9 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A U G U S T 2 0 1 6
Cleaning Task
Task Complete
Initials of
cleaning person
Pass Inspection
Initials of
inspector
Clean and dust the ceiling, AC returns/vents, fire sprinklers,
anesthesia plugs and gas outlets.
Clean and dust walls, doors, wall panels, suction wall mounts,
X-ray view boxes, gas panels, wall outlets and fire extinguisher cages.
Ensure glass, blinds, surface counters, cabinets and all flat
surfaces are cleaned, dusted and spot-free.
Ensure all furniture, metal tables, OR exam table and carts are
thoroughly wiped down, cleaned and dusted.
Clean and dust the surgical lights.
Ensure the sub-sterile room's autoclave and warmer are dusted
and lint-free, and the floor is mopped, cleaned and spot-free.
Move all equipment before thoroughly
sweeping and mopping the floor.
Clean kick buckets and receptacles, and replace red bag liners.
Wipe clean laundry and trash collection frames and lids.
Remove and properly dispose of all trash and biohazardous waste.
This form lists the 10 must-do
tasks our terminal cleaning
crew must complete each
night. We hang the list in each
area that requires a terminal
clean so the cleaning crew can
check off the items as they
complete them. The PASS INSPEC-
TIONcolumn on the far right lets
our OR staff ensure the next
morning that terminal cleaning
has taken place. We also use
this checklist to document that
we're meeting our infection
control standards.
— Nikki Williams, RN, CNOR
DAILY CHECKLIST
10 Steps to Terminal Cleaning Success
Pamela
Bevelhymer,
RN,
BSN
