Slide 1: Surface Hygiene and Microfibre Train-the-trainer
Surface Hygiene and Microfibre Train-the-trainer
Slide 2: Welcome
Welcome Think ahead. In this training material we have gathered all the know-how you need in order to establish proper surface cleaning routines to promote a safer care environment in healthcare facilities. It also shows you how to successfully train your cleaning team using our Interactive Clean Ho
Slide 3: Agenda
Think ahead. g The importance of surface hygiene Slide 4 Th Tork Interactive Clean Hospital training e Cleaning strategies Slide 11 a High-touch surfaces Slide 17 ser) Cleaning processes Slide 19 ca Surface cleaning Slide 25 @® Additional cleaning process resources & Mini microbiology school i =) Co
Slide 4: The importance of surface hygiene
The importance of surface hygiene ov,
Slide 5: The importance of surface hygiene
Y The importance of surface hygiene Think ahead. - Itis widely accepted that environmental contamination plays an important role in Clea all ng forms the transmission of certain pathogens in the healthcare environment . the foundation for - The transmission of microorganisms from environmental surfa
Slide 6: Hospital surfaces
QV Hospital surfaces Think ahead. Hospital surfaces can be divided into two groups: 1. those with minimal hand-contact (e.g. floors, and ceilings) 2. those with frequent hand-contact (“high-touch surfaces”) - The methods, thoroughness, and frequency of cleaning and the products used are determined b
Slide 7: Recent evidence of Transmission
——— oy; . . . TORK Recent evidence of Transmission Think ahead. - Daily disinfection reduces acquisition of pathogens on hands (vs cleaned when soiled) - All touchable surfaces are equally contaminated (high vs low touch) - Pathogens can be disseminated from the floor (socks/shoes) to the hands and
Slide 8: HAIs
——— Y HAIs Think ahead. Healthcare associated Infections What is an HAI? - AHealthcare associated Infection, usually referring to a microbial pathogen Where do you get it? - Hospitals, outpatient surgery centres, nursing homes, rehab facilities or wound care services How do you get it? - Inoculated
Slide 9: Why are HAIs important?
QV _ TORK, Why are HAIs important? Think ahead. - HAls are the main cause of death for 136,000 patients per year in Europe & NA (99,000 USA/37,000 EU) - HAls cost €13 billion in direct cost alone - HAls affect 5-10% of all hospital patients - Inthe USA, 2 million patients are affected by HAls annual
Slide 10: Think ahead.
Think ahead. = SS = + & essity
Slide 11: Cleaning strategies: The step approach
Cleaning strategies The 3 step approach
Slide 12: Before you start to clean
& ——— Before you start to clean Think ahead. It is important to conduct a visual preliminary site assessment to determine if: - Patient status could pose a challenge to safe cleaning - There is any need for additional PPE or supplies (e.g. if there are any spills of blood/body fluids or if the patie
Slide 13: 1. From Cleaner to Dirtier
1. From Cleaner to Dirtier Proceed from cleaner to dirtier areas to avoid spreading dirt and microorganisms. Examples include: - During terminal cleaning, clean low-touch surfaces before high-touch surfaces. - Clean patient areas (e.g. patient zones) before patient toilets. - Within a specified pati
Slide 14: 2. From High To Low (Top to Bottom)
2. From High To Low (Top to Bottom) Proceed from high to low to prevent dirt and microorganisms from dripping or falling and contaminating already cleaned areas. Examples include: - Cleaning bed rails before bed legs - Cleaning environmental surfaces before cleaning floors - Cleaning floors last to
Slide 15: 3. Clockwise or Anti-clockwise?
3. Clockwise or Anti-clockwise? Proceed in a systematic manner to avoid missing areas — for example, left to right or clockwise. In a multi-bed area, clean each patient zone in the same manner — for example, starting at the foot of the bed and moving clockwise. Immediately Attend to Body Fluid Spill
Slide 16: Best practices for environmental cleaning of surfaces
& — er Best practices for environmental cleaning TORK of surfaces: Think ahead. - Use fresh cleaning cloths at the start of each cleaning session (e.g. routine daily cleaning in a general inpatient ward). - Change cleaning cloths when they are no longer saturated with solution, for a new, wet cloth.
Slide 17: High-touch surfaces
High-touch surfaces LN
Slide 18: High-touch surfaces
High-touch surfaces The identification of high-touch surfaces and items in each patient care area is a necessary prerequisite to the development of cleaning procedures, as these will often differ by room, ward and facility. Perform assessments and observations of workflow in consultation with clinic
Slide 19: Cleaning processes
Cleaning processes oh
Slide 20: Key factors for successful surface cleaning
iO Key factors for successful TORK | surface cleaning Think ahead. - Verified policies and procedures - Appropriate cleaning and disinfecting products — Training of staff - FSC, housekeeping and nurses — Monitoring compliance and feedback
Slide 21: Spaulding classification of surfaces
Spaulding classification of surfaces Think ahead. Critical Devices which enter normally sterile tissue or vascular system (e.g. surgical devices, catheters) Semi-critical Devices that touch mucous membranes or non-intact skin (e.g. tongue depressor) Non-critical Devices that touch only intact skin (
Slide 22: Treatment of surfaces
iO ——— Treatment of surfaces Think ahead. Treatment of surfaces: — Critical: Clean, sterilise -— Semi-critical: Clean, medium-high level disinfection - Non-critical: Clean, low-medium level disinfection 2 Steps required to properly treat the surface: — Step 1: Clean — Step 2: Sterilise/disinfect (So
Slide 23: Tools of the trade
Tools of the trade Think ahead. - Cleaning chemicals - Disinfecting chemicals — Cloths/wipers — Combo products — wet wipes, 1 step cleaner/disinfectant — Floor tools — Other equipment — UV, peroxide fogger — PPE- gowns, goggles, shields, respirator & essity
Slide 24: Monitoring
Monitoring Monitoring — Non-critical Surfaces —Cleaning - Visual Disinfection —Swab cultures -ATP —Fluorescent marker (GloGerm) — er TORK] Think ahead. Percentage of surfaces cleaned by different measurement methods Rutala, Kanamori, Gergen Sickbert-Bennet, Huslage, Weber. APIC Poster 2017. A fluore
Slide 25: Surface cleaning
Surface cleaning Co
Slide 26: Cleaning surfaces
oa Cleaning surfaces Think ahead. - Surface cleaning is the necessary first step of any disinfection process - Cleaning will remove organic matter, salts and visible soil — but also a substantial amount of unwanted microbes - If the surface is not cleaned before the terminal reprocessing procedures
Slide 27: Difference between cleaning, sanitising and disinfecting
oa What’s the difference between cleaning, sanitising and disinfecting? Cleaning Cleaning uses detergents and water to physically remove dirt, germs and other impurities. It doesn’t always kill microorganisms but reduces the risk of infection spread by lowering the number of germs. Sanitising This p
Slide 28: Basics of surface cleaning
oa Basics of surface cleaning Think ahead. Cleaning — Water is one of the main components of cleaners and disinfectants. It dissolves or suspends soil, which then can be absorbed or picked up using cloths. However, water is not good at dissolving substances such as oil and fat. — Detergents have an
Slide 29: Basics of surface cleaning: Disinfection
oa Basics of surface cleaning Think ahead. Disinfection — Chemical disinfectants have components that kill microorganisms. The types of microorganisms killed by the disinfectant is dependent on the type of chemical, the concentration and the time of exposure. — Other factors that affect the efficacy
Slide 30: Basics of surface cleaning: Disinfection
Basics of surface cleaning Think ahead. Disinfection There are several types of disinfectants used in healthcare; the most common are: — Quaternary Ammonium Compounds — Chlorine Compounds — Hydrogen Peroxide — Peracetic Acid Other types of technology are also being used for disinfection but are reco
Slide 31: Mini microbiology school
Mini microbiology school
Slide 32: Mini Microbiology School
g Mini Microbiology School What are microorganisms? Bacteria — good and bad! Where do bacteria hide and grow? How to find them? How to fight them? Some special microbes of concern in hospitals Think ahead.
Slide 33: Microorganisms on surfaces
ge — er . . TORK} Microorganisms on surfaces Think ahead. The number and types of microorganisms present on environmental surfaces are influenced by the following factors: a) number of people in the environment b) amount of activity c) amount of moisture d) presence of material capable of supporting
Slide 34: What are microorganisms?
ge ——— . . What are microorganisms? Think ahead. — Microorganisms are small —- we can’t see them with our naked eye — But differ in size — mould is the biggest and we can see mould : growing on our food Virus — Examples of microorganisms are mould, yeast, bacteria and viruses — They grow and multipl
Slide 35: Microorganisms are all small
g Microorganisms are all small — but different from each other Bacteria Archaea Eukaria Funghi fF nf = & Lay & e Prost ——— Think ahead. A yeast cell and humans are more closely related than a bacteria and a yeast cell. & essity
Slide 36: A short history of microbiology
ge — er A short history of microbiology Think ahead. 1590s 1796 1864 |1882 | 1929 1953 1995 The first Antonie van Louis Agar Alexander Fleming} Watson & Crick Haemophilus micro Leeuwenhoek Pasteur plates Penicillin DNA structure influenzae first scope first to see bacteria pasteurisation sequenced b
Slide 37: Gram positive and Gram negative
ge ——— Gram positive and Gram negative... Think ahead. Vibrio - Most bacteria can be divided into two Choleae groups — Gram positive and Gram negative — their cell walls are different. - Bacteria have different requirements on Streprococcus for example nutrition. ia Treponema Palladium Clostridium F
Slide 38: Bacteria — good and bad
ge 4 . Bacteria — good and bad Think ahead. Mouth and throat - Most bacteria do not disturb us at all— we are in contact with them every day without noticing - Many bacteria are important for our health and well-being — they are part of our microflora. They help us stay healthy! Stomach - Some bacte
Slide 39: Where in the environment can microorganisms grow?
g Where in the environment can TORK] microorganisms grow? Think ahead. — Almost everywhere where there is water! — Bacteria are very good at finding nutrition — But the environmental conditions select for which microorganisms: — Some bacteria need oxygen to grow - to other bacteria, oxygen is toxic.
Slide 40: In favourable conditions, bacteria can multiply quickly
In favourable conditions, bacteria can multiply quickly On wet surfaces they form slimy layers — biofilms In biofilms they are protected and more difficult to remove or kill. Examples in our homes is on wet surfaces in the kitchen and the bathroom. Examples in nature is on rocks in the sea. Think ah
Slide 41: Pathogens - Prevalence/Resistance
ge Pathogens - Prevalence/Resistance — The susceptibility/resistance of pathogens to antiseptics and disinfectants varies — Common pathogens in outbreaks (hard to kill): C Difficile, Norovirus, Rotavirus, Adenovirus — Most prevalent pathogens in outbreaks (easy to kill): E coli, Staph, Klebiella, E
Slide 42: For how long do pathogens survive on a surface?
g For how long do pathogens survive on a surface? Think ahead. S. aureus (including MRSA) 7 days to > 12 months Enterococcus spp. (including VRE) 5 days to > 46 months Acinetobacter spp. 3 days to 11 months Clostridium difficile (spores) > 5 months Norovirus (and feline calicivirus) 8 hours to > 2 w
Slide 43: How to find bacteria?
ge How to find bacteria? It’s a problem that they are so small... ...and sometimes it’s easier to measure something else to determine the prevalence of bacteria: ATP is an energy rich molecule. It’s found in all living cells like in bacteria, our skin cells, etc. It is an easy and rapid method best
Slide 44: Of special concern in hospitals
ge ——— Of special concern in hospitals Think ahead. Antibiotic Resistant bacteria - e.g. MRSA and ESBL and VRE — Antibiotic resistance is one of the biggest threats to global health, food security and development today. — Antibiotic resistance occurs naturally, but misuse of antibiotics and some bio
Slide 45: MRSA
ge ——— TORK M RSA Think ahead. - Methicillin-resistant Staphylococcus aureus - Staphylococcus aureus can normally be found on skin and in the nose without causing any problems. But sometimes they can cause infections. - MRSAis a Staphylococcus aureus that has become resistant to common antibiotics —
Slide 46: Clostridium difficile
ge ——— Clostridium difficile Lenore Spore former — Some bacteria can form spores - their own survival mode. — Spores are much more resistant to high temperatures, drying, disinfectants, etc. — Clostridium difficile is a spore former that can cause illness. — It produces two different types of toxins
Slide 47: Viruses
ge ——— . TORK] Vi ruses Think ahead. - Viruses are extremely small (20-300 nanometres) - They contain genetic material- DNA or RNA 5 © uv - They can never propagate on its own. They need to infect a living host. Hepatitis B Ebola Virus - Viruses have an outer coat a capsid made of proteins & yy) g 7
Slide 48: Norovirus
ge Norovirus - Isanon-enveloped virus, belonging to the Calicivirus family, that can cause vomiting and diarrhoea. - People with norovirus illness can shed billions of norovirus particles. And only a few particles can make other people sick. Therefore it is easily spread. - Since it’s quite resistan
Slide 49: Corona viruses
ge Corona viruses Corona viruses (CoV) are enveloped positive-strand RNA viruses. Corona viruses are detected in both humans and animals. On the envelope (the outermost membrane) there are club-shaped glycoproteins. These structures anchor the virus to human cell surfaces, which is the starting poin
Slide 50: Microfibre — the science behind
Microfibre — the science behind Y
Slide 51: What is microfibre?
g — er TORK] What is microfibre? Think ahead. - Microfibre is a fibre of <1 denier / dtex, ~100 X’s finer than hair - Microfibres are mostly used for cleaning products (cloths, mops), clothing, upholstery and industrial filters. - Typically microfibre cleaning cloths are made with fibres that are a
Slide 52: Important properties to look for in a microfibre
What are the important properties TORK) to look for in a microfibre? Think ahead. — Fibre Splitting - for the microfibre to work it’s best, the splitting must be optimised — Fineness of the fibre - some cloths might be called microfibre, but they are not by definition (< 1 decitex) — Blend of polyes
Slide 53: Why are microfibres good for cleaning?
g — er Why are microfibres good for cleaning? Think ahead. - When the microfibres are split, they create very fine fibres. How big are microfibres — From the chart, you can see the best cloths 100 have fibres that are smaller than bacteria, viruses, pollen and red blood cells. 80 70 — Since fibres c
Slide 54: Why are microfibres good for cleaning?
——— Why are microfibres good for cleaning? Think ahead. — These very fine fibres aid in cleaning by: — Gaps between split fibres easily pick up dirt and dust but are also fine enough to pick up microbes where big round fibres just push it all around — Polyamide is absorbent, to pick of liquids When
Slide 55: Microfibre Benefits vs Cotton Cloths
Microfibre Benefits vs Cotton Cloths — More effective in microbial removal — Finer fibres have greater surface area which pick up the microbes — Better cleaning performance - Finer fibres have greater surface area which absorb more liquid and pick up more dirt and dust ~ Better durability - Stronger
Slide 56: Why do some use different colour microfibres?
— er @ ; Why do some use different TORK] colour microfibres? Think ahead, High Risk Areas/Washroom Cleaning General Lower Risk Areas (toilets, urinals) (Excluding food areas) — Colour coding let’s patrons know that the microfibre used in the washroom is not the same one used near the patient! — Some
Slide 57: Tork Interactive Clean Hospital training
Tork Interactive Clean Hospital training How to train your cleaning team
Slide 58: About this training
th — er About this training Think ahead. (EE thine aheoa ao | \ [oF dm = J Makes cleaning staff ah [| ; | understand how important \y a a ii _™ - : their work is for the patient ‘ es v | : pt 4 =) safety rn > yoy A \ « 4 F atau ’ \ \ way ae ‘ Very visual and intuitive x AN \_ — ' \ \ \ bs Engaging (
Slide 59: Training contents
es TORK] Think ahead. 1. Cleaning strategy: the 3 step approach and hand & hygiene technique 2 a. Daily cleaning — occupied patient room (based on AHE Practice Guidance) - Steps for cleaning - Tasks 2 b. Discharge cleaning (based on AHE Practice Guidance) - Steps for cleaning - Tasks
Slide 60: How to train your team
——— . TORK, How to train your team Think ahead, Gather your team (preferable 10-20 employees) Make sure you have enough time for questions Access the Tork Interactive Clean Hospital Training on tork.co.uk/surfacehygiene or tork.ie/surfacehygiene Make sure you have access to a big screen Guide your t
Slide 61: How to train your team cont.
How to train your team.cont. During the training - challenge your team on the steps and make sure to highlight the tips and tricks throughout the training Let everyone try it out themselves. The training is available in many different languages. They can access the app on their phone, tablet or comp
Slide 62: Appendix: Additional reading material
Appendix Additional reading material
Slide 63: Additional cleaning process resources
Additional cleaning process resources - CDC - Guideline for Disinfection & Sterilisation in Healthcare Facilities 2009 - OSHA- Employee Safety Laws - AHE - Practice Guidance for Healthcare Environmental Cleaning US - The Joint Commission - Accreditation across hospital, including EVS services - Nati
Slide 64: Contact info
Think ahead. Contact info www.tork.co.uk or www.tork.ie TorkCS.uk@Essity.com or TorkCS.ie@Essity.com & essity
Slide 65: OS SS ee”
OS SS ee” Think ahead.