PROTOCOLO LIMPIEZA Y DESINFECCION DE AREAS Y SUPERFICIES
Protocolo de Limpieza y Desinfección
Objetivo del Protocolo
- El protocolo tiene como objetivo estandarizar el proceso de limpieza y desinfección, siguiendo los lineamientos del comité de infecciones y vigilancia epidemiológica.
Términos Clave en el Protocolo
- Área limpia: Superficies donde se trabaja con elementos limpios o estériles.
- Área sucia: Lugares donde se eliminan fluidos corporales y se lavan elementos utilizados con pacientes.
- Contaminado: Elemento que ha estado en contacto real o potencial con microorganismos.
- Descontaminación: Proceso físico o químico para hacer seguros los objetos contaminados para su manipulación.
- Limpieza: Remoción física de materia orgánica y suciedad desde los objetos.
Infecciones Asociadas a la Atención en Salud
- Estas infecciones son adquiridas por pacientes durante tratamientos médicos, sin manifestaciones previas al ingreso a la institución. Se asocian a causas como uso de dispositivos médicos y complicaciones quirúrgicas.
Clasificación de Áreas Hospitalarias
Áreas Críticas
- Realizan procedimientos invasivos con riesgo de infección, incluyendo lugares como salas de reanimación y farmacias.
Áreas Semi-Críticas
- Contacto con elementos inmuebles, pueden incluir habitaciones, consultorios, comedores y lavanderías; consideradas semi-críticas debido a la posibilidad de contaminación.
Desinfectantes Comunes Utilizados
- Los compuestos de amonio cuaternario son efectivos contra bacterias gram positivas y negativas, además son fungicidas y virucidas; no irritan ni manchan, siendo adecuados para aguas duras.
Preparación de Soluciones Desinfectantes
Cálculo Concentraciones
- Para preparar soluciones desinfectantes es crucial conocer las concentraciones deseadas (ppm) e identificar la concentración conocida del producto utilizado (ejemplo 5% = 50,000 ppm).
Ejemplo Práctico
- Verificar la etiqueta del producto para determinar su concentración.
Desinfection Techniques and Concentration Calculations
Understanding Desired Concentration and Volume Calculation
- The desired concentration (cde) is defined alongside the volume of the solution (vd), which is equal to the known concentration (cc) multiplied by its volume in milliliters. This relationship helps in calculating the required volume for disinfection solutions.
- By substituting values, cde is set at 2500 parts per million (ppm), with vd as 1000 mL, and cc as 50,000 ppm. The calculation results in needing 50 mL of a 5% disinfectant mixed with 950 mL of water to achieve the desired concentration.
Types of Disinfectants
Quaternary Ammonium Compounds
- Quaternary ammonium compounds are effective antimicrobial agents that eliminate both Gram-positive and Gram-negative bacteria, though they are less effective against the latter.
- These compounds are generally colorless or yellowish, non-irritating, and deodorizing. They function effectively even in hard water conditions.
- Their bactericidal action is attributed to energy-producing enzyme activation, protein denaturation within cells, and disruption of cell membranes.
Polymeric Biguanides
- Polymeric biguanides are derived from guanine found naturally in plants and grains. Some variants possess bactericidal properties.
- They demonstrate effectiveness against Gram-positive/negative bacteria, viruses, molds, and yeasts while being suitable for various applications including surfaces in food processing environments.
Disinfection Guidelines by Area
Critical Areas
- In critical areas: use a disinfectant with 500 ppm for routine cleaning and terminal cleaning; semi-critical areas require 250 ppm; non-critical areas need only 100 ppm for both types of cleaning.
Fluid Spills
- For fluid spills: apply a dilution of 500 ppm for at least 30 minutes to ensure proper disinfection.
Rotation of Disinfectants
- A rotation schedule for disinfectants should be established over a period of twelve months. Quaternary ammonium compounds will be used during odd years while polymeric biguanides will be utilized during even years.
Personal Presentation Standards During Cleaning
- Personnel must maintain cleanliness by wearing complete uniforms without stains or damage. Proper footwear should be worn along with neatly styled hair and short nails without polish.
Safety Protocols
- Jewelry should be removed before cleaning tasks. Protective equipment such as gloves, masks, and goggles must always be used during cleaning procedures.
Cleaning Procedures
General Practices
- Avoid using gloved hands to open doors; ensure all cleaning materials are properly stored after use. Buckets must be cleaned before reuse to prevent contamination.
Cleaning Techniques
- Employ two cloth techniques—one for cleaning surfaces and another specifically for disinfection—while adhering to principles like dry cleaning followed by rinsing before final disinfection steps.
Types of Cleaning
Sanitary Installations and Cleaning Procedures
Comprehensive Cleaning Procedures
- The cleaning process involves a thorough sanitation of all horizontal and vertical surfaces, both internal and external, including walls, floors, ceilings, window frames, and furniture such as beds, mattresses, chairs, and tables.
- Dry sweeping is performed with horizontal movements at an angle greater than 90 degrees. Wet mopping is done in large areas with the mop positioned at approximately 45 degrees relative to the body.
- Surfaces are initially washed with soapy water; baseboards require cleaning with a sponge. After washing, surfaces must be rinsed with a damp cloth to avoid streaks or stains on walls.
Disinfection Process
- Disinfection is defined as a physical-chemical process that kills or inactivates pathogens like bacteria, viruses, and protozoa to prevent the growth of harmful microorganisms on surfaces.
- Key guidelines for using disinfectants include:
- Only use standardized products at recommended concentrations.
- Ensure products are labeled and within their validity period.
- Regularly use soap or detergent for surface cleaning.
Types of Disinfection
- Recurrent disinfection targets objects in direct contact with patients during hospitalization. Terminal disinfection uses more concentrated disinfectants when necessary.
Routine Cleaning Procedure
- The routine cleaning procedure begins with handwashing per institutional protocol followed by wearing protective gear (gloves, masks).
- Materials and safety equipment should be prepared beforehand. A wet floor sign must be placed at the worksite entrance before starting the cleaning process.
Waste Management
- Waste disposal involves emptying trash bags in order: gray first, then green, followed by red bags.
- Begin cleaning from patient surroundings (furniture like cabinets and chairs), moving to items directly used by patients (tables), finishing with floors and bathrooms.
Surface Cleaning Techniques
- Use separate cloths for cleaning (detergent solution) and disinfection (disinfectant solution). Ensure proper dilution based on area type for effective results.
Terminal Cleaning Steps
- For terminal cleaning:
- Start again with handwashing according to protocol.
- Utilize protective gear similar to routine procedures.
- Clean from top to bottom: ceilings first followed by walls, windows, patient environment furniture before addressing doors, handles, floors, and bathrooms.
Finalizing the Cleaning Process
- Use different cloth types for detergent solutions on ceilings/walls versus disinfectant solutions on floors. Ensure thorough rinsing of mops after each use.
- After completing tasks:
- Collect all materials used during service.
- Wash equipment thoroughly before storing them properly according to institutional protocols.
Waste Storage Maintenance