Terminal Room Cleaning: Out of Sight, Out of Mind
Today we are featuring an article by Tru-D’s Director of Clinical Affairs, Ralph Taylor, RN, MSN, MHA, CNOR.
. Ralph has more than two decades of experience in health care and was also a Tru-D end user, successfully implementing Tru-D in several hospitals in Florida.
AORN recommends terminal cleaning be completed on every room used throughout the day. Facilities create policies to determine when, how, who and even some perform step-by-step actions to ensure a safe, clean environment. Many surgical services leaders depend on Environmental Services (ES) to complete these tasks after the daily schedule, but working without clinical supervision could possibly leave patients at risk. With many surgical services leaders’ time being dominated by administration, physicians, meetings and staff, it becomes even more vital to begin a process of effective cleaning.
In the 2017 AORN Guidelines and Recommended Practices, AORN recommends the following: “Terminal cleaning and disinfection of perioperative areas, including sterile processing areas, should be performed daily when the areas are being used.” As they cite “strong evidence,” this process is typically unsupervised, not validated, and unfortunately, not completed properly to reduce risk of infection. AORN recommends terminal cleaning when the area is not being used but some facilities still allow cleaning during the day while procedures continue to be completed. Minimizing traffic flow increases the probability of having a safe, clean environment for the next patient.
Working in the operating room environment for more than 15 years, with 12 years in leadership, has created several opportunities for me to minimize surgical site infections. The largest opportunity is developing, training and validating the terminal cleaning process.
The following is a short guide on how to quickly validate the process, staff and effectiveness of the cleaning team.
- Observe the process time-stamping the amount of time to clean a surgery suite
- Validate the team is cleaning according to evidence-based practice (AORN guidelines)
- Ensure competencies are refreshed yearly for both terminal/turnover cleaning techniques
- During morning huddles, request feedback from the staff before the first case
- Develop a validation checklist of non-negotiable items
- Review chemicals and dwell time, while testing ES knowledge of these critical factors
- Encourage ES to identify, report and photograph damaged equipment, rust or breaks in floor tile, walls, etc.
This simple process not only shows dedication to patient safety but will assist in completing an assessment of the surgery space.
Stay tuned for more information on how to improve your terminal cleaning process.