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Terminal Cleaning

It’s time for better facility-wide terminal cleaning solutions.

Learn about the role that environmental surfaces play in the transmission of healthcare-associated infections (HAIs), and how you can combine manual disinfectants with advanced ultraviolet technology to provide a more comprehensive terminal cleaning solution for your facility.

Terminal Cleaning Checklist Clorox Healthcare Bleach Germicidal Wipes Clorox Healthcare Bleach Germicidal Cleaner Clorox Healthcare Optimum-UV Enlight System
Cleaning Tools 
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Bleach Germicidal Wipes
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Bleach Germicidal Cleaner
Clorox Healthcare Optimum-UV Systems

What Is Terminal Cleaning?


Terminal (or discharge) cleaning is the cleaning methodology used in a patient care area, room or space that occurs upon a patient's departure. This cleaning is meant to render the area safe and ready for the next patient's use.1

Terminal cleaning must include, at a minimum:

  1. Cleaning and disinfection of surfaces touched by patients, healthcare staff and visitors
  2. Cleaning environmental surfaces (e.g., floors, tabletops) and visibly soiled surfaces, followed by disinfection in accordance with the facility’s discharge procedures.

Terminal cleaning should also be tailored to each specific setting. For example, if a patient room includes linens, privacy curtains and the like, those should be replaced.

Terminal Cleaning Quick Facts


Terminal cleaning plays a crucial role in helping to reduce patient exposure to pathogens that cause HAIs. Since several pathogens, such as C. difficile spores and vancomycin-resistant enterococci (VRE), can persist on environmental surfaces for months and can be found outside of isolation rooms, thorough facility-wide cleaning and disinfecting protocols are necessary to ensure patient, staff and visitor safety.

Several studies have demonstrated that there is a need for facilities to adopt effective terminal cleaning strategies:

  • Role of environment for pathogen transmission: Environmental contamination can play a role in the acquisition of infection with MRSA, VRE, C. difficile, Pseudomonas aeruginosa, Acinetobacter species and norovirus.2
  • Disinfection practice is suboptimal: Healthcare workers are cleaning and disinfecting only about 30% to 50% of the surfaces that they should be. These include toilet handholds, light switches, doorknobs, bedside rails, nurse call buttons and patient telephones.2
  • Previous occupancy increases risk for next patient: Patients are at a higher risk of acquiring an HAI when their room was previously occupied by an infected patient. When terminal cleaning protocols are lacking, pathogens can remain on surfaces in the rooms of infected patients.3
  • Dangerous pathogens such as C. difficile spores are found facility-wide: In a New York study, 33% of non-isolation rooms tested positive for C. difficile, despite the common belief that C. difficile can be contained in a patient room.4

Terminal Cleaning in High-Risk Areas


For effective terminal cleaning, always follow your facility’s standard cleaning and disinfection protocols. When using emerging technologies such as advanced ultraviolet devices based on UV-C light, make sure to consult CDC, SHEA and APIC guidelines for additional steps to take as part of a comprehensive bundled approach. UV-C devices should be used as a supplement to — not as a replacement for — standard terminal cleaning protocols.

Patient Rooms

Hospital patient room

With multiple patient, staff and visitor interactions occurring, patient rooms are prone to cross-contamination. According to guidelines for environmental infection control from the Healthcare Infection Control Practices Advisory Committee and Centers for Disease Control and Prevention, high-touch patient room surfaces should be more frequently cleaned and disinfected.

 UV-C technology can also be used to supplement standard manual cleaning and disinfection.


Patient Bathrooms

Hospital patient bathroom

To prevent cross-contamination of dangerous pathogens such as C. difficile, patient bathrooms should be terminally cleaned on a regular, consistent basis. Given all the different surface types within bathrooms, proper disinfecting solutions should be used to clean thoroughly around the toilet, sink and shower.

For an extra layer of assurance, UV-C technology can be used as a supplement to standard manual cleaning and disinfection.


Isolation Rooms

Hospital isolation room

Isolating patients with potentially deadly infections is important, but it’s not always enough to contain HAI outbreaks, because HAI-causing pathogens can be transmitted facility-wide via contaminated surfaces.

To minimize cross-contamination, CDC, APIC and SHEA guidelines recommend using a 1:10 bleach dilution or another EPA-registered disinfectant with claims to kill pathogens of most concern.

UV-C technology can also be used to supplement standard manual cleaning and disinfection.


Intensive Care Units

Intensive Care Unit

ICU patients may be infected with contagious pathogens and are often at high risk for spreading or developing HAIs. Disinfect with bleach to kill pathogens commonly found in ICUs and to minimize cross-contamination.

As an additional precautionary measure, supplement with UV-C technology after standard cleaning and disinfection.

  1. Association for the Healthcare Environment, "Practice Guidance for Healthcare Environment Cleaning," 2nd ed., 2012.
  2. Carling, P.C.; Parry, M.M.; Rupp, M.E.; Po, J.L.; Dick. B.; and Von Beheren, S. "Improving Cleaning of the Environment Surrounding Patients in 36 Acute Care Hospitals." Infection Control and Hospital Epidemiology 29.11(2008): 1035-1041.
  3. Otter, J.A. , Yezli, S., Perl, T.M., Barbut, F., and French, G.L. “The Role of ‘No-Touch’ Automated Room Disinfection Systems in Infection Prevention and Control.” Journal of Hospital Infection 83.1 (2013): 1-13.
  4. Smith, B.A.; Adams, A.B.; Armellino, D.M.; Calfee, D.; Jalon, H.; Straub, T.; and Koll, B. "The Role of Environmental Services in a Collaborative Infection Prevention Model to Reduce Clostridium difficile in the Greater New York Region." American Journal of Infection Control 37.5 (2009): E189-E190.

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