Practice Outcomes . Environmental services (ES) personnel should receive proper training and education on patient room cleaning and disinfecting protocols, and they must use all barrier precautions (such as masks, gloves and gowns) when cleaning in rooms or units where surfaces may be … and infection control courses for students. Excluded were non-peer-reviewed publications and older evidence within the time restriction when more recent evidence was available. At the time of the initial search, weekly alerts were created on the topics included in that search. These fomites may serve as a reservoir for wound contamination through either direct contact with the patient’s skin or by personnel contact with the fomite and subsequent skin-to-skin or glove-to-skin contact with the patient. We aimed to determine the change in both the thoroughness of environmental cleaning and the proportion of environmental surfaces within operating rooms from which pathogenic organisms were recovered. The entire stretcher will be cleaned with an EPA-registered hospital disinfectant when visibly soiled and at the end of the day. We conducted a three-phase study using human factors engineering (HFE) approach to enhance environmental cleanliness. Consider the most obvious source: the patient. 2009;6(6):e1000097. Included were research and non-research literature in English, complete publications, and publications with dates within the time restriction when available. Researchers have shown that cleaning practices in the operating room (OR) are not always thorough or consistent with the policies of the health care organization.1-3  Jefferson et al3  observed a mean cleaning rate of 25% for objects monitored in the OR setting in six acute care hospitals. When I recognized that I could touch many more lives by preventing infections through becoming a Certified Infection Preventionist, I jumped at the chance. Articles identified in the search were provided to the project team for evaluation. damp dust horizontal surfaces at the beginning of the day. Environmental cleaning is a fundamental principle of infection prevention in healthcare settings. Environmental Services Cleaning Frequency Expectations 4.1 Cleaning is done on a regular, consistent basis. AORN Guideline for Environmental Cleaning Evidence Table # CITATION EVIDENCE TYPE SAMPLE SIZE/ POPULATION INTERVENTION(S) CONTROL/ COMPARISON OUTCOME MEASURE(S) CONCLUSION(S) E 1 Munoz-Price LS, Birnbach DJ, Lubarsky DA, et al. CINAHL, Cumulative Index to Nursing and Allied Health Literature, is a registered trademark of EBSCO Industries, Birmingham, AL. Cleanliness of the patient environment is an important factor in promoting recovery from illness. 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. Reception, Pre-operative facilities, Operating Room (or Procedure Room), Recovery Stage 1, Recovery Stage 2, Inpatient Unit (IPU) and Intensive Care Unit (ICU). Munoz-Price et al1  observed cleaning in 43 ORs of a large urban hospital and found only 50% of the surfaces were being cleaned. It is important to implement effective cleaning for the safe hospital environment. Environmental cleaning and disinfection principles for COVID-19 Routine environmental cleaning Cleaning is an essential part of disinfection. Selecting a product that is a registered, hospital grade, EPA-approved disinfectant compatible with surfaces, equipment and cleaning materials is key. She spent nine years as a direct care nurse in many clinical settings. At the end of my week, I am so amazed that I have such an awesome opportunity to help protect patients and loved ones from infections through the use of our products, and the proven science behind them! •stopping the spread of microorganisms from one patient to the next •decreasing the amount of microorganisms in the environment •Do … Clean the . 1. terminally clean all patient rooms terminally daily if being used. Environmental cleaning and disinfection includes considerations for a safe environment of care, transmission-based precautions, and hand hygiene. Seeing the impact I can have with patients, families, and staff through sharing my knowledge of infection control has been a highlight of my career. These findings demonstrate that some ORs may not be as clean as previously thought,1  although the literature has not defined the concept of cleanliness. Results from these alerts were provided to the lead author until May 2019. PDI, makers of Sani-Cloth®, the #1 brand of disinfectant wipes in healthcare, Clinical Science Liaison, PDI West Region, Frances (Fran) K. Canty, MA, BSN, RN, VA-BC™, Marc-Oliver Wright, MT(ASCP), MS, CIC, FAPIC, Learn more about our EPA-registered Sani-Cloth products,, 400 Chestnut Ridge Road, Woodcliff Lake, NJ 07677. Perioperative and environmental services leaders can cultivate an environment in which perioperative and environmental services personnel work collaboratively to accomplish cleanliness in a culture of safety and mutual support. In the Operating Rooms, the environment will be maintained by daily, intraoperative, interim and weekly terminal cleaning routine. The new definition of environmental cleaning advocated by AORN includes the three actions of cleaning, disinfecting, and monitoring. For safe care, OR cleaning must be considered an environmental essential. AORN has many quality assessment audit tools and gap analysis checklists that can be used to accomplish this important step. Policies and procedures will reflect variations in practice settings and/or clinical situations that determine the degree to which the guideline can be implemented. Phone: 720-849-1168 Company Website: Email:, Resin geode and fluid Art Lit RPG fiction Colorado camping and hiking Scrapbooking, Master of Science in Nursing – Emphasis in Infection Control and Epidemiology American Sentinel University, Aurora, Colorado, Bachelor of Science in Nursing, BSN University of Northern Colorado, Greeley, Colorado, Certification Certification Board of Infection Control (CBIC) – CIC Certification Association for Vascular Access – VA – BC. The recommendations in the guideline are intended to be achievable and represent what is believed to be an optimal level of practice. Search terms included adenosine triphosphate, air sampling, ambulatory surgery center/facilit*, ants, aspergill*, auto scrubber, bacterial count, bacterial load, bedding and linens, beds, bioluminescence detection, bleach, body fluids, central processing, central service department, central supply (hospital), checklist, cleaning program/regimen/schedule/standard/policies/guideline/protocol/routine, cleaning zone, cleansing agents, cloths, cockroaches, colony count (microbial), contact surface, contact time, Creutzfeldt-Jakob disease/syndrome, cross infection, curtains, decontamination, decontamination (hazardous materials), detergents, diphtheria, disease reservoirs, disease transmission (infectious), disinfectants, disinfection, dust, dwell time, enhanced environmental cleaning, environmental microbiology/monitoring/cleaning/services/surface, fleas, flies, fluid waste management, fluorescent light, fomites, gram-negative bacteria, gram-positive bacteria, green cleaning, healthcare associated infection, heater-cooler, high-touch objects/ surfaces, hospital housekeeping, hospital laundry service, housekeeping department, housekeeping (hospital), hydrogen peroxide, ice machine, infection control, insects, keyboard covers, laundry, laundry department, laundry service (hospital), lice, luminescent measurements, mattresses, microbial colony count, microfib*, mites, mouse, nosocomial infection, occupational health/exposure/ injuries/safety, operating room tables, operating rooms/suites/ theat*, ozone, patient monitors/transfer board, pest control/management, phenols, Phthiraptera, previous patient, prior patient/ room occupant, quaternary ammonium compounds/disinfectant, room contamination, scrub sink, silver, Siphonaptera, sodium hypochlorite, solvents, sterile processing/supply, sterilization and disinfection, sticky mat, storage areas, subacute spongiform encephalopathy, surgical wound infection, surgical wound infection, surgicenters, tacky mat, terminal cleaning/disinfection/ decontamination, textiles, ultraviolet light, ultra-violet light, ultraviolet rays, vermin, viruses, visual inspection, waste disposal (fluid), and wet time. Describe the different areas of the facility where invasive procedures take place and where guidelines for cleaning and disinfecting the operating room may apply Understand the burden of surgical sit infection, the types of pathogens that cause them and how the environment is a potential source of infection Joining the team at PDI has allowed me to expand my reach even further. 3. Note: The evidence summary table is available at In a literature review, Ibrahimi et al4  stated that the amount of bacteria present in the operative site is one of the most important factors associated with surgical site infection (SSI) development, although the minimum number of bacteria that causes an infection varies depending on the qualities of the organism, the host, and the procedure performed. ... standard attire in operating theatre or trauma room The researchers sampled three bacterial reservoirs: providers’ hands, the patient’s axillae and nasopharynx, and two high-touch sites on the anesthesia machine. 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 Guideline for Environmental Cleaning was approved by the AORN Guidelines Advisory Board and became effective as of January 13, 2020. The lead author requested additional articles that either did not fit the original search criteria or were discovered during the evidence appraisal process. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. … Copyright © 2012-2018, AORN, Inc. All rights reserved. Thus, thorough cleaning and disinfection of high-touch objects as part of a comprehensive environmental cleaning and disinfection program that includes hand hygiene are essential in preventing the spread of potentially pathogenic microorganisms.1. The recommendation strength rating is noted in brackets after each recommendation. Although these topics are mentioned briefly where applicable (eg, standard precautions), they are addressed in other AORN guidelines,18-20  and broader discussions are outside the scope of this document. Aerosolizing of cleaning chemicals and other products potentially could pose a health risk to workers who use the products or the spray could land in unintended areas. Therefore, adequate disinfection of operating rooms is essential. All three reservoirs contributed to transmission, although 64% of stopcock contamination was traced to the anesthesia machine. The AORN eGuidelines+ is the online home of the evidence-based AORN Guidelines for Perioperative Practice and associated tools for OR teams. “It’s studies like this that show us Cleaning equipment should be dedicated to the area in which it is intended, and not used in other areas of the building. The team consisted of the lead author and one evidence appraiser. Inadequate hospital cleaning may contribute to cross-transmission of pathogens. In 2005 she entered into infection control and prevention, where she found a passion for all things related to preventing avoidable HAI’s. Aerosols and sprays should not be used in the OR space. She became certified in infection control through the CBIC, and worked as a front line Infection Preventionist until she advanced to be the Chief Clinical Officer of a 68 bed LTAC in Denver Co. Amanda is also a clinical educator and was an instructor for the LPN and C.N.A. The lead author and the medical librarian also identified relevant guidelines from government agencies, professional organizations, and standards-setting bodies. Contaminated hospital surfaces play an important role in the transmission of dangerous pathogens, including Clostridium difficile, and antibiotic-resistant organisms such as methicillin-resistant Staphylococcus aureus(MRSA) and vancomycin-resistant enterococci (VRE). Healthcare facilities should comply with the Environmental Cleaning Standard Operating Procedures, which contain detailed best practice procedures for environmental cleaning in healthcare facilities. Receive product announcements, educational tools, resources, and more! Ensure safe, effective and timely changeovers. 1. 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. and toilet rooms at least daily, on patient discharge or transfer, and when visibly soiled. Therefore, appropriate disinfection of those surfaces and equipment which patients and healthcare personnel touch is necess… 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. Guidelines for Environmental Infection Control in Healthcare Facilities recommend: • enhanced cleaning for high-touch surfaces that are likely to be contaminated • monitoring the staff’s compliance with cleaning protocols. 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. 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. The strength of the recommendation was determined using the AORN Evidence Rating Model and the quality and consistency of the evidence supporting a recommendation.