Draft Details
- Cleaning and disinfecting of health care facil...
- Draft Standard
- Legal Notice for Draft Standards
- Preface
- + Introduction
- 0.1 Cleaning and disinfecting practices in heal...
- 0.2 Effective cleaning and disinfecting practic...
- 0.3 Microbial contamination on touched surfaces...
- 0.4 Cleaning and disinfecting of environmental ...
- + 1 Scope
- 1.1 Cleaning and disinfecting of HCFs
- 1.2 Cleaning and disinfecting practices in HCFs...
- 1.3 Application to personnel performing cleanin...
- 1.4 Exclusions to cleaning and disinfecting sta...
- 1.5 Terminology
- 2 Reference publications
- + 3 Definitions and abbreviations
- 3.1 Definitions
- 3.2 Abbreviations
- + 4 Approach to cleaning and disinfecting
- + 4.1 General
- 4.1.1 Establishment of cleaning and disinfectin...
- 4.1.2 Training and knowledge requirements for c...
- 4.1.3 Routine and task documentation
- 4.1.4 Cleaning and disinfecting responsibilitie...
- 4.1.5 Notification of spills by patients or vis...
- + 4.2 Cleaning and disinfecting process and frequ...
- + 4.2.1 Cleaning and disinfecting of occupied pat...
- 4.2.1.1 Frequency and targeted moments of clean...
- 4.2.1.2 Engaging with patients and visitors in ...
- 4.2.2 Cleaning and disinfecting of unoccupied r...
- + 4.2.3 Determining increased frequency of cleani...
- 4.2.3.1 General
- 4.2.3.2 Microorganisms requiring a specific dis...
- 4.2.4 Determining disinfectants and disinfectin...
- 4.2.5 Discharge cleaning and disinfecting
- 4.2.6 Dust generated during construction, renov...
- 4.2.7 Daily cleaning and disinfecting of washro...
- + 4.2.8 Cleaning and disinfecting of shared equip...
- 4.2.8.1 Cleaning and disinfecting of portable o...
- 4.2.8.2 Cleaning and disinfecting of fixed, reu...
- 4.2.9 Risk assessment for cleaning and disinfec...
- 4.2.10 High-touch surfaces cleaning and disinfe...
- 4.2.11 Cleaning and disinfecting with cloths an...
- + 4.3 Routine practices
- 4.3.1 General
- + 4.3.2 Hand hygiene
- 4.3.2.1 Adherence to hand hygiene guidelines
- 4.3.2.2 Hand hygiene practices for personnel
- 4.3.2.3 Dedicated use of hand hygiene sinks
- 4.4 PPE for cleaning and disinfecting
- + 4.4.1 General
- 4.4.1.1 Use of PPE by cleaning and disinfecting...
- 4.4.1.2 Use and maintenance of PPE
- 4.4.1.3 Proper removal and disposal of PPE
- 4.4.1.4 Provision and training for PPE and work...
- + 4.4.2 Gloves
- 4.4.2.1 Provision of gloves
- 4.4.2.2 Selection and risk assessment for glove...
- 4.4.2.3 Glove requirements for chemical agent u...
- 4.4.2.4 Requirements for glove usage in patient...
- 4.4.2.5 Use of puncture-resistant gloves for hi...
- + 4.4.3 Additional precautions
- 4.4.3.1 Additional precautions for preventing i...
- 4.4.3.2 Use of PPE in cleaning and disinfecting...
- 4.4.3.3 Patient room signage for additional pre...
- + 4.5 Cleaning and disinfecting products
- 4.5.1 Cleaning agents
- + 4.5.2 Disinfectants
- 4.5.2.1 Use of hospital/healthcare disinfectant...
- 4.5.2.2 Cleaning and disinfecting in visibly or...
- + 4.5.3 Using cleaning and disinfecting agents
- 4.5.3.1 Cleaning and disinfecting process
- 4.5.3.2 Use of cleaning and disinfecting produc...
- + 4.6 Chemical disinfection requirements
- 4.6.1 Requirements for chemical disinfectants
- 4.6.2 Impact of chemical disinfectants on the e...
- 4.6.3 Usage and application of chemical disinfe...
- 4.6.4 Verification of dispensing systems functi...
- 4.6.5 Application of chemical disinfectants on ...
- 4.6.6 Establishment of a SOP for surface wetnes...
- 4.6.7 Prohibition of chemical spraying in occup...
- 4.6.8 Selection and usage of disinfectant wipes...
- 4.6.9 Prevention of chemical disinfectant solut...
- 4.6.10 Equipment maintenance and storage for ch...
- + 5 Specialized areas
- 5.1 General
- 5.2 Policies and SOPs
- + 5.3 Best-practice recommendations and requireme...
- 5.3.1 OR, PACU, labour and delivery, interventi...
- 5.3.2 MDRAs
- 5.3.3 Laboratory
- 5.3.4 Hemodialysis unit
- 5.3.5 Bone marrow transplant departments
- 5.3.6 Pharmacy departments
- 5.3.7 Dental facilities
- 5.3.8 Ambulances and patient transport
- 5.3.9 Morgues and post-mortem rooms
- 5.3.10 Laundry and linen services
- 5.3.11 Food preparation areas
- 5.3.12 Hyperbaric chambers
- 5.3.13 Magnetic resonance imaging (MRI)
- + 6 Sinks and drains
- 6.1 General
- + 6.2 Cleaning and disinfecting of sinks and drai...
- 6.2.1 Cleaning and disinfecting of sinks and sh...
- 6.2.2 Cleaning and disinfecting of sinks
- 6.2.3 Prohibition of liquid waste disposal in c...
- + 6.3 Maintenance of HCF drainage systems
- 6.3.1 Maintenance and auditing of HCF drainage ...
- 6.3.2 Routine maintenance of HCF drainage syste...
- + 6.4 Discharge and transfer disinfecting
- 6.4.1 Standardized discharge/transfer SOP for p...
- 6.4.2 Standardized process of managing plumbing...
- 6.5 Drainage system surveillance
- + 7 Selection, cleaning, and disinfecting of surf...
- 7.1 General
- 7.2 Chemical disinfectant compatibility with su...
- 7.3 Residual disinfectant chemistries
- 7.4 Selection criteria for surfaces exposed to ...
- 7.5 Fabrics
- + 7.6 Soft surfaces
- 7.6.1 Selection criteria for soft surfaces
- 7.6.2 Cleaning, disinfecting and replacement of...
- + 7.7 Furniture, fixtures, and equipment
- 7.7.1 Furniture, fixtures, and equipment requir...
- 7.7.2 Use of water-resistant materials in patie...
- 7.7.3 Maintenance and replacement of furnishing...
- 7.7.4 Use of self-disinfecting surfaces in high...
- 7.8 Equipment procurement
- + 7.9 Electronic devices
- 7.9.1 General
- 7.9.2 Covering
- 7.9.3 Risk assessment
- + 7.9.4 Cleaning and disinfecting
- 7.9.4.1 Cleaning and disinfecting of electronic...
- 7.9.4.2 Considerations for safe use and cleanin...
- 7.9.4.3 Cleaning and disinfecting electronic de...
- + 7.9.5 Responsibility
- 7.9.5.1 Cleaning and disinfecting of electronic...
- 7.9.5.2 Cleaning and disinfecting of electronic...
- 7.9.5.3 Responsibility for cleaning and disinfe...
- 7.9.5.4 Cleaning and disinfecting of electronic...
- + 8 Innovative cleaning and disinfecting technolo...
- 8.1 General
- + 8.2 MIFU, evidence-based standards of practice,...
- 8.2.1 Evaluation of disinfecting systems in HCF...
- 8.2.2 Combined cleaning and disinfecting of env...
- 8.2.3 Use of innovative technologies
- 8.2.4 Responsibilities of the IPAC MDT
- + 8.3 Cleaning technologies
- 8.3.1 General
- + 8.3.2 Electrolyzed, ozonated, and reactive oxyg...
- 8.3.2.1 General
- 8.3.2.2 Electrolyzed water
- 8.3.2.3 Ozonated water
- 8.3.2.3 ROS water
- 8.3.3 Autonomous cleaning equipment
- + 8.4 Bioburden technologies
- 8.4.1 Visible light technology
- 8.4.2 Hands-free devices
- 8.4.3 Antimicrobial paint
- + 8.5 Disinfecting technologies
- 8.5.1 General
- + 8.5.2 Ultraviolet light C (UVC) disinfection
- 8.5.2.1 General
- 8.5.2.2 Mobile, manual UV room disinfection
- 8.5.2.3 Mobile or fixed autonomous UV room disi...
- 8.5.3 Air disinfection using UVGI
- 8.5.4 Fogging systems
- 8.5.5 Self-disinfecting surfaces
- 8.5.6 Photocatalytic oxidation (PCO) disinfecti...
- 8.5.7 Electrostatic spray disinfection
- + 9 Care and storage of supplies
- + 9.1 Prevention of contamination
- 9.1.1 General
- 9.1.2 Distribution and transportation
- 9.2 Sterile supply room
- 9.3 Soiled utility room
- 9.4 Unit or central equipment storage room
- + 9.5 Cleaning closet/equipment rooms
- 9.5.1 Proper use and storage of cleaning and di...
- 9.5.2 Requirements for cleaning closets in care...
- + 9.6 Chemical storage
- 9.6.1 Labelling and storage of chemical cleanin...
- 9.6.2 Periodic checking and monitoring of chemi...
- + 9.7 Cleaning equipment and supply storage
- 9.7.1 General
- 9.7.2 Requirements for storage and maintenance ...
- 9.8 Cleaning carts
- + 9.9 Cleaning equipment and supplies
- 9.9.1 General
- + 9.9.2 Cleaning equipment
- 9.9.2.1 Maintenance and cleanliness of cleaning...
- 9.9.2.2 Disposal and laundering of mop heads
- 9.9.2.3 Selection and storage of toilet cleanin...
- 9.9.2.4 HEPA filter requirements for air vacuum...
- 9.9.2.5 Cleaning and disinfecting of autoscrubb...
- 9.9.2.6 Development and implementation of safet...
- 9.9.2.7 OR department
- 9.9.2.8 Chemical expiry check
- 9.9.2.9 Chemical dispensation and shelf-life la...
- + 9.9.3 Access and use of supplies
- 9.9.3.1 Restricted access
- 9.9.3.2 Chemical use and storage
- 9.9.3.3 Storage around counter sinks
- + 10 Handling of healthcare waste materials
- 10.1 SOPs and waste management plan
- 10.2 Handling of healthcare waste other than hu...
- + 10.3 Handling of human waste
- + 10.3.1 General
- 10.3.2 Waste collection
- 10.3.2.1 Collection of feces
- 10.3.2.2 Collection of urine
- 10.3.2.3 Collection of vomit
- 10.3.3 Management of collected human waste
- + 10.4 Human waste management systems
- 10.4.1 Selection and validation
- 10.4.2 Use of human waste management systems
- 10.5 Transport of human waste containers
- + 10.6 Disposal of human waste
- 10.6.1 General
- 10.6.2 Waste disposal system
- 10.6.3 Use of human waste liners or bags
- 10.6.4 Disposable waste containers
- 10.6.5 Cytotoxic contaminated human waste
- + 10.7 Clean-up of human waste spills
- 10.7.1 Blood and body fluid spills
- 10.7.2 Fecal spills
- 10.7.3 Urine and vomit spills
- + 11 Education, training, and monitoring
- + 11.1 General
- 11.1.1 Requirements for personnel involved in e...
- 11.1.2 Personnel qualifications, education, tra...
- 11.1.3 Cleaning and disinfecting by qualified p...
- + 11.2 Qualifications
- 11.2.1 Supervisory personnel
- + 11.2.2 EVS personnel
- 11.2.2.1 Qualifications
- 11.2.2.2 Competency requirements
- + 11.3 Education and competency assessment
- 11.3.1 Technical training
- 11.3.2 Continuing education
- 11.3.3 Compliance monitoring
- + 12 Health and safety
- 12.1 Minimizing infection risks through educati...
- 12.2 Physical, psychological, and cultural safe...
- + 12.3 OHS issues related to all health care pers...
- 12.3.1 Minimizing OHS risks in HCFs
- 12.3.2 Immunization
- 12.3.3 Personnel exposures
- 12.3.4 Work restrictions
- + 12.3.5 Chemical safety
- 12.3.5.1 Chemical safety policies and SOPs in H...
- 12.3.5.2 WHMIS training and safety documentatio...
- 12.3.5.3 Assessment of personnel with allergic,...
- 12.3.5.4 Chemical storage and handling guidelin...
- 12.3.6 Ergonomic considerations
- 13 Patient and family advisors
- + 14 Quality management system (QMS)
- 14.1 General
- 14.2 Establishment and maintenance of a QMS for...
- + 14.3 Key performance indicators (KPIs)
- 14.3.1 Identification and assessment of KPIs
- 14.3.2 Selection of KPIs
- + 14.4 Audits
- + 14.4.1 General
- 14.4.1.1 Quality verification and control of cl...
- 14.4.1.2 Establishment of oversight and quality...
- + 14.4.2 Audit types for cleaning and disinfectin...
- 14.4.2.1 General
- + 14.4.2.2 Cleaning and disinfecting outcome audi...
- 14.4.2.2.1 Outcome audit policies and SOPs
- 14.4.2.2.2 Patient satisfaction rates or engage...
- 14.4.2.2.3 MSE and electronic portable medical ...
- 14.4.2.2.4 PECD cleaning and disinfecting audit...
- 14.4.2.3 Observational coaching audit
- 14.4.2.4 Organizational financial and business ...
- 14.4.2.5 OPR
- 14.5 Incident management
- 14.6 Environmental Microbial cultures during ou...
- + 15 Pest control management
- 15.1 Integrated pest management system (IPMS)
- + 15.2 Pest management
- 15.2.1 Preventing pests from entering the HCF
- + 15.2.2 Responding to and identifying sightings
- 15.2.2.1 SOP for pest management in HCFs
- 15.2.2.2 Training on identifying potential pest...
- 15.2.2.3 Pest control trap placement, inspectio...
- 15.2.3 Third-party pest control contract servic...
- 15.3 Pest prevention
- + Annex A (informative)
- A.1 Introduction
- A.2 Environmental impacts
- + A.3 Sustainable cleaning and disinfecting
- A.3.1 Integrating sustainable cleaning and disi...
- A.3.2 Key factors to be considered
- A.3.3 Equipment used
- A.3.4 Product packaging and shipping considerat...
- A.3.5 Single-use items
- A.3.6 Innovative cleaning and disinfecting tech...
- + A.4 Recommendations and best practices
- A.4.1 General
- A.4.2 Recommendations
- A.4.3 Best practices
- A.5 Additional references for sustainability
- + Annex B (informative)
- B.1 Introduction
- B.2 Chain of transmission
- + B.3 Role of air in pathogen transmission
- B.3.1 Introduction
- B.3.2 Particle interactions
- B.3.3 Exposure to microorganisms suspended in t...
- B.3.4 Particle clouds
- B.3.5 Human activity and air displacement
- + B.4 Role of water in pathogen transmission
- B.4.1 General
- B.4.2 Reservoir for pathogens
- B.4.3 Biofilm formation
- B.4.4 Routes of transmission
- B.4.5 Aerosolization
- + B.5 Role of surfaces in pathogen transmission
- B.5.1 General
- B.5.2 Transfer of microorganisms to healthcare ...
- B.5.3 Survival of microorganisms
- B.6 Role of vectors in pathogen transmission
- B.7 Zoonosis
- B.8 Role of common-vehicles in transmission
- B.9 Additional references for the mechanisms of...
- Annex C (informative)
- + Annex D (informative)
- D.1 General
- + D.2 Transmission of microorganisms within healt...
- D.2.1 General
- D.2.2 Medical devices
- + D.3 Wet Surface Biofilm
- D.3.1 General
- D.3.2 Water reservoirs
- D.3.3 Moist Surface reservoirs
- + D.3.4 Challenges of cleaning and disinfecting
- D.3.4.1 Factors affecting effective cleaning an...
- D.3.4.2 Mechanical action and friction
- D.3.4.3 Disinfection
- D.3.4.4 Training and SOPs
- D.3.4.5 Quality improvement
- + D.3.5 Remediation of wet reservoirs containing ...
- + D.3.5.1 Drain remediation
- D.3.5.1.1 General
- + D.3.5.1.2 Example of a drain remediation proced...
- D.3.5.1.2.1 General
- D.3.5.1.2.2 Products and equipment typically us...
- D.3.5.1.2.3 PPE
- D.3.5.1.2.4 Procedure
- D.3.5.1.2.5 Unsuccessful salvage protocol
- D.3.5.1.2.6 Ongoing protocol after new extended...
- D.3.5.1.2.7 Discharge protocol
- D.3.5.1.2.8 Additional precautions for MDRO out...
- + D.4 Dry Surface Biofilm
- D.4.1 General
- D.4.2 Surface reservoirs
- D.4.3 Detection of dry surface biofilm on healt...
- D.4.4 Ensuring removal of dry surface biofilm f...
- + D.5 Combined technologies
- D.5.1 General
- D.5.2 Multi-pronged approach
- D.5.3 Targeting different areas
- D.5.4 Addressing different pathogens
- D.5.5 Preventing recontamination
- D.5.6 Effective specific combinations
- D.5.7 Point-of-use automated disinfection syste...
- D.6 Additional references on biofilms
- + Annex E (informative)
- E.1 General
- E.2 Systems approach to cleaning and disinfecti...
- + E.3 UV light systems
- E.3.1 Utilization of UV light for inactivation ...
- E.3.2 Dose and dosage determination
- E.3.3 Safety measures for UV light disinfecting...
- E.3.4 Manual UV disinfecting devices and strate...
- E.3.5 Mobile autonomous UV room disinfecting de...
- E.3.6 Fixed autonomous UV room disinfecting dev...
- E.3.7 UVGI for airborne contamination reduction...
- E.3.8 Odour after use of UV light
- E.4 Visible light and UV-A disinfection
- + E.5 Self-disinfecting surfaces
- E.5.1 General
- E.5.2 Use of Cu alloys in HCFs
- E.5.3 Investment considerations for self-disinf...
- E.5.4 High-touch surfaces for self-disinfecting...
- E.5.5 Antimicrobial paint
- E.6 PCO disinfection
- E.7 Electrostatic spray disinfection/pulverizat...
- E.8 Fogging
- + E.9 Ozonated, ROS, and electrolyzed water
- E.9.1 General
- E.9.2 Ozonated water
- E.9.3 ROS water
- E.9.4 Electrolyzed water
- E.10 Additional references for innovative clean...
- + Annex F (informative)
- F.1 Sample procedure for cleaning and disinfect...
- F.2 Sample procedure for cleaning and disinfect...
- + Annex G (informative)
- G.1 Organizational financial and business proce...
- G.2 Observational coaching audit form
- + Annex H (informative)
- H.1 General
- H.2 Choice of surfaces to be marked
- H.3 Environmental marking method
- H.4 Selection of marker
- H.5 Benefits
- H.6 Limitations
- H.7 Results interpretation
- H.8 Use of audit results
- H.9 Additional references on environmental mark...
- + Annex I (informative)
- I.1 General
- I.2 Use of ATP tests
- I.3 Execution of the ATP test
- I.4 Considerations when using rapid ATP meters ...
- I.5 Additional references for ATP audits
- + Annex J (informative)
- J.1 Introduction
- J.2 Application
- J.3 Limitations
- J.4 Methodology
- J.5 Use of neutralizing media to optimize detec...
- J.6 Use of culture results
1.1 Cleaning and disinfecting of HCFs
This Standard applies to the cleaning and disinfecting of HCFs providing health care services including, but not limited to, inpatient services or outpatient services. It applies to all facilities, public or private, that provide health care treatments, health-related services, or diagnostic testing services, regardless of type, size, location, or range of services.
1.2 Cleaning and disinfecting practices in HCFs
This Standard is intended to address the cleaning and disinfecting of HCFs that includes both manual cleaning and disinfecting practices and automated environmental cleaning and disinfecting systems. This includes all environmental surfaces, and the air within the HCF.
1.3 Application to personnel performing cleaning and disinfecting in HCFs
This Standard applies to all personnel, regardless of their departmental affiliation or professional designation (whether directly employed by the HCF or out-sourced personnel) who perform cleaning and disinfecting functions in HCFs. This Standard also applies to all other parties involved in the cleaning and disinfecting process.
1.4 Exclusions to cleaning and disinfecting standard
This Standard does not apply to
a) cleaning and disinfecting of food services environments, except for the cleaning and disinfecting of food preparation areas (see Clause 5.3.11);
b) cleaning and disinfecting of critical or semi-critical medical devices (see CAN/CSA-Z314);
c) plumbing installation (see CSA Z317.1);
d) HVAC installation (see CSA Z317.2);
e) management of health care waste materials (see CSA Z317.10); and
f) laundering of reusable medical textiles (see CAN/CSA-Z314).
1.5 Terminology
In this Standard, “shall” is used to express a requirement, i.e., a provision that the user is obliged to satisfy in order to comply with the Standard; “should” is used to express a recommendation or that which is advised but not required; and “may” is used to express an option or that which is permissible within the limits of the Standard.
Notes accompanying clauses do not include requirements or alternative requirements; the purpose of a note accompanying a clause is to separate from the text explanatory or informative material.
Notes to tables and figures are considered part of the table or figure and may be written as requirements.
Annexes are designated normative (mandatory) or informative (non-mandatory) to define their application.
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