C. diff Cleaning After The Patient Leaves

In this Daily Tip, I will give you more of the 13 Strategies for Effective Cleaning and Disinfection of C-diff Patient’s Room. Here are the next 5 strategies (some original with me and others borrowed from “best practices”) that could be adopted by every hospital treating patients with this potentially deadly pathogen:

7. At discharge or transfer, the cleaning should be a 2-step process. The first step is to clean all surfaces with a general-purpose cleaner. Concentrate on both high-touch and high-soilage areas (the toilet, the walls around the toilet where bedpan dumping may have soiled). This should provide for optimal soil removal and with the soil will go the “bad guys”. After the first step is complete, it should be followed by disinfecting all the same surfaces using the disinfectant of choice that has a C-diff kill claim on the label. 

10. The ES Terminal Cleaning Team (or Worker), should work from a checklist of cleaning/disinfecting steps to be performed in order for the process to be completed according to policy. This checklist is signed off by the ES worker and kept with the department’s records.

11. In order to monitor the effectiveness of the 2-step process, the management staff of ES along with IP should monitor terminally cleaned C. diff isolation rooms with the use of a hand held meter that test surfaces for adenosine triphosphate (ATP), which is the energy molecule inside all living cells. ATP is found in bacteria (i.e., C. diff), mold, fungus and other organic matter. ATP meters enable cleaning professionals to verify how clean surfaces are with respect to organic matter and to carry out continuous improvement programs to enhance overall performance. Test results should be maintained in the ES department files for future reference.

12. Provide a disposable wipe with a C. diff kill claim for all healthcare workers to perform meticulous cleaning/disinfecting patient care items before removing them from the room (i.e., IV poles, stretchers, wheelchairs, etc.). Isolated patient’s room should have disposable stethoscopes that remain in the room and are discarded at discharge. 

13. Privacy curtains should be taken down while stripping the room and making it ready for cleaning. The curtains should be bagged and sent for laundering. If the privacy curtains are disposable, discard them with other disposables. A fresh curtain should be installed after the room has been made ready for admitting the next patient. 

J. Darrel Hicks, REH, CHESP, is the author of "Infection Control For Dummies" and has over 30 years of experience in the jan/san industry. Hicks has served as past president of IEHA and remains an active member of ASHES. He can be reached at through his website at www.darrelhicks.com or by email at darrel@darrelhicks.com.