Hospital and clinic cleaning guidelines
Patients, staff, and visitors entering health care facilities carry with them bacteria, viruses, and other microbes. Because of this, cleaning and disinfecting are some of the most important steps in preventing the acquisition and spread of infectious disease in health care facilities.
General cleaning involves dirt and dust removal using detergents, scouring powders, toilet bowl, and glass cleaners. This aspect of hospital cleaning is similar to that of an office building or hotel.
In some areas of the hospital, the use of disinfectants is necessary to reduce the risk of infection. Disinfection is generally defined as reducing the number of microbes on a surface to very low levels. Reducing microbial levels involves the use of chemicals, which are considered pesticides and vary in degree of toxicity.
The varying levels of disinfection used in a health care facility may be defined by Spaulding’s Classification (CDC, 2003). Spaulding’s levels, non-critical, semi-critical, and critical, are based on the potential for infectious disease spread via equipment, instruments, and furniture as well as the level of sterility normally required for the body part coming in contact with it. Levels of disinfection that correlate with Spaulding’s classification are low, intermediate, high, and sterilization. The US Centers for Disease Control (CDC) has further delineated disinfection levels for environmental surfaces in its “Guidelines for Environmental Infection Control in Health-Care Facilities”.
Ultimately, waiting areas often need cleaning only; patient rooms need cleaning and low level disinfecting and surgical suites require high-level disinfection and sterilization of instruments. These complex regimens can create confusion, which can lead to multiple disinfectants being used or surfaces unnecessarily being disinfected. This practice results in an increased use of pesticides, exposure risk for staff and patients, and potential for spreading antimicrobial resistance.
Without systems in place for selecting and purchasing cleaning chemicals a facility may have multiple chemicals in use. As an example, a hospital may have five different products on the shelf for each cleaning or disinfecting application. Multiple chemical products in use are not only costly, but make it difficult to manage in terms of safety, proper training, hazard communications, security, and waste management.
The following list classifies a variety of commonly used items found throughout areas of health care facilities. It is organized according to Spaulding’s levels and by the degree of cleanliness or disinfection needed. Cleaning and disinfecting appropriately helps health care facilities ensure adequate infection prevention, while reducing cleaning times, minimizing patient and staff exposures to toxic chemicals, and reducing procurement costs.
Patient Room / Patient Exam Room / Operating Room / Waiting Room / Dining Area / Work StationPatient Care Areas
All surfaces are Spaulding classified as non-critical. The list below indicates the appropriate level of clean or disinfection for surfaces typically found in a hospital patient care room.
|
|
Bed cords |
|
Bedside table (where phone is) |
|
Blinds |
|
Cabinet |
|
Cabinet handles |
|
Carpet floor |
|
Chair adjuster remote - plastic |
|
Chairs-plastic |
|
Chairs - vinyl seat & cloth back |
|
Chairs - vinyl |
|
Clock |
|
Cloth chairs |
|
Coat hooks |
|
Coat rack |
|
Computer |
|
Cords |
|
Cords and tubes on wall |
|
Countertops |
|
Curtain |
|
Desk chair |
|
Desk/countertop |
|
Display case |
|
Door |
|
Door handle |
|
Electric cords |
|
Fan |
|
Floor |
|
Foot pumps for soap |
|
Hand mirror - plastic |
|
Intercom on wall |
|
Lamp |
|
Light fixtures |
|
Lights on ceilings |
|
Lockers |
|
Metal racks |
|
Metal shelves |
|
Microwave |
|
Mirror |
|
Monitors and cords |
|
Oxygen tank |
|
Oxygen units on wall |
|
Paper towel dispenser |
|
Patient food table |
|
Pictures on walls |
|
Power cords |
|
Racks |
|
Radio |
|
Sharps container |
|
Shelves |
|
Shelves - wood & metal |
|
Sides of exam table |
|
Table |
|
Tile floor |
|
TV |
|
Valves on wall |
|
VCR |
|
Vents |
|
Wall equipment |
|
Walls |
|
White board |
|
Window |
|
Window sill |
|
|
Baby scale |
|
Bassinet |
|
Bed equipment |
|
Blood pressure equipment |
|
Crutches |
|
Drawer handles |
|
Emergency button |
|
Emergency call cord |
|
Equipment knobs |
|
High chairs |
|
Incubator |
|
Infant warmer |
|
IV stand |
|
Keyboard |
|
Lifts |
|
Light switches |
|
Linen bag handles |
|
Lounge chair in patient room |
|
Remote |
|
Telephone |
|
Telephone cord |
|
Units on walls |
|
Wheel chairs |
|
Low Level Disinfection or Removal |
|
Suction canisters |
|
Low-Intermediate Level Disinfection |
|
Bed |
|
Bed mattress |
|
Bedrails |
First categorized by Spaulding classification and then within each chart by appropriate levels of clean or disinfection for surfaces typically found in a patient exam room.
Non-critical
|
|
Blinds |
|
Cabinet |
|
Cabinet handles |
|
Carpet floor |
|
Chairs - plastic |
|
Chairs - vinyl seat & cloth back |
|
Chairs - vinyl |
|
Clock |
|
Cloth chairs |
|
Coat hooks |
|
Coat rack |
|
Computer |
|
Cords |
|
Cords and tubes on wall |
|
Countertops |
|
Curtain |
|
Desk chair |
|
Desk/countertop |
|
Display Case |
|
Door |
|
Door handle |
|
Electric cords |
|
Fan |
|
Floor |
|
Foot pumps for soap |
|
Foot stool |
|
Foot stool on exam table |
|
Gloves holder |
|
Intercom on wall |
|
Lamp |
|
Light fixtures |
|
Lights on ceilings |
|
Metal cart |
|
Metal racks |
|
Metal shelves |
|
Mirror |
|
Monitors and cords |
|
Paper towel dispenser |
|
Pictures on walls |
|
Power cords |
|
Racks |
|
Sharps container |
|
Shelves |
|
Shelves wood & metal |
|
Sides of exam table |
|
Step stool |
|
Stool |
|
Tile floor |
|
Trash can |
|
Valves on wall |
|
Vents |
|
Wall equipment |
|
Walls |
|
Window |
|
Window sill |
|
|
Blood pressure equipment |
|
Crutches |
|
Drawer handles |
|
Emergency button |
|
Emergency call cord |
|
Equipment knobs |
|
Exam chair |
|
Height measurer |
|
Hot/Cold shower handles |
|
Keyboard |
|
Lifts |
|
Light switches |
|
Linen bag handles |
|
Oxygen tank |
|
Telephone |
|
Telephone cord |
|
Units on walls |
|
Wheel chairs |
|
Low to Intermediate Level Disinfection |
|
Exam table |
Semi-Critical to Non-Critical
|
|
Exam table |
First categorized by Spaulding classification and then within each chart by appropriate levels of clean or disinfection for surfaces typically found in an operating room.
Non-Critical
|
Neutral Cleaner |
|
Tile floor |
|
Trash can |
|
Valves on wall |
|
Wall equipment |
|
Walls |
|
Window |
|
Window sill |
|
Low Level Disinfectant |
|
Units on walls |
|
Low Level Disinfectant or Removal |
|
Suction canisters |
Semi-Critical
|
|
Operating table |
Ancilliary Areas
All surfaces in this area are Spaulding classified as non-critical. The list below indicates the appropriate level of clean or disinfection for surfaces typically found in a clinic or hospital waiting room.
|
|
Chairs - plastic |
|
Chairs - vinyl seat & cloth back |
|
Chairs - vinyl |
|
Clock |
|
Cloth chairs |
|
Coat hooks |
|
Coat rack |
|
Computer |
|
Cords |
|
Cords and tubes on wall |
|
Countertops |
|
Curtain |
|
Desk chair |
|
Desk/countertop |
|
Display case |
|
Door |
|
Door handle |
|
Electric cords |
|
Fan |
|
Floor |
|
Fold up chairs |
|
Ice/Water machine |
|
Light fixtures |
|
Lights on ceilings |
|
Monitors and cords |
|
Pictures on walls |
|
Power cords |
|
Racks |
|
Shelves |
|
Shelves wood & metal |
|
Tile floor |
|
Trash can |
|
TV |
|
VCR |
|
Vinyl bench |
|
Wall equipment |
|
Walls |
|
Water fountain |
|
Window |
|
Window sill |
|
X-ray light |
|
|
Crutches |
|
Drawer handles |
|
Keyboard |
|
Light switches |
|
Remote |
|
Telephone |
|
Telephone cord |
All surfaces in this area are Spaulding classified as non-critical. The list below indicates the appropriate level of clean or disinfection for surfaces typically found in a hospital dining area.
|
|
Refrigerator |
|
Table |
|
Tile floor |
|
Trash can |
|
Vents |
|
Wall equipment |
|
Walls |
|
Window |
|
Window sill |
|
|
Units on walls |
All surfaces in this area are Spaulding classified as non-critical.
The list below indicates the appropriate level of clean or disinfection for surfaces typically found in a hospital work station.
|
|
Refrigerator for flowers |
|
Tile floor |
|
Trash can |
|
Ultra warmer for gel |
|
Vents |
|
Wall equipment |
|
Walls |
|
Window |
|
Window sill |
|
| Stethoscopes |
|
Ultrasound equipment |
|
Units on walls |
Additional Resources
