Conclusion & Further Reading

Overview

The importance of environmental cleaning as a fundamental IPC intervention cannot be overstated. Environmental contamination plays a role in transmission of HAIs, which are a significant burden globally and disproportionately affect those in resource-limited settings.

The best practices contained in this document provide the framework for implementing effective environmental cleaning procedures and programs in healthcare facilities in resource-limited settings. While they are structured to be most relevant for resource-limited settings, implementing all the best practices for cleaning supplies and equipment, cleaning procedures, and, most importantly, for cleaning programs will require a strong and sustained commitment, including dedicated staff time and resources. Strong leadership support for environmental cleaning and recognition of the important role that it plays in IPC is a critical prerequisite to implementing these best practices.

It is important that environmental cleaning is implemented within the framework of a functional IPC program while ensuring that a multi-sectorial approach is taken to enable engagement and coordination across the various sectors (e.g., WASH) that have a role to play to ensure a functional and effective cleaning program.

A toolkit for guiding the implementation of these best practices is currently under development. It will use the step-wise approach that IPC improvement programs use extensively. It will also address the need to prioritize actions that target the highest transmission risk based on environmental contamination and patient vulnerability, as well as the foundational program elements, which are needed first in order to build an effective and robust environmental cleaning program over time.

Further Reading

Best practices from high-resource settings

• Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for Environmental Infection Control in Health-Care Facilities. 2003.
• Ontario Agency for Health Protection and Promotion (Public Health Ontario), Provincial Infectious Diseases Advisory Committee. Best practices for environmental cleaning for prevention and control of infections in all health care settings. 3rd ed. [PDF – 250 pages]. Toronto, ON: Queen's Printer for Ontario; 2018.
• The Provincial Infection Control Network of British Columbia (PICNet). British Columbia Best Practices for Environmental Cleaning for Prevention and Control of Infection in All Healthcare Settings and Programs [PDF – 158 pages]. 2016.
• National Patient Safety Agency (England and Wales) – The revised health care cleaning manual [PDF – 174 pages]. 2009.
• Government of South Australia. Cleaning Standards for Healthcare Facilities [PDF – 48 pages]. 2017.
• Targeted training package for cleaning staff, generated for resource-limited settings. Soapbox Collaborative, UK. TEACH CLEAN. 2019.

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