Spills, Gastro and Flu Season: How a Melbourne Clinic's Cleaning Should Change

A clinic's routine clean is built for a normal day. The trouble is that clinics have fewer normal days than most workplaces: a patient vomits at reception, a run of gastro comes through the practice, the waiting room is full of coughing people from June to September. The cleaning has to flex, and the time to decide how is before it happens.

This post sets out how we handle the three situations that come up most in the Melbourne practices we clean.

1. A body-fluid spill during the day

This is the practice's job, not the night cleaner's. A spill of blood, vomit, urine or faeces during opening hours should be dealt with by your staff immediately, with a spill kit, because patients will keep walking through it otherwise.

The sequence, in line with the NHMRC's Australian Guidelines for the Prevention and Control of Infection in Healthcare:

1. Keep people clear of the area.
2. Put on gloves, and an apron and eye protection if there is any chance of splashing.
3. Contain and absorb the spill with the absorbent in the kit or paper towel.
4. Remove it into a waste bag.
5. Clean the area with detergent and water.
6. Disinfect with a hospital-grade product appropriate to the organism, left for its contact time.
7. Remove and bag the protective equipment; wash hands.

What the night cleaner does: knows where the spill kit is, restocks it if you have asked them to, and gives the affected area a second clean and disinfection that night. Tell them with a note, a message or a line on the site checklist, so it is not missed. Soft furnishings that were hit need extraction cleaning or replacement, not a wipe.

2. Gastro going around

Norovirus is hardy. It survives on surfaces for days and needs a disinfectant that is actually effective against it; check the label claims of what you are using. When the practice is seeing a run of gastro:

• Step up nightly disinfection of high-touch surfaces in waiting, reception, toilets and consulting rooms: door handles, chair arms, counters, card terminals, taps, flush buttons, light switches.
• Toilets get disinfected, not just cleaned, every visit, with the red-zone equipment kept strictly to the toilets.
• Children's toys in the waiting room come out of circulation until it has passed.
• Set an end date. Enhanced cleaning is easy to start and easy to forget to stop. Agree it for a set period (a fortnight is common) and review.

We add an outbreak clean to a site's schedule the same day a practice asks, and it shows as its own line so you can see what you are paying for.

3. Respiratory season

Melbourne's flu season typically runs from June into September, and the pressure falls on the waiting room. Respiratory viruses mostly spread through the air and hands, so cleaning is one layer among several: ventilation, masks and hand hygiene matter as much. But the cleaning layer is worth getting right:

• High-touch surfaces in the waiting room disinfected nightly throughout the season, not only when someone asks.
• Hand-sanitiser dispensers checked and refilled every visit.
• Magazines and shared items reduced; what remains, wiped.
• Tissues and lidded bins at reception and in consulting rooms, emptied every visit.

Plan it in May, not in July when the waiting room is already full.

Making it routine

The practices that handle this well have three things written down:

1. A spill procedure that names who does what during the day and what the cleaner does at night.
2. An outbreak clean as a pre-agreed add-on with a set scope and price, so it can be switched on with one message.
3. A seasonal scope that changes automatically on a date rather than on a phone call.

And they can show it happened. Every visit we make is signed in and out on our app inside a geofence around the practice, with a photo, and a supervisor inspects every three weeks. When an accreditation surveyor asks how the practice responded to an outbreak, that is the answer.

For the everyday version of all this, read our GP clinic cleaning checklist. If you run a practice anywhere across Melbourne, medical cleaning Melbourne explains how we work, or ask for a walkthrough.