4 essential elements of an OR environmental hygiene program

The fact that environmental hygiene helps reduce the transmission of healthcare-associated infections in the operating room is well-established, but that doesn't mean every hospital's OR staff knows how to go about improving their environmental hygiene practices.

Two industry experts — Linda Homan, RN, BSN, CIC, manager of clinical and professional services at Ecolab Healthcare, and Dawn Hughes, RN, MSN, CEO at Amazing Transformations and executive consultant for Interventional Services — hosted a recent webinar with Becker's Hospital Review to discuss new processes and tools that can enhance OR disinfection.

Highlighted below are takeaways from the presentation.

Why environmental hygiene matters

Research has shown harmful pathogens such as Clostridium difficile, Staphylococci and vancomycin-resistant enterococci can survive on surfaces for months, and they are just a few of the potentially disease-producing bacteria or viruses that can be transmitted to patients.  

The length of time pathogens can survive on surfaces is especially concerning when you consider how inefficiently those surfaces are cleaned.

"On average, when we go around the country and look at how well high-touch objects are being cleaned, it's generally about 25 percent," said Ms. Homan.

Some high-touch surfaces in the OR include the anesthesia computer mouse, OR bed, nurse computer mouse, OR door and the anesthesia medical cart, to name a few.

As industry organizations — such as the CDC, Association of periOperative Registered Nurses, Association for Professionals in Infection Control and Epidemiology and Association for the Healthcare Environment — continue to create quality standards and implement evidence-based guidelines, hospitals and health systems will need to improve practices to support more effective environmental cleaning.

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Important OR cleaning tools

Half the environmental hygiene battle is using the proper tools to clean. For instance, it is important to choose an objective method to monitor environmental hygiene. The four types of environmental monitoring available today are environmental cultures, direct observation, adentosine triphosphate testing and fluorescent markers. Of those, fluorescent markers have the largest body of published evidence to support its use.

According to Ms. Homan and Ms. Hughes, microfiber products, cleaning carts and sweep sets are also effective environmental hygiene tools.

While not all microfiber products are equal, in general, microfiber boasts superior chemistry absorption and ability to release chemistry to the surface when compared to traditional cotton cleaning cloths. It is also lint-free, which is important in the OR.

Cleaning carts optimize the daily setup and use of the materials needed to clean a room and sweep sets can replace straw brooms, which have the bad habit of aerosolizing dust and debris, according to Ms. Homan.

Building a better cleaning program

Ecolab created a comprehensive OR cleaning program that research has proven reduces turnover time — the time between "wheels out" and "room ready" — while boosting OR cleanliness.

The Ecolab program is comprised of the following four essential elements:

1. Monitoring the thoroughness of cleaning, providing feedback and reporting the outcomes

2. Implementing standardized, evidence-based cleaning protocols

3. Coaching and working side-by-side with staff throughout the implementation process

4. Choosing the right cleaning products for the job, including the products listed above

According to Ms. Homan, the program has helped numerous hospitals enhance cleaning thoroughness and sustain those successes.

Ms. Hughes has experience implementing Ecolab's four-phase program in hospitals. She found the program addresses the two areas she looks for in any new initiative — ease and economy. One of the best parts about the Ecolab program, according to Ms. Hughes, is how it helps improve and standardize workflows, which, in turn, ensures the right surfaces are cleaned thoroughly and consistently.

"It doesn't matter how long or how hard we clean in the OR if we are cleaning the wrong things," said Ms. Hughes. The program helps make sure high-touch areas, such as the OR bed, are cleaned every time to prevent the build-up of bioburden and various pathogens.

To learn more, view the full webinar by clicking here.

Note: View archived webinars by clicking here.

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