Special Edition on Operating Room Imperatives Special Edition- Operating Room Imperatives | Page 23
HHM Has anything else changed within the environ-
mental cleaning guideline?
KD: Regarding cleaning products, a new recommendation
has been added that states a chemical hazard risk assessment
of disinfectants being used should be performed each year.
Also, durability and life cycle were added to the list of factors
that should be considered when choosing cleaning materials,
tools, and equipment. Regarding cleaning procedures,
based on new evidence, we added the top and drawer
handles of the anesthesia cart and dials, knobs, and valves
on anesthesia machines to the list of items that should be
cleaned and disinfected following patient care. As a result
of three moderate-quality studies and the CDC Guideline
for Prevention of SSIs, a recommendation was added that
states performing terminal cleaning or closing the OR
after a contaminated or dirty procedure is not required,
unless the causative organism is a multi-drug resistant
organism (MDRO). Basically, the studies found there is no
greater risk of patients getting an infection if their surgery is
performed following a contaminated procedure compared
with a clean procedure. Candida auris was added to the
list of multidrug-resistant organisms for which enhanced
environmental cleaning procedures should be used. Finally,
in order to be in alignment with the IDSA and SHEA 2018
Clinical Practice Guidelines for Clostridium difficile Infection
in Adults and Children which states: “a sporicidal agent
may not be needed if there is not a high endemic rate, an
outbreak or evidence of repeated cases of CDI in the same
room,, the recommendation now states that consultation
with infection prevention should occur to determine the
product needed disinfection of C. difficile cases.
Reference:
McDonald LC, Gerding DN, Johnson S, et al. Clinical practice guidelines
for clostridium difficile infection in adults and children: 2017 update by
the infectious diseases society of america (IDSA) and society for healthcare
epidemiology of america (SHEA). Clin Infect Dis. 2018;66(7):e1-e48.
HHM How much of the experiences of the AORN
membership guides recommendations in general?
KD: We utilize experiences that perioperative nurses
have shared to formulate key terms that are used when
conducting our literature search. Additionally, through
AORN’s representation on outside organizations, such as
the CDC’s HICPAC and the Association of Occupational
Health Professionals in Healthcare (AOHP) we can keep
our pulse on developing issues. The guidelines however
are based on evidence that is published in a peer-review
journal. Therefore, for an organizational experience or case
study to be used in a guideline it must be published in a
peer-reviewed journal.
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