The novel coronavirus has hit long-term care facilities hard. In March 2020, the Centers for Disease Control and Prevention (CDC) estimated that 80% of all deaths associated with COVID-19 were people 65 and older. While the numbers have come down, it is still estimated that as many as half of the COVID-19 deaths are seniors, with a great deal of them living in long-term care and similar type locations.
There can be many reasons for this. Social distancing can be exceedingly difficult in these facilities. Many long-term care locations were explicitly designed to encourage interaction to help alleviate isolation and loneliness. Further, when the outbreak first began spreading, many long-term care locations had only a limited number of masks and other protective gear on hand. Fortunately, these and many other issues have been rectified. However, what still may be an issue in many long-term care locations is cleaning. Cleaning is vital, and without proper cleaning, this virus will continue to spread, cause infections, and with them, deaths.
Whether your cleaning is handled by in-house housekeepers, outsourced to a professional contract cleaning service, or a combination of the two, here is what administrators and cleaning staff need to know to keep them healthy:
Complete a high-touch audit
There are areas in a long-term care facility that are touched frequently by residents and staff. Some are obvious: light switches, door handles, railings, TV remote controls, the tops of chairs and handles on cabinets, etc. But did you know floors can also be a high-touch area? In a study at a hospital in Wuhan, China, the CDC reports that “floors can be a strong source of cross-contamination. Gravity and airflow cause virus droplets to fall to the ground, where medical staff pick it up and potentially tracks it throughout the facility.”
Every time a resident or a staff member touches a high-touch surface — and if that surface is contaminated — those pathogens can collect on hands, starting the spread of cross-contamination.
All staffers, and indeed all cleaning professionals, should wash their hands before beginning work and then again upon leaving. This way, they do not bring pathogens into the facility or take them home.
In most cases, cleaning and disinfecting is a two-step process. First surfaces are cleaned, and then they are disinfected. Cleaning removes soils from surfaces, allowing the disinfectant to work most effectively. We must also remember, should the disinfectant dry on the surface — before the needed wet dwell time for the chemical to completely kill any live microbes — then the entire process must be repeated.
As to the types of disinfectants to use, the Environmental Protection Agency (EPA) has created a list of disinfectants that are proven effective at killing the germs that cause COVID-19. Only these disinfectants should be used: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2-covid-19.
Many of the standard all-purpose disinfectant wipes used in long-term care and other facilities are not EPA-approved. They may kill many types of germs but not necessarily those that cause COVID-19. Again, check the list for EPA approved disinfectants and wipes.
One of the primary ways COVID-19 spreads is because the germs causing the disease becomes airborne. Therefore, it is especially important to have a well-ventilated facility. If the facility is centrally heated and cooled, monitor the system to continually refresh inside air with filtered air from the outside. If the facility does not have central heating and cooling, open windows on opposite walls to help move air from inside out.
Made by different manufacturers, these misters spray a disinfecting mist or fog onto surfaces, which kills pathogens as it is applied. As the systems are used, a fine, negatively charged disinfectant mist wraps around the immediate and surrounding positively charged surfaces. It does this with 75 times the power of gravity, providing full and even coverage. The process also provides longer wet dwell times, enabling the disinfectant to more effectively work. What we have found to be most effective is to clean soiled surfaces first using a disinfecting cleaning solution and then using the electrostatic sprayer.
Mops and buckets
In most long-term care facilities, mops and buckets are typically used to clean floors. In hospitals, the mop heads and cleaning solutions are usually changed after each room is cleaned. This helps prevent the spread of pathogens from one room to another. This same process should be followed in long-term care locations.
Microfiber cleaning cloths should be used. Microfiber is proven to be more effective at removing soils from surfaces. However, just as with mops, they should be changed frequently.
HEPA vacuum cleaners
More advanced vacuum cleaners have HEPA filters, and these should be used to vacuum carpet and hard surface floors in long-term care locations. Using a vacuum cleaner with a HEPA (high-efficiency particulate air filter), the vacuum can capture and trap potentially dangerous microbes and particles, preventing them from becoming airborne. Before COVID-19, this helped protect indoor air quality. Now, with COVID-19, these filters can help prevent the spread of the infection.
Cleaning the cleaning equipment
A variety of tools and equipment are used in professional cleaning. These can include floor machines, vacuum cleaners, brushes, sprayers, auto dilution devices, carts and more. All too often, cleaning the cleaning equipment is overlooked. That cannot continue in the age of COVID-19. All these tools must be put on a regular cleaning schedule based on the frequency of use. This means such tools as vacuum cleaners and carts, used daily, may need to be cleaned each day, possibly after each use. Other tools may need to be cleaned less frequently, again based on their use. The two-step process mentioned earlier is required here as well: first clean the tool and then disinfect.
Training has never been more critical than it is right now. All too often, cleaning workers are not taught the latest and most efficient ways to clean. This has the following drawbacks for long-term care administrators:
- First, it’s costly. Typically, teaching custodial “best practices” helps cleaning workers learn how to do their jobs more efficiently. They get more done in the shortest amount of time, which saves money.
- But now, with the high rates of infections and deaths in so many long-term care facilities, proper, effective cleaning is one of the best ways we have to protect the health of residents and staff.
It is critical, with the pandemic still raging, that cleaning professionals brush up on cleaning best practices and custodial training. It is also a worthy idea to consult with an astute cleaning contractor familiar with effective infection prevention strategies. Quite literally, they can be a lifesaver.
Rick VanderKoy is president of Secure Clean Building Services, based in Marengo, IL. The family-operated facility cleans office buildings, industrial facilities, medical clinics, schools and other commercial facilities throughout the Chicago area and the state of Illinois. He can be reached at email@example.com.