Mopping between procedures

AORN Journal, July, 2008 by Sharon Giarrizzo-Wilson

QUESTION: We are updating our policy for room decontamination, and the 2008 edition of AORN's Perioperative Standards and Recommended Practices no longer states that the OR bed should be moved during between-procedure mopping. Should the bed only be moved during terminal cleaning? Should the entire floor be cleaned between procedures?

ANSWER: Scientific evidence does not support cleaning the entire floor surface after each procedure. (1) Speculation does exist, however, that bodily fluids may be tracked to the room's periphery during some surgical and invasive procedures. The risk for health care-associated infections from environmental surfaces is strongly linked to a pathogen's ability to survive on and be transferred to other surfaces. (2,3) When beginning between-procedure cleaning, staff members should consider the type of procedure performed and the potential for contamination of the floor surface. The entire floor should be cleaned if there is any possibility that contaminants were aerosolized or that body fluids have dripped anywhere on the floor surface.

Removing pathogenic organisms from environmental surfaces has proven to reduce health care-associated infections; (1,3) therefore, between-procedure cleaning includes damp mopping underneath the OR bed when spills of contaminated debris (eg, body fluids, tissue) or visible soiling is evident. Although the bed may not need to be moved for the purpose of mopping, a staff member should move the OR bed to check for loose items (eg, sponges, instruments, sutures) that may be concealed underneath. (4) A staff member then should clean soiled areas with an Environmental Protection Agency (EPA)-approved, hospital-grade germicidal agent. (5)

A staff member should dip a clean mop head into the solution one time and should not dip the mop head back into the solution after mopping the floor. Additional fresh mop heads should be used, when needed, to thoroughly remove all dust, soil, and organic debris. Mop heads may be reusable or disposable string-type mops. Microfiber mops may be used after procedures with low levels of body fluid contamination. (2,6) Implementing practices to remove debris and contain the spread of contaminants protects the patient from sources of exogenous pathogens.

REFERENCES

(1.) Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR; Hospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol. 1999;20(4):250-278. http://www.cdc.gov /ncidod/dhqp/gl_surgicalsite.html. Accessed March 25, 2008.

(2.) Recommended practices for environmental cleaning in the perioperative setting. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2008:375-389.

(3.) Cozad A, Jones RD. Disinfection and the prevention of infectious disease. Am J Infect Control. 2003;31(4):243-254.

(4.) Recommended practices for environmental cleaning in the surgical practice setting. In Standards, Recommended Practices, and Guidelines. Denver, CO: AORN, Inc; 2007:551-557.

(5.) Centers for Disease Control and Prevention. Guidelines for Environmental Infection Control in Health-Care Facilities. Atlanta, GA: Centers for Disease Control and Prevention; 2003:1-249. http:// www.cdc.gov/ncidod/dhqp/pdf/guidelines /Enviro_guide_03.pdf. Accessed March 25, 2008.

(6.) Giarrizzo-Wilson S. Fluid warming; microfiber mops; medication practices; guayule latex; dual-return electrodes. AORN J. 2005;81(6):1324-1332.

SHARON GIARRIZZO-WILSON

RN, MS, CNOR

PERIOPERATIVE NURSING SPECIALIST

AORN CENTER FOR NURSING PRACTICE