Effectiveness of Manual Terminal Cleaning Varies on High-Touch Surfaces Near the Operative Field

Area of Science:

• Healthcare-associated infection control
• Environmental hygiene in healthcare settings
• Surgical site infection prevention

Background:

• Periprosthetic joint infections can stem from environmental pathogen transmission.
• Operating room (OR) surface contamination poses a risk for patient infection.
• Evaluating the efficacy of terminal cleaning is crucial for infection control.

Purpose of the Study:

• To assess the contamination levels on high-touch surfaces in the OR post-manual terminal cleaning.
• To identify specific OR surfaces that remain contaminated after standard cleaning procedures.
• To evaluate the effectiveness of a blacklight fluorescent marking system in assessing cleaning thoroughness.

Main Methods:

• 16 high-touch OR surfaces were marked with a blacklight fluorescent gel before terminal cleaning.
• The next morning, the percentage of removed marks determined surface cleanliness: 'clean' (>75%), 'partially clean' (26%-74%), or 'poorly cleaned' (<25%).
• This process was repeated 12 times, with the OR team unaware of the study.

Main Results:

• Of 936 marks analyzed, 40.8% were untouched and 29.1% were completely clean.
• Only the OR back table (75%) was rated as 'clean'.
• Surfaces like anesthesia carts (21.8%), door handles (20.8%), and supply cabinet doors (6%) were poorly cleaned.

Conclusions:

• Manual terminal cleaning effectiveness varies significantly across OR surfaces.
• Surfaces located further from the surgical site were less likely to be cleaned effectively.
• Inconsistent cleaning necessitates improved protocols to mitigate infection risks.