Healthcare has become one of India’s largest sectors – both in terms of revenue and employment. The industry comprises hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance and medical equipment, etc. In India, the sector is growing at a brisk pace due to its strengthening coverage, services and increasing expenditure by public as well private players.
Rajesh Wariar, national manager – sales, IP Cleaning India
Equipment for cleaning hospitals
Cleaning and decontamination form an important part of an outbreak control plan to maintain the property. Hospitals should not be only cleaned but also be cleaned “hygienically” with the help of mechanised tools. These cleaning equipments and their specialised maintenance and repair may cost more (when compared to traditional cleaning devices) but the results are ideal for the need of a healthcare centre. Depending on the resource availability, cleaning equipments such as below should be added to the inventory and regularly used:
IP Cleaning India
Special carts: Cleaning carts may feature shelves, doors, trash receptacles, or mop buckets. For the paediatrics ward, a cart with a lockable door would be preferred.
Floor machines: While purchasing floor machines, it’s imperative to consider ease of operations, safety features, strength of the motor, availability of spare parts, and after-sale services. Commonly, floor machines are available in sizes from 12 to 23 inches. Smaller diameter machines should be preferred for cleaning crowded OPD, patient care area, narrower corridors, etc. Areas that are larger in size such as wide corridors, reception area, etc would need equipment such as ride on scrubber drier is an ideal choice as it provides a better, faster and economical solution. Meanwhile, articles such as soaps, chemicals and disinfectants should be standardised.
Basic cleaning zones
In hospitals, environmental surfaces are cleaned, or cleaned and disinfected, regularly – perhaps, hourly, daily, thrice a week – when surfaces are visibly soiled, when there are spillages and always after a patient is discharged. The type and frequency of routine cleaning depends upon clinical risk, patient turnover, and intensity of people-traffic as well as the type of flooring. All hospitals should provide a written specification of cleaning services and their delivery for all areas of the hospital, whether provided by inhouse or outsourced, contracted staff. These should be reviewed on a regular basis by cleaning supervisors, infection control and hospital managers, etc:
• Physical removal of visible debris and litter
• Detergent and water for surfaces to remove visible dirt, stains, smears, grease
• Disinfectant and detergent combinations
• Disinfectants by steam cleaning activity
Focused areas of cleaning
Frequent hand-touch sites such as door handles, taps, keyboards, telephones, light switches, etc, are environmental surfaces that pose an increased risk of pathogen transmission. However, there is a wide range of sites and surfaces in the healthcare environment that require cleaning, with or without disinfection, on a routine basis. These include:
• General surfaces such as floors, walls, corridors, stairs
• Bathrooms, toilets, bed pan washer
• Treatment rooms, storage rooms and cupboards, ward kitchens
• High risk unit or ward; surgical theatre environment
• Clean rooms (formulation of medicinal products)
• Outpatient clinics, hospital shops, cafes and kitchens
• Hospital building estates premises
Ideal cleaning schedules
The type and frequency of routine cleaning depends upon clinical risk, patient turnover, and intensity of people-traffic as well as surface characteristics.
Routine daily cleaning: This includes, for example, all wards and clinics (spot checks, spillages or incidents may dictate additional cleaning).
Multiple daily cleaning: This is essential for high risk areas such as critical care, special care baby unit, clean rooms, haematology and transplant units, surgical theatres, oncology wards, etc. These routines can be monitored by the following methods:
• Visual inspection
• Chemical assessment (ATP bioluminescence)
• Microbiological screening
• Cleaning assessment framework
Regular training of cleaning staff plays a major role in day-to-day efforts to maintain hygiene. Housekeeping staff should be trained to work with machines to harmonise and reduce the effort and cost. This will not just increase productivity but also ensure optimisation of manpower and machinery