M A Y 2 0 1 6 O U T P A T I E N TS U R G E R Y. N E T 5 3
Surface disinfection during room turnover tends to
center on such surfaces as the OR table, the over-
head light, the Mayo stand and equipment that's
used in or near the sterile field. "You clean the high-
touch surfaces, of course," says Linda Lybert, presi-
dent of Healthcare Surface Consulting in Seattle,
Wash. "But are you overlooking the highly-touched
surfaces?" Are you even aware of which ones those
are, in your particular clinical environment?
For example: During an average between-cases turnover, how much antimicrobial attention and time does your staff spend on IV
poles' hooks? Or on anesthesia machine knobs, equipment cords and cables, the computer monitor and keyboard, and cabinet and
door handles? Equipment that's farther away from the sterile field might not get immediate and sustained attention, but it shouldn't
be overlooked, as it also gets touched on a regular basis. And anything that pathogens are living on has the potential to trigger
cross-contamination.
"During my consulting visits to healthcare facilities, I watch the working behaviors of the staff that occupy a room to identify
surfaces of increased concern," says Ms. Lybert. "What do they touch? What do they move? Where is equipment located in rela-
tion to a patient at various times? I take notes, and count how many times things were touched. Then I observe the room's
turnover, paying particular attention to all the things that were touched and yet missed disinfection."
Facility managers and staff are usually shocked at how many of those things there are, she adds. "Maybe even as shocked as I
was the time I saw that the body fluids which had spattered a wall were simply wiped off with a dry towel, and that thorough disin-
fection would have to wait for a planned quarterly wall cleaning."
A lot of places that get touched in the patient environment don't get cleaned every time. But watching your team's surface
cleaning and disinfection behavior after selected cases and after different types of procedures will reveal the things they don't rou-
tinely think about, and can put the things that need to be a higher priority into sharp focus.
— David Bernard
WATCH AND LEARN
What Gets Touched During OR Turnovers?
• OUTER EDGES When focusing on high-touch surfaces, don't overlook equipment
that's not in the sterile field.
Pamela
Bevelhymer,
RN,
BSN
