1. K Anil Kumar
Quality Coordinator & Nursing Officer
NQAS - External Assessor
NABH Assessor (5th Edition)
Master Trainer – IPC
General Hospital, Jayanagar, Bengaluru

2. All photographs used in this
presentation are real.
Photographs were taken with
consent from the facility.
They are used only for training
purpose. All efforts are made not
to disclose the identity of the
facility.

3. Theme B – Sanitation & Hygiene

5. Sanitation refers to providing facilities and
services for the safe disposal of human
waste—including waste management systems
such as sewers and latrines. Sanitation is about
creating an environment safe from pathogens
Hygiene refers to personal cleanliness and healthy
habits that prevent the spread of disease—
encompassing everything from washing your hands to
brushing your teeth to cooking food properly

6. To prevent the
spread of
disease
The goals of sanitation and hygiene are similar

7. B1: Clean Circulation
area B2: Clean Wards
B3: Clean procedure
area
B4: Clean Ambulatory
area
B6: Clean Toilets
B8: Standard methods
for cleaning
B9: Monitoring of
cleanliness activities
B10: Drainage and
sewage management
Sanitation &
Hygiene
Theme B
B5: Clean Auxiliary areas
B7: Standard material and
equipment for cleaning

8. Clean Circulation areas
B1
No dirt/ Grease/ stains
No cobwebs/ Bird nest/ dust on walls and roofs of corridors
Wet mop of corridors at least twice in a day
Surfaces are conducive of effective cleaning
Rigorously cleaned with scrubbing/ flooding once in a
month

9. B1.1: No dirt/ Grease/ stains in circulation areas
Corridors
Waiting Areas
Stairs
Ramps
Lifts
Roof tops

10. B1.2: No Cobwebs/ bird nest/ dust on walls and roofs of
corridors

11. B1.3: Corridors are cleaned at least twice in the day
with wet mop

12. B1.4: Corridors are rigorously cleaned with
scrubbing/ flooding once in a month

13. B1.5: Surfaces are conducive of effective cleaning

14. Cleanliness of wards
B2
No dirt/ Grease/ stains
No cobwebs/ Bird nest/ dust on walls and roofs
Cleaning of wards at least thrice in a day
Cleaning of floors, walls, furniture and fixtures once in week
Patient furniture, Mattresses fixtures are without grease
and dust

15. B2.1: No dirt/ Grease/ stains/ Garbage in wards

16. B2.2: No cobwebs/ Bird nest/ dust on walls and roofs
of wards

17. B2.3: Wards are cleaned at least thrice in the day
with wet mop

18. B2.4: Patient furniture, Mattresses fixtures are
without grease and dust

19. B2.5: Floors, walls, furniture and fixtures are
thoroughly cleaned once in a week

20. Cleanliness of procedure areas
B3
No dirt/ Grease/ stains
No cobwebs/ Bird nest/ dust on walls and roofs
Cleaning of OT/ Labor room at least twice in a
day/after surgery
Cleaning of floors, walls, furniture and fixtures once in week
OT & Labor tables without body fluids, grease

21. B3.1: No dirt/ Grease/ stains/ Garbage in procedure
areas
Labour room
OT
Dressing room
Minor OT
Endoscopy room
Dental procedure
rooms
Dialysis

22. B3.2: No cobwebs/ Bird nest/ seepage in OT &
Labour room

23. B3.3: OT/ Labour room floors and procedure surfaces
are cleaned at least twice a day/ after every surgery

24. B3.4: OT & Labor room tables are without grease, body
fluids and dust

25. B3.5: Floors, walls, furniture and fixtures are
thoroughly cleaned once in a week

26. Cleanliness of Ambulatory area
B4
No dirt/ Grease/ stains
No cobwebs/ Bird nest/ dust on walls and roofs
Cleaning at least thrice in a day with wet mop
Cleaning of floors, walls, furniture and fixtures once in week
Furniture & fixtures are without body fluids, grease and
cleaned daily

27. B4.1: No dirt/ Grease/ stains/ Garbages in
Ambulatory areas
OPD
Emergency
Laboratory
Radiology

28. B4.2: No cobwebs/ Bird nest/ seepage in walls &
roofs of ambulatory areas

29. B4.3: Ambulatory areas are cleaned at least thrice in
a day with wet mop

30. B4.4: Furniture & fixtures are without grease, dust,
body fluids and cleaned daily

31. B4.5: Floors, walls, furniture and fixture are
thoroughly cleaned once in week

32. Cleanliness of Auxiliary area
B5
No dirt/ Grease/ stains
No cobwebs/ Bird nest/ dust on walls and roofs
Cleaning at least twice in a day with wet mop
Cleaning of floors, walls, furniture and fixtures once in week
Furniture & fixtures are without body fluids, grease and
cleaned daily

33. B5.1: No dirt/ Grease/ stains/ Garbages in Auxiliary
areas
Pharmacy
Kitchen
Laundry
Mortuary
Administrativ
e Office
MRD

34. B5.2: No cobwebs/ Bird nest/ seepage in walls &
roofs of auxiliary areas

35. B5.3: Auxiliary areas are cleaned at least twice in a
day with wet mop

36. B5.4: Furniture & fixtures are without grease, dust,
and cleaned daily

37. B5.5: Floors, walls, furniture and fixture are
thoroughly cleaned once in a month

38. Cleanliness of Toilets
B6
No dirt/ Grease/ stains
No foul smell
Availability of running water and functional cisterns
Dry Floors
Cleaning of toilets

39. B6.1: No dirt/ Grease/ stains/ Garbage in
Toilets

40. B6.2: No foul smell in the Toilets

41. B6.3: Toilets have running water and functional
cisterns

42. B6.4:Sinks and cistern are cleaned every
two hours or whenever required

43. B6.5: Floors of toilets are dry

44. Use of standard material & equipment for cleaning
B7
Availability of Detergent Disinfectant for cleaning
Using correct concentration of cleaning solution
Carbolic acid/ Baciloacid for surface cleaning
Cleaning equipment
Buckets and carts for mopping

45. B7.1: Availability of Detergent Disinfectant solution/
Hospital grade phenyl for cleaning purpose

46. B7.2: Cleaning staff use correct concentration of
cleaning solution

47. B7.3: Availability of Carbolic acid/ Bacillocid for
surface cleaning in procedure areas – OT, Labour
room
• Mopping is recommended over fogging.
• For fogging: use 1% dilution of Bacillocid
daily. i.e. 20 ml in 2 litres of water.
• Disinfected surfaces must remain in contact
i.e. wet with solution for 10 to 20 minutes
for optimum results.
• Add 25 to 50 ml of Bacillocid to 5 litres of
water to get 0.25% to 0.5% solution

48. B7.4: Availability of Buckets and carts for mopping

49. B7.5: Availability of Cleaning equipment
Hospital with more than 300
beds should have mechanized
mopping machine

50. Use of standards methods for cleaning
B8
3 Bucket system for cleaning
Unidirectional method and out word mopping
No use of brooms in patient care areas
Disinfection and washing of mops after every cleaning cycle
Separate mops for critical and semi critical areas

51. B8.1: Use of Three Bucket system for
cleaning
The Three bucket system
should be ideally practiced.
The first bucket should
contain water with detergent
used in the beginning. The
mop is then rinsed in the
second bucket and dipped in
the third bucket which can
also contain a disinfectant and
the mopping done again.

52. B8.2: Use Unidirectional method and out word
mopping

53. B8.3: No use of brooms in patient care areas

54. B8.4: Use of separate mops for critical and
semi critical areas and procedure surfaces

55. B8.5: Disinfection and washing of
mops after every cleaning cycle

56. Monitoring of cleanliness activities
B9
Housekeeping checklists in toilets
Housekeeping checklists in patient care areas
Housekeeping checklists in procedure areas
Monitoring of adequacy and quality of material used for
cleaning
Designated person for monitoring

57. B9.1: Use of Housekeeping checklists in toilets
SL.NO WORKS
DATE & TIME
1
7.30 am 1.00 pm 7.30 pm
1 Brush the Floor
2 Mop the Floor
3 Dusting
4 Toilet Wash
5 Closet Clean
6 Wash Basin Clean
7 Liquid soap refill
8 Wall tiles clean
9 Lights clean
10 Fans clean
11 Door mat clean
12 Doors clean
13 Windows clean
14 Window screen clean
15 Waste collected
16 Waste bins clean
17 Complaint reported
Name of cleaning / Housekeeping staff.
Signature of Ward Nurse
Sign of HIC Nurse.

58. B9.2: Use of Housekeeping checklists in Patient care areas
SL.NO WORKS
DATE & TIME
1
7.30 am 1.00 pm 7.30 pm
1 Brush the Floor
2 Mop the Floor
3 Dusting
4 Toilet Wash
5 Closet Clean
6 Wash Basin Clean
7 Liquid soap refill
8 Wall tiles clean
9 Lights clean
10 Fans clean
11 Door mat clean
12 Doors clean
13 Windows clean
14 Window screen clean
15 Waste collected
16 Waste bins clean
17 Complaint reported
Name of cleaning / Housekeeping staff.
Signature of Ward Nurse
Sign of HIC Nurse.

59. B9.3: Use of Housekeeping checklists in Procedure areas
SL.NO WORKS
DATE & TIME
1
7.30 am 1.00 pm 7.30 pm
1 Brush the Floor
2 Mop the Floor
3 Dusting
4 Toilet Wash
5 Closet Clean
6 Wash Basin Clean
7 Liquid soap refill
8 Wall tiles clean
9 Lights clean
10 Fans clean
11 Door mat clean
12 Doors clean
13 Windows clean
14 Window screen clean
15 Waste collected
16 Waste bins clean
17 Complaint reported
Name of cleaning / Housekeeping staff.
Signature of Ward Nurse
Sign of HIC Nurse.

60. B9.4: A person is designated for
monitoring of Housekeeping activities

61. B9.5: Monitoring of adequacy and quality
of material used for cleaning
Suggestions/feed back needs to
be taken from the housekeeping
staff, for efficiency of the
cleanliness agents.
Monitoring of the cleaning
material can also be carried out
by doing the surveillance activity
of cleaning effectiveness through
microbiological testing.

62. Drainage and sewage management
B10
Closed drainage system
Gradient of drains is conducive for free flow
Connection with municipal sewage system/ Soak pit
Cleaning of drains once in a week
No block/ overflowing drains

63. B10.1: Availability of Closed drainage
system

64. B10.2: Gradient of drains is conducive for
adequate for maintaining free flow

65. B10.3: Availability of Connection with municipal
sewage system/ Soak pit

66. B10.4: No blocked/ overflowing drains in
the facility

67. B10.5: All the drains are cleaned once in a
week

68. Thank You