UNCONTROLLED WHEN PRINTED

Aim

To reduce the level of microbial burden on patient care equipment and frequently touched surfaces on and in operational vehicles, to reduce the chance of cross infection between patients and improve SJWA personnel safety.

Jump to specific cleaning task

ProcedureComments
Start of shift cleaning
  1. Check vehicle is clean and hygienic.
  2. Clean radio, mobile phones, door handles, steering wheel and indicators, gear stick, AmbiCAD and vehicle keys.
  3. Wipe external surfaces and handles on all bags, including the drug pouch.
Escalate to MMSOC/CMSOC/ PTS Team Leader if there are concerns with vehicle cleanliness.
After every patient transport
  1. Perform hand hygiene and don appropriate PPE (gloves, risk assess need for other PPE).
  2. Clean frequently touched surfaces in the front cab first. 
  3. Move to rear cabin - dispose of all single patient use equipment, PPE, and medical waste in appropriate bin at hospital or station. If on scene this may require bagging waste.
  4. Place linen into linen bag. If linen is heavily soiled, then a red soiled linen bag may be required. Dispose of at hospital or relevant health care facility.
  5. With disposal linen, remove the disposable linen and place in the appropriate waste bin. If heavily soiled, place in clinical waste, otherwise dispose of as general waste.
  6. Wipe surfaces/equipment that have been frequently touched by patient and officers.
  7. Clean personal items used during case.
  8. Dispose of sharps container if 2/3 full.
  9. Empty rubbish bin.

Examples of frequently touched surfaces/equipment:

  • Vehicle controls
  • Ambicad
  • Stretcher
  • Pillow
  • Assessment equipment (pulse oximeter, BSL kit, tympanic thermometer)
  • Monitor
  • Grab rails
  • Door handles
  • Handles of bags
  • Slide boards
  • Handles on lockers
  • Devices protected by sheath/covers must also be cleaned/disinfected

Examples of personal items:

  • iPad
  • Stethoscope
  • Pens
  • Watch
  • Shears

Contact MMSOC/CMSOC a if there are any delays to completion of cleaning (e.g. clean is likely to take longer than 20 minutes), or if you need to return to a station.

After transporting a patient requiring transmission based  precautions (contact, droplet/airborne)

CONTACT PRECAUTIONS

  1. Perform hand hygiene and don appropriate PPE (gloves, risk assess for other PPE).
  2. Clean as per "After every patient transport".
  3. Dispose of any non-packaged stock that was exposed (example back of stretcher items such as towels, incontinence pads).
  4. Wipe the external surfaces and handles on all treatment bags.

    DROPLET/AIRBORNE PRECAUTIONS:

    There is NO REQUIREMENT to air the vehicle prior to cleaning

    1. Don appropriate PPE (Respirator, safety eyewear, gloves - risk assess for gown/coverall).
    2. Open rear and side doors of rear cabin and turn on the extraction fan. The extraction fan must be left on for a minimum of 15 minutes whilst you are conducting this clean.
    3. Clean as per "After every patient transport" AND "Contact Precautions"
    4. Clean the ceiling including yellow handrails.
    5. Working top to bottom, clean all vertical surfaces
    6. Working from top to bottom, clean all horizontal services.
    7. Clean spinal board if in MK6.5 or 7
    8. Wipe external surfaces of treatment and assessment bags.

    At conclusion of vehicle cleaning:

    • Dispose of all waste.
    • Doff PPE and perform hand hygiene.
    • Restock as needed.

    Examples of vertical surfaces:

    • Walls
    • Sides of work station
    • Front of lockers
    • Switches
    • Oxygen flow meters
    • Wall mounted patient monitoring equipment
    • Front grill of extractor fan
    • Air conditioning / lighting controls
    • Oxygen flow meters
    • All rails / handles

    Examples of horizontal surfaces:

    • Seats and seat belts
    • Top of work station
    • Window shelf
    • Ceiling
    End of shift cleaning
    • Remove all personal items from vehicle.
    • Empty rubbish bin.
    • Clean radio, phones, door handles, steering wheel/vehicle controls and AmbiCAD terminal, and vehicle keys.
    • Change sharps container if over two thirds full
    • Sweep floor if required.
    • Mop the floor (starting in front cab and move to rear cabin).
    • Rinse mop head and bucket with fresh hot water, and place mop in an area where is can dry
    • Doff PPE and perform hand hygiene.
    • Restock as needed.
    When medical equipment is to be sent away for maintenance, the equipment must be cleaned as well as possible before sending for maintenance/servicing.
     
    A clean mop head should be used for each vehicle i.e. clean mop head and fresh water/detergent mix for each vehicle. Do not leave mops soaking.
     
    Replace mop head after cleaning of heavy soiling (e.g. large spill of blood/body fluid).
    Every “set” of shifts (and as required)
    • Wash outside of vehicle.
    • Clean all surfaces in the front cab.
    • Vacuum floor, paying attention to areas to the side and behind the seats.
     
    Cleaning after a blood/body fluid spill

    Avoid cleaning techniques that can cause splashing or further contamination of the environment/officer and ensure appropriate PPE is worn

    For small spills (up to 10cm diameter):

    1. Don appropriate PPE (gloves, risk assess for other PPE).
    2. Wipe up spill immediately with absorbent material (e.g. cloth, absorbent pad).
    3. Place contaminated absorbent material into clinical waste bag for disposal.
    4. Clean the area using detergent/disinfectant wipe and allow to dry.
    5. Dispose of clinical waste.
    6. Doff PPE and perform hand hygiene.

    For larger spills (greater than 10cm diameter)

    1. Don appropriate PPE (gloves, gown, eye protection/face shield, risk assess need for respirator).
    2. Where possible, remove equipment from the vehicle to prevent further contamination.
    3. Cover spill with absorbent pad/s and allow to absorb
    4. Place all contaminated absorbent materials into clinical waste bag and discard in to clinical waste bin as soon as possible.
    5. Clean the area with detergent/disinfectant wipes and allow to dry.
    6. Mop the area if required (please discuss with MMSOC/CMSOC about returning to station to do this).
    7. Remove PPE and perform hand hygiene.

    Consideration should be made to remove the vehicle from service if heavily contaminated, contact MMSOC/CMSOC/ PTS Comms to discuss this.

    Hot swap cleans
    1. Clean all radios, phones, door handles, steering wheel/vehicle controls and AmbiCAD terminal.
    2. Clean vehicle keys.

    Appreciating operational tempo and vehicle availability, there may be times when vehicles are hot swapped at shift change, this assumes "After each patient transport" cleaning has been completed.

    Recording of Vehicle Cleaning
    Complete end of shift checklist. 

    Cleaning Products

    Only hospital-grade disinfectants with specific claims listed on the Australian Register of Therapeutic Goods (ARTG) should be used.

    • Clinell Universal Wipes - detergent + disinfectant wipe. Suitable for all surfaces and medical devices
    • Viraclean - detergent + disinfectant. Suitable for surfaces only
    • Lemex - detergent. Suitable for floors

    References
    References

    Document Control


    Directorate
    Clinical Services

    Responsible Manager
    Head of Clinical Services

    Version

    Date

    Review Date

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