The largest reservoir of bacterial pathogens in a long-term care facility is not on the toilet seats, push bars or handrails — it’s on the floors and carpets. That is why experts across the cleaning industry strongly suggest custodial staff, supervisors and facility managers enact and embrace programs to clean and properly maintain vacuums, extractors and interim cleaners in order to prevent the growth and spread of dangerous bacteria.
To begin building a process and creating the culture to address the issue, custodial staff and officials at a long-term care facility should complete an audit documenting current cleaning practices. The audit can be used to set short-term and long-term priorities, such as creating a machine-cleaning program. An assessment of the cleanliness of the facility’s carpets and machines using an adenosine triphosphate (ATP) test can also provide valuable data.
The first step after an audit and assessment is educating and training the custodial staff on where pathogens live, how they are spread and what cleaning procedures kill them, says Mike Sawchuk, founder of Sawchuck Consulting, Ontario, Canada. A review of cleaning, sanitizing and disinfecting processes may also be in store.
The next step, experts say, is for custodial staff and supervisors to learn the proper maintenance and cleaning procedures of the machines and vacuums set by the manufacturer. If the information is not readily available, machine suppliers and dealers should be able to help. This information should include the type of cleaner and disinfectant to use on the machine and how regularly the machine should be cleaned and maintained.
Once that information is gleaned, it is recommended that department supervisors set a schedule to clean the machines and assure that the proper supplies and tools are available.
To end a cycle of bacterial spreading from cleaning machines, environmental services (EVS) staff in long-term care facilities should start by deep cleaning the floor of the custodial closet, which is typically a damp, dark, filthy environment.
“You can use a pressure washer system,” says Sawchuk. “Scrub it with a mop and spray some disinfectant. It’s not that difficult to do.”
The next step is to designate a place or space for the machines to be cleaned, preferably near a sink. Install bright lights so that the custodian who is cleaning the machine can see the buildup. Also make sure workers use proper personal protective equipment (PPE) and the area has adequate ventilation, so they do not have to breathe in the chemicals.
Consultants in the field recommend that staff spray disinfectant solution on vacuum and carpet cleaner wheels, wands and extenders along with electrical cords and hoses when they move to a new area and at the end of their shifts. The user should remember disinfectant needs to sit on the surface for a period of time (between a few minutes to a half an hour depending on the product) before it kills the bacteria and can be removed from the surface.
“Wipe down the machine, wipe down the wheels and keep it protected when it is not being used,” says Bill Griffin, president of Seattle-based Cleaning Consultant Services Inc. “Turn it upside down and clean the bottom with a small pressure washer, then spray disinfectant on it and let it dwell. That would all be a major step in the right direction.”
Most machines have surfaces that are not harmed by water or aerosol disinfectant spray, especially a neutral pH disinfectant.
If the machine is used in cafeterias, where E. coli is easily spread, or in areas where a large group of people gather, then it should be disinfected after each use, says Bill Allen, territory manager at Fagan Sanitary Supply in West Elizabeth, Pennsylvania.
One of the places that bacteria dwells in a vacuum or carpet cleaner is in the brushes at the bottom of the machine that meets the carpet and picks up dirt and debris. Most machines have easy-to-remove brush cylinders that are meant to pop out and be cleaned.
Experts suggest custodians place the brushes under running water and hand wash them to remove the debris. Then, the brushes should be disinfected and air dried. Backup brushes should be available so as not to slow down productivity and still allow for proper brush cleaning and maintenance.
Another concerning place where bacteria dwells are machine wheels.
“All these wheels do is pick up bacteria and they are spreading it throughout the whole facility,” says Sawchuk.
Once the wheels are cleaned, custodial staff should use a garden hose to rinse out the waste tank. Done daily, this will remove the chances of buildup of bacteria-containing dirt, says Mark Exner, an instructor at Restoration Training Services, Orange County, California. He also says to place the cleaner vacuum hose into the solution tank and suck the water out of it.
“[Custodians] need to pour one to two gallons of clear, clean water into the tank and use the wand to flush that through the system,” says Exner.
He adds that if the custodial staff is using a powder concentrate cleaner in the machine, they must use water to clear out the residue after use because it may contain bacteria. Then, on a monthly basis, check wand jets and their filters for any debris.
Wands usually can be disassembled for regular maintenance. When that occurs, the pieces should be disinfected. After properly disinfecting the machine, another suggestion is to take it outside where the sun can dry it out. The ultraviolet light from the sun is proven to naturally kill bacteria, while the fresh air and breeze can effectively dry the machine.
“A lot of custodial closets are damp and dark and there is not a lot of air movement,” says Sawchuk.
Other objects that go overlooked are vacuums and cleaners with HEPA filters, which give some in the cleaning industry a false sense of security. Although HEPA technology is effective in trapping fine particles, it is limited if the user does not maintain the vacuum, says Griffin. These filters are meant to be taken out and cleaned, much like brushes, and replaced when appropriate.
“The other area [that’s overlooked] are the recovery and solution tanks. If you don’t drain it properly, you have water that has been sitting inside of it stagnant,” says Sawchuk. “You should rinse it out and spray disinfectant in it.”
Another way to prevent vacuums and carpet cleaners from spreading bacteria across a long-term care facility is to have designated equipment for specific areas, so that they are not being used in other sections of the facility. That may mean a capital investment.
“The old word is budget,” says Exner. “All of a sudden, we have become frontline fighters in a lot of this.”