continue to the end of the area and direct the mop in the opposite
direction...
- Pick up the mop at about 25 cm...
2. Pick up debris and dirt.
- Use the dustpan and brush...

- Empty it into the trash can or waste container...
3. Changing the mop head.

.
- Replace the mop head when the dirt can no longer be removed.
-8-
removed or find that it is too dirty.
Patient Rooms and Congested Areas
1. Dust removal area.
- Use impregnated mops of size 45-50 cm.

- Work starting from the sides of the room towards the center and
ending with the entrance area.
- Remove any furniture in your path and return it to its correct position.
- Carefully scrub around equipment.
- Carefully remove the gum with the tip of a knife or freeze it with Freon
and remove it with a knife.
2. Pick up waste.
- Use the dustpan and brush.

- Empty it into the trash can or waste container.
3. Changing the mop head.
- Replace the mop head when the dirt can no longer be removed, or you
see that it is too dirty.
Utensils and Equipment Needed:
- Impregnated mop
- Dustpan and brush
- Pointed knife.
2. SCRUBING WITH MOP AND DOUBLE BUCKET
-11-
Objectives: Achieve more careful, more hygienic cleaning and more
environmental beauty.
Steps to perform:
1. Prepare the area.
Post <<Caution>> badges in public areas.
2. Remove dust from the floor.
- Follow procedure 1.
- Use impregnated dust mops when cleaning.
3. Apply the scrubbing solution to the mop
- Immerse the mop in the germicidal detergent solution.

- Partially drain it before applying it to the soil.
- Scrub along the baseboards.
- Use the heel that holds the mop to clean the baseboards as you go.
4. Collect Dirty Water
- Wring out the mop frequently.

- Cover the entire area.
5. Rinse and Dry.
- Use the rinse water.
- Carefully wring the mop into the bucket of rinse water. - Scrub
carefully.
-12-
- Impregnated dust mop.

- Dustpan and brush.
- Door mats.
- Pointed knife.
- Double cube.
- Mop for scrubbing.
3. SCRUB WITH STERILIZED MOPS
Goals. Apply to the hospital floor in all areas, using a method in which the
germicidal detergent is left on the floor long enough to kill bacteria.
Preparation:
- Remove dust from the floor with an impregnated mop.

- Post <<Caution>> signs in required areas.
- Fill a double bucket with the appropriate solution of germicidal
detergents and rinse water.
Steps to perform:
1. Apply the solution.

- Dip the mop into the solution.
- Press gently into the colander.
- Apply the mop to the entire floor area.
2. rinsed
- Rinse the mop with the rinse water from inside the bucket.
- Carefully drain into the bucket of rinse water.
-13-
3. Repeat steps 1 and 2
- As much as necessary to cover the entire area.

- Change the rinse water as frequently as you can.
- Refill with the prepared solution as many times as necessary.
Recommendations:
- Check that all employees use the appropriate dilution.

- Train your people in the use of this simple method.
- Constantly monitor to be sure that everything is done correctly.
- Mops.
- Double cube.
- Placing the <<Caution>> signs.
4. FLOOR RENEWAL
Objectives: Remove any floor dirt, wax or synthetic finishes before

applying new floor finish.
Steps to perform:
1. Prepare the area.
- Put <<Caution>> signs.
2. Remove dust with mops.
-14-
- Clean, with impregnated mops to remove dust.
3. Mopping the floor.
- About 25 liters of hot water in the washing bucket.

- Add wax solvent.
- Apply the solution abundantly with the help of the mop over the entire
area.
- Let it sit for five minutes.
4. Scrubbing or polishing machine.
- Steel wool or synthetic pad under the brush of the scrubbing or

polishing machine.
- Scrub along the baseboard.
- Go from side to side swinging, over the entire area.
- Use the brush for the corners and to scrub the corners of the area.
- Avoid splashing on walls.
5. Collect dirty solution.
- Use the water vacuum cleaner.
- Do not let the solution dry on the ground.
6. Rinse and dry the floor.
- Clean with hot water.

- Cover the floor liberally with scouring water.
- Collect water with a wet vacuum cleaner.
- Dry the baseboard with the heel of the mop.
-15-
7. Clean the socket.
- Follow procedure eight.
Utensils and Equipment Needed
- Floor scrubbing machine provided with brushes.

- Two steel or synthetic scouring pads.
- Water vaccuum.
- <<caution>> signs.
- Scouring buckets with drain.
- Two rinse mops
- Impregnated or treated mops.
- Wax solvent.
- Mats at the entrance of the doors.
- Corner brush.
- Garbage collection shovel and brush.
- Pointed knife.
5. APPLICATION OF THE FLOOR FINISH
Objectives: Protect various types of surfaces and keep floors throughout

the hospital clean, safe, and attractive.
Steps to perform:
1. Soil inspection.
Make sure the floor has been carefully cleaned and dried.
2. Prepare the area
- Post <<Caution>> signs in public areas.
-16-
- Avoid locking doors when possible.
- Put mats at the entrances.
3. Apply the first coat.
- Start by cleaning, gently wipe with a slightly wet mop.

- Dip the mop into the finish.
- Wring out the mop to prevent streaks from forming.
- Apply a thin coat.
- Start with the baseboards, then move on to the surfaces on the sides
of the baseboard.
- Continue in this manner until you have covered the entire floor area.
- When needed, add the finish.
- Make sure you cover the entire area.
- Avoid splashes.
- Let the first coat dry for about 20 minutes.
- Use fans to speed drying.
4. Apply second coat.
- This time skip the baseboards.

- Leave a strip of about 6 inches (about 15 cm) from the baseboard.
- Apply a thin coat.

- Let the second coat dry.
- Let it dry as long as possible before opening it to the public.
5. Polishing machine.
- After 24 hours.
-17-
- Double bucket with mops.

- Mop wringer.
- 16-ounce cotton mops (about 453 gr.) for rooms with patients.
- 24-ounce cotton mops (about 680 gr.) in public areas.
- <<Caution>> signs.
- Mats for entrances.
- Determined liquid of soils.
6. POLISHING OF THE FLOORS
Objective: Keep the floor clean, safe and attractive.
Steps to perform:
1. Remove dust with mops.
- Use clean, properly treated dust mops.
2. Prepare the scrubbing.
- Post <<Caution>> signs in public areas.

- Put the mats at the entrance doors.
3. Mopping the floor.
- Dip the mop into the detergent solution in the bucket.

- Wring out the mop before applying it to the floor.
- Scrub along the baseboards.
- Use the procedure by swinging around the entire area.
- Rinse the mop frequently in the clean water from the bucket.
-18-
- Let the floor dry completely.
4. Floor polishing machine.
- Make sure the brush directional bar is firmly secured. rada before
starting the machine.
- Use a soft buffing pad or a steel wool pad.
- Start polishing on one side in a strip of about 3 m. and walking
backwards go to the other side.
- Polish gently, taking care of baseboards and door frames.
- Move from side to side in order to cover the center of the area.
5. Dust mop again.
- Collect any dust particles as a result of the polishing operation.

- Use properly cleaned and treated mops for dust.
- Scrubbing machine provided with polishing brushes.

- Steel wool pads or synthetic polishing pads.
- Dust-treated mops.
- Double bucket, one for scrubbing and the other for rinsing (1 bucket
with a mild detergent solution and 1 bucket with clean water).
- 16-ounce mopping mops for sick rooms.
- 24 ounce (about 680 gr.) mopping mops for public areas.
- Mats for entrance doors.
7. WASHING THE WALLS
Objectives: That the environment is clean, hygienic and attractive.

An important part is the asepsis technique in the isolation of the room.
-19-
Steps to perform:
1. Prepare the machinery.
- Remove the wash tank cap.

- Pour the germicidal detergent and about 4 and a half liters of water
into the tank... remove the cap from the rinse water tank and also pour
about 4 and a half liters of water.
- Close both caps tightly.
- Pump the pump by hand until the pressure gauge indicates the
recommended pressure.
2. Prepare the popsicles.
- Fold the pile tissue pad in half to the size of 16 inches by 11 inches
(about 40 cm. by 30 cm).
- Tie them tightly along the seams.
- Spread the pads and tie the ends on the other side under the seams.
The pads should be placed stretched, without wrinkles.
- Attach two of the paddles to the tank sleeves.
- The third paddle should not be placed; This is used in the drying
operation.
3. Wall washing
- Work from top to bottom.

- By pressing the discharge valve, soak the blades with water.
- Start at the end of the left-hand corner and mark a section of the wall
with the water from the wash trowel.
- Don't try to do more than you can even if it's easier.
- Completely wet the marked area with the washing paddle.
- Repeat the soaking procedure throughout the marked area.
- Be careful not to let the pads become soaked.
-20-
- When the pad is dirty, turn it over and tie it so the clean side is facing
up.
- Remove tough marks and stains by scratching with the abrasive pad.
4. Rinse the wall.
- Start at the end of the left-hand corner and rinse the marked area
completely.
- Wet the paddle with the rinse water by pressing the release valve.
- Be careful not to slide into the attached dirty area.
- Make sure the pad does not get soaked. When you rinse the pad, if
you think it is convenient, you can turn it over and tie it firmly. you, you
can do this four times since, remember you folded it earlier. te and the
pad has four surfaces when folded.
5. Drying the wall.
- Use the third paddle, which is not connected to the machine.

- Dry starting at the edges of the area you have cleaned.
- Be careful not to leave the area you have cleaned.
- Dry the area completely.
6. Continue with steps 3, 4 and 5.
- Cover the areas.

- Change the pads when you think necessary.
- Pump by hand so that the pressure is always the same.
- Be careful when entering the area that is already clean.
- If the palette tracks the walls, it is a sign that a higher saturation is
necessary.
7. Machine storage.
-21-
- Press the valve in the center to release pressure.
- Remove the plugs from both tanks.
- Remove the paddle pads.
- Stretch the hose and wrap it around the machine.
- Empty the tanks and hose if the machine is not to be used the next
day.
- Wall washing type pressure machine with hoses and three paddles.
- Three hair weaving pads.
- Germicidal detergent.
- Cold water
- A small abrasive pad.
- Scaffold or ladder.
8. CLEANING OF THE PIECES
Objectives: That the environment is clean, hygienic and attractive.
Steps to perform:
1. Solvent application.
- Use a two-inch (about 5 cm) brush.

- Avoid dirtying walls that have been previously cleaned.
- You can do this by covering the walls with any material or with wooden
slats.
- Let it sit for about five minutes.
2. Washing the baseboards
- Use clean cloths and a germicidal detergent solution.
-22-
- Clean stubborn stains from the area you intend to clean.
- Scrub these areas with a paste cleaner and a scouring pad.
- Wash again with germicidal detergent.
3. Rinse and dry
- Use the bucket with rinse water and a clean cloth.

- Rinse the entire area.
- Dry with a soft, clean cloth.
4. Apply the resin finish.
- Apply the finish with a synthetic sponge.

- Just a thin layer.
- A bucket, a little more than a liter, of a germicidal detergent solution.

- A bucket with about 2 liters of clean rinse water.
- ½ liter of wax solvent.
- Two-inch paint brush (about 5 cm).
- Two steel wool pads or scouring pads fitted with a scraper.
- Paste cleaner.
- Clean cloths.
- Synthetic sponge.
- Resin finish used on floors.
9. WINDOW CLEANING
Objectives: Achieve a more pleasant, cleaner and hygienic environment.
Steps to perform:
1. Wet the glass.
-23-
Apply the cleaning solution with a sponge.
- Reduce the solution with water as much as possible.

- Use the smallest amount of solution.
2. Remove stubborn dirt.
- Use a blade to remove paint stains, tar, etc.
3. Scrub the glass.
- Scrub vigorously with a wet sponge.

- Pick up dirt around the window frame with a sponge.
4. First pass with the window cleaner.
- Start at the top of the window.

- Slide the cleaner along the top of the window.
- Wipe the cleaner blade with a cloth.
5. Second pass.
- Start with the dry surface, in the left corner of the top of the window.
- Slide the cleaner down until you are about three inches from the
bottom (about 7.5 cm).
- Repeat these passes until you have wiped the entire window with the
cleaner.
- Be sure to overlap each pass.
- Wipe the cleaner blade with the chamois after each pass.
6. Remove excess water
- Absorb water from the top of the window with a sponge.
-24-
- Wash the suede when it is dirty, with a clean solution.
- Drain and let it be as dry as possible before using it again.
7. Third pass.
- Start at the top of the window.

- Slide the cleaner along the top edge of the window.
- Remove water from the top of the window with a sponge.
NOTE: Be sure to dry the wiper blade after each pass.
The outside of the windows may need a more concentrated solution.

On large windows, soak and wipe the cleaner over the top half of the
window only.
Always start by wiping the cleaner along the window frame.
Make sure the first pass is done exactly as indicated in step 4.
On tall windows use extendable poles.
- A 12-inch (about 30 cm) window cleaner.

- synthetic sponge
- Bucket of about 10 liters
- Suede
- Ladder or scaffold
- Blades
- Cleaning solution
- Water, with any of the components used to clean glass.
10. CLEANING AND POLISHING OF METALS
Objective: Achieve a more pleasant, clean and hygienic environment.
-25-
Steps to perform:
1. Metal washing.
- Use a solution of a germicidal detergent.

- Apply it with a sponge and rub vigorously.
- Use a cloth suitable for the type of metal (it may be more or less
abrasive).
2. Solvent if necessary.
- To remove old finishing applications or stubborn stain problems.

- Apply the solvent with a brush.
- Let it sit for about five minutes.
- Rub with a cloth suitable for the type of metal.
- Wash with the germicidal detergent solution to remove the solvent.
tea.
3. Rinse and dry
- Use the bucket with the rinse water and a clean cloth.
- Rinse completely.
- Dry it with the clean cloth.
4. Application of metal polish.
- Use a clean cloth.
Apply the polish sparingly.

Remove excess rinse aid with a dry cloth.
Buff out with a soft cloth.
-26-
- A double bucket with a little more than 1 liter of the germicidal

detergent solution, and about 10 liters of clean rinse water.
- A ½ liter bottle of solvent.
- Clean cloths (3)
- A two-inch (about 5 cm) painter's brush.
- A synthetic sponge.
- Metal polish (more or less abrasive cloths).
11. FINISHING THE TABLES (FURNITURE)
(Linoleum and embossing)
Objective: Make the equipment more attractive and keep it clean and
hygienic.
Steps to perform:
1. Prepare the table.
- Remove everything from the table.

- Spread cloths or newspapers on the floor around the table.
2. Remove all traces of resins or finishes.
- Put on rubber gloves.
-27-
- Apply the wax or finish thinner with a brush.
- Let it dry for about 5 minutes.
- Scrub with the steel wool pad in one direction only.
- If you think it is necessary, repeat the operation.
3. Washing the table top.
- Use a cloth and detergent solution.

- Work starting on one side and working your way toward the center.
- Avoid letting the solution spill to the sides of the table.
4. Rinse and dry.
- Use clean water, hot water.

- Dry with a clean cloth.
- Let it dry completely.
5. Apply the resin finish.
- Apply it with the synthetic sponge.

- Make three passes, that is, three coats.
- Let it dry completely between coats.
- Shine the entire table surface with a suede mop.
6. Wipe down the sides of the table.
- Wash with the detergent solution.

- Rinse and dry.
7. Polishing of the sides of the table.
- Apply the polishing product to the furniture with a clean cloth.

-27-
Polish with a clean cloth.
- A double bucket of 4.5 liters of resin solvent and 11 liters of clean

water to rinse.
- Two steel cloth scourers.
- Clean cloths (4).
- A pot of resin.
- Furniture polish.
- Rubber gloves.
- Cloths to cover the ground or newspapers.
- Synthetic sponge.
- Two inch brush (about 5 cm).
12. ROOM STERILIZATION PROCEDURE
Objectives: A preliminary procedure in isolating a room to ensure

increased cleanliness while protecting personal cleanliness.
Steps to perform:
1. Prepare to enter the room.
- Put on the appropriate uniform (gown), mask and rubber gloves.
2. Prepare the furniture and equipment.
- Remove mattresses from beds and place them against the wall.
- Raise the head and foot of the bed.
- Open all drawers and sink doors.
-29-
3. Seal the room.
- Close all windows tightly.

- Seal all air ducts with strong paper and also seal faucets.
- Seal the doors except the bathroom or toilet door, as the case may be,
and the exit door.
4. Manual spray.
- Fill the fumigator with the correct germicide solution.

- Spray both surfaces and sides of the mattress.
- Spray box spring frames, box springs, and bed handles.
- Spray the inside of sinks, toilets and drawers.
- Spray the bottom of the drawers and the bedside table.
- Spray all sink and vanity surfaces.
- Place the fumigator on a chair and with the door closed, fumigate for 5
minutes.
- Put mattresses on top of beds.
5. Automatic spray.
- Refill the fumigator with the germicidal solution.

- Place the cleaner on a rotating table in the center of the room.
- Set the control valve to <<Medium>>.
- Point the spray nozzle toward the ceiling at a 45-degree angle.
- Start the automatic for a maximum duration of 30 minutes.
- Leave the room.
- Seal the room door on the outside with gummed paper.

- Put a <<caution>> sign above the door.
6. Aired out of the room.
-30-
- Wait 30 minutes after fumigation before entering the room. - Unseal
the entrance door and enter the room.
- Open all windows and let the room air out for 15 minutes.
- Remove masks from fans and doors.
- Remove fumigation equipment from the room.
7. Manual cleaning.
- Follow procedure 17 – start with step 5
NOTE: What is said is directed to the Service Nurse responsible for

cleaning an unoccupied room that has been sterilized.
After the patient leaves, the beds must be unmade and the sheets folded,
packaged and sealed, marked with the name <<Sterilization>> and sent
to the laundry. All objects that have been used by the patient of minor
importance should be packaged and incinerated.
All utensils that the patient has used and other similar ones that are of
some importance must be removed from the room and taken to be
cleaned according to the patient's specific orders. ra. After all this, you
must inform the Housekeeping Department that the room is ready.
- Gowns, masks, rubber gloves.

- Fumigator and electric rotating table.
- 5 cm roll of gummed paper for sealing.
- A recommended germicide.
13. CLEANING A ROOM THAT IS OCCUPIED BY A PA CENT
-31-
Objectives: Offer a clean, hygienic and attractive appearance without
disturbing the patient.
Steps to perform:
1. Emptying the waste bins.
- In a garbage cart.
- Clean with a wet mop.
- Wash if you think it is necessary.
2. Dust furniture and fixtures.
- A cloth moistened with germicidal detergent.
3. Clean bathroom fixtures.
- A small bucket with germicidal detergent and a clean cloth.
- Clean electrical installations.

- Pipes, under the drain, mirrors, towel racks, etc.
- Clean the sump with cleaning paste.
4. Clean the shelves in the bathroom.
- Remove utensils.
- Clean shelves and mats with germicidal detergent solution.
- Put the mats and utensils back.
5. Sterilize the water bowl.
- Put the germicidal detergent containing the bowl of the water cup.
- With the help of a brush.
-32-
- Rub vigorously.
- Scrub all seat surfaces with the germicidal detergent solution.
- Clean exterior surfaces.
6. Dust the bathroom room with a dusting mop.
- Use properly treated dust mops.
7. Clean the room and bathroom.
- Immerse the mop in a germicidal detergent solution.

- Drain it very well before applying it to the soil.
- Start scrubbing on the side opposite the door.
- Rinse the mop vigorously in the bucket of clean water.
- If the floor is very dirty, use mopping system No. 2.
8. Remove stains.
- Inspect the walls and doors.

- Remove any stains you see that are no larger than your hand. Notify
your superior if you think the walls need to be washed.
9. Inspect and remove cobwebs.
- Tie a clean cloth around the dusting brush.

- Do everything possible so that the spider web does not break and
remove it all.
10. Inspect curtains and hangings.
- If you see that it is necessary, remove them and place clean ones.
-33-
11. Put the furniture in its place.
- Make sure that everything is in its place as before you started cleaning.
12. Replenish what you see is necessary.
- The paper towels.

- The bathroom towels.
- The soap dish that contains liquid soap or bar soap.
Necessary Utensils and Equipment:
- Double team of mops and squeezers (double bucket with the

dissolution of the
germicidal detergent, and with clean water to rinse).

- A mop
- Special dust mop and manual dust extractor.
- Special cloths for removing dust.
- Paste cleaner.
- Basin with a germicidal cleaner.
- Brush for service.
- Knife.
- Garbage collector and brush.
14. CLEANING A ROOM THAT IS UNOCCUPIED
Objectives: Try to offer a clean, hygienic and attractive room to the new
patient who must occupy it.
Steps to perform:
1. Dust on furniture and facilities.
-34-
- Use special cloths to remove dust.
- Include all furniture, fixtures, lamps, etc.
- Don't forget the little things like sconces, door handles and knobs.
2. Dust bathroom fixtures.

- Light installations, pipes under the drain, mirror, towel rack, etc.
3. Mop the floors.
- Use special clean mops to remove dust.
- Tie a clean cloth around the dusting brush.

- Take care that the spider web does not break.
5. Inspect all room facilities.
- Curtains and draperies.

- The interior and exterior part of the windows.
- The mosaic of the floor and the wall covering.
- The lamps and pipes.
6. Scrub the room and bathroom.
- Dip the mop into the bucket containing the germicidal detergent
solution.
- Drain it very well before applying it to the soil.
- Start scrubbing from the opposite side of the door and work your way
around the room.
- Rinse the mop in clean water as many times as necessary.
-35-
- Continue scrubbing until the task is completed.
In step 6 there is an additional procedure that must be included and that is

that this step must be repeated every three days that the room remains
unoccupied.
Special mops for removing dust.
Special cloth for removing dust.

Clean cloths.
Garbage collection container and brush.
In addition to the above, for scrubbing every three days that the room
remains unoccupied, the following is required:
*Double scrubbing equipment and drainer (a bucket with detergent
solution germicidal tea and a bucket of clean water to rinse).
*A scrubbing mop.
15. CLEANING THE ROOM ONCE THE PATIENT HAS CLEANED IT

BUSY.
Objective: Clean the entire room, all furniture and facilities very
meticulously before another patient can occupy it. Done this way you can
offer a hygienically clean and attractive room. tive.
Steps to perform:
1. Empty the trash cans.
- Collect all utensils from the storage room.

- Wash them with germicidal detergent.
-36-
- Dry them with a clean cloth.
2. Remove dust from furniture and fixtures.
- Use special dusting cloths.

- Includes all furniture, installations, lamps, etc.
- Do not forget about small objects with wall lights, sockets, switches
res, door handles and doorknobs.
3. Clean the bed, furniture and facilities.
- Use a small basin filled with a germicidal detergent and a clean cloth.
- Turn the mattress over and clean it completely.
- Do the same with each piece of the bed and the part that covers the
mattress. Wash the closet drawers, clean the shelves, the hangers,
the telephone.
4. Polish the furniture.

- Apply the polishing liquid with a sprayer.
- Rub, dry and polish with a soft cloth.
5. Polish metals.
6. Clean bathroom facilities.
- Shine with a germicidal detergent and a clean cloth.

- Wash electrical installations, pipes under the drain, mirror, towel rack,
etc.
-37-
- Clean the sump with cleaning paste.
- Notify the nurse if utensils have been removed.
- Scrub shelves and mats with the germicidal detergent solution.

- Put the mats back on the shelves.
- Clean vigorously with a brush.

- Clean the exterior surfaces of the toilet.
9. Replace curtains and draperies.
- Take them to the dry cleaners to have them washed.

- Wash the windows as described in procedure 9.
10. Dust the bedroom and bathroom.
- Use clean special dust mops.
- Avoid splashing on walls or furniture.
12. Remove stains.
- Inspect walls and doors.
-38-
- Clean only small dirty areas.
- Notify your superior if you believe a complete wash of the walls is
necessary.
13. Examine and remove cobwebs.
- Tie a clean cloth around the dusting mop.

- Be careful not to break it.
14. Furniture placement.
- Place the furniture in the same place it was before starting the cleaning.
15. Replace utensils.
- Paper towels.
- Toilet towels.
- The liquid soap or bar soap tank.
16. Fill out the <<Unoccupied Room>> sheet.
- Please register the room number correctly.

- Put everything you think should be notified.
17. Notify Supervisor.
- Double team of mops provided with a wringer (double bucket with the
germicidal detergent solution and clean water to rinse).
- A basin with a little more than a liter with the germicidal detergent
solution.
- Scouring mop.
-39-
- Special dust mops.

- Clean cloths.
- Cleaning paste.
- Lebrillo for the germicidal cleaner.
- Toilet brush.
- Furniture and metal polish.
- A 2 (5 cm) brush.
- A synthetic sponge.
- A glass cleaner with handle and cloth.
- Garbage collection container and brush.
16. CLEANING OF THE ROOMS, DISINFECTION OF THE ROOM

ISOLATED OCCUPIED TION.
Objective: Offer a clean, hygienic and attractive room using the most
modern asepsis techniques.
Steps to perform:
1. Preparations to enter the room.

- Put on your mask, gown, and rubber gloves.
- Put all equipment outside the room next to the door.
2. Empty the trash cans.
- Empty trash cans into a trash bag.

- Wipe the bin with a cloth dipped in the germicidal detergent solution.
3. Wipe furniture, fixtures and window lintels with a wet cloth.
-40-
- Use a cloth dipped in the liquid of the germicidal solution containing
nests in a container.
4. Omit anything that is the exclusive responsibility of nurses.
- The waitress table.

- Bedside shelves, appliances, etc.
- With the germicidal detergent solution and a cloth.

- Pipes left from the drain, mirror, towel rack, etc.
- Clean the sump with the cleaning paste.
- Remove all utensils.

- Scrub shelves and mats with the germicidal detergent solution.
- Replace utensils and mats.
7. Sterilize the water cup.
- Put the germicidal cleaner inside the cup.

- Scrub vigorously with the brush.
- Rub all seat surfaces with the germicide solution.
8. Dust the room and bathroom.
Use a clean dust mop.
-41-
- Dip the mop into the bucket containing the germicidal detergent
solution.
- Drain it well before applying it to the soil.
- Mop the floor starting opposite the door and working your way around
the room.
- Rinse vigorously and if the floor is very dirty use scrubbing procedure
2.
10. Remove stains.

- Remove stains that are no larger than your hand.
- Notify your superior if you think the walls need to be washed.
11. Inspect curtains and draperies.
- Remove them and add others if you think it is necessary.

- Those that are dirty, put them in a plastic bag marking <<this
rilization>>, seal it and send it to the Laundry.
- Put the furniture as it was before starting the cleaning.
- Paper towels.
- Towels from the sink.

- Liquid or bar soap.
-42-
14. Prepare to leave the room.
- Put dust mops, dusting cloths inside a plastic bag.

- Tie it tightly and send it to the Laundry with a note of <<Sterilize
tion>>.
- Put the gown in the bag intended for patient laundry.
- Throw the mask in the waste bag.
15. Equipment used.
- Take it to the storage room.

- Soak the mop in the germicidal solution liquid.
- Remove gloves and wash them carefully.
16. Wash your hands.
- Complete the task by washing your hands as prescribed by the

Nursing Service.
- Gown, mask, rubber gloves.

- Double set of mops provided with wringer (double bucket with the
- Scouring mop.
- Special mop for removing dust.
- Clean cloths (3).
- Germicidal solution.
- Brush for the water.
- Two plastic bags.
- A garbage bag.
- 1 Liter of germicidal detergent solution.
-43-
- Garbage collection container and brush.
17. CLEANING OF THE ROOMS, ISOLATED ROOM THAT IS HERE BA

TO BE UNOCCUPATED.
Objectives: Carefully clean the entire room and all furniture before another
patient occupies it, in such a way that it offers an attractive and hygienic
appearance.
Steps to perform:
1. Research the type of insulation.
The nursing service will let you know if they think the walls need to be
washed. If necessary, the wall washing procedure can be found between
steps 6 and 7.
2. Prepare to enter the room.
- Put on the mask, gown and rubber gloves.
3. Fumigated the room.
4. Aired out of the room.
- Open the windows and close the door.

- Allow time for it to air out.
5. Empty trash cans and ashtrays.
- Empty trash cans into a plastic garbage bag.
-44-
- Scrub them with a cloth that has been dipped in the germicidal
detergent solution.
6. Wash furniture, fixtures and window sills.
- Use a cloth moistened with the germicidal detergent liquid . Scrub the
entire bed, mattresses, covers, all furniture, fixtures, and window sills.
- Take the mattress and cover to a place where it can be ventilated as
much as possible.
- Use the container with the germicidal detergent solution and a cloth.
- Flush the pipes under the drain.
- The mirror, towel rack, etc.
- Clean the drain with cleaning paste.
- Notify the nurse if utensils have been removed.

- Wash shelves and mats with the germicidal detergent solution.
- Put the mats back on the shelves.
- Put the germicidal cleaning detergent into the water bowl.

- Scrub vigorously with the brush.
10. Dust the bedroom and bathroom.
-45-
- Use clean special dust mops.
11. Scrubbing the room and bathroom.
- Rinse carefully.
- Avoid splashes.
12. Polishing of furniture.
- Apply the polish with a sprayer.

- Rub until dry and polish with a soft cloth.
13. Shine metals.
14. Change curtains and draperies.
- Put them inside a plastic bag with the sign <<Sterilize tion>>, seal and
send it to the laundry.
Wash the windows following procedure 9.

Hang clean curtains and draperies.
15. Spot clean.

- Clean only stains that do not exceed the size of your hand.
- Tie a cloth around the dusting mop.
-46-
- Avoid breaking them.
- Try to place the furniture where it was before starting the cleaning.
- The paper towels.

- The bathroom towels.
19. Prepare to leave the room.
- Put the dust mop, dust cloths, and cleaning cloths in a plastic bag.
- Tie the bag tightly and send it to the laundry with a label that says
<<Sterilization>>.
- Put the gown in the sterilization bag in the patient's laundry room.
- Throw the mask in the waste bag.
20. The equipment used.
- Take it to the storage room after you have scrubbed it with the
germicidal detergent solution.
- Soak the mop in the bucket of germicidal detergent solution.
- Wash all equipment in the germicidal detergent solution.
- Remove gloves and wash them carefully.
21. Wash your hands.
- Do it according to the same standards established for nurses.
22. Washing the walls if necessary.
-47-
- In step 6, the furniture and bed must be removed from the room before
washing.
- Follow procedure 7 of Wall Washing using the germicidal solution.
- Clean the machine wash walls and scaffolding before use with
germicidal detergent.
- Operators must wear a mask, gown and rubber gloves.
- When you have finished, follow steps 7 to 21.
NOTE:
What follows is the exclusive responsibility of the Nursing Service in

cleaning a room that has just been vacated and that has undergone a
sterilization operation.
- Immediately after the room has been vacated, the bed is unmade and
the sheets are carefully folded and draped. burned, marked with a
<<Sterilization>> sign, sealed and sent to the Laundry.
All objects used by the patient are thrown into the incinerator.
- All objects not used by the patient and other objects that are part of
the equipment are removed from the room, and are cleaned according
to Nursing Service standards. After this, the room is made available to
the Housekeeping Department.
- Gown, mask, rubber gloves.

- Fumigation and germicide machine.
- Double set of mops provided with a wringer (double bucket with the
-48-
- Cleaning paste.
- Special dust mop.
- Clean cloths (4).
- Bath brush.
- The plastic bags.
- Waste bag.
- Container with 1 liter of germicidal detergent.
- Dustpan and brush.
- Synthetic sponges (2).
- Window and cloth cleaner.
- Furniture and metal polish.
18. DAILY MAINTENANCE, REST ROOMS.
Objectives: Offer an attractive, clean and hygienic appearance.
Steps to perform:
1. Empty waste containers.
- Scrub inside and out with a cloth soaked in germicidal detergent.
2. Scrub the fixtures with a wet cloth.
- Use a cloth dipped in the germicidal detergent solution.

- Include the mirror, electrical installations, pipes under the drain, etc.
3. Clean the shelves.
- Use the cleaning paste.

- Dry and polish with a soft cloth.
4. Disinfect the toilet bowl and urinals.
-49-
- Put the germicide solution inside the water.
- Put on rubber gloves.
- Scrub the inside of the water bowl vigorously with a brush.
- Scrub the top and ridges of the seat with a sponge that has been
dipped in the germicidal detergent.
- Dry and polish all toilets and urinals.
5. Dust the floor with the mop.
- Use special dust mops that are clean.
6. Mop the floor.
- Notify your superior if the floor needs a scrubbing.
7. Replenish supply utensils.
- Paper towels.
- Toilet paper towels.
- The supply distribution machine.
- Double set of mops provided with a wringer (double bucket with the
- Container with 1 liter of germicidal detergent solution.
- Special dust cloth.
- Clean cloths (2).
- Cleaning paste.
-50-
- Toilet brush.
- Waste collector and brush.
- Cellulose sponge.
- A pair of rubber gloves.
- 1 Knife
19. DAILY MAINTENANCE – PUBLIC AREAS
Steps to take.
1. Cleaning ashtrays and garbage cans.
- Clean sand containers; If you think it is necessary, change them.

- Empty and wash ashtrays.
- Empty waste bins.
- Scrub and wash them as agreed.
2. Dust the walls.
- Use special mops intended exclusively for removing dust.

3. Dust the floor.
- Use special 48-inch (just over a meter) dusting mops for hallways and
hallways.
- 12-inch (about 30 cm) mops for narrower areas.
4. Scrubbing the floors.
- Put <<Caution>> signs.

-51-
- Monitor patient, visitor and employee safety.
5. Floor renewal machine.
- Use aluminum scouring pads on vinyl floors.
- Brushes or polishing pads.
6. Clean the windows.
- The procedure to use to achieve correct cleaning is described in

procedure 9.
7. Shiny metals.
- The doorknobs and handles.

- The edges of the trays, the electrical installations.
8. Routine maintenance.
- Repeat the steps outlined above as necessary or directed by

management.
- Double team of mops provided with a wringer (double bucket with the
- A mop to scrub.
- Special 48-inch dust mop (a little more than a meter).
- Special 12-inch (about 30 cm) dust mop.
- Dust container and brush.
-52-
- <<Caution>> signs.
- Metal polisher.
- Special mop for dusting walls 24 inches (1/2 m).

- Knife.
- Window washer utensil and a chamois.
- Floor polishing machine and brushes.
- Clean cloths (3).
20. DAILY MAINTENANCE – LIVING ROOMS.
Steps to perform:
1. Empty ashtrays and trash cans.
- Rub with a damp cloth.

- If you think it is necessary, put them in the dustpan, wash them and
dry them.
2. Dust furniture.
- Tables, chair legs, lamps, etc.

- Brush the upholstery with a brush.
- If you think it is necessary, vacuum.
- Wash and dry plastic coverings on furniture.
3. Dust the window sill.
- Use a special dust mop.
4. Dust the floor.
-53-
- Use a special, clean mop to remove dust.
5. Mop the floor.
6. Shine the furniture.

- Apply the polish with a sprayer.
- Polish with a clean cloth.
7. Shine metals.
8. Clean the windows.

9. Remove stains.

- Clean only stains that are no larger than your hand.
- Notify the supervisor if you believe a complete wash of the walls is
necessary.
- Place the furniture in its place as it was before starting the cleaning.
-54-
- Double team of mops provided with wringer.

- A floor mopping mop of about 60 cm.
- A special dust mop.
- Waste container and brush.
- Special cloth for removing dust.
- Clean cloths (3).
- Metal polish.
- Furniture polish.
- Utensils to clean the windows and a chamois.
- A container with about 6 liters with one part germicidal detergent.
- Brush.
- Manual vacuum cleaner.
21. DAILY MAINTENANCE – STAIRS
Objectives: Offer an attractive, clean, hygienic and safe environmental

appearance.
Steps to perform:
1. Wipe down the railing and stairs with a mop and dust cloth.
- Start at the designated spot on the floor of the stair portion.

- Mop the bottom of it.
2. Pick up waste.
- Use the dustpan and brush.

- Empty it into the waste collector.
3. Dust the walls and trim the windows and railings.
-55-
4. Scrub the handrail and stairs.
- With the mop and cloth well wrung out.

- Carefully remove the gum with the tip of a knife or freeze it with Freon
and remove it with a knife.
- Use the ends of the mop to clean corners.
5. Repeat the same operations indicated above on each flight of stairs

that goes from one floor to another.
Every time you have completed a flight of stairs you should try to gather
all the equipment you are using before starting the lower flight. NOTE:
Using a handheld vacuum cleaner of a type that can be very easily
maneuvered back, until the work of steps 1 and 2 will be done much more
quickly and effectively.
With an extension plugged into the top of the ladder and descend down
the center of the stairs can be easily swept with a vacuum cleaner without
having to constantly change plugs.
- A bucket of about 10 liters fitted with a drainer.

- Special small mop for dusting.
- Blade.
22. DAILY MAINTENANCE – ELEVATORS
Objectives: Offer a clean, attractive and hygienic environmental

appearance in elevators.
-56-
Steps to perform:
1. Dust the floor.
- Put the elevator button plug in the <<Off>> position - stopped.

- Pick up debris with a dustpan and brush.
- Vacuum the floor and door lintels.
- Carefully remove the gums with a knife or freeze them with Freon and
remove them with a knife.
2. Mop the floor.
- Be careful when splashing the walls.
- Rinse the entire enclosure.
- Let the soil dry.
3. Dewaxing machine.
- Use aluminum scouring pads on vinyl floors.

- Synthetic polishing discs on other types of floors.
4. Clean stains from the walls.
- Use a germicidal detergent placed in a container of about 10 liters.
5. Shiny metals.
- Apply the rinse aid with a spray bottle to a clean cloth.

- Buff out with a soft cloth.
-57-
- Double set of mops provided with wringer.

- (Double bucket with the germicidal detergent solution, and with clean
water to rinse).
- A mop to scrub.
- A container of about 10 liters with a solution of the germicidal
detergent.
- Manual vacuum cleaner.
- Floor polishing machine provided with polishing or aluminum brushes.
- Clean cloths (2).
- Special mops to remove dust.
- Waste collection container and brush.
- Blade.
- Metal polish.
23. CLEANING AND DISINFECTION IN CRITICAL AREAS
In these areas, strict cleaning and disinfection is recommended. In this a

key point is the prevention and control of infection.
For the physical plant there are two techniques:
- Recurrent cleaning and disinfection:
It is done daily and repeated 2 or more times a day depending on the

conditions of each area.
Terminal cleaning and disinfection:
It is done when an infected patient comes out or periodically every 8 days.

It is intended to cover all materials, equipment and the entire area
including the top of the walls and windows, as well as the ceilings.
-58-
PROCEDURE FOR CLEANING AND DISINFECTION
- Recurrent:
- Prepare all the necessary equipment, mops, mops and dusters

infected, 2 buckets, gloves, disinfectant solution, bath brush and
clothing (mask, gown if a patient's conditions require it).
- Sweep the floor with a damp mop.
- Then wash with disinfectant solution, sodium hypochlorite.
- Clean windows, blinds, lower part of the wall with disinfectant solution
tant, sodium hypochlorite.
- Wash and disinfect the siphon, toilet, sink and material washing sink,
using sodium hypochlorite.
- The siphon, toilet and material washing sink must be disinfected every
time contaminated substances are poured into them.
- Wash and disinfect the wall and floor of the toilet and septic room until
it is soap-free and dry.
Precautions for personnel doing cleaning and disinfection:
- Wear clean gloves.
- Wear a gown, mask, gaiters if the conditions of some patients require

it.
- Hand washing before and after entering the Intensive Care Unit.
-59-
- Disinfect the mop with sodium hypochlorite before and after use.
- Adhere to specific behavioral standards for each critical area.
Precautions for nursing staff.
- Strict personal hygiene and cleanliness. Use of a gown, mask, hat, if

conditions require it.
- Rigorous asepsis practices in each procedure.
- Wash hands before and after each procedure and dry with a
disposable towel.
- Special care with secretions and excretions.
- Proper disposal of materials, contaminated clothing and waste.
- Disinfection of stretchers and X-ray equipment before entering these

areas.
- Timely cleaning and disinfection of equipment and materials:

respirators,
elements for respiratory therapy, elements for the patient's bath.
- Proper storage of clothing, materials and equipment.
- Rigorous cleaning and disinfection of the patient's unit upon leaving

the hospital.
- The hoses of ventilators and Respiratory Therapy equipment must be

changed every 24 hours and sent to be sterilized.
-60-
- Monitor the appearance of signs of infection in each patient.
- Monitor compliance with the rules of these areas in all personnel who
enter there. X-ray technicians, doctors, cleaning staff, visitors.
- Instruct visitors about the rules they must comply with.
- Avoid the entry of people with respiratory infections.
- Use of disposable probes and sterile gloves to perform any aspiration.
For cleaning and terminal disinfection, the necessary elements are

added. rios for cleaning the upper parts of walls, windows and ceilings.
Also including the cleaning and disinfection of all equipment in each area.
TERMINOLOGY IN DISINFECTION METHODS, ETC.
Sterilization:
Process by which all organisms, both pathogenic and non-pathogenic,

including spores, are destroyed. In an absolute term.
Disinfection:
Spauding defines disinfection as the process that destroys most

microorganisms, but not all forms.
Degermination:
Procedure aimed at reducing the number of germs in an area. Such is the

case of washing hands or cleaning floors.
-61-
Disinfectants:
They are strong agents or substances, usually of a chemical nature, that

do not come into contact with living tissue, but are applied to inanimate
objects, destroying pathogenic microorganisms.
Antiseptics:
They are weaker solutions because there is a danger of damaging tissues

since they are applied to the human body. With sufficient microbial activity
to interfere with the development of the infection.
Bacteriostatic:
Any chemical agent that delays or inhibits the growth of bacteria.
Bactericide:
Any chemical agent that destroys bacteria.
24. CLEANING OF THE OPERATING ROOMS
In most hospitals, those in charge of cleaning the operating rooms are

currently cleaning specialists.
To be able to clean operating rooms, a certain knowledge of microbiology

and electricity as well as considerable mastery of sanitation procedures is
necessary.
Generally, the manager chooses the best-trained personnel for the

operating rooms.
The information that we take into consideration below is very general and
the personnel in charge of cleaning the operating rooms will have to be
-62-
instructed in a much more specific way with the assistance of the health
director and medical staff.
GERMS
The world of microbiology is extremely fascinating. To make this argument

more understandable to everyone we refer to all living microscopic animal
and plant beings as germs.
These germs are alive, they grow and reproduce: they are so small that
they obviously cannot be seen with the naked eye. Germs and bacteria
are found everywhere in our environment: in the air and on all surfaces.
It is said that approximately 80,000 germs are alive and reproducing right
now right in our mouth. Millions are also found on our skin.
PATHOGENIC GERMS
Bacteria come in different shapes and colors, just like human beings, and
have characteristics due to family or origin of permanence. Some are
round, others are rod-shaped or curved like a pig's tail.
Identification of the family under a microscope by an expert will tell which

ones among them can cause diseases and infections. Most bacteria are
harmless to humans. Some are even necessary to prepare food, to help
the digestive system and to eliminate certain foods. There is a small
number of very harmful bacteria and it is this that we will deal with in the
health field. They are called pathogenic bacteria and can cause serious
illness. diseases and infections.
GROWTH RATE
Under ideal conditions, bacteria reproduce approximately every 20

seconds with an increase of the type 2-4-8-16, etc. In twelve hours the
-63-
first initial bacteria may have multiplied by 64,000,000,000.
Bacteria are living cells, and as such, their survival is linked to the
availability of food. Like us, they suffer from cold and heat, and too much
cold or too much heat kills them. Without food they die quickly mind. Dirt
and other organic matter are an excellent food source for bacteria and this
is where our cleaning task begins.
It is we who have to remove dirt and dust. By eliminating dirt and dust we
will also eliminate bacteria.
VULNERABILITY OF MAN
We humans have an innate natural system against bacteria. Our skin is a

natural barrier and when the skin is opened, as in surgical operations, our
line of defense is nullified. Bacteria thus have the possibility of entering
the body and starting their growth. to.
Bacteria present in the air, on doctors' hands, on clothing, and also on the
patient's skin, can penetrate the patient and cause infections or diseases.
If the doctor has clean hands and uniform, if the patient's body is clean,
and the operating room is clean (sanitized), these germs are less likely to
penetrate the patient.
IMPORTANCE OF CLEANING
These are some ways in which patients, and especially those in operating
rooms, can become infected. If the infection is serious enough, the patient
can die. The cleaner the operating room, the less chance types of
infection will exist for our patient. If there are thousands of bacteria around
the patient, it is clear that there will be more chances of infection than if
there are very few. Therefore it is our duty to keep the number of bacteria
as low as possible (control of the bactericidal load). We must therefore
-64-
have the operating areas as free of dirt, dust and bacteria as possible.
The sanitation levels of the operating rooms must be the highest in the
entire hospital.
CLEANING PROCEDURES
The basic techniques currently used in operating rooms are three:

- Mop and double bucket,
- Cleaning with the floor washer,

- Spray cleaning
The person in charge of the operating rooms can use one of these three
techniques or a combination of all of them. We prefer a combination and
we will indicate below the modalities of intervention.
DAILY CLEANING
Daily cleaning:
- Wash your hands and nails with surgical soap for three minutes.
- Put on a clean surgical uniform.
- Clean the lights, furniture and other devices in the room with an
appropriate solution of a germicide.
- Check the wheels of all portable appliances for accumulated debris
and threads if the room has been used overnight.
- Check sinks, soaps and replace brushes.
- Collect waste and clean the entire operating area with a deodorant
disinfectant spray.
- Look under the tables, as sponges, glass, sutures or debris could have
fallen during the night.
- Empty the dirty clothes container, and if necessary, empty the buckets.
-65-
POST-OPERATIVE CLEANING
General instructions for the person in charge of cleaning after an

operation:
- Collect all clothes, paying attention to placing white and green clothes
in separate bags.
- Make sure that no paper or any instrument is left wrapped in the

middle of your clothing.
- Sponges and clothes soiled with blood should be placed in
containers. separate containers for cleaning.
- Napkins, tongs and other instruments should also be collected, when
necessary for cleaning.
- Take dirty clothes out of the room as soon as the room is cleaned.
- Collect the waste and put it in the appropriate bins.
- Collect the stitches and needles and place them in the appropriate
bucket for disposal.
- Remove clothes from the bins and get rid of waste and dirty clothes.
- Wash the buckets with germicidal soap.
- Wash tables, carts and stools.
- Set aside the operating table to verify a possible presence of spon jas
or other instruments.
Move the furniture to one part of the room while cleaning lasts.
SCRUBBING THE OPERATING ROOM FLOOR
Using a clean mop and properly prepared germicidal detergent, cover half
of the floor with an amount of germicidal detergent solution, moving and
scrubbing the mop as you go, allowing it to dry. Move the furniture to the
other part of the room or in the center and finish the cleaning. Check the
-66-
walls for stains and clean them if necessary. They let the objects dry for a
few minutes.
The room will thus be ready for another operation.
CHANGING THE MOP HEAD
After having finished cleaning the room, it will be advisable to eliminate

the solution used and prepare a clean one for later cleaning. It is also
advisable to change the mop head every time. If this is not possible, leave
it submerged in a clean solution of germicidal detergent for at least twenty
minutes.
MISCELLANEOUS CLEANING
Between one operation and another, assuming there is time, check and
clean the rest rooms, those for doctors and nurses. Empty trash cans and
ashtrays, and clean them if necessary. Check that everything is in its
place and proceed with its possible replacement. Wash your hands
carefully whenever necessary.
OPERATIONS TO CARRY OUT DURING THE WEEKLY BREAK
Scrub all the rooms adjacent to the operating rooms with it. Clean the
wheels of furniture and portable appliances. Work with control cards.
Wash the walls of locker rooms, rest rooms, lobbies and workplaces.
Where necessary, clean baseboards and vacuum hallways and sick

rooms; Clean automatic doors, all windows inside and out.
GENERAL CLEANING OF THE OPERATING ROOMS
The cleaning of the operating room in the afternoon would have to begin
-67-
once all the scheduled operations had finished, generally between 6 and
7, and would have to be completed in such a way that the room would not
be used again for a few hours. Every seven days or more often, if
necessary, the operating room would be cleaned from top to bottom.
When you arrive at work, wash your hands with surgical soap for at least
three minutes. Change out of your uniform and put on your regular
surgical uniform, including shoes.
Start gathering the material you need. A double mop, a squeegee, a

ladder, a floor scrubber with suitable abrasive discs, a vacuum cleaner, a
machine for cleaning the walls, or a spray bottle or sponge mop for the
walls, a brush, some cloths, two mops , a germicidal detergent, a
measuring cup (or a measurer), scratching felts, a general detergent in a
spray bottle and a detergent for the glass, also a spray.
CLEANING THE WALLS
Move all furniture and appliances to one side so that there are no
obstacles to movement. Prepare a solution for cleaning the walls with a
germicidal detergent in the correct dilution.
Start the operation of washing the walls from the ceiling. Scrub the entire
ceiling, including the light points.
Continue with the walls. Remember that to scrub the walls, you will have
to start at the top and go down progressively. This will prevent possible
drops from leaving any traces on the walls. If you use a machine to clean
walls, apply the detergent liberally to the entire area and let it sit for at
least five minutes.
After using a rinsing device, go through again and rinse with clean water.
If you use a sponge mop, apply the detergent, leave it for 5 minutes, and
use another mop and pure water to rinse. If you use a machine to clean
walls, apply the detergent liberally to the entire area and let it act for 5
-68-
minutes.
FLOORING CLEANING
Once you have finished cleaning the walls, start cleaning the floors. Make
sure all debris has been vacuumed or swept. Using a bucket with a clean
germicidal detergent, cover the entire pavement. Put an abrasive disc in
the machine and start scrubbing the pavement. Make sure you don't
forget any points. Work starting from the side opposite the door. Remove
the disc from the machine and immerse it in a very powerful germicidal
detergent. Clean the machine well.
WET SUCTION
Start vacuuming up the dirty water with a liquid vacuum cleaner. Dry the
pavement as best as possible. Once the dirty water has been collected,
empty and clean the machine by placing it back in the utensil room.
CONDUCTIVE PAVEMENTS (CONDUCTIVE)
Floor cleaning is a very important operation since it eliminates large

concentrations of bacteria, prevents the accumulation of non-conductive
materials and prevents personnel from slipping.
Many operating room floors are conductive, they prevent the formation of
static electricity and constitute a <<grounding>> for all personnel working
in the room.
I am convinced that everyone has suffered a jolt touching a switch or a

door handle after walking across a carpet.
This shaking is caused by a buildup of static electricity, and in the case of

operating rooms, a tiny spark caused by static electricity could cause a
dangerous explosion. In surgical operations In this case, highly explosive
-69-
gases are often used and a spark could ignite them.
This is another reason why the floors in operating rooms must be

extremely clean, to prevent dust and dirt from isolating people from the
floor, nullifying this "grounding".
DO NOT USE THE SEALANT
Never apply a sealant to conductive floors in operating rooms unless such

application has been authorized by the person responsible for
maintenance or the operating room supervisor.
If a suitable material is not used, this seal would isolate people from the
conductive pavement.
Conductivity readings of the operating room floors are always carried out
once a month.
FURNITURE AND APPLIANCES
While the floor is drying completely, you should clean all furniture and
appliances with a germicidal detergent.
The boards, buckets, baskets should be cleaned carefully, paying special

attention to the wheels, which should always be very clean. The casters
may need to be cleaned with a brush to remove all threads and other
debris.
Once this operation is done and the pavement is dry, make sure that
everything is in its place. Fans should also be cleaned and filters changed
when necessary. Windows and screens must be cleaned both inside and
out.
Once you have finished the operating room, take a general look to make
-70-
sure you have not forgotten anything. Remember that if you forget just
one item, bacteria could spread quickly. This is a fact that must be kept in
mind.
SUBSTERILE STAYS
Start cleaning the sub-sterile area. Clean the ceilings and walls with the
same procedures already indicated. Clean the fans and light points. Also
the autoclave, if there is one.
Toilets are very important in these areas and should be cleaned very
carefully and scrupulously. Clean the sinks inside and out and go through
all the pipes with an aseptic powder or liquid detergent. Rinse and dry with
a clean paper napkin. Make sure the pipes are cleaned periodically with a
good metal detergent to remove rust and stains. Clean the floor with a
germicidal detergent not previously used and use the floor machine.
Check the entire sub-sterile area to make sure everything has been
scrubbed.
After you have finished the operation in an operating room and its sub-
sterile area, move on to the next one. It is advisable to clean the operating
room in this way, at least every two weeks. Many hospitals follow these
procedures maintenance and clean the operating areas weekly. Every
person in charge of the general cleaning of the operating room should be
able to finish at least two operating rooms with their corresponding sub-
sterile rooms during the eight working hours, along with other related
tasks. such as collecting waste, cleaning emergency supplies and other
small things. If the instructions are followed correctly, cleaning an
operating room and its sub-sterile room will be completed in about two
and a half hours.
EXTRA TASKS
-71-
Some sub-sterile areas have rubber or fiber mats. These should be
cleaned daily with a clean germicidal detergent and vacuumed at least
once a week. If possible, they should be steam sterilized once a week.
The cleaning of all areas outside the operating room, such as offices,
work areas, doctors' and nurses' locker rooms, will require daily cleaning
and daily dusting.
Pick up scattered waste and place it in waste baskets. duos. Transport the
waste to the disposal area or to the waste cart. Wet dust all furniture.
Clean daily Clean floors with a wet mop and a germicidal detergent and
remove stains from walls and windows. Rest rooms require daily cleaning.
RESUSCITATION ROOM
In many cases the surgery section is also responsible for the resuscitation
room. Daily cleaning of the resuscitation room will include wet dusting of
furniture and appliances with a germicidal detergent and wet cleaning the
entire floor of the resuscitation room with a mop. A complete cleaning
should be done monthly. This cleaning also includes washing the walls,
light points and cleaning with eventual protective waxing of the floors.
25. CLEANING AND DISINFECTION IN ENDOSCOPY ROOMS
INTRODUCTION
Although reports of the transmission of infectious agents through

endoscopic studies are rare, there is the possibility that the endoscope is
a vehicle in the transmission of infection, given the possibility of infection
by patients with hepatitis or hepatitis A virus. acquired immunodeficiency
disease since the virus has entered the body's blood fluids.
The majority of infections have occurred through direct contact with the
-72-
patient or through equipment contaminated with patients and that has
been poorly disinfected, due to the use of inadequate technique.
In 1978 a group of experts met in order to reach the conclusion of what

the procedure for disinfection and sterilization should be. lization of
equipment to avoid infection.
It is important to establish that since this time the points of view have
practically been maintained and have not changed anything regarding
infection control.
GOALS
Standardize the cleaning and disinfection processes of the Diagnostic

Aids area in order to:
- Provide the patient, who is going to undergo any of the endoscopic

procedures, a safety margin in not transmitting sion of any of the
infectious diseases.
- Achieve good disinfection of the endoscopic equipment used with the

patient to avoid any risk of disease transmission. infectious and
contagious diseases.
- Provide medical and paramedical personnel with security in carrying

out the procedure.
The causes of transmission of the infection in these cases are due to:
- Inadequate cleaning prior to the disinfection and sterilization

procedure lization.
- The use of an ineffective agent for disinfection.
-73-
- Incomplete disinfection due to inadequate exposure time in the
disinfectant.
- The inadequate dilution of the disinfectant used to disinfect the

endoscopic equipment.
CLEANING AND DISINFECTION OF THE ENDOSCOPY AREA:
- Carry out daily cleaning of: Side tables, kidney tables, stretchers; with
soap and water and then spray with a 1:150 mud remover.
- Sweep the floor with a wet system, then clean.
- Wash and disinfect daily with sodium hypochlorite at 200 ppm. the
area or area for washing or disinfecting endoscopic equipment.
- Keep the equipment storage room clean and airy.
PRECAUTIONS FOR MEDICAL AND PARAMEDICAL PERSONNEL:
- Thoroughly wash your hands before and after the procedure.
- Use gloves for any of the procedures.
- Use protective blouses to carry out the procedure.
- Use the plastic apron to protect the endoscopist during

rectosigmoidoscopies or in cases of contact with organic liquids
(blood, vomit, etc.).
- Use protective glasses, masks, hats and gaiters in cases where there
is contact with organic liquids or aerosol formation (cough, vomiting,
etc.). This protection especially for the endoscopist and personnel who
-74-
collaborate in the procedure.
EQUIPMENT CONSERVATION:
- Wash the exterior of the equipment with soap and water, as well as the
internal channels of the equipment, using soft brushes of various
diameters in length in order to remove residues of organic material.
- Immerse the equipment in 2% glutaraldehyde solution for 20 minutes,

protecting the lens of the equipment. Then rinse thoroughly with plenty
of water, including the biopsy channels.
- Dry the equipment very well with 70% alcohol, including the biopsy
channels, since microorganisms tend to multiply in a humid
environment.
- Biopsy forceps and other accessories that do not withstand steam

sterilization should be sterilized in ethylene oxide after each
contaminated case and at the end of the day's work.
- Thoroughly check the equipment to detect damage and send it for

repair. Thus helping to extend the useful life of the equipment.
- Lubricate all sliding parts of the equipment in a suitable substance.

gives for this.
- Place each of the equipment in the storage area, which must be

ventilated; Locate them in such a way that the optical fiber does not
bend or break.
If strict rules are followed by both medical and paramedical personnel,
many problems will be avoided.
CLEANING AND DISINFECTION OF OPERATING ROOMS
-75-
INTRODUCTION
Any cleaning and disinfection process carried out in a hospital center

seeks to eliminate or reduce the number of germs present in an area, thus
reducing the risks of infection.
Taking into account that in surgery rooms the natural defense barriers
against infection, which are the skin and mucous membranes, are broken,
this area has been considered a critical zone from the point of view of
intra-hospital infection.
26. PROPER MANAGEMENT OF HOSPITAL WASTE
Every human activity, such as work, recreation or illness, creates

inevitable byproducts that must be eliminated or destroyed.
The same cleaning service activity, the process carried out on patients for
their recovery and administrative work, etc. contribute yen to the increase
in garbage. If we consider that the objective of cleaning is to leave an area
free of germs harmful to humans, the task only ends once the waste has
been removed.
By properly managing hospital waste, the appearance of the Institution will

be better and it will be safe from fires, accidents, pests and unpleasant
odors.
Garbage management activities must be carried out appropriately gives.
- Containers containing garbage should not remain in high traffic areas

in a way that causes sanitary or aesthetic problems. cos.
- Garbage separation must be done at the source of origin.
-76-
- Garbage should not get stuck or squeezed inside plastic bags as
accidents occur because the hand may come into contact with sharp
or sharp objects hidden in the garbage.
- Garbage should not be emptied from one container to another. Doing

so results in spilled dirt and dissemination of dust into the air, the
proliferation of bacteria, and conditions that facilitate the transmission
of diseases to humans.
There is contamination and generation of unpleasant odors.
STORAGE AREA
They must comply with the following location and driving conditions:
- They will be smooth surfaces to allow easy cleaning and prevent the
shape tion of environments conducive to the development of
microorganisms in general.
- They must have ventilation.
- That they have a water supply.

- That facilitate the prevention and control of fires.
- That prevent the access of insects.
- They must have fumigation.
- Terminal disinfection must be carried out regularly.
- They must be easily accessible for people who, due to their work
status, must be there.
-77-
- They must have accessibility and ease for the management and
evacuation of garbage and conservation of the aesthetics of the
contour.
CHARACTERISTICS OF THE CONTAINERS
Storage containers must be such that contact with the medium is avoided
and may be returnable or disposable.
- The returnables
They must be in such a way that they facilitate the collection process,
made of waterproof material that is easy to clean, equipped with a well-
fitting lid, be closed and covered and that do not allow the entry of water,
insects or rodents, or the escape of liquids, They must be washed
frequently so that they are presented in unobjectionable sanitary
conditions, with protection against mold and corrosion.
- The disposable ones
They must be made of plastic, with similar characteristics that resist the
tension exerted by garbage and its handling. Opaque in color and for
storage they are presented closed with a knot or fixed lashing system.
WASTE TYPES
They are all those residual elements, solid, semi-solid or liquid,

biodegradable or not, that can finally be subjected to a recycling or total
elimination process.
We basically have two types of waste:
-78-
- Ordinary type waste:
Those that are the product of domestic activity. Are:
Garbage: Solid or semi-solid waste of non-food origin.
Food waste: Derived from the handling of general foods We generally

know them as waste.
Feces and excreta: Solid and liquid products from the normal
physiological processes of the human and animal organism.
- Hospital-type waste:
In hospitals, in addition to the previous types of waste, we find other very

specific types:
Material waste: These are all those elements derived from the
procedures carried out in the direct or indirect care of the patient.
Human organic waste: These are the remains of tissue, organs and
parts of the body removed from it for different reasons.
Organic animal waste: Product of laboratory animals.
Industrial waste: From the production of the hospital's own materials and
supplies.
Polluting waste: They can be materials or organics capable of causing

infections or diseases.
-79-
EFFECTS OF WASTE
Among the harmful effects that we most commonly find caused by waste
we have:
Pollutants: Caused by all those wastes that are easily decomposed.

position, such as food, feces and excreta, organics and some materials
because they are not subjected to adequate management in their
collection and disposal, generating contamination to people, animals,
objects and also environmental contamination.
Toxic: Some wastes, due to their physical or chemical characteristics,

their concentration, the type of exposure or storage, can form gases that
cause toxic effects to living beings.
Pathogens: Through waste that due to its characteristics, composition,

use or handling are vehicles to cause infections or diseases in animals
and humans.
Pests: Due to inadequate collection and prolonged exposure of waste in

sites that do not meet the special characteristics, they can create an
appropriate habitat for the proliferation of animals, especially insects and
rodents.
PRESENTATION OF WASTE
The containers intended for the storage of garbage fulfill a specific

function according to their color;
Red container: To store glass, jars, etc. This material is recoverable by

third parties. They accept recycling.
Orange container: To deposit plastic.
-80-
Green plastic container: Contains a gray plastic bag that protrudes 5 or
10 cm. of the edge of the boat and is used to deposit ordinary non-
recoverable waste.
Black plastic bag: To deposit pathogenic solid waste and toxic solid
waste.
Rigid container: To deposit used needles and give them their final
disposal.
SOLID WASTE RECOVERY
Solid waste recovery has several fundamental purposes:
- Reduction in the amount of garbage produced for sanitary disposal.
- Give a new treatment to the waste, modifying its characteristics. cas.

- Recovery of economic values. Solid waste includes: cardboard, paper,
plastic, glass, X-ray plates, wooden boxes, etc.
HARVEST
Garbage collection presents several problems.
The collection frequency should prevent the containers from being

completely filled. Schedules must be selected so that garbage collection is
carried out in all areas, at times that do not coincide with those with the
highest traffic (food, patient cleaning, visits).
Eliminate, as much as possible, the noise that could be produced when

collecting.
There must be separate containers to collect dry garbage and wet
-81-
garbage: they must always remain covered.
Dry garbage is that which comes from daily cleaning, and also includes
solid waste that is recoverable for third parties.
Wet garbage is that from food service, surgery, etc.
FREQUENCY
Collection in each area of the Hospital must have a minimum frequency of

twice a day.
Any person other than the person in charge of this task is prohibited from
uncovering, removing or extracting the total or partial contents of the
garbage containers before their evacuation.
After evacuation, no person can do the above.
When collecting, the plastic bags are closed by tying them at the top and
placed directly in the duct or conveyor cart, depending on its
characteristics.
Before placing new bags in the containers, they must be washed inside
and out to keep them in conditions that do not threaten people's health.
The bags must be introduced into the can so that they protrude 5 or 10 cm
from the upper edge, in order to fold over it.
EVACUATION
The evacuation of waste in the hospital is done through at least two

channels, depending on the hospital's construction system.
- In manual cars.
-82-
- Through the pipeline.
- Garbage evacuation in the manual cart. In the manual cart it

transports dor that is carried through the different areas, there are two
returnable containers (large containers); one of these is used to
deposit the contents of the red container (glass), and the other is used
to deposit the contents of the orange container (plastic).
These wastes are taken to the unusable deposit for later sale.
- Evacuation through the duct. The bag is removed from the container,
closed with a fixed knot and thrown through the duct at the base of
which is a receiving cart with a shock-absorbing element to prevent
the bags from breaking.
LIST OF NECESSARY EQUIPMENT
Floor scrubbing machine
- Rotating discs.
Machine with Brushes
- Fiber scrubbing discs.

- Nylon scrubbing discs.
- Aluminum scourers.
- Synthetic discs.
- Fiber polishing discs.
- Synthetic polishing discs.
- Lamb wool discs.
- Velvet polishing discs.
Vacuum cleaners
-83-
- Vacuum cleaners for both sucking up liquids and collecting dust.
- Stainless steel tanks.
- Manual vacuum cleaners so they can be used on stairs.
Wall washing machine
- Type with two pressure tanks each.

- Scaffold.
scrubbing equipment
The buckets size about 10 liters.
- A mop wringer.
- A mop provided with a corner pad.
- Replacement cotton mop heads in 16 ounces (450 grams) and 24
ounces (750 grams).
<<Caution>> Signs
- Placing 5 signs is enough, or perhaps the department will do it.

maintenance ment.
Dust Mops
- 12 inches (about 30 cm) and 48 inches (about 120 cm) made of cotton
or nylon.
Rolling brush
- Fiber, nylon, or cotton brushes that are easy to change.
Mats for the entrance door
-84-
- About 45 cm in size, made of cotton with several pads to give them a
certain thickness and sewn together along the edges.
Knife
- A sturdy knife of about 3 cm.
A brush for corners
- Type <<V>> fiber or nylon.
Germicidal detergent
- There are now several quality germicidal detergents.

- The solution ranges from about 30 grams to about 175 grams per
about 4 and a half liters of water. This all depends on the effectiveness
of the products you use.
A paste cleaner
- There are a large number of very satisfactory paste cleaners on the

market.
A dewaxer
- Used in conjunction with one of the new synthetic mop pads.

- They do not represent any problem in achieving efficient work.
Germicidal cleaning container
- There are different cleaning containers, all of them contain a

germicide, they are valid in liquid, powder, or pill form.
Metal polishes
-85-
- There is a large amount of good quality to choose from.
Furniture polish
- There is a wide range of good quality furniture polishes to choose

from.
Both in liquid, paste, or in the form of aerosols.
Special dust removal mops
- Both those that are made based on oils and those that are made
based on waxes, all of them are valid, the latter are usually the ones
that are used the most, since they can be applied to all types of floors.
- There are several methods of application to soils; from the spray
method, the entire washing cycle, submerging the mop in the solution
and allowing sufficient time for drying.
Floor finishing
- Nowadays, especially in hospitals, synthetic resin finishes are rapidly

gaining popularity.
- There are a large number of brands with different names, many of

them have been on the market for many years and have been very
successful.
-86-
EQUIPMENT CARE
- Objectives: To ensure the proper functioning of the machines and all

the equipment.
MANUAL EQUIPMENT
Cubes and juicers
- Mops, transport cart, wringers, must be cleaned daily mind. Clean and
put oil on the gears of the garbage containers on top of the transport
cart, change them for others when you think necessary.
- Regularly oil all juicer gears.
- Change the cart stops when you think necessary.
Mops
- Do not twist the mop when wringing.

- Clean the mop, rinse and wring it out after each session.
- Use mop hangers when storing them so the heads do not touch the
floor.
- Use appropriate size mops for each juicer.
Glass cleaner
- Wash and dry them after each session.

- Adjust the tension of the blades, or put others in place when
necessary river.
- A glass cleaner is a professional tool, treat it as such.
Sponges and Chamois
-87-
- Wash and rinse them after use.
- When storing them, put them in a row, or, if possible, hanging them so
that they dry well.
Dust Mops
- Using an electric diffuser, spray the dusting mop so that it is

impregnated with the liquid.
- Put it on the headstock.
- Do not use on wet or oily floors.
- When you see that it is dirty, remove it and put a clean one.
- Wash dirty mops, dry them, or re-spray them with the electric spray
liquid.
FLOOR CLEANING MACHINES
Assemble brushes by hand
- Make sure the machine is unplugged.

- Only start the machine when the brushes have engaged. completely
fixed. Use the appropriate brushes for each task.
Be careful with electrical cables
- Be careful not to step over electrical cables when the machine is

operating.
- Frequently inspect the cables to check for any type of damage that
may have occurred due to continuous use, frays, etc.
Scheduled periodic review
- It should be done by expert electricians or by the men who are in

charge of them.
-88-
- Don't expect minor repairs to get complicated.
- Scheduled inspections will save you time and money.
Brush care
- Remove the brushes from the machine when it is not working.
- Hang brushes or put them on a shelf so the bristles face up.
- Wash the brushes when they are dirty with a solution of the detergent
with warm warm water.
- Be careful not to let the wooden backrests get soaked.
- Let them dry, always ensuring that the strands are facing up.
- Make sure that the retaining hubcaps are securely fastened.
Cleaning and lubricants
- Wipe the machine with a cloth dipped in a container containing a

germicidal detergent solvent.
- Make sure that the engine and electrical parts do not get wet. Put oil in
all the gears and lubricate the engine.
Shine all metal parts.

Keep it in a safe place.
LIQUID VACUUM CLEANERS
Use them correctly
-89-
- Start working next to the machine.
- Walk away from the machine so that both the hose and the electrical
cord follow you.
- Do not return to the machine.
- Use the appropriate accessories.
Electrical cord care
- Wipe the cable with a damp cloth after each session and dry
thoroughly.
- Check the cable regularly to ensure its good condition.
- Take care that the machine does not slide over the cable.
- Wind the cord securely around the top of the machine when you are
finished using it.
Scheduled periodic review
- Be sure of the need for adjustments or repairs.
Make sure that the work is done by expert electricians or special

people lized in this work.
- Negligence in repairing minor damage or improper adjustments can

cause you unnecessary loss of time and money.
Clean and lubricate
-90-
- Wipe the machine inside and out with a cloth moistened with a
germicidal detergent solution.
- Empty and dry the tank after each session.
- Clean and oil the wheels.
- Lubricate the engine according to the instructions recommended by

the manufacturers. songs.
- Store the vacuum cleaner by removing the top for better drying.
LEXICO OF WORDS USED IN HOSPITAL MAINTENANCE
Phenol coefficient
This term applies to disinfectants, or to all those products that have the
power to destroy bacteria or contagious germs. One of the oldest and
most widely used chemicals used for these purposes was pure carbonic
acid. Carbonic acid has many negative facets, and today, there are many
harmful germ exterminating agents that are much more effective. There
are some methods to establish the exterminating power of a product,
always comparing it with carbonic acid as a base, whose power is
definitively established. The term <<phenol coefficient>>, applied to a
product, is the measure of the exterminating power of this product,
compared to that of pure carbonic acid.
For example, when a product has a phenol coefficient of 2, it means that it

is approximately 40 times more effective than carbonic acid and can also
be diluted with 40 parts of water. Likewise, a phenol coefficient of 3
means that it can be diluted with 60 parts of water, etc. And so with each
coefficient. Furthermore, the <<phenol coefficient>> gives us a uniform
basis for comparing one germ-killing agent with another. Due to other
-91-
factors that are not relevant now, this does not always correspond to
reality, but it does give us a fairly reliable approximation.
Use of the dissolution test
Reading the application at the top that tells us about the <<Phenol
Coefficient>>, notice that the word <<approximate>> is used.
Agents that exterminate infectious germs are used to protect human

health and life. The United States Department of Agriculture is responsible
for verifying the use of agents that destroy infectious germs, both for the
protection of animals and humans. And it is this body that, in order to give
a tighter, and not approximate, precision, has ruled on the use of the
dissolution test. In simpler language, it is a test that proves the true
extermination power of infectious germs that a product has, as long as
they are used with the appropriate dilution recommended by the
employment regulations on the use of the product. The Department
-92-
The United States Department of Agriculture requires that it be done this
way and not that the <<Phenol Coefficient>> test be used.
Conductive
The word conductive, applied to hospital floors and the material used for
their maintenance, means that it has the property of allowing electric
current to pass through it.
This refers to the possibility of an ignition source being transmitted to

other flammable materials that exist in hospitals, especially operating
rooms, through a casual spark. Everyone knows that a spark can be
generated by walking on a mat and touching a piece of metal. This is
called <<static electricity>>. If the floors were good conductors, the
electricity generated by the friction of the feet when walking on the carpets
would be distributed throughout the floor, losing all its static force.
However, in a ground that is not a good conductor of electricity, it
accumulates and that is when the spark jumps through the air to the
surface of the metal that has been touched.
It is easily conceivable that with all the movement and rubbing of clothes,
a buildup of electricity is generated that can cause a spark to fly in an
operating room. It is also extremely important It is important that both the
materials and the methods used in the maintenance of soils of this type do
not interfere with the degree of conductivity that is required in these areas.
Germicidal
It is everything that exterminates bacteria, it is especially applied to

chemical agents that kill pathogenic germs but not necessary - -97-
mind to the spores. These chemicals are used for both living tissues and
inanimate objects.
Disinfectants
It is a substance that is applied to a surface that is assumed to be infectious.

The same as <<germicide>>, but with the particularity that the term
<<disinfectant>>, generally applies to a product that serves to kill infectious
bacteria on inanimate objects.
Sanitization products
It is a product that reduces the number of germs or bacteria in order to

guarantee the minimum levels of safety recommended in safeguarding public
health. Widely used in food product plants and restaurants in which the
infectious agents that may be present are not specifically known, but their
presence is suspected. It does not guarantee full protection under all
bacteriological environmental conditions.
Bacteriostat
It is a product that does not destroy all bacteria quickly, but rather slowly and
progressively, preventing their growth or reproduction. If you want a faster
action, germicides should be used, they disinfect teas, or bactericides.
Sanitizing products and bacteriostatics have a very limited action and use.
Chelating
The “chelating agent” in a cleaning product than in a detergent increases the

effectiveness of the product. When combined with insoluble materials, such
as calcium salts, magnesium, etc. makes them soluble in such a way that:
-94-
1st they cannot escape the cleaning power that the product has.
2nd they cannot set to form a film that makes rinsing difficult.
3º they do not combine with fatty soaps, so that they do not form soapy foam.
However, they are capable of dissolving films that have formed on the
surface due to improper use of cleaners or those of very poor quality.
The pH factor
Knowing the pH of a given product gives us a very definite indication of the

product's properties. “pH” is a number that indicates whether the material is
an acid, an alkaline, or neither (neutral). pH number 7 is neutral. Numbers 1
to 6 on the pH scale indicate that it is acidic, and numbers 8 to 14 indicate
that it is alkaline. Acids are stronger when the number is smaller, that is, from
6 to 1, and alkalines are stronger from 8 to 14, according to the pH scale. A
pH indicator of little economic value, it is really very useful in chemical
product supply houses, and a tool of proven effectiveness in maintenance.
ning of all hospitals.
Polymers
Every day more floor finishes are being replaced by synthetic products, many
times primitive waxings are replaced by these products. A “polymer” or “co-
polymer” is a pure synthetic material. This plastic material has been
chemically treated so that it is emulsified and dispersed in water, and when a
surface is sprayed with this emulsion, it dries forming a very thin, uniform and
transparent film. te on this surface. There are many types of “polymers” that
can be used, and depending on the composition of each one, they give
different properties to the floor finish.
Acrylics
-95-
Certain types of chemical polymers are known as “acrylics.”
Not all polymers are “acrylic,” and each type exhibits some properties. that
are inherent to them and that others do not have. Some are harder than
others, others are more lustrous. Some make good uniform films month
above the ground and others not so much.
Every day new types of more perfect acrylics are coming onto the market.
ned, which with the progressive use that is made of them are imposing
themselves, leading us towards a better floor finish.
-96-
INVENTORY OF TASKS CARRIED OUT
Name_________________________
Towel racks
Armchair
Containers
Litter bins
Windows
Date _________________________
22 PROCEDURES THAT MUST BE CARRIED OUT IN THE
Ceiling
Nightstand 1
Chairs
Curtains
Dresser
Lights
Floor
Beds
Walls
Basin
Zone CLEANING A HOSPITAL
—
Name________________________________________
Teaching began________________________________
Number of rooms
Procedure number
1.- Dust with mops

2.- Scrubbing with mops
3.- Scrubbing with disinfectant
4.- Dewaxing floors
5.- Application of floor finish
6.- Floor polishing
7.- Wall washing
8.- Baseboard cleaning
Comments: 9.- Window cleaning
10.- Cleaning and polishing of metals
11.- Furniture finishing
-102-
12.- Room disinfection procedure

Instructions: Inspect anything you see that needs repair and notify your supervisor immediately.
13.- Room cleaning – rooms occupied by a patient
14.- Room cleaning – unoccupied room

15.- Room cleaning – room that has just been vacated by
a patient
16.- Room cleaning – isolated occupied room
17.- Room cleaning – isolated room that has just been
vacated by a patient.
18.- Daily maintenance – rest rooms

19.- Daily maintenance – public areas
20.- Daily maintenance – lobbies
21.- Daily maintenance – stairs
22.- Daily maintenance – elevators
Supervisor
-97-
-98-
No part of the Text may be Reproduced, Stored in a System
of Computer Science, or Transmitted Wholly or Partially, in Any Form or
by any electronic, mechanical, photocopy, recording or other means
Methods, without Prior and Express Written Authorization of
ITEL
(Spanish Technical Institute of Cleaning) .
The amount of subscriptions, books, technical notebooks and videos or audiovisuals

is fully deductible. (Tax regulations Art. 111-112).
-99-

TEMA6 - TEMA7 - Hospital Cleaning and Maintenance Manual

Uploaded by

Copyright:

Available Formats

You might also like

TEMA6 - TEMA7 - Hospital Cleaning and Maintenance Manual

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

TEMA6 - TEMA7 - Hospital Cleaning and Maintenance Manual

Uploaded by

Copyright:

Available Formats

REFERENCE: LN-300

SPANISH TECHNICAL INSTITUTE OF CLEANING

RESEARCH AND ADVICE CENTER FOR CLEANING

TEL.: 93-877 41 01 / 93-877 40 79 - FAX: 93-877 40 78

CLEANING AND MAINTENANCE OF HOSPITALS

<<In 22 Hospital Cleaning Procedures>>, the instructor supervisor will find

Through graphic representations, the supervisor allows the employee to

The Cleaning and Maintenance department of a Hospital is the center

Due to a very careful effort of working 24 hours a day, 7 days a week, it is

A good Cleaning and Maintenance program must be based on three basic

It is this combination that produces maximum efficiency. To achieve

It is also of vital importance to try to raise the morale of the components of

It should be noted that competent supervision and a good training program

1 .- REMOVE DUST WITH MOPS

Public areas, hallways and lobbies.

1. Area in which dust must be removed.

- Use 1.20 m impregnation mops.

2. Pick up debris and dirt.

- Use the dustpan and brush...

3. Changing the mop head.

Patient Rooms and Congested Areas

1. Dust removal area.

- Use impregnated mops of size 45-50 cm.

- Use the dustpan and brush.

3. Changing the mop head.

Utensils and Equipment Needed:

2. SCRUBING WITH MOP AND DOUBLE BUCKET

1. Prepare the area.

Post <<Caution>> badges in public areas.

2. Remove dust from the floor.

3. Apply the scrubbing solution to the mop

- Immerse the mop in the germicidal detergent solution.

4. Collect Dirty Water

- Wring out the mop frequently.

5. Rinse and Dry.

- Use the rinse water.

- Impregnated dust mop.

3. SCRUB WITH STERILIZED MOPS

- Remove dust from the floor with an impregnated mop.

1. Apply the solution.

- As much as necessary to cover the entire area.

- Check that all employees use the appropriate dilution.

Utensils and Equipment Needed:

Objectives: Remove any floor dirt, wax or synthetic finishes before

1. Prepare the area.

- Put <<Caution>> signs.

2. Remove dust with mops.

3. Mopping the floor.

- About 25 liters of hot water in the washing bucket.

4. Scrubbing or polishing machine.

- Steel wool or synthetic pad under the brush of the scrubbing or

5. Collect dirty solution.

- Use the water vacuum cleaner.

- Do not let the solution dry on the ground.

6. Rinse and dry the floor.

- Clean with hot water.

- Follow procedure eight.

Utensils and Equipment Needed