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Infection prevention and control guidelines

9. Cleaning, laundry and waste management

Cleaning after contamination by blood or other body substances (spills)

      1. Cleaning after contamination by blood or other body substances (spills)

Last revised: 18 Aug 2023

Cleaning after contamination by blood or other body substances (spills)

Blood or body substances other than sweat (including faeces, urine, saliva or vomitus) need to be treated as potentially infectious substances that can transmit disease on contact.

Incidents that result in contamination of surfaces by blood or other body substance need to be managed promptly. Faeces is highly contaminated. Blood and body substances that contain blood also carry a risk of transmission of blood-borne viruses.

All staff members need to be familiar with the practice’s policy and procedure for managing blood and body substance spills. They should be managed promptly to reduce the potential for contact with other patients or staff or visitors and minimise damage to surface materials.

Detergent is be used for initial treatment and may be sufficient for very small spills that require only spot-cleaning.

Disinfectant is necessary for:

  • small (<10 cm) spills
  • large (≥10 cm) spills
  • any spill on a surface that is in contact with the skin
  • spills involving a potentially serious pathogen.

Small and large spills require a two-step process, in which immediate treatment of the surface is followed by thorough cleaning with detergent or disinfectant, using the usual cleaning supplies.

When a surface is soiled by blood or other body substances, when the presence of multi-resistant organisms (eg C. difficile) is suspected, or during transmission-based precautions, manual cleaning with a detergent solution must be followed by (or combined with) the use of an appropriate-grade disinfectant with specific claims for efficacy against the relevant microorganisms, and which is listed on the Australian Register of Therapeutic Goods (see Table 9.4. Classification of disinfectant activity).

Practices must have a kit readily available to manage contamination of floors or other surfaces by blood or other body substances.

A spills kit usually consists of a suitable rigid-walled, labelled container (eg bucket or plastic sealable box) containing materials for basic cleaning (Table 9.5. Sample contents of a basic spills kit). 

Practices can purchase commercially available ready-made spills kits or assemble their own.

Practices that provide consultations off-site could carry a spills kit in the vehicle. This is required if carrying sharps or clinical waste.

Table 9.5. Sample contents of a basic spills kit

Laminated printed guide with a list of spill kit contents and the management procedure

Single-use gloves

Eye protection (eg goggles/face shield)

Surgical masks

Disposable waterproof aprons

Clinical waste bags (marked as hazardous waste)

General waste bags

Emesis bags

Absorbent agent (eg clumping cat litter, polymerising beads or other absorbent material)

Paper towels (will need ample to absorb liquids such as urine)

Scoop and scrapers (eg two small pieces of cardboard)

Detergent wipes (for spot cleaning only)

Disinfectant wipes (a larger volume of disinfectant may sometimes be needed, but need not be kept in the kit)

Hospital-grade disinfectant or sodium hypochlorite listed or registered by the Therapeutic Goods Administration

Hazard signs to place around the area to be quarantined

Note: All components should be disposable, to ensure against cross-contamination between uses.

Standard precautions apply, including personal protective equipment appropriate to the task (eg gloves, goggles/face shield, apron). The person performing this cleaning must put on personal protective equipment while keeping well away from the spill.

The method for cleaning spills will depend on the volume of the spill and where it occurs (hard surfaces or textiles; see Table 9.6. Sample spills cleaning protocols).

Do not use liquid on a spill, as this will spread the spill.

If the spill is on a hard surface:

  1. Confine and contain the spill with an absorbing agent suitable for that spill type:
  • For blood, use wads of paper towel or purpose-designed absorbent agent.
  • For vomitus, use a clumping agent to cover and deodorise.

Scoop or wipe up and safely remove any solid matter and excess material.

  1. Clean with detergent and water or detergent wipes.
  2. Dry the surface.
  3. Use disinfectant, if required.
  4. Dispose of contaminated material, including personal protective equipment, as instructed in the cleaning and waste management policies.
  5. Cleanse hands (see 2. Hand hygiene).

If the spill is on soft textile fabric or carpet:

For non-removeable textile fabric (eg upholstery) or standard carpet:

  1. Cover the site with an absorbent agent (cat litter, polymerising beads or other absorbent material).
  2. Scoop up residue safely without causing material to disperse.
  3. Damp-pat surface (do not wipe or scrub) to remove more material.
  4. Dispose of contaminated material, including personal protective equipment, as instructed in the cleaning policy.
  5. Clean fabric or carpet by damp patting with dampened disposable cloth using detergent and water or recommended carpet cleaning agent.
  6. Quarantine the area until the soft fabric or carpet is dry. (Arrange steam cleaning when dry, if needed – do not vacuum-clean.)
  7. Discard the used cleaning materials in the appropriate waste container.
  8. Cleanse hands (see 2. Hand hygiene).

For removable fabric or carpet tiles, remove from the area, clean as for non-removable textiles, and replace when completely dry. Heavily contaminated carpet tiles can be discarded.

Table 9.6. Sample spills cleaning protocols  Download the spills cleaning protocols template

Spot cleaning (very small, well-defined spills that do not require use of spill kit)

Use examination gloves. (If glass suspected, use protective utility gloves and discard them afterwards.)

Wipe up spot immediately with a damp cloth, tissue or paper towel.

Consider disinfecting according to potential for skin contact with the site and suspected pathogens.

Discard contaminated materials and dispose of gloves.

Perform hand hygiene.

Small spills (up to 10 cm diameter)

Select appropriate personal protective equipment.

Wipe up spill immediately with absorbent material.

Place contaminated absorbent material into impervious container or plastic bag for disposal.

Clean the area with detergent.

Wipe the area with [Insert name of TGA-approved disinfectant used in the practice]. Ensure surface remains wet for the required time [insert number of minutes] (reapply if necessary). Allow to dry.

Perform hand hygiene.

Large spills (> 10 cm diameter)

Select appropriate personal protective equipment.

Cover entire area of the spill with an absorbent clumping agent and allow a few seconds to absorb

Using two scoops, lift absorbed material into waste bag placed at the site.

Change gloves. if visibly soiled.

Clean site with detergent.

Remove bag to waste storage area and remove personal protective equipment.

Perform hand hygiene.

Don fresh gloves.

Wipe the area with a suitable disinfectant and allow to dry for the time advised by the product manufacturer.

Perform hand hygiene.

TGA: Therapeutic Drug Administration