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Cleaning Standards, Time Standards, and Workloads

Achieving Attainable Cleaning Standards

There are numerous factors involved to achieve the cleaning standards necessary to help

control the possible outbreak of microbial infections:

● Items to be cleaned

● Methodology required (equipment, chemicals, materials and physical ergonomics) to

clean the items

● Frequencies of cleaning tasks

● Worker fatigue factors

● Accepted time standards to clean items

“The Cleaning Standards determine what the object will look like after using the proper

procedure to clean that object. The frequency of how often that object will be cleaned over a

period of time is a factor in setting the standard of cleanliness. The department’s budget is

another factor. The budget determines the frequency by which the object will be cleaned. The

more hours the budget has the more frequently the object is cleaned, the greater the frequency

the higher the quality of cleanliness. The formula, as follows, is simple:

CLEANING TASK X FREQUENCY = QUALITY LEVEL OF CLEANLINESS”

Time Standards

Time standards are used to assist in constructing fair work loads for the ‘qualified’ worker. “A

qualified worker is one who is accepted as having the necessary physical attributes, who

possesses the required intelligence and education, and who has acquired the necessary skill

and knowledge to carry out the work in hand to satisfactory standards of safety, quantity, and

quality.”

Source: Introduction to Work Study, International Labour Office Geneva, 1981, Geneva,

Switzerland.

The following examples of time standards are taken from the ISSA (International Sanitary

Supply Association “447 Cleaning Times” publication, 2003.

Note: Healthcare facilities cleaning times could vary from the following examples due to

equipment, materials and methodologies used to carry out the cleaning tasks.

Questions? Contact Us Ontario Healthcare Housekeeping Association (OHHA), 2892 South Nation Way, South Mountain, ON, K0E 1W0 https://ohha.org | [email protected] | 1-613-352-5696

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Workloads

“Workload is the assigned routine of tasks developed for any shift. The activities that take place

in a health-care facility are never totally predictable on a day to day, week to week, or month to

month basis. The best that can be predicted is based on an average of probable activity. The

cleaning activity in an office area can be measured objectively since the cleaning usually takes

place at night when the office staff is less likely to be working and therefore less likely to

interfere with the cleaning staff. Measuring the workload of cleaning activity in a nursing unit

must involve the variable of discharge rates of that particular nursing unit.2

Workloads are not just the accumulation of total tasks required to fulfill the amount of time to

fill the shift. Worker fatigue must also be taken into account when developing workloads that

are fair and equitable. When ‘time standards’/’cleaning times’ are used to theoretically develop

workloads, are the ‘time standards’/cleaning times’ cohesive to the equipment, materials and

methodologies used in your healthcare facility?

If not, then ‘time studies’ should be conducted to develop ‘time standards’ consistent with the

equipment, materials and methodologies in your healthcare facility. Time studies must be

conducted by those qualified and experienced in the housekeeping field.


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Quality Control Model

The results of ‘Patient/Resident Satisfaction Surveys’ are indicative of the ‘patient/resident’s

perception of the services rendered and of the environment in which they are serviced.

Perceptions are not always indicative of the services that have been provided nor are

perceptions always indicative of the state of the environment in which those services are

provided.

The cleaning service is directed to provide a facility that is clean and safe for patients, residents,

staff and visitors. The responsibility for ensuring that the cleaning standards are adhered to lies

not just with the person performing the task but also with the direct supervisor and

management of the department providing the cleaning service.

Figure 1 Quality Control Model

The Quality Control Model assumes that:

a) The method of performing the task has been proven, through a work study, to be the proper

method to use to ensure that the cleaning standard will be attained.

b) The method of training facilitates ease of adequately understanding the method of

performing the task required to achieve the cleaning standard for the item or area.

‘Figure 1’ also applies to any inspections required to maintain quality control for regular staff. It is the responsibility of the management of the department, responsible for cleaning, to ensure that regular inspections are completed.


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The following two systems are samples of inspection formats used.

Systems No.1 and No.2 were excerpted from – University of Windsor and Ontario Health Care

Housekeepers’ Association ‘Housekeeping Methodology’ January 1995

System No.1 – The items not inspected in this system are not counted in the percentage factor.

This system only allows for the items inspected as “cleaned” (satisfactory) or “not cleaned”

(unsatisfactory).

System No. 2 – The items in this system are given a rating of priority or a ‘weighed factor’, such

as 1 to 9, with 1 being least of priority and 9 being of greatest priority.

Example of rating items for priority: bed = 9

bedside locker = 9

floor = 7

mirror = 1

overbed table = 9

toilet = 9

Scoring these same items in terms of quality cleaning need not be difficult. First, has the item

been cleaned? Secondly, does the cleaned item meet or exceed the cleaning standard? If the

item has not been cleaned, has it been neglected for just one day or is there an inordinate

amount of dust, dirt accumulation or stains on the item?

If the scoring rating system has a greatest value of 9, then the scoring system should not exceed

9.

The following illustrates how to score

the quality of work: neglected badly = 1 (rather disgusting)

not completed to standards = 3

satisfactorily completed to standards = 5

completed and exceeds standards = 7 (this item shines)


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High Touch Point Cleaning Checklist

Unit/Ward: __________________ Date: __________________ Room #: _______________________ Start time: _______________

Employee (print name): ___________________________ Finish time: ______________

DONN Appropriate PPE according to Additional Precautions Use appropriate hospital grade disinfectant

High Touch Patient Room Initial Doorknob and Door lock Light Switch Sink Surface/Counter Faucets and Tap Handles Linen Hamper Mobile Equipment (Medical equipment, wheelchairs, mobility aids) Alcohol Based Hand Rub Dispenser Soap Dispenser Paper Towel Holder Bed Rails Overbed Table Call Bell Footboard/Headboard Bedside Table T.V./Monitors Podium/Pick Cart (if applicable) Chair/Sleep Chair Light Pull Phone Patient Locker Handle Washroom High Touch Areas Doorknob and Door Lock Sink Surface Faucet and Tap handles Grab Bars Shower (grab bars and tap handles if applicable) Call Bell Paper Towel Dispenser Toilet Paper Dispenser Toilet Surface, (seat, bowl, toilet base, toilet handle) Commode thoroughly cleaned (if applicable) Doff PPE and Perform Hand Hygiene

Discharge/Terminal Clean for Patient Room in Additional Precautions

Unit/Ward: __________________ Date: __________________ Room #: ___________________ Start time: _____________ Employee (print name): ___________________________ Finish time: ____________ DONN Appropriate PPE according to Additional Precautions Use appropriate hospital grade disinfectant Item Initial Remove all garbage/wipe down can inside & out/reline Remove all linen and strip bed/do not shake bedding, remove 1 piece at a time Remove all privacy curtains Wipe down all mobile equipment Wipe down door inside and out, top and frame of door Dust and wipe down tops of locker/ wardrobes Wipe down ceiling lights and vents outside Wipe down privacy curtain lift tracks Wipe down any ceiling lifts and tracks Wipe down mounted wall features, whiteboards, PPE cupboards, mirrors, pictures Wipe down wall mounted equipment and TV bracket Wipe down TV arm and screen sides and back Wipe down light pull cord and call bell Wipe down inside and outside lockers/wardrobe, door and handle Wipe down all horizontal surfaces from clean to dirty Wipe down bedside table, drawers and all sides Wipe down over bed table underneath, base, sides and drawers Wipe down chairs and furniture Dust and wipe down light over handwashing sink Clean mirror/taps & faucets/ hand washing sink basin Wipe down dispensers, inside and out Clean exposed plumbing Wipe down bed controls/head & foot board/entire frame & casters Inspect mattress for damage and wipe down pillows Wipe down all sides of mattress/top and bottom and allow to air dry before making the bed Wipe down windowsills and clean windows Wipe down wall vents / radiators/ grills Wash walls and inspect for damage Dry mop floor Wet mop floor Remove barrier/isolation sign when room is clean Wipe all housekeeping tools after cleaning room Doff PPE and perform hand hygiene

Isolation Terminal Clean Washroom Checklist

Unit/Ward: __________________ Date: __________________ Room #: ___________________ Start time: ______________ Employee (print name): ___________________________ Finish time: _____________ DONN Appropriate PPE according to Additional Precautions Use appropriate hospital grade disinfectant Item Initial Remove all garbage/wipe down can inside & out/reline Wipe door, doorknob, frame Wipe light switches, wall fixtures Remove shower curtain Wipe shower stall walls, grab bar, shelves and call bell Dust and wipe down light over washroom sink Dust/wipe vents (outside) Clean mirror Wipe taps, faucets and sink basin Clean exposed hand wash sink plumbing Wipe down soap dispenser Wipe down paper towel dispenser Wipe down toilet paper dispenser Wipe down call bell Wipe down handrails and grab bars Apply hospital grade disinfectant under rim of toilet With toilet bowl mop clean under rim and toilet bowl Wipe toilet, seat, rim and outside of toilet Wipe base of toilet and exposed plumbing Wipe commode surfaces/top, sides & under seat, frame and casters Remove toilet paper, discard & wipe down dispenser Remove paper towels, discard & wipe down dispenser Wash all walls Dry mop floor Wet mop floor Wipe all tools after clean Doff PPE and perform hand hygiene

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