Summary of the Operating Room cleaning procedures
Previous studies had established that operating rooms (ORs) were able to transmit microorganisms that could cause ill health to nurses and patients (Allo and Tedesco, 2005). As a result, there was a need to enhance cleaning procedures in operating rooms. The practicum focused on the best practices and procedures applied in cleaning operating rooms. The general approaches involved the following procedures found in the AORN guidelines (DeGross, 2012).
Generally, cleaners scrubbed the OR for operations of the day while nurses prepared the room for the operation of the day with materials, and equipment required as a part of prior cleaning. They used specific cleaning agents recommended for operating rooms. Damping was a routine procedure in OR cleaning. They also removed all other materials or equipment not needed in the room.
Another procedure involved rotation. Cleaning took place after the first operation and transfer of the patient to the recovery room. Scrub personnel focused on all contaminated locations of the OR. They also sterilized OR furniture, floor, and equipment. Decontamination involved the use of cleaning agents for OR. Cleaning also covered overhead lights and other contaminated areas, as well as sterilization of anesthesia materials. Cleaners collected all disposable cleaning materials in trash for later disposal. Disposal took place after cleaning of other OR was complete, but reusable materials and equipment were placed in laundry bags. Cleaners also carefully sealed their trash bags. The normal cleaning procedure for the floor involved wet vacuum cleaning with disinfectants.
There was also daily terminal cleaning. Cleaners focused on all areas of the OR whether they were used or not at the end of the day. The focus of terminal cleaning was to reduce bacteria, dust, and other organic wastes. Daily terminal cleaning involved scrubbing of furniture, floors, walls, and overhead surfaces. They also cleaned other materials and equipment in the operating room.
Disposing of wastes followed the recommended practices. Cleaners sorted wastes based on their origins and place of disposal. Finally, sterilizing surgical equipment was also an important aspect of cleaning in OR. Only recommended OR agents were suitable for OR equipment cleaning. There were rinsing and autoclave procedures for equipment.
Overall, these OR cleaning procedures resulted in safe and clean operating rooms with minimal chances of transmitting bacteria to patients, nurses, physicians, and support staff.
Critical analysis and evaluation of operating room cleaning procedures
It is imperative to conduct a thorough analysis and evaluation of effectiveness cleaning procedures in OR because previous studies identified potential risks before and after cleaning (Carling, Briggs, Perkins and Highlander, 2005). During the practicum, one could identify few failures in cleaning procedures, especially in airflow areas. Cleaners did not focus much on such critical areas while previous studies noted that ventilated and air conditioning systems required thorough cleaning (Below et al., 2010).
In some cases, cleaning procedures did not follow the recommended guidelines. For instance, cleaners did not always apply the recommended agents for sterilizing specific equipment. This could lead to the growth of resistant microorganisms in OR. In addition, some high-touch areas did not receive frequent cleaning as required (Carling et al., 2005). Hospitals did not have sustained cleaning procedures in OR. In other words, cleaners did not follow specific guidelines for cleaning certain areas of the OR. Cleaning tended to be general with similar agents in most areas.
Overall, operating room cleaning procedures were effective. There were no observed cases of infections from OR due to bacteria. Nurses and cleaners should focus on the best practices when cleaning OR as recommended by the AORN (DeGross, 2012). Cleaners had the proper attire and protective equipment in order to reduce chances of carrying OR contaminants beyond the OR. Cleaners also minimized human traffic during OR cleaning processes. In addition, physicians restricted all movements inside the OR during the operative procedures. This practice minimized access and movement.
While cleaners followed most of the OR recommended guidelines, they did not focus on sources of microorganisms. Sources of contamination in the OR were common and could be from patients, surgical equipment, health care workers, and other materials that could harbor microorganisms. However, cleaners did not concentrate on human as a potential source of bacteria. There were no procedures on how to handle human as a potential source of infectious bacteria in OR. Health care professionals should develop cleanliness procedures for humans who can gain access to OR.
Cleaners observed hand washing, sterilization, and disinfection of materials and cleaning equipment. Storage practices were also effective because they used cleaning storage rooms. This reduces the growth and spread of microorganisms in the OR. Although cleaners washed their hands, they did not observer hand washing strictly as it should be. Hand washing is the basic OR cleaning procedure, which all people who handle equipment must observe in OR. Bacteria could simply spread from the hands to other patients or caregivers through surgical equipment.
There were also environmental factors, which could be potential sources of infections in the OR. Apart from human sources, cleaners also did not disinfect supplies, packaging materials, and any other foreign materials, which entered the operating rooms. These materials have surfaces that could serve as breeding places for microorganisms. Moreover, it is important to evaluate any materials or chemicals that affect patients’ or nurses’ health and safety in the OR.
Generally, cleaners performed cleaning in a way that protected themselves and others, including caregivers, patients, and nurses. There were no exposures to possible dangerous and contagious bacteria. Cleaners also observed cleaning procedures for OR before and after operative procedures. There was no cleaning during surgical processes. Cleaning was regular on a daily basis.
How the OR practicum will assist me to operate as MSN prepared nurse
The MSN course provides me with evidence-based practices for cleaning OR. This allows me to apply theoretical concepts in real-life situations in the OR and understand practical implications for nurses and OR cleaners. I noted that the thoroughness of OR cleaning relied on the best procedures of cleaning protocols, which aimed to create and sustain a sterile OR for all stakeholders. Cleaning reduced cases of infection in OR. Hence, cleaning and decontaminating of all instruments and equipment used in the OR should follow specific standards and procedures. I also noted that cleaners had to sterilize and wrap certain surgical instruments in sterilized containers in order to avoid frequencies of human contacts and bear handling. These are practical and valuable lessons that MSN prepared nurses can apply in the OR.
The practicum also showed me that the OR had physicians, nurses, and other professionals or trainees from different specialized areas. For instance, there were nurses, surgeons, support staff, anesthesiologists, respiratory therapists, and medical students on practicum. These professionals interacted at various levels in order to provide services to patients. Hence, collaboration was a fundamental lesson from the practicum.
The cost of health care has risen steadily. Therefore, there is a need to minimize costs and deliver quality health care to patients. The practicum provides opportunities for me to understand how health care facilities can implement simple procedures and eliminate cases of patient infections in the OR. Maintaining absolute cleanliness is a method of reducing costs of health care associated with operating procedures.
The practicum also provided an insight on why nurses require thorough training in OR cleaning. I noted that training was an effective way of ensuring that health care workers effectively understood and strictly adhered to all OR recommended cleaning procedures and practices. Professionals can ensure that support staff and cleaners follow the recommended OR cleaning guidelines by reviewing and confirming that all practices meet the required standards. This helps in identifying any inconsistencies in cleaning procedures, which could lead to infections in the OR.
From the practicum, I noted that health care professionals should develop standard procedures for specific OR guidelines. For instance, cleaning agents for floors, furniture, carriers, and others should contain specific and standard chemicals. I also noted that cleaning teams require professional managers, who have qualifications in OR cleaning processes. There should be a central point for cleaning and sterilizing all OR instruments. This should be a controlled environment with regular cleaning practices. Health care facilities should conduct regular audits to ensure that all ORs and equipment meet AORN recommend cleaning procedures. Professionals should adopt evidenced-based practices to enhance the quality of care in health care facilities and reduce the spread of microorganisms.
References
Allo, D., and Tedesco, M. (2005). Operating room management: operative suite considerations, infection control. Surgical Clinics of North America, 85(6), 1291- 7.
Below, H., Ryll, S., Empen, K., Dornquast,T., Felix, S., Rosenau, H.,…Kramer, A. (2010). Impact of surface disinfection and sterile draping of furniture on room air quality in a cardiac procedure room with a ventilation and air-conditioning system (extrusion airflow, cleanroom class 1b (DIN 1946-4)). GMS Krankenhhyg Interdiszip, 5(2).
Carling, P., Briggs, L., Perkins, J., and Highlander, D. (2005). Improved cleaning of patient rooms using a new targeting method. Clin Infect Dis., 42(3), 385-8.
DeGross, T. (2012). Surgical Center Cleaning Standards Using AORN Recommended Practices. Web.