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Are you feeling a little lost in the world of Environmental Cleaning terminology? Don't worry, I've got your back!
After spending some time diving into various guides and manuals on Environmental Cleaning, I've put together the ultimate glossary of terms. Whether you're new to the subject or just need a quick refresher, this glossary is here to make your life easier.
Understanding these terms is crucial, especially if you're involved in environmental cleaning tasks within the healthcare industry. So go ahead, and bookmark this page for future reference – you'll thank yourself later!
Happy reading and happy cleaning!
Key Definitions
Accreditation Canada: Accreditation Canada is a not-for-profit, independent organization accredited by the International Society for Quality in Healthcare (ISQua). It provides national and international healthcare organizations with an external peer review process to assess and improve the services they provide to their patients and clients based on standards of excellence. More information is available at www.accreditation.ca.
Additional Precaution Daily Clean: daily cleaning and disinfection process for rooms/cubicles/spaces where patients are on additional precautions.
additional precautions: interventions implemented for certain pathogens or clinical presentations, in addition to routine infection control practices, to reduce the risk of transmission of microorganisms from patient to patient, patient to healthcare provider, and healthcare provider to patient.
airborne precautions: interventions to reduce the risk of transmission of microorganisms through the inhalation of airborne droplet nuclei or dust particles containing an infectious agent. airborne precautions include placing the patient in a negative pressure room and the use of N95 respirators and other personal protective equipment (gowns, gloves, face shields), as directed by the signage of the facility, when giving direct care to patients or when in contact with their environment.
alcohol-based hand Rub (ABHR): a liquid, gel, or foam formulation of alcohol (e.g., ethanol, isopropanol) that is used to reduce the number of microorganisms on hands in clinical situations when the hands are not visibly soiled. ABHRs contain emollients to reduce skin irritation and are less time-consuming to use than washing with soap and water.
antibiotic-resistant organism (ARO): a microorganism that has developed resistance to the action of several antimicrobial agents and that is of special clinical or epidemiological significance.
antiseptic: an agent that can kill microorganisms and is applied to living tissue and skin.
audit: a systematic and independent examination to determine whether quality activities and related results comply with planned arrangements, are implemented effectively, and are suitable to achieve objectives.
automatic dispensing system: systems that provide computer controls (automation) for preparation of cleaning or disinfectant solutions. These systems replace the need for manually measuring a quantity of cleaning or disinfectant products and water.
biomedical waste: contaminated, infectious waste from a healthcare setting that requires treatment prior to disposal in landfill sites or sanitary sewer systems. Biomedical waste includes human anatomical waste; human and animal cultures or specimens (excluding urine and feces); human liquid blood and blood products; items contaminated with blood or blood products that would release liquid or semi-liquid blood if compressed; body fluids visibly contaminated with blood; body fluids removed in the course of surgery, treatment or for diagnosis (excluding urine and feces); sharps; and broken glass which has come into contact with blood or body fluid.
British Columbia Provincial Infection Control Network (PICNet): PICNet is a provincial program of the Provincial Health Services Authority with a specific interest in the prevention and control of healthcare-associated infections. PICNet works together with partners on province-wide surveillance, development, and promotion of evidence-based best practices, and the creation of educational and operational tools. More information is available at www.picnet.ca.
IPAC-Canada: Infection Prevention and Control Canada is a professional organization of persons engaged in infection prevention and control activities in healthcare settings. IPAC-Canada members include infection prevention and control professionals from a number of related specialties including nurses, epidemiologists, physicians, microbiology technologists, public health, and industry. The IPAC-Canada website is located at www.ipac-canada.org.
broad-spectrum virucide: an environmental (low-level) disinfectant demonstrated to irreversibly inactivate, at a minimum, one representative hard-to-kill non-enveloped virus and which would be expected to inactivate most enveloped and non-enveloped viruses.
chemical-resistant gloves: gloves that protect the hands from chemicals. They can be made of latex or another manufactured material, such as nitrile, and can be water- or liquid-proof.
chemical sterilant: an agent that is applied to inanimate objects or heat-sensitive devices to kill all microorganisms and bacterial spores.
cleaning: the physical removal of foreign material (e.g., dust, soil) and organic material (e.g., blood, secretions, excretions, microorganisms) using mechanical and/or chemical means. Cleaning physically removes, rather than kills, microorganisms. It is accomplished with water, detergents, and mechanical action.
cleaning cart (also known as cleaning trolley): a dedicated cart or trolley that carries environmental cleaning supplies and equipment, in addition to bags or bins for soiled materials, such as laundry, for disposal or reprocessing.
cleaning intensity: refers to the type of cleaning required, such as cleaning with detergent, the use of disinfectant, or the use of a sporicidal agent.
cleaning products (also known as cleaning agents): liquids, powders, sprays, or granules that remove organic material (e.g., dirt, body fluids) from surfaces and suspend grease or oil. Can include liquid soap, enzymatic cleaners, and detergents.
cleaning session: a continuous environmental cleaning activity performed over a defined time period in defined patient care areas. A cleaning session could include routine or terminal cleaning.
cleaning solution: a combination of water and cleaning product (e.g., detergent) in a ratio specified by the manufacturer.
cohort: two or more patients colonized or infected with the same organism that are separated physically, in a separate room or ward, from other patients who are not colonized or infected with that organism. This can also apply to staff when they are specifically assigned to care only for patients known to be colonized or infected with the same organism.
construction clean: cleaning performed by construction workers at the end of a workday or completion of a project that removes visible soil and dirt, construction materials, and workplace hazards.
contact precautions: interventions to reduce the risk of transmission of microorganisms through direct or indirect contact. Contact precautions include the use of gloves and gowns when giving direct care to patients or when in contact with their environment.
contact time: the time that a disinfectant must be in contact with a surface or device to ensure that appropriate disinfection has occurred. For most disinfectants, the surface should remain wet for the required contact time.
contamination: the presence of an infectious agent on hands or on a surface such as clothing, gowns, gloves, bedding, toys, surgical instruments, patient care equipment, dressings, or other inanimate objects.
continuum of care: care provided across all healthcare sectors, including settings where emergency (including pre-hospital) care is provided; hospitals; rehabilitation facilities; residential care and assisted living facilities; outpatient clinics and centers; community health centers; clinics and programs; and physician, dental, and allied health services provided on contract through health authorities.
critical patient care equipment: equipment and devices that enter sterile tissue or the vascular system, such as surgical instruments, cardiac and urinary catheters
cytotoxic waste: waste cytotoxic drugs, including leftover or unused cytotoxic drugs and tubing, tissues, needles, gloves, and any other items that have come into contact with a cytotoxic drug.
detergent: a synthetic cleansing agent that can emulsify oil and suspend soil. A detergent contains surfactants that do not precipitate in hard water and may also contain protease enzymes (see enzymatic cleaner) and whitening agents.
direct care provider: a healthcare provider who provides care directly to the patient.
Discharge/Transfer Clean: the thorough cleaning of a patient's room or bed space and bathroom following discharge, death, or transfer of the patient, or when additional precautions are discontinued, to remove contaminating microorganisms that might be acquired by subsequent occupants of the room.
disinfectant: a product that is used on surfaces or medical equipment/devices which results in disinfection. Disinfectants are applied only to inanimate objects. Some products combine a cleaner with a disinfectant.
disinfectant fogging: misting or fogging a liquid chemical disinfectant to disinfect environmental surfaces in an enclosed space.
Disinfectant solution: a combination of water and disinfectant, in a ratio specifieded by the manufacturer.
disinfection: the inactivation of disease-producing microorganisms. Disinfection does not destroy bacterial spores. Disinfection usually involves chemicals, heat, or ultraviolet light.
droplet precautions: interventions to reduce the risk of transmission of microorganisms via respiratory droplets. Droplet precautions include the use of a surgical mask and eye/face protection whenever one is within two meters of the patient.
Drug Identification Number (DIN): In Canada, disinfectants are regulated as drugs under the Food and Drugs Act and Regulations. Disinfectants shall have a drug identification number (DIN) from Health Canada prior to marketing, which ensures that labeling and supporting data have been provided and that it has been established by the Therapeutic Products Directorate that the product is effective and safe for its intended use.
dry sweeping: using a broom to clean dry floors.
dry mopping: using a dry mop to clean dry floors.
equipment depot: defined space dedicated to the management of patient care equipment within a healthcare facility.
environment of the patient: the immediate space around a patient that may be touched by the patient and may also be touched by the healthcare provider when providing care. The patient's environment includes equipment, medical devices, furniture (e.g., bed, chair, bedside table), telephone, privacy curtains, personal belongings (e.g., clothes, books), and the bathroom that the patient uses. In a multi-bed room, the patient environment is the area inside the individual’s curtain. In an ambulatory setting, the patient environment is the area that may come into contact with the patient within their cubicle. In a nursery/neonatal setting, the patient environment is the isolette or bassinet, and equipment outside the isolette/bassinet that is used for the infant. See also, healthcare environment.
environmental cleaning: cleaning and disinfection (when needed, according to risk level) of environmental surfaces (e.g., bed rails, mattresses, call buttons, chairs) and surfaces of noncritical patient care equipment (e.g., IV poles, stethoscopes).
environmental cleaning services area: a dedicated space for preparing, reprocessing, and storing clean or new environmental cleaning supplies and equipment, including cleaning products and PPE. Access is restricted to cleaning staff and authorized personnel.
enzymatic cleaner: a pre-cleaning agent containing protease enzymes that break down proteins such as blood, body fluids, secretions, and excretions. Most enzymatic cleaners also contain a detergent. Enzymatic cleaners are used to loosen and dissolve organic substances on surfaces and equipment prior to cleaning.
focal person: a person who serves as a coordinator or focal point of information concerning an activity or program.
fomites: objects in the inanimate environment that may become contaminated with microorganisms and serve as vehicles of transmission.
fungicide: an environmental (low-level) disinfectant capable of inactivating fungi (including yeast) and fungal spores on environmental surfaces and inanimate items.
general patient areas: outpatient or ambulatory care wards and inpatient wards with patients admitted for routine medical procedures who are not receiving acute care (i.e., sudden, urgent or emergent episodes of injury and illness that require rapid intervention).
hand hygiene: a general term referring to any action of hand cleaning. Hand hygiene relates to the removal of visible soil, or removal or killing of transient microorganisms from the hands. Hand hygiene may be accomplished using soap and running water, or an alcohol-based hand rub (ABHR).
hand washing: the physical removal of microorganisms from the hands using soap and running water.
Hawthorne effect: a phenomenon where a study subject's behaviour and/or study outcomes are altered as a result of the subject's awareness of being under observation.
health authorities: Health authorities are responsible for the delivery of health service delivery in their respective regions. Five health authorities (Fraser Health, Interior Health, Northern Health, Vancouver Coastal Health, and Vancouver Island Health) govern, plan, and coordinate services regionally, and participate with the Provincial Health Services Authority, which coordinates and/or provides provincial programs and specialized services, such as cardiac care, transplants, and pre-hospital care. The First Nations Health Authority is a newly created entity whose role is being developed.
healthcare-associated Infection (HAI): a term relating to an infection that is acquired during the delivery of healthcare (also known as nosocomial infection).
healthcare environment: people and items that make up the care environment (e.g., objects, medical equipment, staff, patients) of a hospital, clinic, or ambulatory setting, outside the immediate environment of the patient. See also, environment of the client/patient/resident.
healthcare facility: a set of physical infrastructure elements supporting the delivery of health-related services. A healthcare facility does not include a patient’s home or physician/dental/other health offices where healthcare may be provided.
healthcare provider/Staff: any person working in the healthcare system. This includes but is not limited to, the following: emergency service workers, physicians, dentists, nurses, respiratory therapists and other health professionals, personal support workers, clinical instructors, students, environmental and food service workers, facility maintenance workers, contracted providers, and home healthcare providers. In some settings, volunteers might provide care, and would be included as healthcare providers.
healthcare setting: any location where healthcare is provided, including settings where emergency care is provided; hospitals; complex continuing care; rehabilitation hospitals; long-term care homes; mental health facilities; outpatient clinics; community health centers and clinics; physician offices; dental offices; offices of other health professionals; and home healthcare.
hemodialysis station: a hemodialysis machine with a chair or bed and connections to puri?ed water and sanitary sewer. Stations in facilities with central delivery can also have acid concentrate and bicarb concentrate connections.
HEPA filter: a high-efficiency particulate air filter meeting the minimum specifications of a nuclear grade filter, providing a 99.97% filtration efficiency at a 0.3-micrometre particle size.
high-level disinfection (HLD): kills all microorganisms, with the exception of small numbers of bacterial spores.
high-touch surfaces: surfaces that have frequent contact with hands. Examples include but are not limited to, doorknobs, call bells, bedrails, overbed tables, light switches, wall areas around the toilet, and edges of privacy curtains.
hoarding: a temporary fence or wall enclosing the construction site.
hospital: A hospital is defined by the Hospital Act (RSBC 1996) as a non-profit institution that has been designated as a hospital by the minister and is operated primarily for the reception and treatment of persons (a) suffering from the acute phase of illness or disability, (b) convalescing from or being rehabilitated after acute illness or injury, or (c) requiring extended care at a higher level than that generally provided in a private hospital.
Hospital Clean: the measure of cleanliness routinely maintained in client/patient/resident care areas of the healthcare setting. Hospital clean is ''Hotel clean'' with the addition of disinfection, increased frequency of cleaning, auditing and other infection control measures in client/patient/resident care areas.
hospital-grade disinfectant: a disinfectant that has a drug identification number (DIN) from Health Canada indicating its approval for use in Canadian hospitals.
Hotel Clean: a measure of cleanliness based on visual appearance that includes dust and dirt removal, waste disposal, and cleaning of windows and surfaces. Hotel clean is the basic level of cleaning that takes place in all areas of a healthcare setting.
incubator (also known as isolette): a self-contained unit that provides a controlled heat, humidity, and oxygen microenvironment for the isolation and care of premature and low-birth weight neonates.
infection: the entry and multiplication of an infectious agent in the tissues of the host. Asymptomatic or sub-clinical infection is an infectious process running a course similar to that of clinical disease but below the threshold of clinical symptoms. Symptomatic or clinical infection is one resulting in clinical signs and symptoms (disease).
infection prevention and control (IPAC): evidence-based practices and procedures that, when applied consistently in healthcare settings, can prevent or reduce the risk of infection in patients, healthcare providers and visitors.
infection prevention and control professional (ICP): trained individual responsible for a healthcare setting’s infection prevention and control activities.
infectious agent: a microorganism, i.e., a bacterium, fungus, parasite, virus, or prion, which is capable of invading body tissues, multiplying, and causing infection.
long-term care: a broad range of personal care, support, and health services provided to people who have limitations that prevent them from full participation in the activities of daily living. The people who use long-term care services are usually elderly, people with disabilities, and people who have a chronic or prolonged illness.
low-level disinfectant: a chemical agent that achieves low-level disinfection when applied to surfaces or items in the environment.
low-level disinfection (LLD): level of disinfection required when processing non-invasive medical equipment (i.e., non-critical equipment) and some environmental surfaces.
low-touch surfaces: surfaces that have minimal contact with hands. Examples include walls, ceilings, mirrors, window sills, and floors.
manufacturer: any person, partnership, or incorporated association that manufactures and sells medical equipment/devices under its own name or under a trademark, design, trade name, or other name or mark owned or controlled by it.
material compatibility: the chemical compatibility and other factors that affect corrosion, distortion, or other damage to materials.
material safety data sheet (MSDS): a document that contains information on the potential hazards (health, fire, reactivity, and environmental) and how to work safely with a chemical product. It also contains information on the use, storage, handling, and emergency procedures all related to the hazards of the material. MSDSs are prepared by the supplier or manufacturer of the material.
mechanical action: the physical action of cleaning—includes rubbing, scrubbing, and friction.
medical equipment/device: any instrument, apparatus, appliance, material, or other article intended by the manufacturer to be used for the purpose of diagnosis, prevention, monitoring, treatment, or alleviation of disease, injury, or handicap.
methicillin-resistant Staphylococcus aureus (MRSA): MRSA is a strain of Staphylococcus aureus that has a minimal inhibitory concentration (MIC) to oxacillin of ≥ 4 mcg/ml and contains the mecA gene coding for penicillin-binding protein 2a (PBP 2a). MRSA is resistant to all of the beta-lactam classes of antibiotics, such as penicillins, penicillinase-resistant penicillins (e.g. cloxacillin), and cephalosporins.
microfiber cloths: cloths made from a tightly woven combination of polyester and polyamide (nylon) fibers.
micron filter: a particulate air filter that provides an 85-90% filtration efficiency at a 1 micrometre particle size.
mid-level disinfection (also intermediate-level disinfection): kills inactive vegetative bacteria, including mycobacteria, most viruses, and most fungi, but might not kill bacterial spores.
monitoring: a planned series of observations or measurements of a named parameter (e.g., monitoring cleaning of patient rooms).
multidrug-resistant organisms (MDRO) and pathogens: germs (viruses, bacteria, and fungi) that develop the ability to defeat the drugs designed to kill them. Typically refers to an isolate that is resistant to at least one antibiotic in three or more drug classes.
mycobactericide: an environmental (low-level) disinfectant capable of irreversibly inactivating mycobacteria present on environmental surfaces and inanimate surfaces.
non-critical medical equipment/device: equipment/device that either touches only intact skin (but not mucous membranes) or does not directly touch the patient. Reprocessing of non-critical equipment/devices involves cleaning and may also require low-level disinfection (e.g., blood pressure cuffs, and stethoscopes).
non-enveloped virus: non-enveloped viruses such as Norovirus lack an outer lipid membrane. As a result, non-enveloped viruses are less susceptible to drying and heat and are more resistant to disinfectants. These viruses can survive for longer on environmental surfaces than enveloped viruses.
Occupational Health and Safety (OHS)/Workplace Health: preventive and therapeutic health services in the workplace provided by trained occupational health professionals, e.g., nurses, hygienists, and physicians.
Ontario Agency for Health Protection and Promotion (OAHPP): A Crown corporation dedicated to
protecting and promoting the health of all Ontarians and reducing inequities in health. OAHPP’s operating
name is Public Health Ontario (PHO). More information is available at www.publichealthontario.ca.
Canadian Healthcare Housekeepers’ Association (CHHA): An organization representing professional
healthcare housekeepers and providing management and leadership education, training, and
representation across Canada. More information is available at www.healthcarehousekeeping.org.
patient zone: the patient and his or her immediate surroundings. Includes all surfaces that are temporarily and exclusively designated for that patient.
personal protective equipment (PPE): clothing or equipment worn by staff for routine practices and additional precautions (e.g., gloves, masks, protective eyewear, gowns). General work clothes (e.g., uniforms, pants, shirts, or blouses) not intended to function as protection against a hazard are not considered to be personal protective equipment.
point of care: the place where three elements occur together: the patient, the healthcare provider, and care or treatment involving patient contact. Point-of-care products should be accessible to the healthcare provider, within arm’s reach, without the provider leaving the zone of care.
precautions: interventions taken to reduce the risk of transmission of microorganisms (e.g., patient-to-patient, patient-to-staff, staff-to-patient, contact with the environment, contact with contaminated equipment).
pre-hospital care: Pre-hospital care or emergency health service means the provision of first aid or medical services by a licensed healthcare professional in emergency situations as well as the provision of ongoing care during transfer to definitive care. Pre-hospital care may also include inter-facility transfer.
Provincial Infectious Diseases Advisory Committee (PIDAC): a multidisciplinary scientific advisory body that provides to Public Health Ontario evidence-based advice regarding multiple aspects of infectious disease identification, prevention, and control.
Public Health Agency of Canada (PHAC): a national agency that promotes improvement in the health status of Canadians through public health action and the development of national guidelines. The PHAC website is located at www.phac-aspc.gc.ca.
relative light unit (RLU): a measurement of bioluminescence or output of light.
reprocessing: the steps performed to prepare reusable medical equipment for reuse (e.g., cleaning, disinfection, sterilization).
reservoir: any person, animal, substance, or environmental surface in or on which an infectious agent survives or multiplies, posing a risk for infection.
residential care: Residential care facilities provide 24-hour professional nursing care and supervision in a protective, supportive environment for people who have complex care needs and can no longer be cared for in their own homes.
Routine cleaning: the regular cleaning (and disinfection, when indicated) when the room is occupied to remove organic material, reduce microbial contamination, and provide a visually clean environment. Emphasis is on surfaces within the patient zone.
routine practices: the system of infection prevention and control practices used by all healthcare providers with all patients for all care based on the premise that all blood, body fluids, and secretions are presumed to carry infectious pathogens. Routine practices were previously known as standard precautions.
safety-engineered medical device: a medical sharp with a built-in safety feature or mechanism that eliminates or minimizes the risk of accidental parenteral contact while or after the sharp is used.
Scheduled cleaning: cleaning (and disinfection, when indicated) that occurs concurrently with routine cleaning and aims to reduce dust and soiling on low-touch surfaces.
semi-critical patient care equipment: equipment, such as endoscopes, respiratory and anesthesia equipment, and vaginal ultrasound probes, that comes into contact with mucus membranes.
sharps: any object that can readily penetrate the skin, including, but not limited to broken glass, needles, scalpels, lancets, and clinical glass.
single-use/disposable: A device designated by the manufacturer for single-use only; after use, it is discarded. Single-use devices shall not be reprocessed except by an approved third-party preprocessor.
sluice room: a dedicated room or area, separated into dirty and clean areas, where noncritical patient care equipment is reprocessed. Access is restricted to cleaning staff and authorized personnel.
sporicidal activity: A 3-4 logarithmic reduction of spores.
sporicide: an environmental (low-level) disinfectant capable of activating bacterial spores on environmental surfaces and items.
Standard Precautions: are used for all patient care. Based on a risk assessment and make use of common sense practices and personal protective and other equipment that protects healthcare providers from infection and prevent the spread of infection from patient to patient.
surge capacity: the ability to provide adequate services during events that exceed the limits of the normal infrastructure of a healthcare setting. This includes providing additional environmental cleaning (materials, human resources) when required, e.g., during an outbreak and when over capacity.
Terminal Clean: see discharge/transfer cleaning.
three-bucket system (mopping): floor mopping system for cleaning and disinfection. One bucket contains a detergent or cleaning solution, the second bucket contains disinfectant or disinfectant solution, and the third bucket contains clean water for rinsing the mop.
Transmission-Based Precautions: are used in addition to Standard Precautions for patients with known or suspected infections. There are three categories:
- Contact: intended to prevent transmission of infectious agents, including epidemiologically important microorganisms, that are spread by direct or indirect contact with the patient or the patient’s environment.
- Droplet: intended to prevent transmission of pathogens spread through close respiratory or mucous membrane contact with respiratory secretions.
- Airborne: intended to prevent transmission of infectious agents that remain infectious over long distances when suspended in the air (e.g., rubeola virus [measles], varicella virus [chickenpox], M. tuberculosis, and possibly SARS-CoV).
For some diseases that have multiple routes of transmission (e.g., SARS), more than one Transmission-Based Precautions category can be used.
Transport equipment: wheelchairs, trolleys, stretchers, and other portable equipment used to transport patients.
Twice Daily Clean: cleaning process that requires a daily clean and disinfection followed by a second clean and disinfection of high-touch surfaces in patient rooms and bathrooms approximately 6-8 hours later.
two-bucket system (mopping): floor mopping system for cleaning only (not disinfection). One bucket contains a detergent or cleaning solution and the second bucket contains clean water for rinsing the mop.
Two-Step Clean: process that requires an initial clean with a detergent and water, followed by disinfection of the same area (i.e., surfaces, equipment, furniture, etc.) using a disinfectant. The product for both the cleaning and disinfection steps might be the same product if a combined detergent/disinfectant is used, and the area is visibly soiled.
Vancomycin-resistant enterococci (VRE): VRE are strains of Enterococcus faecium or Enterococcus faecalis that have a minimal inhibitory concentration (MIC) to vancomycin of ≥ 32 mcg/ml. and/or contain the resistance genes vanAor vanB.
visibly soiled: hands or surfaces on which dirt, blood, or body fluids can be seen.
washer-disinfector: a machine used to clean and disinfect reusable patient care equipment (e.g., bedpans, urine bottles and bowls) and pre-clean reusable minor surgical instruments before sterilization.
Workplace Hazardous Materials Information System (WHMIS): The Workplace Hazardous Materials Information System (WHMIS) is Canada's national hazard communication standard. The key elements of the system are cautionary labeling of containers of WHMIS ‘controlled products’, the provision of Material Safety Data Sheets (MSDS), and staff education and training programs.
WorkSafe BC: provincial agency that regulates worker health and safety, as well as provides compensation to injured workers, in British Columbia.
