Access Now: AORN COVID-19 Clinical Support

Archive July 2020 XXI, No. 7

No Surface Left Untouched

Cleaning protocols carry added importance during the COVID-19 pandemic.

Joe Paone

Joe Paone


CHECK THE LABEL Due to shortages, you'll likely need to switch disinfectants at a moment's notice — which makes reading the manufacturer's instructions for use vital.

Believe it or not, there is some good news about the coronavirus. It's an enveloped virus, meaning it's very easy to kill on hard surfaces. Of course, there are a lot of surfaces to clean in your facility and the virus can live on every one of them for several days. As your facility resumes elective surgeries during this historic pandemic, here are a few tips for improving your surface disinfection practices in order to protect patients and staff from COVD-19.

1. Set clear expectations

Now's a great time to observe and audit your surface disinfection processes. "Think about all the stainless steel and plastic in operating rooms," says J. Darrel Hicks, BA, Master REH, CHESP, a St. Louis-based infection prevention consultant. "That's where COVID-19 lives longest. It remains on every surface that doesn't get properly cleaned and disinfected."

Don't leave any stone unturned (or uncleaned, in this case.) "You need to know what is actually being cleaned during OR turnovers," says Mr. Hicks. "That's done through observation, but also I believe we need to be measuring cleanliness."

He suggests using adenosine triphosphate (ATP) or invisible fluorescent markers to confirm that surfaces are being wiped, which can tell you if additional training or supervision is needed. This evaluation of cleaning efficacy involves engaging clinical staff as well as cleaning staff. "You need to identify who is responsible for cleaning the different surfaces in the OR," says Mr. Hicks.

For example, environmental services employees might be hesitant to touch equipment such as anesthesia carts and video monitors or assume anesthesia providers and nurses have already cleaned them. To clear up any miscommunication or confusion, Mr. Hicks suggests setting clear expectations of which staff members are responsible for cleaning specific surfaces in the OR, and including the assignments in your facility's cleaning protocols. Don't overlook often-missed items such as IV pumps, side rails and patient transport equipment, warns Mr. Hicks. "Make sure there aren't any gaps in what's getting wiped down, whether it's during between-case cleaning or end-of-the-day cleaning," he says.

Mr. Hicks suggests performing audits with staff present. Put your hand on a surface and ask, "Who cleans this?" Walk through the entire facility with staff and ask for feedback on who cleans every surface. Their responses will reveal where you need to refocus your cleaning.

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