Environmental cleaning (herein referred to as cleaning) is an essential part of infection prevention and control. Trying to assess whether a service area is considered “clean” is very subjective, and visibly clean may be very different from microbiologically clean. Similarly, frequency of cleaning is difficult to measure because it cannot be observed by enumerators in one day and responses are likely to be subject to respondent bias. How frequently a facility needs to be cleaned is linked to patient load, therefore cleaning schedules vary greatly from facility to facility.
Question G-C1 asks about the existence of protocols for cleaning which serves as an indication of the importance a HCF places on
environmental hygiene. Protocols may or may not be written given cleaners may not be literate.
Questions G-C2 asks whether staff with responsibility for cleaning (either dedicated cleaners or other staff with cleaning responsibilities) have received training. They should be trained according to the protocols reported in G-C1, but it is possible that training may take place in the absence of any formal, written protocols.
The 2016 WHO Guidelines on core components of infection prevention and control programmes recommend delivery of IPC education and training to all staff, irrespective of level or position. Cleaning may be the responsibility of dedicated cleaning, auxiliary or domestic staff or part of the responsibilities of health care staff (particularly in smaller facilities)
RECOMMENDED SURVEY QUESTIONS (Q) AND ANSWERS (A)
G-C1 - are cleaning protocols available?
Response options: yes / no
Note: Protocols should include:
• step-by-step techniques for specific tasks, such as cleaning a floor, cleaning a sink, cleaning a spillage of blood or body fluids, and
• a cleaning roster or schedule specifying responsibility for cleaning tasks and frequency at which they should be performed.
The term for protocols may differ according to local practice; they may be referred to as Standard Operating Procedures (SOPs), guidelines, instructions, etc. Where possible, protocols should be observed by the enumerator.
G-C2 - have all staff responsible for cleaning received training?
Response options: yes, all have been trained / no, some but not all have been trained / no, none have been trained / no, there are no staff responsible for cleaning
