Welcome to 2014! As most of you begin to update your regulatory documents and revise any outdated regulations or recommended practices for your facility, I thought I would make you apprised to a few of the changes that have been made regarding environmental cleaning for hospitals and Ambulatory Surgery Centers. We all know that auditors can change the playing field from one facility to another, so from our experience of working with multiple facilities it is always good to air on the side of caution and play it safe regardless of any changes being made. Most of your Infection Control Plans follow the guidelines of at least one or more of the top agencies (eq. AAAHC, AORN, CMS, AHA, etc.) as they all closely follow the same protocols and recommended guidelines. MediClean tends to review all of the above to ensure we are ahead of the game and going above and beyond what is expected to ensure your facilities are not only clean but properly disinfected.
AORN (Association for periOperative Registered Nurses) just released their 2014 revised edition to their Perioperative Standards and Recommended Practices. Their chapter on Environmental Cleaning has been significantly updated from their last revision. One of the new requirements is that “all perioperative and environmental services personnel should receive initial and ongoing education and competency verification on their understanding of the principles and the performance of the processes for environmental cleaning in the perioperative areas” 1. Well, the good news is if you are a client of MediClean then you already have this requirement covered. Lucky you! The bigger question you should ask yourself is whether your Perioperative staff has had the proper training and education in regards to environmental cleaning? We have come across so many staff members who, for so many years, believed that their job didn’t need to include certain steps in environmental cleaning because it gets completed by the cleaning staff at night, or so they thought. That exact statement is why studies have now shown significant lack in failure to clean rather than failure of a product or cleaning procedure. What if your current cleaning service simply didn’t have the proper education and knowledge to be aware that a certain surface needed to be cleaned? Now take into consideration that your staff during the day wasn’t cleaning the same surface for one reason or another. What is left is a very high possibility of a contaminated surface that is now a breeding ground for microorganisms (eg. Clostridium difficile, MRSA, etc.). Because of this disconnect, the auditors want to make sure everyone is aware and being properly educated. However, guess who gets the big bad points against them if they aren’t complying? Yep, that would be you! And in all honesty though shouldn’t you expect that your staff and your cleaning service already be aware and knowledgeable in infection control in regards to environmental cleaning?
Another significant change has been in regards to the 24-hour terminal cleaning regulation for unused rooms in the sterile core. Over the past few years we have noticed that a lot of ASC’s were being docked for not complying with the 24-hour terminal clean requirement of all sterile rooms, even those not used every day. The initial reasoning for this requirement was to help prevent cross contamination as well as producing more aerosols into the air and then re-contaminating clean surfaces. Many ASC’s felt this was a little over kill, especially those who don’t use all of their ORs each week. Well good news, it looks as though AORN has changed their recommendation for terminal cleanings. The new recommendation states that “for terminal cleaning in semi-restricted and restricted areas (eg. operating or procedure rooms, sterile processing areas, corridors and storage areas), a multidisciplinary team should determine the frequency and extent of cleaning required when areas are not occupied (eg. unused and weekends)” 1. For many ASC’s changing the recommendation to a more agreeable approach isn’t a bad idea, and we agree. However, take into account why the recommendation was put in place to begin with. It is good to consider when determining how frequent your unused rooms should be cleaned and to what extent. Also remember documentation of your terminal cleaning plan will most likely be requested as well.
If you would like further details regarding these changes or any others pertaining to the 2014 revised edition, please click the following link. Making sure your facility is not only clean but safe is our number one goal.
1. Wood, Amber., et al. Recommended Practices for Environmental Cleaning. 2014 Perioperative Standards and Recommended Practices. Last revised: September 2013: e65-e85
Multidisciplinary team: should consist of Perioperative nursing, sterile processing, environmental services, infection prevention. The team should allow input from personnel who perform environmental cleaning in perioperative areas and from personnel with expertise beyond clinical end-users.