The process of decontaminating cleaning an environment is used to reduce contamination to a level that is not harmful. Hard floor cleaning London techniques are used to reduce contamination, including:

• Cleaning;
• Disinfection;
• Combinations of both.

Cleanliness and disinfection

Until recently, there was no evidence that the healthcare environment contributed significantly to the transmission of bacteria, fungi, and viruses responsible for healthcare-associated infections. The problem has been reevaluated in the light of recent evidence, and today it is widely acknowledged that contaminated environments play a critical role in the transmission of some pathogens that cause in hospitals, care homes, and in the community.

This finding is perhaps the most compelling evidence of the role of contaminated environment, which is that admission to a hospital room containing a pathogen – such as Clostridium difficile, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, or Acinetobacter baumannii – can increase the risk of acquiring that pathogen for the incoming occupant. At a discharge, the environment cannot be effectively decontaminated. Furthermore, other studies have shown improving cleaning can reduce infection risks associated with prior occupants of a room.

The spread of pathogens

It is unusual for cleaning and disinfection to eliminate pathogens from a hospital environment – only approximately half are eliminated with terminal decontamination. One of the reasons for this might be that not all surfaces in a room are manually cleaned or sanitized as part of the discharge process: a well-known US study found that only half of the surfaces in patient rooms were cleaned or sanitized at discharge.

Health care workers often touch dry surfaces with their hands, which are then colonized by bacteria present on the skin and other parts of the patient. An experiment conducted almost 20 years ago appeared to have demonstrated this by seeding a telephone in a neonatal intensive care unit with DNA markers. Immediately after being exposed to the DNA marker, healthcare workers’ hands and environmental surfaces had been contaminated.

Environmental decontamination

Environmental decontamination services are offered differently by hospitals, however cleaning and disinfecting in the clinical environment always requires a multidisciplinary approach. Non-clinical staff (cleaners or domestics) usually clean and disinfect non-critical surfaces on a daily and terminal basis. Nursing staff typically disinfect semi-critical surfaces at the point of care or send them to a reprocessing unit for decontamination. A critical surface is normally either used one-time or sent to a reprocessing unit using validated techniques for decontamination.

Microbiological scenarios will influence the decontamination strategy. Due to Clostridium difficile’s resistance to many disinfectants, sporicidal disinfectants are necessary (such as chlorine-releasing disinfectants, hydrogen peroxide, or peracetic acid).

Nursing plays an important role in decontaminating the environment. The decontamination team in addition to focusing on decontaminating specific items collaborates with environmental decontamination services and develops policies and training schedules, delivers training and education, audits the cleaning process, informs buying decisions, and escalates cleaning issues daily.

Environmental contamination plays a key role in the transmission of pathogens in healthcare settings. In addition to being a legal requirement, it is essential for patient safety that surfaces are clean and properly disinfected. Cleaning and maintaining a safe environment varies from setting to setting, but they are always interprofessional, and nurses are always crucial to that process.