The What, Why, and How of Terminal Cleaning in Healthcare

Maintaining a clean and safe environment in healthcare settings is crucial for protecting both patients and staff. This is where terminal cleaning comes in. If you’ve heard the term but aren’t sure what it entails or how to go about it, we’ve got you covered.

This guide will walk you through the importance of terminal cleaning, its key components, and how you can implement effective procedures to ensure your facility minimizes infection risks and meets safety standards.

What Is Terminal Cleaning?

Terminal cleaning refers to the thorough cleaning and disinfecting of a patient care area, including an operting room, after it has been vacated, such as when a patient is discharged or transferred. Unlike routine cleaning, terminal cleaning involves sanitizing every surface—including hard-to-reach areas—to remove pathogens and reduce the risk of infection transmission.

It’s a critical process in hospitals, clinics, surgical centers, and other healthcare facilities. For environments where sterility is paramount, such as operating rooms, terminal cleaning ensures the area is ready for the next patient.

Why Terminal Cleaning Matters for Infection Control

Healthcare-associated infections (HAIs) are significant risks in medical facilities. According to the CDC, HAIs affect an estimated 1 in 31 hospital patients daily. Terminal cleaning is one of the most effective strategies to curb the spread of infections by targeting bacteria, viruses, fungi, and other pathogens.

Benefits of Terminal Cleaning Include:

• Reducing Infection Transmission: Proper disinfection boosts patient safety by eradicating germs that could spread to the next patient.
• Protecting Vulnerable Populations: Patients with weakened immune systems, such as those undergoing chemotherapy, are particularly at risk.
• Improving Patient Satisfaction: A visibly clean and sanitized room creates a safer and more welcoming environment.
• Meeting Regulatory Compliance: Adhering to terminal cleaning standards shows that your facility prioritizes both compliance and care quality.

Reviewing Your OR Terminal Cleaning Processes

Hospital-acquired Clostridium difficile is common and can be deadly. The infection can cause mild diarrhea to severe colitis. Depending on the patient, C.dff can even be fatal. This infection is typically caused when antibiotics disrupt normal gut bacterial. A weakened immune system can also be a cause. (And most people in a hospital do have a weakened immune system simply because they are ill).

C. diff prevention? Correct and consistent evnironmental cleaning.

An OpenWorks cleaning crew specializes in top-to-bottom terminal cleaning for healthcare facilities, ensuring thorough disinfection and adherence to best practices. Here’s how we approach it:

• Systematic Cleaning: We clean every OR from ceiling to walls to floors, working from edges to the center where contamination is highest. A consistent, clockwise or counterclockwise approach helps eliminate oversights.
• Comprehensive Disinfection: Every surface is sanitized, including wheels, casters, vents, and hard-to-reach areas. We use disinfectants following manufacturer instructions, ensuring proper dwell times for maximum effectiveness (from 2 to 10 minutes depending on the agent).
• Highly Trained Staff: Our cleaning professionals are well-educated on disease transmission, properly trained, and equipped to neutralize bacteria, including those resistant to typical cleaning agents like C. diff spores, which can persist for up to 90 days.
• Checklist-Driven Precision: We rely on detailed checklists to ensure nothing is missed, focusing on 100% coverage of all areas.

While even the most diligent manual clean can’t entirely eliminate human error, our expertise and rigorous process minimize risks, providing your facility with peace of mind and a healthier environment. Remember it is vital that your center is tracking HAI occurances, like C.diff, with the ultimate goal to get them as low as possible.

Key Areas and High-Touch Surfaces for Terminal Cleaning

Certain surfaces and areas are more prone to contamination and require extra attention during terminal cleaning. High-touch surfaces, in particular, serve as hotspots for germ transmission.

High-Touch Surfaces to Clean:

• Bed rails and patient stretchers
• Door handles and light switches
• IV poles, monitors, and other equipment
• Telephones, remote controls, and keyboards
• Sink handles and soap dispensers

Don’t forget low-touch surfaces such as walls, ceilings, and vents. These areas may not seem intuitive, but airborne pathogens and dust can settle there, leading to contamination.

How to Perform Terminal Cleaning Step-by-Step

Successful terminal cleaning requires planning, precision, and the right supplies. Below is a detailed process based on CDC-recommended best practices:

Step 1: Gather Supplies

Ensure you have all the necessary tools before beginning. This includes cleaning cloths, mops, personal protective equipment (PPE, such as gloves and masks), hospital-grade disinfectants, and trash liners.

Step 2: Remove Debris and Linens

Remove all used linens, disposable items, and personal care equipment from the room. Linens should be folded into a bundle and handled without shaking to prevent the release of pathogens into the air.

Step 3: Disinfect Low-Touch Surfaces

Start with low-touch surfaces, working from top to bottom. This includes cleaning ceilings, vents, and light fixtures. Use a microfiber cloth dampened with disinfectant for maximum effectiveness.

Step 4: Clean and Disinfect High-Touch Surfaces

Focus on high-contact areas such as doorknobs, bed controls, and medical equipment. Wipe surfaces clean to remove visible dirt before applying a disinfectant, allowing appropriate dwell time for it to take effect.

Step 5: Address the Restroom

For patient room restrooms, clean and disinfect all high-touch surfaces, including faucets, handles, and toilet seats. Floors should also be mopped with a neutral detergent.

Step 6: Mop Floors

Remove any debris from the room's floor with a vacuum or dust mop, then proceed with damp mopping using a disinfectant solution. Always mop from cleaner areas to dirtier ones to avoid recontamination.

Step 7: Inspect the Room

Perform a final inspection to verify that all surfaces have been thoroughly cleaned and disinfected. Any missed spots should be remedied immediately.

Developing a Cleaning Schedule

Consistency is key to effective infection control. Developing a structured cleaning schedule ensures that no task is overlooked.

Include in Your Schedule:

• Frequency: Specify how often high-touch and low-touch surfaces need to be cleaned (e.g., after each discharge).
• Responsibilities: Assign tasks to specific staff to avoid confusion.
• Methods: Define cleaning techniques and the products required for each task.

Providing a checklist for janitorial or cleaning staff is an excellent way to ensure all steps are followed correctly.

Special Considerations During Outbreaks

During an infectious disease outbreak, terminal cleaning should be intensified to contain the spread of pathogens within the facility. Additional steps might include using sporicidal agents with EPA-approved effectiveness against specific bacteria and viruses (e.g., Clostridium difficile, norovirus).

Pro Tips:

• Close off the room until cleaning is complete.

• Utilize advanced cleaning technologies like UV-C light systems to enhance disinfection.

• Use ATP measurement devices to verify cleaning effectiveness.

Why Leave Terminal Cleaning to Experts?

While internal staff can perform basic cleaning, terminal cleaning requires specialized training and expertise. Hiring professional cleaning services ensures compliance with CDC guidelines and hospital-grade standards. Plus, it allows your healthcare team to focus on patient care instead of cleaning protocols.

Taking Infection Control to the Next Level

Effective terminal cleaning isn’t just a chore; it’s your facility’s first line of defense against disease transmission. Implementing rigorous cleaning protocols protects patients, boosts staff morale, and upholds your reputation as a safe and welcoming environment for care.

Want to ensure your facility meets the highest standards in terminal cleaning? Chat with us today to learn more about how our expert team can customize a cleaning plan for your unique needs.