Enhancing Infection Control in Aged Care with Colour Coding

Cleaning is a cornerstone of infection control, especially in environments as sensitive as aged care facilities. The accumulation of dust, dirt, and microbes on surfaces poses a significant risk of infection transmission. Maintaining impeccable hygiene in these settings is not just best practice; it’s a critical measure to protect vulnerable residents. This article outlines essential cleaning procedures for aged care facilities, emphasizing the vital role of colour coding in enhancing infection control.

Fundamental Cleaning Principles for Aged Care

Effective cleaning protocols are built upon a foundation of sound principles. In aged care, these principles are amplified due to the heightened susceptibility of residents to infections. Adhering to the following guidelines is paramount:

Develop Comprehensive Written Protocols: A detailed cleaning protocol is indispensable. This document should specify cleaning methods, frequencies for different areas, and clear guidelines for the supply and usage of cleaning and disinfectant products. It should be readily accessible and regularly reviewed to ensure its relevance and effectiveness.
Implement Standard Precautions Consistently: Protecting cleaning staff is as important as protecting residents. Standard precautions, including the appropriate use of Personal Protective Equipment (PPE), must be rigorously followed during all cleaning activities. This safeguards staff from potential exposure to pathogens.
Prioritize Aerosol-Reducing Cleaning Methods: Certain cleaning methods can inadvertently spread contaminants through the air. Techniques that minimize aerosol generation are preferred. For instance, damp cleaning is preferable to dry sweeping to prevent the dispersal of dust and microbes.
Maintain Hygiene of Cleaning Supplies: Reusing cleaning items without proper processing can negate cleaning efforts and spread contamination. All cleaning equipment, such as cloths and mop heads, should be changed after each use and thoroughly cleaned and dried before reuse. In situations involving spills of blood or bodily fluids, immediate replacement is crucial. Single-use items are highly recommended whenever feasible, particularly for critical tasks.
Avoid Sprays in Routine Cleaning: Spray bottles can become breeding grounds for bacteria and are difficult to clean effectively. Furthermore, sprays often fail to provide consistent surface coverage, reducing their efficacy. Alternative application methods for cleaning solutions are advisable.
Never Mix Cleaning Chemicals: Combining different cleaning agents can produce hazardous chemical reactions and diminish the effectiveness of the products. Strict adherence to product-specific instructions and avoiding mixtures are essential safety practices.
Prepare Fresh Cleaning Solutions Daily: The efficacy of cleaning solutions can degrade over time. To ensure optimal performance, all cleaning solutions should be freshly prepared at the start of each cleaning session.

Specific Cleaning Procedures in Aged Care Settings

Surface Cleaning Protocols

Maintaining clean surfaces is a primary defense against infection spread. The following procedures are essential for aged care facilities:

Floors: Floors should be cleaned daily or more frequently as needed. Vacuum cleaners equipped with particulate-retaining filters are recommended to minimize dust dispersal. Ensure filters are changed according to the manufacturer’s guidelines. When vacuuming, direct exhaust away from the floor to prevent dust circulation. Ducted vacuum systems can also be used, provided exhaust air is safely vented. Damp dusting with lint-free cloths is crucial for effective surface cleaning. Brooms are discouraged in resident areas due to their tendency to spread dust and bacteria. Dust-retaining mops, while better than brooms, should still be used cautiously in high-risk areas.
Routine Surface Cleaning Procedure:
- Prepare all cleaning solutions immediately before use.
- Clean work surfaces with a neutral detergent and warm water solution. Wipe, rinse, and dry surfaces before and after each task or when visibly soiled. Address spills promptly.
- When disinfection is necessary, strictly follow the manufacturer’s instructions for disinfectant use and adhere to workplace health and safety guidelines.
- Empty buckets after each use, wash them with detergent and warm water, rinse with hot water, and store them upside down to dry completely.
- Launder mops or clean them with detergent and warm water, rinse in hot water, and store them dry. Mop heads should be detachable or stored facing upwards to facilitate drying and prevent bacterial growth.

Colour Coding: A Key Enhancement for Infection Control

To further enhance cleaning efficacy and prevent cross-contamination in aged care, implementing a colour-coding system is highly recommended. Colour coding assigns specific colours to cleaning equipment and supplies based on the area or task they are intended for. This visual system minimizes the risk of using the same cleaning cloth or mop in different zones, thereby preventing the transfer of pathogens from potentially contaminated areas to cleaner ones.

A typical colour-coding system in aged care might look like this:

Red: Bathrooms and toilets – areas with the highest risk of contamination.
Blue: General areas, including resident rooms, hallways, and offices.
Green: Kitchen and food preparation areas.
Yellow: Isolation areas or areas where specific infection risks are present.

By consistently using colour-coded equipment, cleaning staff can easily adhere to designated zones, reducing the likelihood of cross-contamination and contributing significantly to a safer environment for residents. Training staff on the colour-coding system and regularly reinforcing its importance are vital for its successful implementation.

Cleaning in Specialised Areas within Aged Care

Certain areas within aged care facilities require heightened cleaning frequencies and protocols due to their specific functions and potential for contamination:

Isolation Rooms and Ensuite Bathrooms: Clean at least twice daily, or more frequently depending on the type of microorganism of concern.
Operating/Procedure Rooms (if applicable): Clean after each session and when visibly soiled. Thorough daily cleaning is also necessary.
Oncology Areas (if applicable): Clean twice daily due to residents’ compromised immune systems.
Sterile Processing Departments (if applicable): Clean at least twice daily and when visibly soiled to maintain sterility.

Wet Area Cleaning

Wet areas are prone to microbial growth and require diligent and frequent cleaning:

Toilets, sinks, washbasins, baths, and shower cubicles: Clean daily and more frequently as needed.
Shower, bath, and handbasin fittings: Clean daily and more frequently as needed.
Surrounding floor and wall areas: Clean daily and more frequently as needed.

Cleaning Walls, Fittings, and Fabrics

Walls and screens: Clean quarterly or when visibly soiled.
Blinds and curtains: Clean quarterly or when visibly soiled. Consider more frequent cleaning in high-risk areas or during infection outbreaks.
Carpets: Vacuum daily. Hard floors should be washed daily and when soiled. Consider the suitability of carpets in high-traffic or high-risk areas of aged care facilities due to cleaning and infection control challenges.
Bed and examination screens: Change weekly and when visibly soiled. Opt for disposable screens where practical or ensure robust cleaning protocols for reusable screens.

Managing Spills of Infectious Agents

Specific protocols are necessary for managing spills of infectious materials:

Creutzfeldt-Jakob Disease (CJD) Agents: Absorb spills of central nervous system tissue or cerebrospinal fluid with paper towels and incinerate them. Soak the surface with one molar sodium hydroxide or 2.0–2.5 percent sodium hypochlorite for 1 hour, then clean again with paper towels and incinerate.
Other Infectious Disease Agents (e.g., blood, body fluids): Follow standard spills management procedures. PPE used during cleanup should be incinerated. Reusable eye protection should be cleaned according to established protocols.

Maintenance of Cleaning Equipment

Proper maintenance of cleaning equipment is integral to preventing contamination and ensuring effective cleaning:

Change cleaning items (solutions, water, cloths, mop heads) after each use and immediately after cleaning blood or body fluid spills.
Wash reusable items in detergent and warm water, rinse, and store them dry between uses. Launder detachable mop heads between uses.

Spills of Laboratory Cultures (if applicable)

Absorb spills of laboratory cultures with paper towels and dispose of them as clinical waste. Treat contaminated surfaces with 2.0–2.5 percent sodium hypochlorite for 1 hour and clean again with paper towels, disposing of them as clinical waste. Refer to relevant laboratory safety guidelines for detailed procedures.

Waste Disposal in Aged Care

Aged care facilities must have robust waste management policies and procedures in line with environmental and health regulations. Waste is generally categorized into:

General waste: Dispose of in designated general waste bins.
Clinical waste: Place in biohazard bags (typically yellow with a biohazard symbol) as soon as possible. Single-use sharps must be placed directly into sharps containers meeting relevant safety standards.
Pharmaceutical waste: Return leftover pharmaceuticals to a pharmacy for proper disposal. Never dispose of medications in general waste or down drains.

Clinical and pharmaceutical waste should be stored securely and collected by licensed waste disposal companies for specialized treatment and disposal. Waste should be removed from clinical areas at least three times daily, or more frequently as needed, and waste bags should be securely tied before removal.

Conclusion

Maintaining a clean and hygienic environment is paramount in aged care to safeguard the health and well-being of vulnerable residents. Implementing comprehensive cleaning protocols, adhering to best practices, and embracing enhancements like colour coding are essential steps. By prioritizing meticulous cleaning and consistent infection control measures, aged care facilities can significantly reduce the risk of infection transmission and provide a safer, healthier living environment for their residents. Regular training, monitoring, and review of cleaning protocols are crucial to ensure ongoing effectiveness and adaptation to evolving best practices in infection control.