What are the types of cleaning that can be done to promote infection control?

Cleaning in a health care environment involves the following three levels of cleanliness:

• Clean
• Disinfected
• Sterilized

The level of cleanliness required for a particular device or location depends on what that device or location is designed to accomplish and should not be based on killing any particular kind of pathogen.

The most basic level of cleanliness in a health care environment is cleaning. It involves physically removing dirt, organic matter, and most germs from surfaces using soap (or detergent) and water. This process does not necessarily kill germs but is essential because it lowers their numbers and thus the risk of spreading infections. Cleaning is always the first step because it removes the physical matter that might inhibit the effectiveness of subsequent disinfection or sterilization processes.

Disinfecting follows cleaning if the goal is to kill germs on surfaces that might come into contact with patients but do not typically penetrate the body’s sterile tissues. Disinfectants are chemicals specifically used to destroy harmful microorganisms except for bacterial spores. Common areas for disinfection in a healthcare environment include items like bedrails, bedside tables, and other surfaces near patients. Different disinfectants have different levels of efficacy, and their use depends on the specific risk assessment of the area or item being treated.

Sterilization represents the highest level of cleanliness and is required for any instruments or items that enter sterile areas of the body, such as surgical tools or implants. Sterilization processes eliminate all forms of microbial life, including spores, which are the hardest form of microbial life to destroy. Methods of sterilization include using steam under pressure (autoclaving), ethylene oxide gas, hydrogen peroxide gas plasma, and others. This level is critical for procedures where even a small number of microbes could result in severe infections. It’s important for healthcare facilities to have clear policies that specify which cleaning level is appropriate for different types of equipment and various areas within the facility. This ensures that all staff members understand and adhere to the necessary infection control protocols to protect both patients and healthcare workers.