Suite Success: Following Updated Environmental Cleaning Guidelines for the Operating Room (OR)

Author: Amanda Thornton, CIC, RN, MSN

Cleaning an environment where surgeries take place can be overwhelming, but is such an important task in order to promote patient safety, prevent risk of surgical site infections (SSIs), and achieve good patient outcomes. In a very interesting study of an outbreak associated with multi-drug resistant Klebsiella pneumoniae in an ICU, the researchers found that there was a connection to a contaminated surface in the OR¹. The new AORN updated guidelines² have some key takeaways that help direct the team of surgical professionals to better accomplish this necessary part of the surgical process.

The new definition of environmental cleaning advocated by AORN includes the three actions of cleaning, disinfecting, and monitoring. Let’s take a high-level look at the updated guidelines regarding the cleaning and disinfecting of the surgical suite².

1. First form a team of interdisciplinary professionals. The key players on the team should include anesthesia professionals, perioperative nurses, environmental services personnel, sterile processing personnel, and Infection Preventionists. This team should develop and determine each of the policies and procedures which will help provide specific directions and guidance to the personnel who will be performing the cleaning steps.
2. One of the first things the team should determine is the frequency of cleaning as well as what items need to be cleaned on a daily, weekly and/or monthly basis. The composition of the surface, the volume of procedures, and frequency of contact with the surfaces, as well as how often those areas are occupied, should help to determine how often these surfaces should be cleaned.
3. Selecting a product that is a registered, hospital grade, EPA-approved disinfectant compatible with surfaces, equipment and cleaning materials is key. Following selection of this product, personnel should be trained to follow the instructions for use (IFU), as well as the contact times for the kill claims per organism. Learn more about our EPA-registered Sani-Cloth products
4. Cleaning personnel should avoid using brooms with bristles, mops that use sprays, and the use of spray bottles in general for applying disinfectant, opting for the use of a cloth instead. Cleaning equipment should be dedicated to the area in which it is intended, and not used in other areas of the building. Check out our Pail and Refill formats for Sani-Cloth® Bleach and Sani-Cloth® AF3 wipes: The high-count, X-Large wipe is ideal for Environmental Services Professionals
5. Environmental surgical suite personnel should be evaluated for competency in all cleaning procedures, and assigned specific tasks to perform so there is no confusion on role responsibility.
6. Special care should be given to enhanced environmental cleaning following Multi-Drug Resistant Organism (MDRO) infected patient cases, such as the use of sporicidal agents following patients diagnosed with difficile or Candida auris.
7. Lastly, the evaluation of cleaning practices using audit tools is a key component to keeping consistently high environmental cleaning standards. AORN has many quality assessment audit tools and gap analysis checklists that can be used to accomplish this important step.

By adhering to the outlined guidance, your facility can share in the suite success of patient safety!