Is it true that Cleaning is only necessary when the operating room is visibly dirty.?

Cleaning is done to minimize the number of microorganisms, regardless of visible dirt, and occurs before the first patient, after every patient, and at the end of the day.

Perioperative Environment Care Cheat Sheet

Maintaining a clean perioperative environment is critical for minimizing microorganism transmission and ensuring patient safety, requiring meticulous cleaning protocols before, during, and after surgical procedures.

Core Principles

All patients are entitled to a clean environment for surgical procedures.
Cleaning follows a top-down, center-out approach, moving from the cleanest to the dirtiest areas.
A schedule for routine cleaning is essential for maintaining hygiene.

Action Steps

Before the start of the day: Arrange trolleys away from traffic, damp dust all equipment from top down, prepare rubbish and linen trolleys, and damp mop the floor.
Room turn over after surgery: Remove drapes and used items, discard waste appropriately (biohazard, medical, general), prewash instruments, and prepare the room for the next patient.
Daily terminal cleaning (end of day): Clean walls, operating lights, tables, trolleys, equipment, cabinets, doors, kick buckets, exhaust grilles, and mop floors, ensuring correct waste segregation.

Key Terms

AORN: Association of perioperative registered nurses, indicating a professional standard for care.
Turnover time: The time between the end of one surgical procedure and the start of the next, which includes cleaning and setup.
Terminal cleaning: A thorough cleaning of the operating theatre performed at the end of each day, whether the room was used or not.

Pro Tips

When discarding soiled items, follow specific policies for soiled linen bags, biohazard bins, and medical waste bins.
Dispose of sharp items in a designated sharp container, handling blades, SSG blades, trocars, and needles with special care.
For fine instruments, use sonic washers; for larger items like instruments, suction tubes, and bottles, use big washers.

Pitfalls to Avoid

Failing to clean the perioperative environment before the first patient can lead to pre-existing contamination.
Improper waste disposal (e.g., mixing medical and general waste) increases the risk of infection transmission.
Skipping terminal cleaning at the end of the day allows microorganisms to proliferate, posing a risk for subsequent procedures.

Myth vs Reality

Cleaning is only necessary when the operating room is visibly dirty.: Cleaning is done to minimize the number of microorganisms, regardless of visible dirt, and occurs before the first patient, after every patient, and at the end of the day.

Real World Examples

A patient's surgery is cancelled due to high blood pressure after being placed on the operating table.: The sterile setup prepared by the scrub nurse must be handled according to policy, likely involving discarding it to maintain sterility for future use.
Disposing of used drapes after a procedure where blood was present.: Drapes with blood should be handled properly and placed under the instrument trolley for discarding into the soiled linen bag, following specific settings policy.

Statistics

Average room readiness time for the next patient: 10 to 15 minutes

Timeline

Before the start of the day: Perform housekeeping duties including damp dusting, arranging trolleys, and damp mopping the floor.
During surgery: Nurses are responsible for maintaining cleanliness intraoperatively to minimize contamination.
After surgery (Room turn over): Scrub nurse removes equipment, discards waste, prewashes instruments, and prepares the room for the next patient.
At the end of the day: Conduct daily terminal cleaning of the entire operating theatre.