Environmental Infection Prevention Toolkit

The resources in this toolkit may only be used for internal improvement and education efforts. They may not be used for commercial purposes.

Contaminated environments increase the risk of transmission of healthcare associated infections. Appropriate environmental infection prevention practices are important to maintaining a safe environment of care for both patients and providers.

The ASC Quality Collaboration has assembled a variety of resources and information that may be used to supplement your current processes to enhance existing environmental infection prevention practices.

The BASIC Environmental Infection Prevention Toolkit includes three essential resources:

• Environmental Infection Control — What CMS Surveyors Are Looking For
• Environmental Cleaning Policy and Procedure Template
• Spills Policy and Procedure Template

The EXPANDED Environmental Infection Prevention Toolkit contains both essential resources and a broader array of materials, including:

• Assessment Tools
• Implementation Aids
• Training Materials
• Monitoring Tools
• Workplace Reminders
• Guidelines from Leading Authorities

Comments and other feedback may be directed to Ann Shimek, Executive Director, ASC Quality Collaboration, ashimekco@gmail.com.

Assessment Tools

• Environmental Infection Control — What CMS Surveyors Are Looking For
  Perform a self-assessment using the same tool CMS surveyors use when evaluating environmental infection control practices in the ASC setting.
• Environmental Cleaning Audit Template
  This sample audit template may be used to assess environmental cleaning. It should be customized to reflect the unique environment of each facility.

Implementation Aids

• Environmental Cleaning Policy and Procedure Template
  This sample environmental cleaning policy and procedure is based on Centers for Disease Control and Prevention (CDC) guidelines and recommendations from the Provincial Infectious Diseases Advisory Committee (PIDAC). It should be adapted as needed for use in each facility. Cleaning of other areas, such as recovery rooms, should also be addressed in facility policy and procedure.
• Blood or Other Body Fluid Spills Policy and Procedure Template
  This sample policy and procedure for managing spills of blood and other body fluids is based on the Centers for Disease Control and Prevention (CDC) guidelines. It should be adapted as needed for use in each facility.
• OSACH Cleaning and Disinfection of Environmental Surfaces
  This article from the Ontario Safety Association for Community & Healthcare (OSACH, which is now a part of the Public Services Health & Safety Association) provides information on evaluating and selecting environmental disinfectants for use in healthcare settings.
• Selected EPA Registered Disinfectants (EPA)
  The links below lead to lists from the Environmental Protection Agency (EPA) itemizing products that are registered as effective against various infectious pathogens.

• List B: EPA Registered Tuberculocidal Products Effective Against Mycobacterium tuberculosis
• List C: EPA's Registered Antimicrobial Products Effective Against Human HIV-1 Virus
• List D: EPA's Registered Antimicrobial Products Effective Against Human HIV-1 and Hepatitis B Virus
• List E: EPA's Registered Antimicrobial Products Effective Against Mycobacterium tuberculosis Human HIV-1 and Hepatitis B Virus
• List F: EPA's Registered Antimicrobial Products Effective Against Hepatitis C Virus
• List G: EPA's Registered Antimicrobial Products Effective Against Norovirus
• List H: EPA's Registered Antimicrobial Products Effective Against Methicillin Resistant Staphylococcus aureus (MRSA) and Vancomycin Resistant Enterococcus faecalis or faecium (VRE)

Training Materials

• Blood Spill Clean Up Video (Yale University)
  This 3 ½ minute training video from Yale University demonstrates the procedure for clean up of a moderate size blood spill. Though set in the laboratory, many of the processes demonstrated here are applicable to the surgery center setting. Please note that for spills outside the laboratory, the room does not need to be aerated for 10 minutes. You may also reference pages 134–135 of the CDC Guidelines for Environmental Infection Control in Health Care Facilities for additional information.

Monitoring Tools

• Environmental Cleaning Audit Template
  This sample audit template may be used to assess environmental cleaning. It should be customized to reflect the unique environment of each facility.

Workplace Reminders

• Environmental Cleaning Guide Template
  This template may be used to create a facility-specific guide to environmental cleaning agents, methods and frequency.

Guidelines from Leading Authorities

• CDC Surface Disinfection
  This excerpt from the Centers for Disease Control and Prevention's (CDC) more comprehensive Guideline for Disinfection and Sterilization in Healthcare Facilities (presented below) provides guidance on surface disinfection.
• CDC Guidelines for Environmental Infection Control in Health Care Facilities
  These 2003 guidelines were developed by the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC).
• CDC Guideline for Disinfection and Sterilization in Healthcare Facilities 2008
  This 2008 guideline was developed by the Centers for Disease Control and Prevention (CDC).