Advertisement

Determining high touch areas in the operating room with levels of contamination

      Highlights

      • The operating room was not included in the 2010 Centers for Disease Control and Prevention's list of recommended high touch hospital areas to clean.
      • This study identified high touch areas within an operating room setting.
      • The researchers recommend that an established cleaning protocol be established and followed within the operating room setting based on the findings of this study.

      Background

      The Centers for Disease Control and Prevention put forth the recommendation to clean areas considered high touch more frequently than minimal touch surfaces. The operating room was not included in these recommendations. The purpose of this study was to determine the most frequently touched surfaces in the operating room and their level of contamination.

      Methods

      Phase 1 was a descriptive study to identify high touch areas in the operating room. In phase 2, high touch areas determined in phase 1 were cultured to determine if high touch areas observed were also highly contaminated and if they were more contaminated than a low touch surface.

      Results

      The 5 primary high touch surfaces in order were the anesthesia computer mouse, OR bed, nurse computer mouse, OR door, and anesthesia medical cart. Using the OR light as a control, this study demonstrated that a low touch area was less contaminated than the high touch areas with the exception of the OR bed.

      Conclusions

      Based on information and data collected in this study, it is recommended that an enhanced cleaning protocol be established based on the most frequently touched surfaces in the operating room.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • The Joint Commission
        Surgical Care Improvement Project Core Measure Set.
        (Available from:) (Accessed December 23, 2014)
        • The Joint Commission
        National Patient Safety Goals.
        (Available from:) (Accessed December 23, 2014)
        • Zimlichman E.
        • Henderson D.
        • Tamir O.
        • Franz C.
        • Song P.
        • Yamin C.K.
        • et al.
        Health-care associated infections. A meta-analysis of costs and financial impact on the US health care system.
        JAMA Intern Med. 2013; 173: 2039-2046
        • Guh A.
        • Carling P.
        • Environmental Evaluation Workgroup
        Options for evaluating environmental cleaning.
        (Available from:) (Accessed December 23, 2014)
        • Huslage K.
        • Rutala W.A.
        • Sickert-Bennett E.
        • Weber D.J.
        A quantitative approach to defining “high-touch” surfaces in hospitals.
        Infect Control Hosp Epidemiol. 2010; 31: 850-853
        • Jefferson J.
        • Whelan R.
        • Dick B.
        • Carling P.A.
        Novel technique for identifying opportunities to improve environmental hygiene in the operating room.
        AORN J. 2011; 93: 358-364
      1. Guideline for environmental cleaning.
        in: Guidelines for Perioperative Practice. AORN, Inc, Denver, CO2016
        • Munoz-Price L.S.
        • Birnbach D.J.
        • Lubarsky D.A.
        • Arheart K.L.
        • Fajardo-Aquino Y.
        • Rosalsky M.
        • et al.
        Decreasing operating room environmental pathogen contamination through improved cleaning practice.
        Infect Control Hosp Epidemiol. 2012; 33: 897-904
        • Loftus R.W.
        • Muffly M.K.
        • Brown J.R.
        • Beach M.L.
        • Koff M.D.
        • Corwin H.L.
        • et al.
        Hand contamination of anesthesia providers is an important risk factor for intraoperative bacterial transmission.
        Anesth Analg. 2011; 112: 98-104
        • Guh A.
        • Carling P.
        • Environmental Evaluation Workgroup
        Options for evaluating environmental cleaning.
        (Available from:) (Accessed December 23, 2014)
        • Dancer S.J.
        • White L.
        • Robertson C.
        Monitoring environmental cleaning on two surgical wards.
        Int J Environ Health Res. 2008; 18: 357-364
        • Dancer S.J.
        How do we access hospital cleaning? A proposal for microbiological standards for surface hygiene in hospitals.
        J Hosp Infect. 2004; 56: 10-15
        • Centers for Disease Control and Prevention
        Emergency response resources: surface sampling procedures for Bacillus anthracis spores from smooth, non-porous surfaces.
        (Available from:) (Accessed April 26,2012)
        • Association of periOperative Registered Nurses
        Environmental Cleaning Toolkit.
        (Available from:) (Accessed April 22, 2016)
        • Mulvey D.
        • Redding P.
        • Robertson C.
        • Woodal C.
        • Kingsmore P.
        • Bedwell D.
        • et al.
        Finding a benchmark for monitoring hospital cleanliness.
        J Hosp Infect. 2011; 77: 25-30