APPENDIX A
BASIC HYGIENE & SANITATION PRACTICES POLICY
GUIDELINES FOR REGULATED PROGRAMS
The following guidelines provide simple and effective protection against transmission of disease for all persons who may be exposed to the blood or other body fluids of another person. Body fluids consist of urine, vomitus, feces, wound drainage and blood.
1. The licensee shall promptly disinfect all hard (not cloth) surfaces soiled with blood or body fluids by using a freshly prepared disinfectant solution of household bleach (1/4 cup bleach to 1/2 gallon of water) or a comparable disinfectant solution**. Disposable towels or tissues shall be used, and mops shall be rinsed in the disinfectant.
Persons cleaning up, particularly those with chapped hands, cuts or broken skin, are advised to wear disposable latex gloves.
2. Areas of the skin which come in contact with another person’s blood or body fluids shall be immediately washed thoroughly with a disinfectant solution**. When contact occurs to a mucus membrane, such as the eye, nose or mouth, rinse immediately with water and have the person contact a physician for any further advice.
3. Toothbrushes, razors and other personal hygiene utensils shall not be shared and shall be stored in a manner to prevent contact with other persons’ personal hygiene utensils.
4. Sponges and other cleaning utensils used to clean the floor of any body fluid spills shall not be used to wash dishes or to clean blood preparation areas. Mop water shall not be poured down the sink where food is prepared. Sponges and mops shall be disinfected after each use by soaking in a solution of bleach (1/3 cup of bleach in 1/2 gallon of water) for 5 minutes. The soaking solution shall be changed every week.
5. Rugs and cloth furniture (not hard surfaces) that have been soiled with blood or body fluids shall be cleaned with rug shampoo which contains a germicidal detergent, then vacuumed as usual.
6. Linen and laundry:
a. Laundry soiled with blood or body fluids shall be rinsed clean and laundered in hot, soapy water. Bleach shall be added to the wash load according to the product manufacturer’s recommendations, but care shall be taken that ample rinsing occurs, as any residue may cause skin irritation and subsequent infection. Soiled (by any fluid produced by the body) clothing or linens not washed immediately shall be placed in a bag separate from other laundry.
b. Towels and wash cloths shall not be shared without laundering in between use.
** The following disinfectant solutions are comparable in terms of their effectiveness. However, a 70 percent alcohol solution is preferred for objects that may be put into the mouth of a person as, for instance, a thermometer.
1. Sodium hypochlorite with at least 500 ppm available chlorine (1:100) needs to be freshly prepared each time it is used or daily.
An easy way to dilute bleach is to add 1/4 cup bleach to 1/2 gallon water - 1:65. The date of preparation of the bleach solution must be indicated because freshness of the solution is important, for effectiveness. The solution should not be stored for longer than one week.
2. Ethyl or isopropyl alcohol (70-90 percent). Use full strength.
3. Phenolic germicidal detergent in a 1 percent aqueous solution, such as Lysol. Follow product label.
4. Hydrogen peroxide, a 3 percent solution.
5. Quaternary ammonium germicidal detergent in 1-2 percent aqueous solution, such as Tri-Quat, Mytar or Sage. Follow manufacturer’s recommendations.
6. Iodophenol germicidal detergent with 30-50 ppm available free iodine, such as Wescodyne. Follow product label for dilution.
