Operating Room Turnover Cleaning and Disinfection: The Infection Preventionist’s Survival Guide

Session Description: The operating room (OR) can be an intimidating and unfamiliar territory for infection preventionists (IPs), regardless of experience level. Traditional OR culture leads us to believe that perioperative spaces are “sterile” and free from external contamination. A brief walk through even the most reputable OR tells a different story. Informed IP observations of OR cleaning and disinfection can reduce the risk of pathogen transmission, increase patient and occupational safety, and support regulatory and accreditation readiness.

Research has shown that cleaning and disinfection practices in ORs are not always consistent with policies or best practice guidelines. In ambulatory surgery centers, environmental hygiene challenges are multiplied, given resource limitations and contracted cleaning teams. Likewise, labor and delivery operating rooms may be overlooked in traditional OR monitoring programs. OR contamination is common in areas such as the anesthesia workstations, table, touchscreens, and keyboards, as well as on providers’ hands. Some studies reveal an average cleaning compliance of less than 50% at terminal cleaning. IPs commonly play a role in assessing terminal cleaning compliance via adenosine triphosphate (ATP) bioluminescence swabbing and fluorescent marking (FM), but in-between case cleaning is much harder to observe and assess.

This session introduces the audience to a standardized process checklist for OR cleaning and disinfection assessments, created by environmental hygiene experts and tested in ORs across North America. For those new to IP or to ORs, specific examples of common challenges and errors are provided. Additional tools and resources will be shared, including a brief review of the equipment and surfaces commonly found in ORs. Presenters will use gamification to encourage interaction, including “what’s wrong with this picture” and live polling. Upon completion of this presentation, attendees will feel more confident walking into the perioperative space and have a deeper understanding of the complexities surrounding perioperative environmental hygiene.