Hospital and Clinic Cleaning Guidelines – Courtesy, Regents of the University of Minnesota

Hospital and Clinic Cleaning Guidelines – Courtesy, Regents of the University of Minnesota. In Hospitals, the Use of Disinfectants is Necessary to Reduce the Risk of Infection. Varying Levels of Disinfection Used in a Healthcare Facility May Be Defined by…

In Hospitals, the Use of Disinfectants is Necessary to Reduce the Risk of Infection

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.

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 that vary in degree of toxicity. Patients, staff, and visitors entering healthcare 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 healthcare facilities.

Varying Levels of Disinfection Used in a Healthcare Facility May Be Defined by Spaulding’s Classification (CDC, 2003)

Spaulding’s Levels Are Non-Critical, Semi-Critical, and Critical

Levels of disinfection that correlate with Spaulding’s classification are low, intermediate, high, and sterilization. The classification levels 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 that may be coming in contact with it. 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”.

Waiting Areas often need cleaning only while 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 chemicals, exposure risk for staff and patients, and potential for spreading antimicrobial resistance.

Medical Facilities Need Systems in Place for Cleaning Chemical Use

Without systems in place for selecting and purchasing cleaning chemicals, a facility may have multiple chemicals in use. Using multiple chemical products is not only costly, but makes 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 Healthcare Facilities

It is Organized According to Spaulding’s Levels and By the Degree of Cleanliness or Disinfection Needed

NOTE – Appropriate cleaning and disinfecting helps healthcare facilities ensure adequate infection prevention, while reducing cleaning times, minimizing patient and staff exposures to toxic chemicals, and reducing procurement costs.

Patient Care Areas

Patient Room Non-Critical

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.

Neutral Cleaner		Low Level Disinfectant	Low Level Disinfection or Removal
Bed cords	Bedside table (where phone is)	Baby scale	Suction canisters
Blinds	Cabinet	Bassinet	Low-Intermediate Level Disinfection
Cabinet handles	Carpet floor	Bed equipment	Bed
Chair adjuster remote – plastic	Chairs-plastic	Blood pressure equipment	Bed mattress
Chairs – vinyl seat & cloth back	Chairs – vinyl	Crutches	Bedrails
Clock	Cloth chairs	Drawer handles
Coat hooks	Coat rack	Emergency button
Computer	Cords	Emergency call cord
Cords and tubes on wall	Counter tops	Equipment knobs
Curtain	Desk chair	High chairs
Desk/counter top	Display case	Incubator
Door	Door handle	Infant warmer
Electric cords	Fan	IV stand
Floor	Foot pumps for soap	Keyboard
Hand mirror – plastic	Intercom on wall	Lifts
Lamp	Light fixtures	Light switches
Lights on ceilings	Lockers	Linen bag handles
Metal racks	Metal shelves	Lounge chair in patient room
Microwave	Mirror	Remote
Monitors and cords	Oxygen tank	Telephone
Oxygen units on wall	Paper towel dispenser	Telephone cord
Patient food table	Pictures on walls	Units on walls
Power cords	Racks	Wheel chairs
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

Patient Exam Room Non-Critical

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.

Neutral Cleaner		Low Level Disinfectant	Low-Intermediate Level Disinfection
Blinds	Cabinet	Blood pressure equipment	Exam table
Cabinet handles	Carpet floor	Crutches
Chairs – plastic	Chairs – vinyl seat & cloth back	Drawer handles
Chairs – vinyl	Clock	Emergency button
Cloth chairs	Coat hooks	Emergency call cord
Coat rack	Computer	Equipment knobs
Cords	Cords and tubes on wall	Exam chair
Counter tops	Curtain	Height measurer
Desk chair	Desk/counter top	Hot/Cold shower handles
Display Case	Door	Keyboard
Door handle	Electric cords	Lifts
Fan	Floor	Light switches
Foot pumps for soap	Foot stool	Linen bag handles
Foot stool on exam table	Gloves holder	Oxygen tank
Intercom on wall	Lamp	Telephone
Light fixtures	Lights on ceilings	Telephone cord
Metal cart	Metal racks	Units on walls
Metal shelves	Mirror	Wheel chairs
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

Semi-Critical to Non-Critical

Low to Intermediate Disinfection

Exam table

Operating Room Non-Critical

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.

Neutral Cleaner	Low Level Disinfectant	Low Level Disinfection or Removal
Tile floor	Units on walls	Suction canisters
Trash can
Valves on wall
Wall equipment
Walls
Window
Window sill

Semi-Critical

Low to Intermediate Disinfection

Operating table

Ancilliary Areas and Waiting Room Non-Critical

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.

Neutral Cleaner			Low Level Disinfectant
Chairs-plastic	Chairs – vinyl seat & cloth back	Chairs – vinyl	Crutches
Clock	Cloth chairs	Coat hooks	Drawer handles
Coat rack	Computer	Cords	Keyboard
Cords and tubes on wall	Counter tops	Curtain	Light switches
Desk chair	Desk/counter top	Display case	Remote
Door	Door handle	Electric cords	Telephone
Fan	Floor	Fold up chairs	Telephone cord
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

Dining Area Non-Critical

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.

Neutral Cleaner

Refrigerator

Table

Tile floor

Trash can

Vents

Wall equipment

Walls

Window

Window sill

Low Level Disinfectant

Units on walls

Work Station Non-Critical

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.