Zone I.

Lights and Bed/ Monitoring Equipment/ Anesthesia Machine and Cart

· Remove used linen, circuit, anesthesia suction, anything left on anesthesia machine itself, as well as waste basket on cart. Remove used towel on anesthesia cart.

· Wipe lights, then the bed, followed by pedals if left beneath.

· Wipe all monitoring equipment, anesthesia machine, and laryngoscope handle and dirty handle receptacle, replacing on cart.

· Wipe drawer faces and handles of anesthesia machine and cart, computer keyboard and mouse. Wipe pull-out table on anesthesia machine.

· Once entire room is clean, make bed in proper configuration for next procedure and place monitoring equipment. Replace circuit and suction liner/tubing. Replace towels on anesthesia cart and machine.

Zone II.

Room Periphery

· If Scrub or Circulator has not removed clean equipment/supplies, do so prior to cleaning after verifying with Scrub if OK. Sanitize hands prior to handling clean supplies.

· Remove dirty suction liners, dirty linen hamper and attached waste sacks.

· After Scrub Tech has left the room with dirty instruments, wipe down all equipment in periphery of the OR, including computer keyboards (RN and PACS) and mice, shavers, head lamps used. Remove any equipment not needed for next case, returning it to its proper storage place.

· Wipe OR door handles inside and out as well as spot wipe walls and doors. Wipe all tubing and hoses.

· If Zone II done first, help Zone I.

· Once entire room is clean, get needed equipment and arrange in proper configuration for next procedure and help Zone I set up if not done.

Zone III.

Floor

· Remove pedals from bags and dispose of water bugs as needed.

· Unlock bed and using towels, pre-mop floor if pools of fluid noted.

· Mop floor from clean to dirty, moving bed/equipment as needed, working toward exterior hall door exit. Avoid slapping mop onto equipment.

· Once entire room is clean, help with remaining tasks to prepare for next patient.

Final Pause.

· A designated person will call for a pause and question all cleaning staff as to completion of cleaning tasks and inspect the room.

Guiding Principles:

All items touched during the OR procedure will be cleaned with a disinfectant prior to set up of the next procedure.

Gloves will be changed between dirty and clean processes. Hand hygiene will be performed immediately after glove removal and prior to donning clean gloves.

Change rags frequently and discard after cleaning legs/feet of stools and tables at or close to the floor.

Strokes taken with cleaning rags will be done in a manner that does not leave spaces un-cleaned.

OR table platforms will be cleaned under the pad’s edges Pads will be removed entirely as needed for thorough cleaning of platforms/pads.

In addition to horizontal surfaces, bed and gurney rails and sides will be wiped.

Anesthesia machines are considered to be dirty. At the start of a case, a clean towel will be placed on the table top of the anesthesia machine. At the end of the case, the towel and any airway equipment contained on it will be considered dirty and will be disposed of accordingly.

Top of anesthesia carts are considered clean.

Used rags and mop heads will never be re-dipped into cleaning basins or buckets.

In addition to the OR bed, lights and equipment, areas to clean between each case will always include:

· Keyboard and mouse on all OR computers; .

· Anesthesia machine table tops, drawer faces and handles;

· Anesthesia cart drawer faces and handles, waste baskets and laryngoscope holders;

· OR doors

· All stool backs where hands would have touched