Research Output
Four Steps to Clean Hospitals: Look; Plan; Clean; and Dry
Now that cleaning and decontamination are recognised as integral to infection control, it is timely to examine the process in more detail. This is because cleaning practices vary widely within healthcare districts and it is likely that both time and energy are needlessly wasted with ill-defined duties. Furthermore, inadequate cleaning will not reduce the infection risk but may even enhance it. The process would benefit from a systematic appraisal, with each component placed within an evidence-based and ordered protocol.
A literary search was performed on ‘hospital cleaning’, with focus on manual aspects of cleaning, pathogen reservoirs and transmission, hand-hygiene, staff responsibilities and patient comfort.
There were no articles providing an evidence-based practical approach to systematic cleaning in hospitals. This review therefore proposes a simple four-step guide for daily cleaning of the occupied bed space. STEP 1 (Look) describes a visual assessment of the area to be cleaned; STEP 2 (Plan) argues why the bed space needs preparation before cleaning; STEP 3 (Clean) covers surface cleaning/decontamination; and STEP 4 (Dry) is the final stage whereby surfaces are allowed to dry.
Given the lack of articles providing practical cleaning guidance, this review proposes a four-step protocol based on evidence if available, or justified where not. Each step is presented, discussed and risk-assessed. It is likely that a systematic cleaning process would reduce the risk of healthcare-acquired infection for everyone, including outbreaks, in addition to heightened confidence in overall quality of care.

  • Type:


  • Date:

    27 December 2018

  • Publication Status:


  • Publisher

    Elsevier BV

  • DOI:


  • Cross Ref:


  • ISSN:


  • Library of Congress:

    QR180 Immunology

  • Dewey Decimal Classification:

    614 Incidence & prevention of disease

  • Funders:

    Edinburgh Napier Funded


Dancer, S. J., & Kramer, A. (2019). Four Steps to Clean Hospitals: Look; Plan; Clean; and Dry. Journal of Hospital Infection, 103(1), e1-e8.



Healthcare environment, cleaning, decontamination, hospital hygiene, bed-space,

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