Healthcare Facility Disinfecting Practices & How to Hire the Right Crew

Best Practices for Cleaning Healthcare Facilities: Why Your In-House Team Isn’t Cutting It and Who to Call to Annihilate Viruses

You look around at your healthcare facility and each surface is sparkling. Your in-house team has sanitized every high- and low-touch surface they can find with EPA-registered chemicals like Oxivir TB or hypochlorite and peracetic acid. 

But how safe is your facility really? How safe are your patients? What your in-house team doesn’t know about the complexities of cleaning, sanitizing, and disinfecting could lead to damaging consequences. When dealing with new insidious viruses like COVID-19, you need a professional team to come on board and take over to ensure every square inch of your facility is properly armed against disease and pathogens.

Most methods and materials for cleaning examination rooms may not be adequate for cleaning other areas, such as operating and isolation rooms. These aspects of cleaning are where your crew is likely going astray. By understanding established safety standards and best practices, and knowing how to take care of things when a professional cleaning crew is not on-hand, your facility can be a safe, comfortable haven for all patients and staff members. 

What You Can’t See Can Hurt You: Why Proper Cleaning, Sanitizing, and Disinfecting Is Imperative

Without proper cleaning, sanitizing, and disinfecting, microbes and pathogens run amok. These are the organisms that can cause viral and bacterial infections in high-risk health and medical facilities.

For instance, the virus that causes COVID-19 is mainly spread via respiratory droplets. One droplet from a sneeze or cough is all it takes to infect someone nearby. Even though viruses like COVID can’t be absorbed through the skin, breathing in the virus or touching your face or wiping your eyes after contacting a droplet can cause the virus to spread quickly.

With a new virus comes the demand for reinforced cleaning, sanitizing, and disinfecting procedures that show no mercy to these nefarious pathogens and germs. If you don’t understand the efficacy of these procedures on virus control or like to see the numbers behind the science, recent studies prove that proper disinfection is imperative.

For instance, a study from the National Institutes of Health revealed that SARS-CoV-2, the virus responsible for COVID-19, can remain on plastic surfaces for up to three days, stainless steel for two to three days, and cardboard for 24 hours. Taking this information about the coronavirus’s stability duration on surfaces, healthcare facilities need to implement practices that minimize exposures to these enduring pathogens and use agents and products to ensure long-term prevention.

Another issue many healthcare facilities may not understand is that sanitation is not the same thing as disinfection. Sanitizing only removes about 85% of microorganisms, meaning that sanitation may count as a good cleaning job but will not eradicate all of the harmful pathogens and germs.

On the other hand, disinfecting can remove up to 99.9999999%, which is a 7 log kill. “Logs” are based on a logarithmic scale, where each “log” stands for a 10-fold (one decimal point) reduction in bacteria. Basically, log rates reflect how different disinfectants reduce the number of live bacteria by 90 percent for every step.

The most effective disinfectants are a 7-log kill, which is what Spotless Cleaning insists on using with every client to truly annihilate pathogens.

The team you hire should be well aware of these numbers and able to effectively and safely perform cleaning, disinfecting, and sanitizing across a variety of healthcare facility types, such as dental offices, hospitals, surgical centers, and general practices. Although you may think there’s not much difference between sanitizing and disinfecting, it’s helpful to know the definitions of each so you can evaluate the performance of your cleaning crew.

Cleaning - Cleaning is the process that removes dirt, debris, and some germs, usually accomplished with soap or detergent and water. When deep cleaning is conducted and can help reduce the germ population, it does not help against the threat of virus-spawning pathogens and should never be a stand-alone process. Even the most competent hired janitorial teams cannot eradicate pathogens and germs through cleaning alone. You’ll have a sparkling facility, but it won’t fully protect against viruses and disease. 

Sanitizing - Sanitizing is another phase that should be used frequently on surfaces throughout the day. The procedure will lower the number of bacteria to a safe level, but will not eliminate all viruses, such as coronaviruses. For many facilities, sanitizing is much more about reducing the number of germs on a regular basis, rather than killing them all. It makes the trifecta of cleaning, sanitizing, and disinfecting a more efficient process, but, again, it’s not a standalone practice. You need disinfecting to finally ensure your facility is as safe as possible.

Disinfecting - While cleaning and sanitizing are two phases of disease prevention that should be practiced throughout the day by your in-house cleaning team, effective disinfecting should be left to the professionals. Disinfection teams like Spotless Cleaning utilize the latest disinfecting agents recommended by the CDC that are proven to eliminate the most infectious pathogens, including bacteria, viruses, and fungi. The best cleaning crews should select the right disinfectant for the job, depending on your facility’s individual practice and the type of care you provide.

Pathogen-Busting Cleaning and Disinfecting Techniques Most In-House Cleaning Crews Aren’t Aware Of

No matter how diligent and dedicated your in-house cleaning crew is, there are a number of aspects of disinfection most cleaning crews just don’t know; and what they don’t know could hurt you, your facility, and your patients. 

Key areas most in-house training crews aren’t savvy about include:

• Low-touch Surfaces - Low-touch surfaces don’t have as big of a chance of exposure to pathogens as high-touch and require less-rigorous cleaning. These surfaces include ceilings, tops of light fixtures, the reflective portion of surgical lights, walls, and the insides of cupboards. 
• High-touch Surfaces - Surfaces regarded as high-touch are hotbeds for pathogen growth. These surfaces require much more frequent and rigorous cleaning and disinfecting. Common high-touch surfaces include bed rails, IV poles, sink handles, bedside and operating tables, counters where medications and supplies are prepared, doorknobs, light switches, patent monitoring equipment, and transport equipment -- essentially anything that regularly comes into contact with patients and/or staff.
  Disinfecting crews should thoroughly wipe down all these surfaces using a disposable wipe soaked in a hospital-grade disinfectant. These special disinfectants won’t leave a residue like bleach will, and don’t require rinsing or wiping once applied.
• Terminal Cleaning - Patients are the most vulnerable to disease while undergoing a procedure in an operating room. The most dangerous patients in your building will be those who are already infectious and are kept in isolation rooms. In both types of rooms and for both types of patients, you need to implement terminal cleaning.
  
  Terminal cleaning is a process used to ensure that all pathogens are completely eliminated from the environment, providing a safe environment for not only the next patient to enter the room, but also staff members.
  
  This disinfection procedure involves removing every detachable item in the room. Each item is disinfected and then the entire room is disinfected, including light fixtures, air ducts, and all surfaces from the ceiling down to the floor. Your chosen cleaning crew must understand and implement the terminal cleaning process in vital areas of your facility, ensuring that they clean low-touch surfaces first and then high-touch surfaces to prioritize disinfecting from cleaner to dirtier areas. 
• Dwell Time - Dwell time refers to the duration for which a disinfectant needs to remain wet on any surface to zap germs. Each disinfectant comes with its own prescribed dwell time. If you don’t apply the disinfectant correctly and heed to the dwell time, even the best disinfectants will not be effective.
  
  Each disinfectant’s average dwell time depends on the type of germs or viruses the product is designed to kill. Especially when it comes to killing coronaviruses, most CDC- and EPA-approved disinfectants have a dwell time of at least 10 minutes.
  
  A properly trained commercial cleaning service who understands the nitty-gritty of healthcare facility disinfecting understands each of these basic, yet essential, components of effective cleaning and disinfection to optimize virus and bacteria control.
  
  Once you hire a professional disinfecting service to bring out the big guns for electrostatic disinfection and proactive deep cleaning, your internal cleaning crew can continue to provide routine maintenance. 

Top Cleaning, Sanitizing, and Disinfecting Agents A Cleaning Crew Should Use

Even the most knowledgeable cleaning crew can’t properly expunge all viruses and disease from your facility if they’re not using the most aggressive EPA-approved disinfectants. The best disinfecting agents and antimicrobial pesticides are registered with the EPA, and should have proven effectiveness against hard-to-kill viruses while still being safe for your healthcare environment.

Cleaning Agents

Typical cleaning products include liquid soap, enzymatic cleaners, and detergents. Your regular in-house team can easily utilize these products for daily cleaning in your facility.

The chief purpose of these cleaning products is to remove organic material (such as dirt and body fluids) and suspend grease or oil. This removal of material is done by combining the product with simple water and scrubbing or causing friction to break up the particles and clear them away. You’ll find that the most environmental cleaning detergents have pH levels between 6 and 8, and are easily soluble in warm and cold water.

Other specialized cleaning products are ideal for healthcare facilities (e.g., bathroom/toilet cleaners, floor polishers, and glass cleaners), although these products should be purchased and used on a case-by-case basis. A professional cleaning team can point you to the best cleaning products for your facility, based on correct storage, preparation, and use.

Sanitizing Products

The best sanitizers lower the numbers of germs on surfaces that meet safety level standards set in place by public health organizations. We recommend Oxivir TB, which is a hospital-grade disinfectant and has a one-minute kill claim on COVID. This product is also highly effective against other viruses and bacteria for overall daily prevention.

Disinfecting Agents

Disinfectants are used only after cleaning has been performed, and should never be a substitute for cleaning (unless a detergent-disinfectant product is used) -- just as deep cleaning should never be a substitute for disinfection. Cleaning is always performed first to remove all organic material and soil, preparing surfaces for the disinfection process.

Regarding best-advised disinfection products, many products are either low-level or intermediate-level. Low-level products are often applied for environmental cleaning procedures, but intermediate-level disinfection is called upon when sporicidal requirements are needed, such as with C. difficile, MRSA, or dangerous viruses like COVID.

Common low- and intermediate-level disinfectants used in healthcare settings include quaternary ammonium compounds, alcohol (ethyl or isopropyl), chlorine releasing agents, and improved hydrogen peroxide. Spotless Cleaning unleashes what we like to refer to as the “weapons of mass disinfection,” which are tougher on germs and pathogens than many agents available.

Along with Oxivir TB, we utilize fierce agents like Clorox 360, MediClean, and Decon 7, depending on the application. Clorox 360 is valuable for its coronavirus kill rate and compatibility with the high-tech electrostatic sprayers we use. Many disinfectants do not have this degree of a verified kill claim with spraying methods.

We bust out Decon 7 in certain applications where we need extra-level aggressiveness towards viruses. Decon 7 was developed by the US Department of Defense during the Gulf War amid bio-terrorism fears and has a history of being deployed against anthrax, sarin, ricin, mustard gas, and other biological toxins. This product is safe to use in facilities because it biodegrades. 

Highly Effective Tools for the Most Aggressive Disinfecting

Knowing which tools are the most effective for applying disinfecting agents is another important piece of the puzzle when making sure you are equipped with a professional disinfecting company worth their mettle. Some of the most cutting-edge disinfecting technology out there is your best chance at making sure your facility is impeccably clean, disinfected, and safe.

Two of the most popular and proven disinfecting tools in the industry are cold-foggers and electrostatic technology. Unlike a thermal fogger that vaporizes the fogging liquid and turns it into a mist, a cold fogger utilizes high air pressure to spray the liquid out in tiny particles. Foggers are mostly ideal for odor control, not for disinfecting. Electrostatic sprayers apply a positive charge to liquid disinfectants as they pass through the nozzle, which is attracted to negatively charged surfaces. This allows for efficient coating of hard nonporous surfaces, making electrostatic technology a recent go-to tool for the public health emergency sector.

Both cold foggers and electrostatic sprayers allow for shorter dwell times and even faster application times, which is essential with dealing with a virus like COVID-19. At Spotless Cleaning, we use disinfecting agents that have a 45-second kill claim and spray systems like the Clorox 360 electrostatic sprayer to provide fast and full coverage for large areas.

When you work in an environment (like a hospital) where the turnaround time for disinfecting must be within 5-7 minutes, it’s vital to use the latest technology and agents to ensure disinfection is done correctly and immediately to keep everyone in your facility safe. 

Choosing the Best Deep Cleaning and Disinfecting Service: Certifications and Questions to Ask

Now that you know what a professional cleaning crew should know and what tools and techniques they should bring to your facility, it helps to ensure their experience and certifications line up with their promises.

Certifications are a big deal in healthcare facility cleaning. You need to know that the healthcare facility cleaners or Environmental Service Providers (EVS) you’re hiring will properly and safely protect your building. 

If a cleaning crew isn’t certified, you can likely expect the virus to still be creeping in the crevices of your facility. They may be a cheaper bid, but putting your health, and the lives of your patients, in jeopardy is never worth pairing down the budget.

The Association for Healthcare Environment (AHE) provides a number of certifications that you will want to double-check and cross-reference qualifications with potential cleaning service providers.

Some certifications to look out for include:

• CHEST -  CHEST stands for Certified Healthcare Environmental Services Technician. This certification signifies that a technician is proficient in infection prevention procedures, cleaning and disinfecting chemicals and procedures, customer-focused communication, safety, and waste management.
• CSCT - The Certified Surgical Cleaning Technician certification covers method-based prevention of pathogen transmission, cleaning and disinfecting high-risk areas like the OR, and problem-solving in fast-paced healthcare environments.
• IICRC - IICRC refers to the Institute of Inspection Cleaning and Restoration Certification. Holders of this certification are technicians who have met the stringent standards of this organization, which include understanding and implementing all up-to-date industry procedures and competently administering state-of-the-art contamination control. 
• CRI - The Carpet and Rug Institute awards the “CRI” label to professional cleaning teams who meet the institute’s standards for improving the health of indoor spaces. This certification emphasizes the importance of maintaining indoor air quality (IAQ) and sets high standards to ensure that carpets, adhesives, and cushions have minimal Volatile Organic Compounds (VOCs), which are emitted as toxic gases that can affect the IAQ. 
• ISSA/CMI - Professional cleaning crews with the International Sanitary Supply Association (ISSA) certification have proven they are experts in effectively managing cleaning procedures, green cleaning, sustainability, and protecting human health. The Cleaning Management Institute (CMI) is one of ISSA’s most recognized programs and certifications. Those with this certification are equipped to offer the latest proven methods and technological tools to protect buildings in the industrial, educational, and healthcare sectors. 

The above certifications are important to look for when hiring a professional cleaning company, although this list is not exhaustive. Spotless Cleaning is proud to hold IIRC, CRI, and ISSA/CMI certifications, along with many others that are a mark of our dedication to education and impeccable service. For a full list of our certifications and qualifications, visit our website.

5 Questions to Ask a Medical Facility Cleaning Crew to Ensure Quality and Safety

Even when you’re armed with all this knowledge about what you should look for in a cleaning team and how to identify best disinfecting practices, it can still be overwhelming to determine if you’re hiring a good crew.

To help you out, we’ve compiled five essential questions you should ask any cleaning crew before you hire them. For a more substantial list of questions to ask a cleaning company, check out our blog post

• Does the cleaning company provide before-and-after pictures and inspection reports?

A post-cleaning inspection reports details which procedures were completed during the service, but also modifications you can make to your daily facility cleaning regimen between professional cleaning visits. Quality cleaning companies should also make recommendations on additional services to keep your facility safe without unnecessarily gouging your cleaning budget.

• Can they provide disinfection and decontamination services during flu or virus outbreaks? 

With the wild ride 2020 and 2021 put us all through, this question is extremely important. As we’ve covered, there’s a huge difference between deep cleaning and disinfecting. Using the knowledge we’ve supplied in this article, you can more easily determine whether a cleaning company offers the latest in disinfection services and methods, including all CDC- and EPA-approved products and equipment. You’ll also want to inquire about their protocols for what happens if someone in your facility gets sick, and what needs to be in place for your facility to continue to operate safely. 

• How does the company handle product safety, labeling, and maintenance of SDS (safety data sheets) to be OSHA compliant?

As you know, staying compliant with state and federal safety regulations can be complex, but a violation on behalf of someone else’s oversight or incompetence is not what you need. Make sure you see a comprehensive safety and training program designed by the cleaning company to keep your facility compliant, safe, and efficient at reducing risks. 

• Does the company carry liability with a $10 million umbrella policy and workers’ compensation insurance policies for their employees? 

Accidents happen and can easily happen at your facility, even when a cleaning company utilizes best practices. Make sure your cleaning company has sufficient liability and workers’ comp insurance to protect yourself if they injure themselves on your property. 

• If an issue arises, what is the cleaning company’s response strategy and typical resolution turnaround? 

If an issue pops up or you want to add services in between cleaning appointments, it should be easy to receive a quick response to your request. Small problems can quickly turn into overwhelming issues, so make sure your cleaning company’s customer service is top-notch and that they have good reviews. You can also ask what their guaranteed resolution response time is, and if they have a way for you to easily contact them should an emergency or issue arise. 

Get Your Crew Involved: Prevention and Maintenance Methods for Overall Efficiency and Safety

After you’ve selected and hired a professional cleaning service to protect your facility, you can still enlist your in-house cleaning crew and medical staff members to help prevent germs and viruses in between pro disinfection visits. We recommend that you have your team pay special attention to high-touch surfaces while supplementing your in-house efforts with weekly professional electrostatic disinfecting. We’ve outlined some tips for overall prevention and upkeep. For more information on how to protect your team and facilities, check out our commercial disinfecting services page.

• Utilize touchless soap/towel sanitizer dispensers: This simple modification greatly reduces the number of virus touchpoints. Also add paper towel dispensers near doors and elevators to keep both staff, guests, and patients practicing proper sanitary precautions. 
• Disinfectant products: Switch to an EPA- or CDC-approved disinfectant for all cleaning to ensure you’re using the most effective products.
• HEPA filters in the HVAC and UV filtration systems: Although not verified by the CDC, many experts in the industry believe this implementation improves overall control of pathogens and germs. 
• Change your strategy: Overhauling your daily cleaning strategy goes a long way towards keeping your facility safe and sanitary when the professional cleaning team is away. Make sure you review your scope of work with your professional janitorial team and shift from sanitation-focused cleaning to a disinfection program. Also, insist that employees in nurse’s stations and at information desks also disinfect their workstations throughout their shifts. 

Your healthcare facility is safest for both patients and staff members when you have a professional cleaning and disinfecting crew at the helm. If you’d like to ask us more questions about what you should look for in hiring a professional team or would like a quote from us to properly disinfect your building, call us today.