As patients in your facility are discharged or transferred out of a room, the surfaces in the room will need to be cleaned and disinfected to remove any potentially infectious germs.
During terminal cleaning, your staff will need to complete extra steps in order to prepare the room for the next patient. These extra steps will reduce the chance of germs and illnesses being spread between patients.
While cleaning will include the same process taken to clean the room when it was occupied, low touch surfaces should be cleaned and disinfected as well.
Taking the right steps to make sure patient rooms have been thoroughly cleaned in preparation for the next patient can help you achieve higher patient satisfaction scores.
A sanitary patient area will lower the risk of germ transmission while also leaving a good impression on the people in your facility.
In this article and video, we will explore the 11 steps necessary to prepare patient rooms for the next patient.
What is Terminal Cleaning of Inpatient Rooms?
Terminal cleaning is a cleaning procedure that is performed when a patient is discharged or transferred from a previously occupied patient room.
During terminal cleaning, your cleaning team should fully clean and disinfect all surfaces in a patient room. These surfaces should include floors and patient care equipment.
Why is Terminal Cleaning Important?
Terminal cleaning greatly reduces the chance of illness-causing germs and bacteria being transmitted from one patient to the next.
The thorough cleaning procedures that make up terminal cleaning aim to remove soil load and kill any germs, bacteria, or pathogens that are in the room.
What are the Best Practices for Terminal Cleaning of Inpatient Rooms?
When your janitorial staff is completing terminal cleaning of inpatient rooms, there are some best practices that can ensure that each room is receiving the most effective clean possible.
To achieve the most effective clean, your cleaning team should clean:
- From Cleaner to Dirtier
During terminal cleaning, all surfaces in a patient room will be cleaned and disinfected.
Because of this, your staff should clean low touch surfaces, like the tops of doors and electrical cords, before cleaning high touch surfaces.
By cleaning cleaner surfaces and objects first, the risk of cross-contamination is reduced. If dirtier surfaces are cleaned first, dirt from those surfaces may be transferred to cleaner surfaces, creating an unsafe situation.
- From Top to Bottom
Cleaning from top to bottom prevents dirt, dust, and germs from dropping or falling on any already cleaned areas.
Surfaces, like bed rails, IV poles, and handwashing sinks should be cleaned before the floor to avoid having to clean and disinfect the floor twice.
- In One Direction
By cleaning in one direction, or in a pattern, your cleaning staff can make sure they don’t miss any areas in the patient room.
Your janitorial team can clean from left to right or clockwise starting from the area near the door. Cleaning can also be done from back to front, starting from the furthest wall and ending near the entrance of the room.
What Are The Steps For Terminal Cleaning Of A Patient Room?
Preparing for Terminal Cleaning of a Patient Room
It’s important to prepare for any cleaning or maintenance procedure by gathering the proper tools, commercial cleaning supplies, janitorial cleaning equipment, and personal protective equipment (PPE).
Materials:
- Cloths (Microfiber/Wipers)
- Wet Floor/Caution Signs
- Trash Can Liners
Cleaning Supplies:
- Surface Cleaner
- Disinfectant
- Glass Cleaner
Equipment:
- Vacuum or Dust Mops
- Double Bucket Mopping/Microfiber Mopping System
PPE:
- Gloves
- Eyewear
- Face Mask
To complete terminal cleaning of a patient room in your healthcare facility, follow the steps below:
- Conduct a Preliminary Room Assessment
- Remove Any Soiled or Used Personal Care Items
- Collect Linens From The Patient Bed For Disposal or Reprocessing
- Inspect Window Areas
- Dispose of Trash and Change Sharps Container
- Apply Disinfectant to Trash Cans
- Clean and Disinfect Low Touch Surfaces
- Clean and Disinfect High Touch Surfaces & The Restroom (If applicable)
- Vacuum/Dust Mop Floor As Required
- Damp Mop Floor
- Visually Inspect To Be Sure There’s No Soil Load Left Behind
1. Conduct a Preliminary Room Assessment
Before your staff begins the terminal cleaning, a preliminary visual assessment should be performed.
During this visual assessment, your staff should check for any blood or bodily fluids that need special clean-up.
The area should also be checked for any obstacles, issues, or broken furniture and surfaces that would be hazardous during cleaning.
2. Remove Any Soiled or Used Personal Care Items
Once your janitorial staff has checked the area, any personal items in the patient area should be removed.
Personal care items should be collected and set aside for reprocessing or disposal.
Items that are considered personal care items include cups, dishes, and napkins.
3. Collect Linens From The Patient Bed For Disposal or Reprocessing
After all personal care items have been removed, the patient bed should be stripped and inspected.
Before the linens are removed, your staff should check for sharps in the bed. Sharps are any medical devices with sharp points or edges that can cut or puncture the skin.
If any sharps are found in the bed, they should be disposed of properly into the sharps container.
Next, the linens should be removed carefully so as not to spread germs and bacteria into the air. Your janitorial team should be careful not to shake the bundle.
All four corners should be folded towards the center of the bed to create a bundle.
As the bundle is transferred into the hamper, it should be held away from the body.
When all of the linens have been removed, the mattress should be inspected for any tears or damage. Any tears and damage should be reported so the mattress can be replaced.
If the mattress doesn’t have any damage, the upper and lower mattress surfaces should be cleaned if there are any visible soils. Once the mattress has been cleaned, a disinfectant should be applied and allowed to dwell.
Disinfectants need to dwell on a surface for a specific amount of time to be sure that all of the germs and bacteria on a surface are killed.
After the disinfectant has met the required dwell time, the bed can be remade with fresh linens.
4. Inspect Window Areas
The window area should be inspected for any spots that need to be cleaned and disinfected.
The blinds on the window should be cleaned and disinfected.
It is important that your cleaning team cleans surfaces before applying a disinfectant. Cleaning will remove loose soils while disinfecting will kill any germs and bacteria on the surface.
Next, if there are curtains on the windows, the curtains should be removed to be reprocessed. The curtain rod should be cleaned and disinfected before the soiled curtains are replaced with clean curtains.
5. Dispose of Trash and Change Sharps Container
At this point, the trash cans should be emptied. If there is any large debris present on the floor, it should also be disposed of in this step.
If the sharps container in the patient room is full, it should be removed and replaced with a new, clean sharps disposal container.
6. Apply Disinfectant to Trash Cans
After the trash has been emptied, your staff should apply a disinfectant chemical to the interior and exterior of the trash can.
The disinfectant chemical should be allowed to dwell and dry before a new can liner is inserted.
7. Clean and Disinfect Low Touch Surfaces
Low-touch surfaces are areas in the patient room that aren’t touched often by people in your facility.
In a patient room, low touch surfaces include:
- Tops Of Doors And Door Frames
- Ceiling Vents
- Light Fixtures
- Top Of The Television
- Picture Frames
- Air Conditioning Vents
- Heat And Floor Registers
- Electrical Cords
- Tops Of Shelves
- Moldings
Though these surfaces aren’t touched frequently, they should still be cleaned and disinfected thoroughly.
Remember, these surfaces and objects should be cleaned from top to bottom to avoid needing to reclean areas that can get soiled from any dust, dirt, or soils dropping.
At this point, non-critical items can be cleaned and disinfected as well. Non-critical items are items that are used by healthcare workers to touch patients and may be shared between patients.
Non-critical items include:
- IV Poles
- Commode Chairs
- Blood Pressure Cuffs
- Stethoscopes
Your staff should be sure that each surface is cleaned before being disinfected. Once the surfaces have been cleaned, a disinfectant should be applied and allowed to dwell for the appropriate amount of time.
8. Clean and Disinfect High Touch Surfaces & the Restroom (If applicable)
After the low-touch surfaces have been cleaned and disinfected, your cleaning staff should clean and disinfect high-touch surfaces in the patient room.
High-touch surfaces are surfaces in the patient room that are touched frequently and will hold germs that can spread illness from patient to patient.
Your janitorial team should take care to clean and disinfect all of the high-touch surfaces.
As we have mentioned, your staff should first clean these objects and surfaces, and then apply a disinfectant. The disinfectant should be allowed to dwell for the required amount of time to ensure that all of the pathogens listed on the product label are being killed from the surface.
During this step, your janitorial team should also clean and disinfect surfaces in the patient restroom.
9. Vacuum/Dust Mop Floor As Required
Once all of the surfaces and objects in the room have been cleaned and disinfected, the floors should be dust mopped or vacuumed.
If a dust mop is used, the dust mop should be run over the entire surface of the floor to collect any dust and small debris. Be careful not to lift or shake the dust mop to avoid any airborne dust particles.
A vacuum can be used to clean the floors. Vacuums with a HEPA filter will be able to trap any dust and dirt that would be redistributed into the air.
10. Damp Mop Floor
The floor should be damp mopped using a microfiber flat mop and a neutral floor cleaner. When damp mopping has begun, your staff should put down a wet floor sign to alert anyone entering the room that the floors are wet.
Using a microfiber flat mop will allow your team to clean the floors using less water.
Floors should be mopped from the inner corner towards the door so your staff doesn’t step on the clean floors. If your staff doesn’t work from the inner corner, they may have to perform reworks.
11. Visually Inspect To Be Sure There’s No Soil Load Left Behind
After terminal cleaning is complete, your staff should perform another visual inspection of the patient area.
During this inspection, your janitorial team should check that each area has been thoroughly cleaned and disinfected.
The wet floor sign should be removed once the floor is dried and safe to walk on.
Final Thoughts
Terminal cleaning is important to set up a clean and sanitary area for the next patient.
By completing thorough terminal cleaning, your staff will reduce the chance of germ spread and illness in your facility. Terminal cleaning of patient rooms will ensure that any residual bacteria from the previous patient are removed.
Having a clean and sanitary patient room ready for new patients will also contribute to increased patient satisfaction scores.
If you’re located in the United States, Puerto Rico, the Caribbean, or Canada contact a specialist today for a full review of your current patient room cleaning protocols to help identify ways to increase patient satisfaction scores and to help you create the best terminal cleaning program for your facility.
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