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The Infection Prevention Assessment Survey provides the recognized "standards," or ideals, for the various infection prevention practices described in this training course. By using this survey, you can compare the infection prevention practices at your health care facility with the standards to determine whether or not each standard is being met. This User's Guide to the Infection Prevention Assessment Survey provides a brief explanation of and rationale for each standard and provides more detailed information about how to get the most out of using the survey.
Note: In order to assess whether or not a standard is being achieved, it is best to observe the practices as they are being conducted. However, if direct observation is not possible, routine performance of various practices may be determined by talking with service providers and ancillary staff and by touring the facility.
Handwashing significantly reduces the number of potentially infectious microorganisms on the hands of service providers and reduces client sickness (morbidity) and death (mortality) caused by infections spread in the health care facility.
1. Hands should be washed when indicated.
Hands should be washed in all of the following situations:
Check "YES" if hands are washed during these situations.
2. Hands should be washed with soap and running water.
Water and mechanical friction (scrubbing or rubbing) alone are not adequate for cleaning hands. Soap must be used in conjunction with water and rubbing to remove transient organisms and soil. Running water does not have to come from a tap mounted on a sink; running water can come from a bucket with a tap or a pitcher. If water is not available and hands are not visably soiled, an alcohol handrub may be substituted for handwashing with soap and water.
Check "YES" if hands are washed with soap and running water. If running water is not available and an alcohol handrub is used, check "NO" and record this in the Comments area.
3. Hands should be dried with a clean towel or allowed to air-dry.
If towels are used, they should be either disposable or for personal use only. More than one person should not use the same towel, because towels quickly become contaminated with microorganisms from the users' hands that can easily be passed from one user to another.
Check "YES" if hands are dried with a clean towel or allowed to air-dry.
4. Plans should be made and supplies should be available for times when running water is not available.
Even if water from a tap is normally available at a facility, there may be times when water from a tap is not available. Therefore, plans should be in place for these times and all of the necessary supplies should be available to obtain water from an alternate source.
Check "YES" if plans have been made and supplies are available for times when water is not available from a tap.
Gloves provide a barrier against potentially infectious microorganisms in blood, other body fluids, and medical waste and protect against hazardous chemical waste. There are three types of gloves used in health care settings: surgical, single-use examination, and utility gloves.
5. Gloves should be worn whenever contact with blood or other body fluids is anticipated.
Sterile or high-level disinfected surgical gloves are preferred for procedures in which there will be contact with the bloodstream or tissues under the skin (e.g., surgical procedures, insertion of Norplant implants, pelvic examinations of women in labor). Single-use examination gloves are indicated for all procedures in which there will be contact with intact mucous membranes (e.g., IUD insertion, manual vacuum aspiration, pelvic examination) or for situations in which the provider may be exposed to a client's blood or other body fluids (e.g., drawing blood, working in the laboratory).
Check "YES" if sterile or HLD surgical gloves and examination gloves are used as indicated.
6. Utility gloves should be worn when handling contaminated instruments and other items, handling medical or hazardous chemical waste and linen, performing housekeeping activities, and cleaning contaminated surfaces.
Staff who may not have direct client contact are at risk of infections if their work exposes them to potentially contaminated instruments or other items or to blood or other body fluids. Wearing utility gloves when handling any potentially contaminated materials and when cleaning instruments or other items reduces the risk of infections.
Check "YES" if staff wear utility gloves as indicated.
Antiseptics are chemical agents that are used on the skin and mucous membranes to remove or kill microorganisms. Examples include alcohol, chlorhexidine gluconate (e.g., Hibitane, Savlon), hexachlorophene (e.g., pHisoHex), iodine, iodophors (e.g., Betadine), and para-chloro-meta-xylenol (PCMX; e.g., Dettol). Disinfectants are chemical agents that are used on inanimate objects, such as instruments and surfaces, to kill microorganisms. Examples include chlorine and glutaraldehyde.
7. Antiseptics should be used only on the skin and mucous membranes.
Antiseptics are indicated for:
Antiseptics should never be used on instruments or other items, surfaces, or reusable gloves. In addition, instruments and other items should never be left soaking in an antiseptic solution.
Check "YES" if antiseptics are used only on the skin and mucous membranes as indicated. (Note: Record the name(s) of the antiseptic(s) used in the Comments area.)
8. Disinfectants should be used only for processing instruments and other items for reuse and for housekeeping activities.
Disinfectants are indicated for:
Disinfectants are not to be used on the skin or mucous membranes. In addition, instruments and other items should not be left soaking indefinitely or stored in disinfectant solutions.
Check "YES" if disinfectants are used on inanimate objects as indicated. (Note: Record the name(s) of the disinfectant(s) used in the Comments area.)
9. Antiseptics and disinfectants should be handled in a manner that reduces the risk of contamination.
Antiseptic and disinfectant solutions can easily become contaminated; microorganisms can survive and grow in them. Care must be taken to avoid contamination of antiseptics and disinfectants by following these guidelines:
Check "YES" if antiseptics and disinfectants are handled as indicated.
Aseptic technique refers to practices that help reduce the risk of postprocedure infections in clients by reducing the likelihood that, during clinical procedures, microorganisms will enter areas of the body where they can cause disease.
10. A surgical handscrub should be performed before all surgical procedures.
A surgical handscrub should be performed to prevent the rapid growth of microorganisms inside surgical gloves for a period of time and reduce the risk of infections to clients if gloves develop holes, tears, or nicks during the procedure.
A surgical handscrub should be performed as follows:
If an antiseptic soap is not available or staff are allergic to the available antiseptic, staff should scrub as described above with plain soap and water and then apply 3-5 mL of alcohol or an alcohol handrub solution and rub hands together until they are dry. Ideally, surgical handscrub should be performed between each procedure. However, to prevent skin irritation from too-frequent handscrubbing in high-volume settings, the surgical team can use 3-5 mL of an alcohol handrub solution between clients, rubbing the hands together until they are dry. Staff should scrub every hour or after every four clients (whichever comes first).
Check "YES" if a surgical handscrub is performed as indicated before all surgical procedures.
11. Sterile or high-level disinfected surgical gloves should be put on and removed in ways that do not contaminate the gloves or allow the wearer to touch the contaminated outside part of the gloves.
Sterile or high-level disinfected surgical gloves should not be contaminated while they are being put on. When removing contaminated gloves, the wearer should not touch the outside of the glove, which is contaminated.
Check "YES" if staff follow the procedures for putting on and removing surgical gloves.
12. Shaving the surgical site should not be performed routinely and should be performed only when absolutely necessary.
Shaving can create nicks and breaks in the skin, which can lead to increased risk of postprocedure infections. Research has shown a reduction in the number of postoperative surgical-site infections when shaving is not performed. Clipping hair with scissors is acceptable if hair interferes with the procedure. Shaving the surgical site should be performed only when absolutely necessary.
Check "YES" if shaving is not performed routinely, hair is clipped with scissors if it interferes with the procedure, and shaving is performed only when absolutely necessary.
13. The surgical/procedure site should be prepared properly using an appropriate antiseptic solution.
The surgical/procedure site should be cleaned with soap and water and then cleaned with an antiseptic solution just before the procedure. If an iodophor (e.g., Betadine) is used, the antiseptic should be left on for 1-2 minutes before wiping off the excess solution. The site should be wiped using a circular motion, beginning in the center of the site and moving out.
Check "YES" if the surgical site is prepared as indicated.
14. A sterile field should be established and maintained during all surgical/clinical procedures.
A sterile field is maintained by:
Once the sterile field is established, it should be maintained until the procedure is finished. If a "break" (contamination) occurs, it must be corrected before the procedure continues.
Check "YES" if the sterile field is maintained as indicated.
15. Traffic and activities should be controlled and appropriate attire should be worn in surgical/procedure areas.
Minimizing traffic in surgical/procedure areas reduces the amount of dirt, dust, and insects in the area. Only necessary staff should be allowed in these areas during procedures. Changing into attire designated for use in the surgical area further reduces the introduction of microorganisms into the area. Proper surgical attire includes caps, masks, gowns, protective eyewear, and sturdy footwear. Staff (including cleaning staff) should wear caps, masks, and sturdy footwear at all times in the surgical area. Masks should cover the nose and mouth. Caps should cover all hair. Street shoes should be clean and covered, or staff should change to shoes or boots that are worn only in the surgical area.
Check "YES" if these conditions are met.
Injury from hypodermic needles or other sharp objects is the number-one cause of occupational exposure to bloodborne pathogens. Therefore, all sharps must be handled and disposed of properly.
16. Hypodermic needles should not be routinely recapped and should never be bent or broken before disposal. Needles should not be removed from syringes before disposal.
Needles and other sharps should be handled as little as possible after use. If recapping is absolutely necessary, the one-hand technique should be used, as follows:
Check "YES" if hypodermic needles are not routinely recapped and are never bent or broken before disposal. Also check "YES" if the one-hand technique is used when recapping is necessary.
17. Sharps should be disposed of in puncture-resistant containers.
A puncture-resistant sharps container can be made out of a heavy cardboard box, an empty plastic jug, or a metal container.
Check "YES" if sharps are disposed of in puncture-resistant containers.
18. Sharps containers should be available wherever sharps are used. Containers should be disposed of when they are three-quarters full.
Sharps containers should be available in injection rooms, treatment rooms, operating theaters, labor and delivery rooms, and laboratories. They should never be filled to capacity, because sharps may penetrate the container wall and cause injury.
Check "YES" if sharps containers are available in all the areas when sharps are used and are emptied when they are three-quarters full.
19. Unprotected sharp items should not be passed directly from one person to another during surgical/clinical procedures.
During surgical/clinical procedures, sharps should be placed in and picked up from a kidney basin or a designated "safe zone" to minimize the risk of injury to clients and providers.
Check "YES" if sharps are not passed directly from one person to another during surgical/clinical procedures.
20. A new or properly processed needle and syringe should be used every time an injection is given or medication is withdrawn from a multidose vial.
A new or properly processed needle and syringe should be used to prevent contaminating the solution in the vial. Needles should never be left inserted in the vial cap, because the hole in the needle can allow contaminates to get into the solution.
Check "YES" if a new or properly processed needle and syringe are used as indicated and if needles are not left inserted in multidose vials.
Processing reusable instruments and other items used in surgical/clinical procedures involves four steps:
The order of the steps, as well as the area in which they are performed, are important to reduce the number of microorganisms on the instruments and other items, and minimize the risk of infections.
21. "Clean" and "dirty" activities should be performed in separate areas. When only one room is available for processing instruments and other items, it should be arranged so that activities and objects flow in an organized fashion from receiving used items to storing sterilized or high-level disinfected items.
"Clean" areas--areas in which sterilization, HLD, and storage are performed--should be separated from "dirty" areas--areas in which decontamination and cleaning are performed--in order to reduce the risk of contaminating sterile or high-level disinfected instruments and other items.
Check "YES" if clean and dirty activities are performed in separate areas.
22. Instruments and other items should be stored dry and should never be left soaking indefinitely in solutions.
Instruments and other items should be stored dry, since bacteria can grow in solutions, even if a disinfectant is added. Instruments and other items should never be left soaking indefinitely in any type of solution; if they are high-level disinfected, they should soak only for the amount of time specified and then be removed from the disinfectant solution, rinsed, and stored dry.
Check "YES" if all instruments and other items are stored dry and are not left soaking indefinitely in solutions.
23. Soiled linens should be handled wearing utility gloves in a way that prevents exposure of the skin and mucous membranes to potentially contaminated material.
When removing soiled linens, they should be gathered so that the contaminated area is on the inside. All laundry, whether or not it is visably contaminated, should be handled wearing utility gloves and clothing that covers the arms, legs, and feet. Protective eyewear is recommended.
Check "YES" if soiled linens are handled as indicated.
Decontamination kills viruses (such as hepatitis B, other hepatitis viruses, and HIV) and many other microorganisms, making instruments and other items safer to handle by staff who clean them.
24. Instruments and other items should be decontaminated by placing them in a 0.5% chlorine solution immediately after use and letting them soak for 10 minutes.
Immediately after a procedure is over, instruments should be placed in a bucket of 0.5% chlorine solution and left soaking for 10 minutes. The bucket should be in close proximity to the surgical/clinical area. The chlorine can be in powder or liquid form. (Note: Record the chlorine product used and the percent of "active" chlorine in the Comments area.)
Check "YES" if instruments and other items are decontaminated immediately after use as indicated.
Cleaning is performed before instruments and other items are sterilized or high-level disinfected to remove blood, other body fluids, organic material, tissue, and dirt and to ensure that sterilization and HLD are effective.
25. Instruments and other items should be thoroughly scrubbed using a soft brush and detergent and water and rinsed thoroughly with clean water before sterilization or HLD.
Detergent is necessary to remove protein, oils, or grease. Hand soap should not be used to clean instruments and other items, because the fatty acid contained in the soap will react with the minerals of hard water, leaving a residue or scum that is difficult to remove. Instruments with multiple parts should be disassembled, and the grooves, teeth, and joints of the items should be brushed.
Check "YES" if cleaning is performed as indicated.
26. If gloves are processed, they should be checked carefully for holes or tears after cleaning.
Gloves can tear and be punctured easily; therefore, they should be checked for holes before washing. To check for holes, inflate the glove with air and hold it under water; if air bubbles appear, the glove has a hole and should be disposed of. Alternatively, fill the glove with water; if any leaks out, the glove has a hole and should be disposed of.
Check "YES" if gloves are checked for holes after cleaning.
Sterilizing eliminates all microorganisms (bacteria, viruses, fungi, and parasites), including bacterial endospores. It is the recommended method for processing instruments and other items that will come in contact with the bloodstream or tissues under the skin. Instruments and other items can be sterilized by steam under pressure (autoclaving), dry heat, or soaking in chemicals.
27. For steam sterilization, instruments and other items should be packed in a way that allows steam to reach all surfaces.
For steam sterilization to be effective, steam must have direct contact with all surfaces of the items, as follows:
Check "YES" if instruments and other items are properly prepared and loaded in the autoclave as indicated.
28. Appropriate parameters (time, temperature, pressure) for steam sterilization should be followed.
Specific time, temperature, and pressure requirements are necessary for steam sterilization to be effective. While parameters may vary depending on the autoclave, the following rules generally apply (the manufacturer's instructions should be followed whenever possible):
Timing should not begin until the temperature and pressure requirements are met.
Check "YES" if the appropriate parameters for steam sterilization are followed as indicated.
29. Appropriate parameters (temperature, time) for dry-heat sterilization should be followed.
Specific time and temperature requirements are necessary for dry-heat sterilization to be effective, as follows:
| Temperature | Time |
| 170 degrees C (340 degrees F) | 1 hour |
| 160 degrees C (320 degrees F) | 2 hours |
| 150 degrees C (300 degrees F) | 2 1/2 hours |
| 140 degrees C (285 degrees F) | 3 hours |
Timing should not begin until the temperature requirement has been reached.
Check "YES" if the appropriate parameters for dry-heat sterilization are followed as indicated.
30. Sterilization equipment should be properly monitored and maintained.
Autoclaves (steam sterilizers) and dry-heat ovens should be properly maintained to ensure that sterilization has been achieved. Routine maintenance should become standard procedure, and someone should be assigned to be responsible for this task. If repairs are necessary, they should be made before the equipment is used again. Biological monitoring should be performed weekly (or monthly, if testing weekly is not possible) to verify that sterilization is effective.
Check "YES" if autoclaves and dry-heat ovens are properly maintained and biological monitoring is performed regularly as indicated.
31. A properly prepared chemical solution, such as a product containing glutaraldehyde, should be used for chemical sterilization.
The products that are most likely to be available for chemical sterilization are those containing glutaraldehyde (e.g., Cidex, Sporicidin). Formaldehyde should not be used. Most glutaraldehyde-containing solutions are effective for anywhere from 14-30 days from activation (the manufacturer's instructions should always be followed), and the container should be labeled with the date the solution was prepared and the date it expires. The solution should be discarded if it becomes cloudy.
Check "YES" if an appropriate chemical solution is prepared and used as indicated.
32. For chemical sterilization, instruments and other items should be dry, opened or disassembled, and completely submerged in the solution.
Instruments and other items should be dry before chemical sterilization, because water from wet instruments and other items dilutes the chemical solution and reduces its effectiveness. For chemical sterilization to be effective, the chemicals must have contact with all surfaces. Therefore, all instruments and other items, ports, and valves must be opened, disassembled, and completely submerged in the solution.
Check "YES" if instruments and other items to be chemically sterilized are dry, opened or disassembled, and completely submerged in the solution as indicated.
33. Instruments and other items should soak in the chemical solution for the time listed in the manufacturer's instructions and be rinsed with sterile water.
Instruments and other items should soak in a glutaraldehyde-containing solution for 10-12 hours (the manufacturer's recommendation should be followed, especially if other products are used). No instruments or other items should be added to or removed from the solution once timing has begun. Instruments and other items should be thoroughly rinsed with sterile water. (Boiled water is not sterile water.)
Check "YES" if instruments and other items are soaked in the chemical solution and rinsed with sterile water as indicated.
34. After any method of sterilization, instruments and other items should be stored in a way that limits the risk of contamination.
Regardless of the sterilization process, sterile instruments and other items should be stored dry. Wrapped instruments and other items should be stored in a closed cabinet, and unwrapped instruments and other items should be stored in a covered, sterile container. All sterile instruments and other items should be stored in an environment that is free of dust, dirt, and insects. Properly stored wrapped instruments and other items are considered sterile as long as they remain intact and dry; properly stored unwrapped instruments and other items may be stored for 1 week.
Check "YES" if instruments and other items that have been sterilized are stored properly as indicated.
High-level disinfection (HLD) eliminates all microorganisms (including bacteria, viruses, fungi, and parasites), but does not reliably kill all bacterial endospores. HLD is suitable for instruments and other items that will come in contact with broken skin or intact mucous membranes. It is the only acceptable alternative to sterilization when sterilization is not possible. Instruments and other items can be high-level disinfected by boiling, soaking in chemicals, or steaming.
35. For HLD by boiling, instruments and other items should be opened or disassembled, completely submerged in the water, and boiled for 20 minutes from the time when the water comes to a rolling boil.
Water must touch all surfaces for HLD by boiling to be achieved. Therefore, all instruments and other items must be disassembled, opened, and completely submerged in the water. (The exception to this is cannulae used in manual vacuum aspiration, which does not need to be submerged in the water if the pot/boiler is kept covered.) Timing does not begin until the water is at a rolling boil. No additional water, instruments, or other items should be added or removed once timing has begun. Instruments and other items are ready to be removed after 20 minutes and should be removed while the water is still boiling, using sterile or high-level disinfected pickups (lifters, cheatle forceps).
Check "YES" if instruments and other items are high-level disinfected by boiling as indicated.
36. Appropriate and properly prepared disinfectant solutions should be used for chemical HLD.
Appropriate chemicals for use in HLD include:
Solutions must be properly prepared. The products that are most likely to be available for chemical sterilization are those containing glutaraldehyde (e.g., Cidex, Sporicidin). Formaldehyde should not be used. Most glutaraldehyde solutions are effective for anywhere from 14-30 days from activation (the manufacturer's instructions should always be followed), and the container should be labeled with the date the solution was prepared and the date it expires. The solution should be discarded if it becomes cloudy. A new chlorine solution should be prepared each day. (Note: Record the type of solution(s) used in the Comments area.)
Check "YES" if a chemical solution is properly prepared and used for chemical HLD as indicated.
37. For chemical HLD, instruments and other items should be dry, opened or disassembled, and completely submerged in the solution.
Items should be dry before chemical HLD, because water from wet instruments and other items dilutes the chemical solution and reduces its effectiveness. For chemical HLD to be effective, the chemicals must have contact with all surfaces. Therefore, all items, ports, and valves must be opened, disassembled, and completely submerged in the solution.
Check "YES" if instruments and other items are chemically high-level disinfected and are dry, opened or disassembled, and completely submerged in the solution as indicated.
38. Instruments and other items should soak in the chemical solution for 20 minutes and be rinsed with boiled water.
Items should soak in a chemical solution for 20 minutes. No items should be added to or removed from the solution once timing has begun. Items should be thoroughly rinsed with boiled water.
Check "YES" if instruments and other items are soaked in the chemical solution and rinsed with boiled water as indicated.
39. If gloves or MVA cannulae are steamed, they should be placed in the steamer so that steam can contact all surfaces and steam for 20 minutes.
For HLD by steaming to be effective, steam must have direct contact with all surfaces of the gloves or MVA cannulae. Paired, cuffed gloves or MVA cannulae should be placed in a steamer tray, loosely layered in a criss-cross design. Gloves should never be rolled into balls or packed tightly in the tray(s).
Check "YES" if gloves and MVA cannulae are HLD by steaming as indicated.
40. After any method of HLD, instruments and other items should be stored in a way that limits the risk of contamination.
Regardless of the HLD process, high-level disinfected instruments and other items should be stored dry. They should be placed in a covered, dry, high-level disinfected container in an environment that is free of dust, dirt, and insects.
Check "YES" if instruments and other items that have been high-level disinfected are stored properly as indicated.
Housekeeping is the general cleaning and maintenance of cleanliness in a health care facility. In addition to cleanliness, it reduces the number of microorganisms in the facility (thus reducing clients' and staff members' risk of infections) and provides an appealing work and service-delivery space.
41. Non-client-care areas should be kept free of dust, dirt, and organic debris.
Client-care areas should have an orderly appearance, as follows:
Check "YES" if non-client-care areas and toilets, latrines, and sluice rooms are cleaned and wastebaskets are emptied as indicated.
42. Client-care areas should be dusted each morning and cleaned with a disinfectant cleaning solution between clients and at the end of each clinic session or day.
Client-care areas require special attention to cleaning, as follows:
Check "YES" if client-care areas are cleaned as indicated.
43. Once a week, the ceilings in operating theaters and procedure rooms should be cleaned with a mop dampened with a disinfectant cleaning solution.
Check "YES" if the ceilings in operating theaters and procedure rooms are cleaned each week as indicated.
44. Housekeeping equipment (mops, buckets, and cloths) should be decontaminated, cleaned in detergent and water, rinsed in clean water, and allowed to dry before reuse.
Items used for housekeeping need to be cleaned themselves to reduce the chances of spreading infections. Contaminated cleaning equipment spreads, rather than reduces, microorganisms in the environment.
Check "YES" if housekeeping equipment is decontaminated, cleaned, rinsed, and dried before reuse as indicated.
45. Fumigation and ultraviolet (UV) light should not be used to disinfect operating theaters or other areas of the facility.
Fumigation and use of ultraviolet (UV) light are ineffective methods of reducing the number of microorganisms in health care facilities. In addition, formaldehyde and other agents that are commonly used for fumigation are harmful to staff. These approaches should not be used to disinfect any room in the facility.
Check "YES" if fumigation or UV light is not used to disinfect in the facility.
There are three kinds of waste generated at a health care facility: general, medical, and hazardous chemical waste.
Proper handling and disposal of waste minimizes the spread of infections and reduces the risk of accidental injury to staff, clients, visitors, and the community. All staff should wear utility gloves and shoes when handling medical and hazardous chemical waste.
46. General and medical waste should be separated into appropriate containers at the point at which it is generated.
Separating waste can greatly reduce the amount of waste requiring special handling. Waste should be separated at the point at which it is generated by placing it into bins marked "general waste" and "medical waste." These containers should be emptied frequently. Waste should never be separated at the disposal or transfer site because it needlessly exposes the staff to infectious agents.
Check "YES" if waste is separated at the point at which it is generated as indicated.
47. Solid medical waste should be either burned or buried in a pit.
Properly burning or burying medical waste protects the community from accidental exposure to infectious agents. Burning in an incinerator or oil drum is recommended. Open burning is not recommended, because it causes scattering of waste, is dangerous, and is unattractive.
If medical waste is burned in an incinerator, the following criteria should be met:
If medical waste is buried, the following criteria must be met:
Check "YES" if medical waste is burned or buried as indicated.
48. The community should be protected from possible exposure to medical waste.
Interim storage sites and medical waste-disposal sites should be located in areas that are minimally accessible to staff, clients, and visitors. If they are not contained (e.g., in an incinerator), they should be protected by a barrier such as a fence or wall to keep animals and children out.
Check "YES" if the interim storage site and medical waste-disposal site are located in isolated areas or are protected by a fence or wall as indicated.
49. Liquid medical waste and hazardous chemical waste should be poured down a drain or buried in a pit.
Liquid medical waste and hazardous chemical waste can be hazardous to the environment and should be disposed of according to local regulations. If there are no guidelines, pour solutions down a utility-sink drain, flushable toilet, or latrine, or bury them in a pit. Do not pour solutions directly on the ground or near an outdoor water source.
Check "YES" if liquid medical waste and hazardous chemical waste are disposed of according to local guidelines or as indicated.
50. Medical-waste containers should be cleaned with a disinfectant cleaning solution and rinsed with water daily, or more often, if visibly contaminated.
Staff should always wear heavy utility gloves and shoes when cleaning the containers.
Check "YES" if medical-waste containers are cleaned daily as indicated.
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