Appendix B1 – Cleaning procedure summaries for general patient areas

Best Practices for Environmental Cleaning in Global Healthcare Facilities with Limited Resources

At a glance

  • Cleaning procedure summaries for general patient areas in global healthcare settings.
  • The materials on this page were created for use in global healthcare facilities with limited resources, particularly in low- and middle-income countries.

General outpatient area (adult)

This is a low-risk area because the probability of contamination and the vulnerability of the patients to infection is low; however, procedural areas are moderate risk and therefore require more frequent and rigorous environmental cleaning.

Appendix B1 Table 1. Cleaning Procedure Summaries for General Outpatient Areas (Adult)

Cleaning Procedure Summaries for Adult Outpatient Areas by Area Description, Frequency, Staff, Products, and Techniques.
Area Description Frequency Person/Staff Responsible Products/Technique Additional Guidance/Description of Cleaning
Waiting/ admission areas (Adult) At least daily Cleaning staff Clean (neutral detergent and water):
  • high-touch surfaces
  • floors
 In addition, clean low-touch surfaces on a scheduled basis (e.g., weekly)
Consultation/ examination areas (Adult) At least twice per day Shared cleaning possible: clinical and cleaning staff Clean (neutral detergent and water):
  • high-touch surfaces
 Last clean of the day: clean the entire floor with neutral detergent and water

In addition, clean low-touch surfaces on a scheduled basis (e.g., weekly)
Minor operative procedure rooms Before and after (i.e., between) every procedure Shared cleaning possible: clinical and cleaning staff Clean and disinfect:
  • any surface visibly soiled with blood or body fluids
  • high-touch surfaces in the patient zone
  • floors in the patient zone
 Last clean of the day clean and disinfect:
  • other high-touch surfaces
  • low-touch surfaces
  • handwashing sinks
  • scrub/sluice areas
  • the entire floor

General inpatient area (adult)

This is a low-risk area because the probability of contamination and the vulnerability of the patients to infection is low.

Appendix B1 Table 2. Cleaning Procedure Summaries for General Inpatient Areas (Adult)

Cleaning Procedure Summaries for General Adult Inpatient Areas by Type, Frequency, Staff, Product, and Description.
Type of Clean Frequency Person / Staff Responsible Products/Technique Additional Guidance / Description of Cleaning
Routine clean At least daily Cleaning staff Clean (neutral detergent and water):
  • high-touch surfaces in the patient zone
  • handwashing sinks
  • floors
 In addition, clean low-touch surfaces on a scheduled basis (e.g., weekly)
Terminal clean At patient discharge or transfer Shared cleaning possible: clinical and cleaning staff Clean and disinfect:
  • high-touch surfaces
  • low-touch surfaces
  • floors
  1. Remove soiled/used personal care items (e.g., cups, dishes) for reprocessing or disposal.
  2. Remove facility-provided linens for reprocessing or disposal; see Appendix D – Linen and laundry management.
  3. Inspect window treatments. If soiled, clean blinds on-site, and remove curtains for laundering.
  4. Reprocess all reusable (noncritical) patient care equipment; see 4.7 Noncritical patient care equipment.
  5. Clean and disinfect all low- and high-touch surfaces, including those that may not be accessible when the room/area was occupied (e.g., patient mattress, bedframe, tops of shelves, vents), and floors.
  6. Clean (scrub) and disinfect handwashing sinks.

Patient area toilets

These are high-risk areas because they have high patient exposure, are frequently contaminated, and therefore pose a higher risk of pathogen transmission than other general patient areas.

Appendix B1 Table 3. Cleaning Procedure Summaries for Patient Area Toilets

Cleaning Summaries for Patient Area Toilets by Area, Frequency, Staff, Products, and Description.
Area Description Frequency Person/Staff Responsible Products/Technique Additional Guidance/Description of Cleaning
Toilets for general inpatient and outpatient areas; frequently used by visitors, family members
At least once daily (private patient room)

At least twice daily (public/shared toilets) and as needed

 Cleaning staff Clean and disinfect:
  • high-touch / frequently contaminated surfaces handwashing sinks
    • faucets
    • handles
    • toilet seat
    • door handles
  • floors
  • any surface visibly soiled with blood or body fluids
 In addition, clean low-touch surfaces on a scheduled basis (e.g., weekly).

Patient area floors

Floors in general inpatient and outpatient areas generally have low patient exposure (i.e., are low-touch surfaces) and pose a low risk for pathogen transmission.

Appendix B1 Table 4. Cleaning Procedure Summaries for Patient Area Floors

Cleaning Procedure Summary for Patient Area Floors by Area, Frequency, Staff, Products, and Description.
Area Description Frequency Person/Staff Responsible Products/Technique Additional Guidance/Description of Cleaning
Floors in general inpatient and outpatient areas, always cleaned last after other environmental surfaces At least daily Cleaning staff Clean (neutral detergent and water):
  • clean to dirty, systematic manner clean to dirty, systematic manner (figure-eight pattern, regularly rinse in rinse bucket)
 Floors may require, depending on the risk-level in a specific patient care area:
  • more frequent cleaning
  • use of a disinfectant

Spills of blood or body fluids

Regardless of the risk-level of an area, spills or contamination from blood or body fluid (e.g., vomitus) must be cleaned and disinfected immediately using a two-step process.

Appendix B1 Table 5. Cleaning Procedure Summaries for Spills of Blood or Body Fluids

Cleaning Procedure Summary for Spills of Blood or Body Fluids by Area, Frequency, Staff, Products, and Description.
Area Description Frequency Person/Staff Responsible Products/Technique Additional Guidance/Description of Cleaning
Any spill in any patient or non-patient area Immediately, as soon as possible Cleaning staff
  1. Wear appropriate PPE; see Table 5 in 3.4 Personal Protective Equipment for Environmental Cleaning.
  2. Confine the spill and wipe it up immediately with absorbent (paper) towels, cloths, or absorbent granules (if available) that are spread over the spill to solidify the blood or body fluid (all should then be disposed as infectious waste).
  3. Clean (neutral detergent and water).
  4. Disinfect using a facility-approved intermediate-level disinfectant.
  5. Immediately reprocess all reusable supplies and equipment (e.g., cleaning cloths, mops) after the spill is cleaned up.
 Mark off spill area to prevent contact, as well as accidental slips and falls
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Content Source:
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)