because surgical pro-
fessionals assume
surfaces are being
cleaned properly."
In fact, it's best to
assume the opposite and focus on making sure your staff does more
than skim the surface when disinfecting ORs between cases.
Ms. Link suggests you gather representatives from infection control,
anesthesia, radiology and surgery — any department that brings
equipment into the OR — to determine who will be responsible for
cleaning specific surfaces between cases. You should also develop a
way to document that every surface in the OR has been wiped down
between cases. "Establish enhanced cleaning protocols to ensure
high-touch areas are addressed between cases," she says. "The OR
surfaces stay the same, but the people who clean them varies."
Dr. Carling's widely referenced study published in the journal
Infection Control & Hospital Epidemiology used transparent fluores-
cent gel to mark surfaces in 43 ORs of a major teaching hospital
before the first case of the day (osmag.net/Z8RnHq). His research
team then used a UV lamp to evaluate how many of the marks were
removed 24 hours later. They also took environmental cultures in
unused ORs that had been terminally cleaned the night before.
Contaminated objects included intravenous poles, operating room
beds, Mayo stands and floors. Less than 50% of tested surfaces had been
cleaned before the researchers conducted 4 months of ongoing perform-
ance feedback of the staff's cleaning practices. The educational efforts
led to an 82% increase in cleaning of the test gel markers. In addition,
when the hospital made anesthesia providers responsible for cleaning
anesthesia machines' knobs, switches, keyboards, oxygen reservoir bags
and medication carts, the percentage of negative culture samples
D E C E M B E R 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 1 2 3
One of the biggest challenges staff
face when turning over rooms is
being efficient and effective.
