Environmental Cleaning (Spills, Room Turnover, Terminal Cleaning)

Guidelines:

• The patient should be provided a clean, safe environment
• Environmental cleaning
  • Cleaning procedures should be uniform throughout the OR and for all patients
  • Policies and procedures should be in place that clearly identify what needs cleaning, how it should be cleaned, and what it should be cleaned with, how often it should be cleaned, and who is responsible for cleaning it. Procedure should be in place for ongoing monitoring and evaluation of processes
• Cleaning measures are needed before, during, and after surgical procedures and at the end of each day

Considerations:

• All patients should be considered to be potentially infected with bloodborne or other infectious material
• All patients should be treated with standard precautions
• Uniform cleaning practices protect from visible and invisible contamination and prevents the need for special cleaning procedures for “dirty” cases
• Patients with documented infection or suspected infection with a highly transmissible pathogen require additional precautions
• Professional and regulatory standards
  • Policy and procedures for cleaning should follow CDC guidelines
  • Local and state environmental regulations should be consulted before establishing guidelines for waste disposal
  • EPA approved hospital disinfectant for cleaning

Nurse’s role:

• Ensure proper environmental cleaning for spills, room turnover, and terminal cleaning
• Before first case: Damp dust all horizontal surfaces
• During surgery: confine contamination, keep doors closed
• After surgery: environmental cleaning including removal of trash and laundry once the patient has left the room.
• End of day: terminal cleaning. Surgical lights and external tracks, fixed and ceiling mounted equipment, all furniture and
  equipment, hands of cabinets, ventilation faceplates, horizontal surfaces, floor, kick buckets, scrub sinks
• Throughout perioperative care, careful adherence to surgical aseptic principles including hand hygiene and standard precautions

Pitfalls:

• Infection control practices should focus primarily on prevention
• Transmission of infection involves a chain of events
• Prevention occurs when there is a break in the chain of transmission

Examples:

• N/A

Linchpins (Key Points):

• Perioperative patient care is based on surgical aseptic principles
• Careful adherence to these principles supports infection prevention and control
• Improves surgical patient safety and outcomes
• Infection control practices = prevention