Best practices for organizing cleaning routines in healthcare settings

In a healthcare facility, surface cleaning and disinfection protocols are defined by the institution, with the participation of the infection control committee (CCIH/SCIH) and in accordance with the applicable regulations. These protocols set the products, frequencies and procedures for each area.

The cleaning and support team carries out these protocols rigorously and reports any situation that falls outside the standard. It does not make clinical decisions or change procedures on its own. This clear division of roles is the foundation of a safe operation.

Areas in a healthcare facility are classified by the risk of infection transmission, and each class has its own routine:

• Critical areas: locations with higher-risk procedures or more vulnerable patients, such as surgical suites, ICUs and isolation rooms.
• Semi-critical areas: occupied by patients at lower risk, such as wards and outpatient clinics.
• Non-critical areas: with no patient traffic, such as administrative departments and storerooms.

The classification comes from the institution. It is up to the operation to organize schedules, teams and supplies so each area receives the corresponding routine.

Two routines structure the work in patient care areas:

• Concurrent cleaning: done daily, while the patient is admitted or the room is in use. It covers high-touch surfaces, floors, the bathroom and waste collection.
• Terminal cleaning: more thorough, done after discharge, transfer or death, or at scheduled intervals. It includes walls, furniture and the other surfaces specified in the institution's protocol.

For terminal cleaning, communication with nursing and hospitality services is decisive. Knowing right away that a bed has been vacated shortens the wait for the next admission and keeps the cleaning from being rushed.

Some practices help keep protocols in place on every shift:

• Routes by unit, with the sequence of rooms and areas defined by the institution, generally from the least contaminated area to the most contaminated.
• Supplies identified by color and by area, so a cloth used in an isolation room does not end up in another unit.
• Products diluted in a controlled way or through a dosing system, as directed by the institution.
• Terminal cleaning checklists filled out by the team and checked by supervision.
• A defined workflow for urgent requests, such as spills of biological material, following the facility's specific protocol.

In healthcare settings, training goes beyond cleaning technique. It includes correctly putting on and taking off protective equipment, hand hygiene, identifying isolation areas, waste segregation and what to do in the event of a sharps injury.

Refresher training should be frequent and keep pace with protocol updates. Having the CCIH/SCIH take part in training helps align the team with the facility's rules. The health of the workers also counts, with the vaccinations and medical exams called for in these settings.

Beyond cleaning, support teams may handle the internal transport of materials, such as moving medications between the pharmacy and the units, as well as internal waste collection. Workflows, schedules and recording rules are also defined by the institution.

The team's role is to follow these workflows punctually and with traceability, recording what was delivered, when and to whom. Dispensing and administering medications remain the responsibility of pharmacy and nursing.

Indicators show whether routines are working: the time it takes to release beds after terminal cleaning, inspection compliance, response to requests and completion of training. The results of infection control audits should feed back into the operation as concrete actions.

Regular meetings among contract management, hospitality services and the CCIH/SCIH help adjust whatever is needed. This is how Milclean organizes the contracts it serves in hospitals.