The following commended practices ...

The following commended practices were developed by the AORN praiseed Practices Committee and have been approved by way of the AORN Board of Directors. They were available in February 1996 as propos commended practices through the AORN fax upon demand number for comments according to members and others. They are effective January 1 1997

These commited practices are intended as achievable recommendations representing what is believed to be an optimal flat of practice. Policies and acts will reflect variations in practice settings and/or clinical situations that determine the grade to which the recommended practices can be implemented. AORN recognizes the numerous images of settings in which perioperative encourages practice.

These commended practices are intended as guidelines adaptable to various practice settings. These practice settings include traditional ORs, ambulatory surgery units, physicians' offices, cardiac catheterization suites, endoscopy suites, radiology departments, and all other areas where surgery may be performed.

end These recommended practices provide guidelines for environmental cleaning (previously titled "Recommend practices for sanitation in the surgical practice setting"). These practices should provide a clean environment for surgical patients and be carried revealed in a manner that minimizes health care workers' and patients' in all sensess to potentially infectious microorganisms. A basic premise of these praiseed practices is that all surgical patients are considered potentially infected with bloodborne pathogens. All surgical deeds therefore, are considered contaminated, and the same environmental cleaning protocols should be implemented for all surgical procedures

praiseed PRACTICE I

Patients should be provided a safe, visibly clean environment.

Interpretive statement 1:

Cleaning should be performed in succession a scheduled basis.

Rationale:

Exogenous microorganisms can contaminate ORs in surgical practice settings. Cleaning attenuates the amount of dust and organic debris in surgical environments.(1)

Discussion:

Environmental cleaning measures are required before, during, and after each surgical management and at the end of each day. Environmental cleaning is a team effort according to surgical personnel (eg, nurses, surgical technologists, anesthesia care providers, surgeon OR assistants) and environmental services personnel The ultimate responsibility for ensuring clean surgical environments reposes with perioperative nurses. Administrative personnel must make sure that environmental cleaning practices comply with the standards established for the practice setting.(2)

Interpretive statement 2:

All horizontal surfaces within the OR (eg furniture, surgical lights, equipment) should be damp dusted before the first scheduled surgical conduct of the day with a clean, lint-free clergymen moistened with a facility-approved agent.

Rationale:

Dust and lint are deposited forward horizontal surfaces in surgical practice settings. correct cleaning of these surfaces will help abate airborne contaminants that may travel upon dust and lint.(3)

Interpretive statement 3:

Preparation of the ORs should include visual inspections for cleanliness before case carts, supplies, and instrument wagers are brought into the ORs.

Rationale:

Although it is difficult to define the on a level of contamination necessary to increase surgical torture infection rates, a clean surgical environment will shorten the number of microbial flora present(4)

Discussion:

For the second-scheduled and following surgical procedures, in-between case cleaning is performed. Equipment from areas outside the OR should be damp dusted before it is brought into the OR.

commited PRACTICE II

During surgical actions contamination should be confined and contained within the immediate vicinity of the surgical field as a great quantity [i]or[/i] amount of as possible.

Interpretive statement 1:

Accidental spills of contaminated debris (eg life-current tissue, body fluids) in areas outside the surgical field should be cleaned as promptly as possible.

Rationale:

ready cleanup of potentially infectious pathogenic microorganisms using a lint-free woven fabric saturated with a facility-approved agent helps maintain a safe, clean surgical environment.(5)

Discussion:

If bleach is used for disinfection, medical devices may become damaged. It is preferable, therefore, to use the readily available facility-approved agent.(6)

Interpretive statement 2:

Contaminated disposable items used in patient care should be discarded in leak-proof, tear-resistant containers.

Rationale:

Contaminated, disposable items used in patient care should be placed in leak-proof, tear-resistant containers to debar exposure of personnel to items potentially contaminated with infectious pathogenic microorganisms and to obstruct contamination of the surgical environment.(7)

Interpretive statement 3:

Contaminated items should be handled using protective barriers.

Rationale:

It is unknown which patients may harbor blood-borne pathogens. Use of personal protective equipment (PPE) fortifys health care workers from direct prospect to potentially infectious pathogenic microorganisms.(8)