OR turnover cleaning procedures

AORN Journal, August, 2007 by Byron L. Burlingame

QUESTION: Sometimes, staff members at our institution try to expedite room turnover by beginning the room cleaning process, such as mopping the floor, while the current patient is in the room emerging from anesthesia. This practice has created controversy. Some staff members say that the room should not be mopped until the current patient has left the OR, while others believe that it is okay to mop the room while the patient is emerging from anesthesia. What is the correct time to start cleaning?

ANSWER: The correct time to start the cleaning process is after the patient has left the OR. (1) AORN's "Recommended practices for environmental cleaning in the surgical practice setting" discusses the steps for between-procedure room cleaning, including: "After each surgical procedure, a safe, clean environment should be established." (2) The recommended practices also explain that the OR bed should be moved when the floor is mopped to check for debris remaining after the previous procedure. (2) The recommended practices do not specify a time, but to accomplish these recommendations, the cleaning should be initiated after the patient leaves the room.

Turnover cleaning frequently is performed by additional personnel (eg, nursing assistants, housekeepers) who are not in the room during the procedure; therefore, if turnover cleaning is started before the patient leaves the room, the amount of traffic in the room may be increased. As stated in AORN's "Recommended practices for traffic patterns in the perioperative practice setting," traffic in the OR should be limited because an increase in the number of people in the room has been associated with an increase in microorganisms. (3) Furthermore, mopping the room while the patient is still in the room may contribute to a staff member slipping or falling, which could result in an injury.

The patient should be out of the room to ensure that any surface that has been cleaned is not recontaminated. For example, if the patient coughs during extubation and the mucous lands on the surface previously cleaned, the area will have to be cleaned a second time, which could result in an increased turnover time.

The perioperative nurse in the room should be concentrating on the patient and not on the cleaning process. Lack of concentration on the patient may result in the patient being neglected, and an adverse event could occur. The only time cleaning should be performed before a patient leaves the room is when blood or other potentially infectious materials have been spilled on the floor or another surface. (2)

REFERENCES

(1.) Phillips NF. Care of the perioperative environment. In: Berry & Kohn's Operating Room Technique. 10th ed. St Louis, MO: Mosby; 2004:206-208.

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

(3.) Recommended practices for traffic patterns. In: Standards, Recommended Practices, and Guidelines. Denver, CO: AORN, Inc; 2007:703.