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Archive Infection Control 2018

Scratch Beneath the Surface

Audit the effectiveness of OR cleaning by taking a big-picture view of the entire process.

JoEllen McBride

JoEllen McBride, PhD


TO THE LETTER Make sure endoscope reprocessing guidelines are always followed and document that your scopes are clean and in good working order.

Assessing your surface disinfection practices isn't just about randomly swabbing high-touch areas to check for the presence of bacteria or secretly observing your room turnover staff in action. In order to conduct a thorough audit, follow these 3 steps, which will help you look at your facility's entire OR cleaning process, from the disinfectants staff use to when, where and how they're using them.

1. Decide who's cleaning what

Who's Cleaning
What and When?

If you don't clearly define cleaning duties for your housekeeping and nursing staffs, some surfaces might get cleaned twice — and some not at all. We've got you covered. Go to
to download a cleaning protocols form and a terminal cleaning checklist.

Start by standardizing who is responsible for cleaning specific items in the OR, and put the assignments in writing. Not having these duties clearly defined can create confusion between your nursing and housekeeping staffs, says Stephanie Nester, RN. When she took over as the infection control and quality coordinator at Carris Health Surgery Center — Willmar (Minn.), she found out that the OR staff didn't know that housekeeping was cleaning some things weekly that they assumed were being done daily.

To remedy this, Ms. Nester met with each department separately to find out what items they were cleaning and when they were cleaning them. She then worked out a protocol that specifically laid out what nursing staff and housekeeping would be responsible for addressing and created logs that they could mark off every day to help them keep track.

In the mornings, before the surgical day begins, the nursing staff comes in and wipes down everything in the ORs and employs an ultraviolet light whole-room disinfecting robot in each room. In between cases, they take 10 to 15 minutes to wipe down high-touch areas such as computers, the surgical table and any items that were within 3 feet of the patient. Then, after the day's last case, they wipe down everything one last time, including door handles, light switches and computers.

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