Environmental Cleaning

Question 1

What is key to preventing the spread of potentially pathogenic microorganisms that may cause surgical site infections?

Answer 1

cleaning and disinfecting the OR and procedure rooms

Question 2

Where does the chain of infection begin? What does it include?

Answer 2

begins with an infectious organism that resides in a reservoir (human, animal, environment). Includes a susceptible host and a mode of transmission

Question 3

What disrupts the chain of infection to help prevent infections?

Answer 3

Cleaning and disinfection the surgical environment

Question 4

What is the single most effective action to prevent infection?

Answer 4

hand hygiene

Question 5

What must we implement to effectively clean the perioperative environment?

Answer 5

standardized cleaning procedures

Question 6

What are cleaning agents for perioperative environment selected based on?

Answer 6

the environmental protection agency registration and hospital grading, contact time of the cleaning agent, and targeted organisms

Question 7

What should you not used to apply cleaning agents in the perioperative environment?

Answer 7

DO NOT use spray bottles

Question 8

What should you do if an environmental cleaning agent is removed from its original container and placed into a secondary container?

Answer 8

clearly label

Question 9

What should you not use for wet cleaning?

Answer 9

broom for debris (wet cleaning)

Question 10

What should not be shared between the semi-restricted and restricted areas?

Answer 10

cleaning equipment

Question 11

How do you clean in the perioperative environment?

Answer 11

1. Clean from top to bottom

2. Clean from less-soiled areas to the dirtiest

Question 12

What do you want to move and mop under?

Answer 12

the OR bed

Question 13

What do you want to do cleaning wise before the first surgical procedure of the day?

Answer 13

damp dust all horizontal surfaces in the OR

Question 14

Turnover cleaning, or between-case cleaning, occurs when?

Answer 14

occurs after a patient exits an operating room and before the next surgery setup begins.

Question 15

What kind of process is turnover cleaning?

Answer 15

standardized, methodical, cleaning process

Question 16

When does terminal cleaning occur?

Answer 16

At the end of each day the operating room or procedure room are used.

Question 17

What kind of process is terminal cleaning?

Answer 17

more extensive, thorough cleaning that is performed by training personnel.

Question 18

What type of cleaning is scheduled cleaning?

Answer 18

cleaning of equipment that occurs on a periodic, routine basis.

Question 19

What type of cleaning is enhanced cleaning?

Answer 19

Implemented for patients who are suspected or diagnosed with transmissible diseases

Question 20

What are the 4 areas of the sterile processing department?

Answer 20

1. decontamination area
2. Assembly area
3. sterilization of equipment area
4. sterile storage areas

Question 21

What kind of environmental cleaning do you want to do at the beginning of the day when in SPD?

Answer 21

Using a designated cleaning agent, wipe down all the horizontal surfaces int he assembly and sterilization of equipment areas.

Question 22

What do you want to terminally clean in SPD everyday?

Answer 22

each area in the SPD that has been used

Question 23

What do you want to clean in the SPD before cleaning the decontamination area?

Answer 23

1. SPD’s assembly area
2. sterilization of equipment area
3. sterile storage area

Question 24

What do you want to do everyday in SPD areas that have been used?

Answer 24

Clean the floors

Question 25

After procedures performed on patients with known or suspected airborne transmissible disease (TB, measles, chicken pox), what must happen?

Answer 25

the OR must be empty for a designated amount of time for the airborne particles to be filtered before environmental cleaning begins

Question 26

What are universal key points about environmental cleaning the perioperative setting?

Answer 26

1. Always keep the trash, equipment, and contaminated linen in the OR until the pt. leaves the OR. 2. Always clean and disinfect surgical equipment before bringing it into the OR and before returning it to the storage room/area. 3. The floor is always considered contaminated in every area.

Question 27

What do you want to wear and follow when handling trash, linens, or other items contaminated with blood, body fluids, and other infectious materials?

Answer 27

PPE and follow standard precautions

Question 28

What do you want to follow when disposing medical waste, including liquid medical waste?

Answer 28

local, state, and federal regulations

Question 29

What do you want to segregate and discard into designated, puncture-proof sharps containers?

Answer 29

disposable sharps - knife blades, suture needles, hypodermic needles, stapling devices

Question 30

When spills occur, what should you do?

Answer 30

clean them immediately with the designated environmental cleaning agent

Question 31

Where do you want to place contaminated linens/

Answer 31

designated linen receptacle

Question 32

What do you want to label labs sand other container with when they contain medical waste (laparotomy sponges saturated with blood/fluids)

Answer 32

biohazard label

Question 33

What are 2 things you want to do with construction/renovation/repair areas in the Periop environment?

Answer 33

1. clean areas before barriers are removed | 2. Terminally clean areas before they are returned to service

Question 34

How can you ensure that cleaning is quality?

Answer 34

1. performed and document quality checks of how well environmental cleaningg is performed 2. use standardized checklists for cleaning

Question 35

What are 3 ways to assist in measuring cleanliness of Periop environment?

Answer 35

1. visual inspections 2. fluorescent gels/markers with black light illumination 3. adenosine triphosphate monitoring

Question 36

define cleaning

Answer 36

removal of dust, debris, blood, and other infectious materials

Question 37

define disinfection

Answer 37

removal of pathogenic and other micro-organisms from surf through chemical or physical means

Question 38

Why is it critical to follow the cleaning agent manufacturer's IFU?

Answer 38

contact time/dry time --> how long the product needs to stay wet before you can use it

Question 39

What key info is in the IFU for a cleaning agent that is used for environmental cleaning in the Periop setting?

Answer 39

MSDS - contact time, indication for use, how poisonous, what to do if in contact

Question 40

What types of disposable items used in the OR must be place in a bag or container labeled with a biohazard label?

Answer 40

body tissue, anything contaminated with blood

Question 41

What info should you communicate to the cleaning personnel when a patient is suspected or diagnosed with TB and the OR needs to be cleaned?

Answer 41

room has to be unoccupied for a certain amt. of time - 60 min.

Question 42

When should you tell personnel when a patient is suspected or diagnosed with TB and the OR needs to be cleaned?

Answer 42

before the procedure

Question 43

Describe the 3 ways to assist in measuring cleanliness of Periop environment?

Answer 43

Visual inspection --> another staff member, or direct observation 2. Fluorescent gels (B4 cleaning) & black light (after cleaning) 3. Microbiology test --> swap, insert into luminometer, read results. Done through ATP