Welcome to Health Services Advisory Group’s Cleaning Between Cases and Terminal Cleaning
for Ambulatory Surgery Centers video.
We believe that education on cleaning operating rooms and procedure rooms creates safer infection
prevention practices for your entire facility.
Our goal is to assist you in creating safe environments for you and your patients.
The importance of a strong partnership between infection prevention and environmental services
cannot be stressed enough.
Regardless of whether your facility has a team of 5 people or just 1 person cleaning,
standardization is key.
We will help you come up with a game plan to make sure the same process is followed
every time a room is cleaned.
Be sure to perform hand hygiene before you begin cleaning.
This can either be by washing your hands with soap and water, or by using hand gel or foam.
It is important that cleaning team members have clearly designated tasks.
This allows the team to work effectively without duplicating efforts.
It also helps speed up the cleaning process.
Make sure that you are aware of all the products your staff members use to clean and disinfect.
All cleaning products must be Environmental Protection Agency or EPA approved for healthcare
environments and reviewed by your leadership.
All staff members must know the “contact time,” and adhere to it every time they
clean.
Contact time is the amount of time it takes for a product to kill germs.
Make sure your facility changes mop heads and dust cloths or microfiber rags after every
use.
Never reuse cleaning cloths, rags, or mop heads from room to room.
Also, staff must clean out the mop bucket every time it has been used before moving
to the next room to clean.
Here are some questions to consider when educating your staff:
Do all staff members who clean know the contact time for each product, and do they adhere
to it?
What items are kept on the cleaning carts and what’s kept in the housekeeping closets?
Be sure that everyone who cleans always performs hand hygiene before beginning cleaning and
after cleaning.
Also, it is important that everyone performs hand hygiene after removing gloves.
Gloves are not a substitute for hand hygiene.
Always ensure your cleaning policies match your actual cleaning practices and everyone
who cleans is educated about them.
This education includes housekeepers, whether they work for your facility or are contracted,
as well as clinical staff members who assist with cleaning such as: nurses, nursing assistants,
and clinical technicians.
Always begin cleaning furthest out from the periphery and work toward the center of the
room or bed in a clockwise or counter-clockwise motion.
Pick one direction and follow that process for every cleaning.
As you start the cleaning process remember to always clean from the top of the room down
and from the cleanest areas to dirtiest areas.
Starting with the cleanest area is safest because it reduces the chances of transmitting
organisms from the dirtier items.
Typically, the periphery or the room is cleaner than the center of the room where the procedure
is performed.
However, it‘s important to do a visual review of the room before you start cleaning.
Also, it is important to clean from the top down because as you clean items nearer the
ceiling, dust and debris could fall on equipment below, potentially transmitting organisms.
Standardizing the cleaning process for your facility is key to getting it right!
First, survey the room and look for safety hazards such as sharps, unsecure medication
left on the anesthesia cart, and blood or body fluid spills.
Remove those safety hazards firs, including items in the biohazard and dirty linen bin.
Next, make sure everyone on the team is following the same process and that this process matches
the facility’s actual policies.
Keep in mind that not all operating room and/or procedure rooms will have the same equipment,
furnishings, and supplies, so you will need to adapt these recommendations to fit your
facility.
Be sure to maintain your cleaning direction, using either a clock-wise or counter clockwise
motion.
For the frequency of cleaning, remember that high-touch items and items that are visibly
soiled should be cleaned between each patient.
All items must be cleaned during the terminal cleaning.
Clean after every patient: The entire bed from top to bottom, the IV pole, the anesthesia
cart, the anesthesia machine, any carts with computers or monitors, and suction canisters,
everything closest to the bed.
Be sure not to forget the tables or man stands by the wall, boom monitor stations, upper
screens or monitors, such as the x-ray monitor screen and any equipment or objects that touch
the bed or the patient such as patient slide.
The following list provides an example of items to clean.
The Table and carts Boom lights, Boom controls
The monitory station Upper screens or monitors
Anesthesia cart and anesthesia machine Any carts with computers, monitors, and suction
canisters Everything closest to the bed, including the
bed
The Terminal cleaning process at the end of each work day is a different process than
that used for cleaning between patients.
Remember that during a terminal cleaning, everything in the operating room and/or procedure
room needs to be cleaned whether visibly soiled or not.
For terminal cleaning at the end of the day, make sure to always thoroughly clean the walls
and the floor.
Before completing the terminal cleaning, look over the room and make sure you didn’t miss
anything.
And finally, be sure to wash your hands thoroughly after you have finished cleaning.
For more information, please visit our website at www.hsag.com/asc