DS 36 - Equipment and Surface Location in Operating Rooms and Potential Impact on Terminal Clean Effectiveness

Background: Evidence supports that environmental cleanliness plays a significant role in the prevention of hospital-acquired infections (HAIs). Within surgical services, daily terminal cleaning is a frequent focus for the prevention of surgical site infections (SSIs).

Determining the effectiveness of terminal cleaning is vital to ensuring a safe surgical environment and optimal patient outcomes. During routine terminal clean audits in three acute care hospitals and two ambulatory surgical centers, it was noted that certain high touch surfaces had a higher percentage of cleaning compliance. This brought about the question as to whether the location of high touch surfaces in an operating room (OR) play a role in how effectively they are cleaned.

Methods: Prior to terminal cleaning, pre-selected surfaces were marked in randomly selected rooms utilizing a fluorescent marking method. Terminal cleaning was performed by environmental service technicians. Evaluation of terminal clean was conducted by trained members of the Infection Prevention team. Items were noted as “clean” if there was no residual fluorescent marking and “not clean” if residual was found.

Results: A total of 83 ORs were audited, with 561 items marked. Of these items, 33% (184/561) were rated as clean. The surfaces rated as cleaned most frequently were mayo stands (58%), followed by back tables (49%), procedure tables (40%), and overhead lights (31%). Items that were noted to be in the periphery of the room had lower instances of achieving a clean rating. These included door handles (29%), telephones (27%), intravenous (IV) poles (21%), and light switches (17%).

Conclusions: Equipment and surface location in the OR have potential to impact terminal clean effectiveness. Items located centrally to the core of the room are more likely to be rated as clean than those further from the core. Attention should be provided to all areas and reinforced through education, competency, and training.