Environmental Cleaning

Quick Reference: Environmental Cleaning

How to clean equipment and surfaces, when to clean, what to use

Visibly Soiled surfaces:

  1. Scrub the surface with a cleaner/detergent or a disinfectant that contains a cleaner/detergent. Wear gloves!
  2. May need to rinse (check label). Will NOT need to rinse if using a wipe that contains both a detergent and a disinfectant.
  3. Disinfect and allow surface to air-dry, using a fresh wipe or cloth. Check label for amount of “wet” contact time needed. Usually 60 seconds of wet contact time is adequate to disinfect most environmental surfaces if the bacteria is not a spore former.  With difficile, five minutes of “wet” contact time with a 1:10 chlorine bleach product or a 1:10 solution of household chlorine bleach is needed to disinfect.

Visibly clean surfaces:  

Disinfect surface thoroughly with EPA-registered disinfectant and let air dry a minimum of 60 seconds (read label). Use 1:10 chlorine solution/wipe for C. difficile and allow “wet” contact time of 5 minutes).

Remember C. difficile is spore forming and 1:10 chlorine bleach solutions/wipes are currently the only EPA-registered products that are effective against these spores.

Item to clean Wipe down what? When? With what?
Blood pressure cuff

(disposable preferred)


Cuff, tubing, bulb (if manual) After each use Wipe nylon or plastic cuffs with low-level disinfectant (LLD); if visibly soiled, wash in soap and water, rinse and hang to dry.

(Cannot disinfect cloth cuffs between patients-replace them.)

Pulse ox probe

(disposable preferred)

Inside and outside of reusable probe, discard if disposable After each use Wipe with 70% isopropyl alcohol (IPA) or low-level disinfectant (LLD).
Stethoscope Bell and tubing After each use Wipe with 70% isopropyl alcohol (IPA) or low-level disinfectant (LLD).
Reflex hammer Handle and head After each use Wipe with 70% isopropyl alcohol (IPA) or low-level disinfectant (LLD).
Otoscope speculae

(disposable preferred)

If reusable, wash and disinfect All surfaces after each use 70% isopropyl alcohol (IPA) may be used for non-disposable oto speculae, soak for 20 minutes.
Otoscope handle Handle After each use Wipe with low level disinfectant (LLD) and air dry.
Nasal, vaginal and rectal specula

(disposable preferred)

If reusable, clean after each use. After each use If reusable, clean in enzymatic detergent. Then autoclave or soak in high-level disinfectant (HLD).
Metal basin

(disposable preferred)

Basin After each use Wash in enzymatic detergent and rinse well, then autoclave.
Flexible endoscopes Scope After each use Wash in enzymatic detergent per manufacturer’s instructions. Soak in high-level disinfectant HLD according to manufacturer’s instructions.
Vascular/fetal doppler Head of Doppler After each use Wipe with 70% isopropyl alcohol (IPA).

(change the tip after each use)

Wand and controls on the unit After each use Wipe with low-level disinfectant (LLD).
Cloth appliances (neck or arm traction, etc.) All cloth After each use Wash in laundry detergent in hot/warm water, rinse well and hang to dry.
Exam tables, gurneys, papoose board, etc.


Baby scale or changing table


Canes, walkers, crutches, wheelchairs (other rehab equipment)


Waiting room:

chairs, tables, etc.

(vinyl furniture preferred)

Top of table, other areas that came in contact with patient and/or bodily fluids

Surfaces that come in contact with patient or staff

Special attention to surfaces that come in contact with people

All surfaces that can come in contact with patient

After each use

After each use

After each use

At least once daily and as needed during the day

If visibly soiled, clean first with friction, using a cleaner/detergent. Cleaners may have to be rinsed off (check label). Then wipe down with low-level disinfectant (LLD). (Some pop-up wipes can be used as cleaners first, then used as disinfectants-check label).

If visibly soiled with stool, clean first with friction using a cleaner/detergent. Then wipe down with a chlorine bleach product 1:10 solution and allow five minutes of wet contact time. (Some chlorine products also contain disinfectants and can be used as cleaners first, then used as disinfectants-check label).

Door knobs, phones, keyboards, light switches

(other “hand touch” items)

Front door, inside and out, and “community” pen at the desk; shared keyboards, counters, telephones, doorknobs, drawer pulls and other “hand touch” areas.

(avoid sharing pens, pencils)

At least once daily Disinfect keyboards for five seconds daily and when visibly dirty by wiping with low level disinfectant (LLD) or isopropyl alcohol (IPA). Do not spray chemical directly on keyboard.


(Eliminating toys from office/clinic is preferred; use videos instead)

If office/clinic has toys—Use only washable toys; OR

Give child 3–4 crayons in a baggie with individual sheets of pictures to color and let child keep.

After each use—between patients Wash “used” toys with dish soap and hot water, air dry.

May use dishwasher.


  • Surfaces must be moisture-resistant to be able to disinfect them.
  • Upholstered furniture that is not vinyl covered, soft toys, etc., cannot be disinfected and their use is discouraged.
  • Carpet cannot be disinfected; use is discouraged.