Effective cleaning in schools and senior living facilities

In my last article, I highlighted the connection between the contaminants on the floor and the superbug risks for patients in hospitals. In this article, you might wonder why we have joined schools and our seniors together.

Well, there are two good reasons. First, both cleaning contexts involve people who are at an elevated risk of serious health complications from infectious diseases and common microbial pathogens, such as the influenza virus.

Children are at risk because their immune systems are still developing. For this reason, they can be more vulnerable to serious complications with germs that would pose little threat to a normal adult.

The older members of our communities, particularly the frail and infirm, often have many other existing health conditions.

These other health difficulties can add up and leave the elderly with a lower immune response to fight off germs that in the past may have caused them no more than a passing cold or flu.

This is also the case with the risks associated with the COVID-19 pandemic involving the SARS-CoV-2 virus (the latest designated name for this novel coronavirus), particularly for the elderly, and especially when they are living in close proximity to each other.

The second reason to link schools and senior care is cleaning. In both the school and senior living facilities, the standards of cleaning are often poor, and cleaning is conducted without meaningful quality control.

The cleaning processes, when performed badly, will simply move the germs around rather than remove them altogether.

The purpose of cleaning is “to remove germs and soils,” says industry expert Dr. Mike Berry, and where cleaning simply moves the germs from one place to another, this amounts to cleaning failure, and probably negligent conduct.

The common feature in both schools and senior living facilities is the close proximity of people to each other. Also, there is the abundant frequency of commonly touched surfaces. So, if one person gets an infectious germ, then the closer proximity increases the likelihood of person to person spread, or person to surface to person spread.

Surface contamination

Remember this simple principle: “What gets touched gets contaminated.”

So, what are the items that get touched most frequently in schools and senior living facilities? In no particular order, every surface, tap, knob, door, and object in a bathroom, everything around where people eat, most doorknobs, and all corridor and staircase railings.

In schools, you can include school desks, cafeteria tables, and racking for cafeteria trays. In senior living facilities you can also include bed railings, bed trays, call buttons, and walking aids.

There is a relatively new term used in healthcare settings to indicate high touch objects and surfaces. That term is HTO (high touch objects and surfaces).

Focusing cleaning efficacy around HTO is the best way to minimise the spread of infectious organisms via hand touch. The contaminated surface and contaminated hands are inevitably connected via the act of touching something.

So, to clean an HTO, the key concern should always be to remove the germs and soils, as well as achieve a clean looking object or surface.

There are two key points to consider in the cleaning process. First, what is “thorough cleaning” and how can it be measured? And second, given wiping is the most fundamental activity in any cleaning process, what does “effective wiping” really mean, and can it be measured?

Thorough cleaning

Remembering what Dr. Mike Berry says, that cleaning is “…the removal of unwanted germs and soils,” thorough cleaning must, therefore, include and reflect the removal of germs and soils.

In the context of schools and senior living facilities, this means the removal of the germs and soils that frequent those locations, particularly on the HTO. Measuring the cleaning process involves using a fluorescent marker (FM).

Pricing drives the cleaning tendering process rather than the quality of cleanliness outcome. Where no valid scientifically based measurements are taken to assess the quality outcome, germs and superbugs can exploit the failure with both survival and infectious intent.

Too often the scale of cleanliness is assessed using only a visual or sensory method (e.g. visual dust or malodorous smell), and so germs (which cannot be seen with normal eyesight), survive in biofilms or layers of soil that is left behind after the cleaning staff has passed by.

Measuring the cleanliness outcome should involve microbiology, (FM) fluorescent marker or ATP (adenosine triphosphate) measurement. Studies have demonstrated that where the cleanliness outcome is improved, the risk of disease transmission is lowered. This applies equally to schools and senior living facilities.

For schools, there is an additional benefit because both the health and educational outcomes for students are improved through better cleaning outcomes.

So, what should we do? Focus on cleaning quality in schools and senior living facilities to reduce the risk of disease transmission in these community settings. This will by necessity involve improved monitoring of the quality of the cleanliness as an objective outcome.

As responsible and professional members of the cleaning community, with superbug threats on one side, and the new COVID-19 disease risk on the other (all are spread via droplet and surface contact), we need to be vigilant to ensure that what gets touched gets decontaminated.

Dr Greg Whiteley is chairman of Whiteley Corporation. This article first appeared in ISSA Today and has been re-published in the July/August issue of INCLEAN magazine with permission. 

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3 thoughts on “Effective cleaning in schools and senior living facilities

  1. I have been working in the cleaning industry for over 40 years and see it all too often it boils down to the price
    No one is worried about how clean but how much
    Wages paid down the line means the big boys get paid and what is left for the workers is minimal (contract holder,sub contractor and then the workers)
    Most of the contract managers don’t even know what the place looks like and have never cleaned in their life
    Why not encourage proper pay for the people doing the job they will show some interest instead of I DON’T GET PAID ENOUGH TO DO THAT

  2. Unprofessionalisn at all levels of Covid cleaning is simply “Fatal”,training is imperative, cleaners cant get conscientious if they are paid peanuts, $50.00 an hour should be minimum and thats for the cleaner not the contractor, they must have total realization that slack attention to the job can and will be responsible for their illness and the same with 3rd parties, the final act may be death, Covid cleaning is as important as Forensic cleaning and should be treated as such. We read at the minimal attention applied by Security personel attending to people in Quarantine and the incredible spread of covid 19 by that action, if cleaners were to act in that same manner then their time in the Covid cleaning industry will be indeed short.There needs to be a standard set by the Industry now in relation to Covid cleaning, and endorsed by the Dept of Health, now, next week will be too late.

  3. Current Australian Cleaning Standards in Health Care Facilities and the internal and external auditing process, most likely needs to expand it’s reach to include public areas such as schools, kindergartens, libraries, prisons, health/fitness operations, or more astutely where large amounts of traffic occur on a daily basis. Internal “Infection Control” teams operating in hospitals most likely will now be needed and utilised in such areas in a capacity which best suits each diverse setting. Whether that engages the need to test surfaces for existing pathogens, virus or bacteria could be argued. The current status when conducting external audits is based on the concept of visual appearances of surfaces being maintained. The knowledgeable or well informed/trained cleaner is well aware of “touchpoints” or ‘High Touch Surfaces”. They are always dealing with such fittings on a daily basis.
    The appearance of Covid 19 in our lives translates for the cleaner into more frequent cleaning of these surfaces and the adaptation of suitable cleaning techniques as well as chemicals used. Not to mention the greater use of personal protective equipment. The approach to cleaning requires a similar level of outcomes as stated in the standards used for health care facilities nationally. Cleaning just got more expensive. It is for management to educate the greater population and clientele as to why this cost is greater and why it should be greater. It is also the onus of management to demonstrate to their staff through better wages and training opportunities, this cost increase.

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