What is terminal cleaning of the operating room?

Terminal cleaning of the operating room (OR) is a comprehensive and thorough cleaning process that is performed after every surgical procedure to ensure the complete removal of all contaminants and maintain a sterile environment for the next surgery. It involves the cleaning and disinfection of all surfaces, equipment, and instruments within the OR to eliminate any potential sources of infection and promote patient safety.

Here are the steps typically involved in terminal cleaning of the operating room:

1. Preparation: Before starting the cleaning process, the surgical team removes all surgical instruments, drapes, and other materials used during the surgery from the OR. The room is then closed off to restrict access and prevent contamination from outside sources.

2. Gross Decontamination: The first step in terminal cleaning is to remove any visible dirt, debris, and organic matter from surfaces and equipment. This includes wiping down surfaces with a disinfectant solution and removing any bodily fluids or tissue remnants.

3. Cleaning: The entire operating room, including walls, floors, ceilings, fixtures, and equipment, is thoroughly cleaned using a disinfectant cleaner and a microfiber cloth. Particular attention is given to high-touch surfaces such as doorknobs, light switches, and surgical equipment handles.

4. Disinfection: After cleaning, all surfaces, equipment, and instruments are disinfected using a sporicidal disinfectant. This is done by applying the disinfectant solution to the surfaces and allowing it to dwell for the recommended contact time according to the manufacturer's instructions.

5. Rinsing: After the disinfection process, all surfaces are rinsed thoroughly with sterile water to remove any residual disinfectant.

6. Drying: The surfaces and equipment are then dried using sterile towels or allowed to air dry.

7. Equipment Maintenance: Any reusable surgical instruments and equipment are disassembled, cleaned, and sterilized according to the manufacturer's guidelines.

8. Verifying Cleanliness: Once the terminal cleaning is completed, the cleanliness and sterility of the operating room are verified through visual inspection and, in some cases, by conducting microbial surveillance testing to ensure the absence of harmful microorganisms.

9. Documentation: The completion of terminal cleaning and any relevant observations or findings are documented in the operating room logbook or electronic medical record.

By following a standardized terminal cleaning protocol and adhering to strict infection control practices, healthcare facilities can minimize the risk of surgical site infections and maintain a safe environment for patients undergoing surgery.