we need to be measuring cleanliness."
He suggests using adenosine triphosphate (ATP) or invisible fluores-
cent 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 differ-
ent 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 assign-
ments 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.
2. Read the directions
Focusing on the basics of surface disinfection will help fight COVID-19,
says Ann Marie Pettis, RN, BSN, CIC, FAPIC, director of infection pre-
vention at University of Rochester (N.Y.) Medicine. She stresses that
staff must always pay attention to the manufacturer's instructions for
use (IFU) for whatever disinfectant they're using at any given time.
"Constantly remind your team that they need to be aware of what
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