Minnesota Hospital Association



Controlling CDI — Emergency Department Patient Room Cleaning Checklist

Objectives: Learner understands the Mercy Hospital Emergency Department cleaning procedure and implements use during cleaning of patient rooms.

Assessment criteria:

• All skills must be met and demonstrated in the order presented.

• Verifier places check mark in appropriate box.

• After learning requirements met, Learner and Instructor sign and date at bottom of page.

Key points to remember with this room cleaning procedure checklist:

• The employee is to complete the skills using the proper cleaning procedure.

• Proper dry times must be allowed for each cleaning product being used.

|Learner performs skill: Cleaning of ED room |Met |Needs |

| | |review |

|Identifies different types of cleaning and who is responsible for each. | ο |ο |

|Identifies room turnover procedure by demonstrating steps below: |ο |ο |

|Removes dirty linen from cart and places into nearest soiled laundry bin. |ο |ο |

|Identifies proper cleaning technique for Enteric precautions room by verbalizing using bleach wipes for all surfaces and |ο |ο |

|equipment. | | |

|Cleans visible soil with appropriate wipes using friction. Disinfects surface using a second appropriate wipe and allows to |ο |ο |

|dry for recommended time. | | |

|Demonstrates wiping ED cart using a minimum of five AF wipes: three for mattress, two for side rails and cart handles. Clean |ο |ο |

|pillow with two wipes, one for each side. Allow to dry for minimum of three minutes. | | |

|Disposes of trash in proper receptacles. |ο |ο |

|Wipes down counter top with appropriate wipes. Allows to dry for a minimum of three minutes for AF wipes and four minutes for|ο |ο |

|bleach wipes. | | |

|Wipes down dash monitor cables, not including cardiac leads, with AF wipes. Allows to dry for a minimum of three minutes. |ο |ο |

|Wipes down dash monitor cardiac cables with bleach wipes. Allows to dry for a minimum of four minutes, then replace cables on|ο |ο |

|holder. | | |

|Identifies chairs used by patients or family members should be wiped down with AF wipes and placed in chair holder. |ο |ο |

|Wipes down computer keyboard. |ο |ο |

|Shuts cabinet doors. |ο |ο |

|Verbalizes equipment that needs to be cleaned: |ο |ο |

|EKG machines | | |

|Bladder scanner | | |

|Doppler | | |

|Thermometers | | |

|Commodes | | |

|Portable cardiac monitors (cardiac leads with bleach wipes) | | |

|Nitrous machine | | |

|Mayo stands | | |

|Bedside tables | | |

|Infant crib | | |

I have successfully completed the procedures “Cleaning of ED Room.” I have demonstrated the tasks/skills and understand that these steps are to be used to comply with Mercy Hospital’s ED Room Cleaning Procedure E-R-2.

|Employee name (print) | |Employee number | |

|Employee signature | |Employee job title | |

|Verifier name (print) | |Verifier job title | |

|Verifier signature | |Department | |

|Date | | |

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