The following advice is based on:
- Infection and Prevention Control Canada Best Practice Document: Cleaning and disinfection of non-critical multi-use equipment and devices in community settings
- Office Guidance: IPAC and Provision of In Office Care This document provides clear operational guidance pertaining to PPE, office IPAC practices, and how to stratify patients with regard to personal protection. The document is clear and practical. The “Top 10” questions are a great quick read.
- BC Centre for Disease Control – guideline on medical office cleaning
- Reopening Guide for Primary Care and Specialist Offices WO/SWO Pandemic Response Group
- Limit the risks of COVID contamination. Screen patients for symptoms and limit their contact with your office environment, especially masks and hand hygiene).
- Use appropriate cleaners/disinfectants and know how to use them properly, especially concentrations and contact times. See Health Canada’s list of disinfectants for use against COVID-19.
- Clean tools that come into contact with patients, ideally after every use. Refer to table below
- Clean the office environment ideally once or twice a day. Again, refer to table below.
- Wear appropriate gloves when cleaning (procedure gloves for wiping down your tools, heavier-duty for heavier cleaning) and a surgical mask: not so much for exposures as much as to normalize mask use in clinical setting.
Prepared by Doug Sider, Hamilton Public Health.
Plexiglass barriers are to be included in routine cleaning (e.g. daily) using a cleaning product that will not affect the integrity or function of the barrier.
Non-essential items are recommended to be removed from patient care areas to minimize the potential for these to be contaminated and become a potential vehicle for transmission (e.g., magazines and toys).
After every patient visit, whether the patient is symptomatic or not, patient contact surfaces (i.e., areas within 2 metres of the patient) should be disinfected as soon as possible. Treatment areas, including all horizontal surfaces, and any equipment used on the patient
Wondering who you need to use PPE for for in-person visits with? See page 2 of Considerations for In-person Visits – August, 2021 from OCFP
Frequency of cleaning items in the clinical practice setting
From Infection Prevention and Control for Clinical Office Practice (Public Health Ontario, Provincial Infectious Disease Advisory Committee)
Clean Between Patients
- Armrests on chairs
- Beds (e.g., examination table)
- Blood pressure cuff
- Electronic monitoring devices, if shared (e.g., glucometer)
- Imaging equipment (e.g., ultrasound transducers, mammography paddles, film cassettes)
- Orthopaedic equipment (e.g., crutches)
- Reflex hammer
- Scales (infant)
- Transport equipment (e.g., wheelchairs)
Clean at end of the day and when visibly soiled
- Carpets (vacuumed)
- Chairs, couches
- Light switches
- Overbed lamps and lights
- Scales (standing)
- Wall-mounted items (e.g., soap and ABHR dispensers, paper towel holders, glove box holders)
Clean according to a fixed schedule and when visibly soiled
- Appliances (refrigerators, microwaves, coffee makers)
- Carpets (steam cleaning)
- Ceilings and air vents
- Exterior surfaces of machines and equipment
- Furnishings in office spaces (e.g., desks, cabinets, bookcases)
- Ice Machines
- I.V. poles
- Privacy curtains
- Toy boxes and cupboards
- Window air conditioners
- Windows, window sills, window coverings
- Clean and disinfect twice daily – more often if possible
- Disinfect high touch surfaces frequently with appropriate disinfectants including faucets, toilets, handles, doorknobs, and light switches
Electronics, such as tablets, touch screens, keyboards, remote controls, and point of sale machines
- Consider a wipeable cover if possible
- Check manufacturer’s instruction for cleaning and disinfecting. If no manufacturer’s guidance, use alcohol-based wipes or sprays containing 70-90% alcohol. Dry surface thoroughly.
- The OCFP provided suggestions for sanitizing mobile phones
Cloth gowns, clothing, towels, linens, and other items
- Launder items according to the manufacturer’s instructions.
- Use the warmest appropriate water setting and dry items completely.
- Wear disposable gloves when handling dirty laundry, especially from a person who is unwell. Wash hands before and after using gloves.
- Do not shake dirty laundry.
- Clean and disinfect clothes hampers according to guidance for surfaces.