happen. I often see staff come in and out of the OR without sanitizing
their hands, particularly when they're coming in. "But I washed my
hands at the scrub sink before I came in," they'll say. Or, "I just sani-
tized my hands with the alcoholic sanitizer dispenser outside the OR
before I came in." A surveyor won't accept that. Make sure your OR
suites have hand sanitizer dispensers or bottles of sanitizer readily
available. And be sure wall-mounted dispensers are always filled.
The proper way to use a waterless scrub preparation is to rub the
preparation into and under fingernails, as well as the hands and lower
arms. Follow the manufacturer's instructions for use to ensure efficacy
of the product. Refrain from wiping the waterless scrub product off
hands and arms with a sterile towel, and don't don gloves while the
preparation is wet. Other common hand-hygiene breaches include staff
not practicing hand hygiene after handling their personal cell phones
and other electronic devices.
4. Environmental cleaning. Don't be surprised if a CMS surveyor
asks staff for the dwell (or contact, kill or wet) time of the product
they're using for surface disinfection and how they know how long the
surface remained wet. The number is right there on the container of
impregnated cleaning cloths (for example, 1, 2 or 3 minutes), but does
the germicide stay wet for the appropriate time before you place the
new sheet or cloths on tables or stands? My suggestion: Time it. If the
surface dries in less time than it's supposed to remain wet, take another
cloth and wipe over the surface again until attaining the required total
number of minutes. It's not necessary to begin timing over again, as long
as the specified number is reached, that part of the process is optimal.
5. Pre-cleaning. You can sterilize and high-level disinfect by the
book, but if your pre-cleaning and cleaning practices are suboptimal,
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