Not long ago, state health inspectors cited a Missouri hospital for dirty floors, dusty equipment, messy sinks and other infection control deficiencies related to the surgical environment. According to local reports, it took an entire weekend and more than 100 employees to correct the problems with a massive cleanup.

Don't let this happen to you. It's imperative, not just for regulatory compliance but also for patient safety, that all operating rooms receive a thorough cleaning every 24 hours during the regular work week, regardless of whether they were used and regardless of what types of procedures were performed in them (see "What Gets Terminally Cleaned?").

16-step guide
Here's a 16-step guide to cleaning an operating room at the end of the day based on AORN's Recommended Practices for Environmental Cleaning in the Surgical Practice Setting:

Step 1. Prepare fresh germicidal cleaning solution for the room in both your mop bucket and microfiber cloth bucket. Immerse microfiber cleaning cloths in solution bucket and immerse mop in mop bucket. (See "Your Terminal Cleaning Toolkit" for the supplies your staff will need.)

Step 2. Move items away from the walls and toward the center of the room.

Step 3. High-dust the room starting by the door and working from left to right (or right to left).

Step 4. Clean walls, ceiling and ceiling light fixtures with germicidal cleaner.

Step 5. Begin cleaning the items (equipment) in the room that the housekeeper is responsible for cleaning. Keep the clean items together and away from the dirty items. Do not roll them through blood or body fluids on the floor after cleaning. Pay close attention to wheels and casters.

Step 6. When finished cleaning items, begin dry mopping and auto scrubbing the floor around the outside edge of the room.

Step 7. Replace items to the outer edge of the room and begin cleaning the items in the center of the room, such as lights, monitors and equipment over the operating table and the OR table and pads. Pay close attention to screw connections, Velcro and bed controls on the operating table.

Step 8. Clean other items in the center of room.

Step 9. Move operating table to the side of room and allow germicidal cleaner to dry before replacing linens.

Step 10. Dry mop and auto scrub the floor in center of room and return the operating table to its original location.

Step 11. Replace empty hand sanitizer dispensers as needed. Do not refill. Refilling can contaminate the container and serve as a reservoir for microorganisms.

Step 12. Empty all waste containers, clean containers thoroughly inside and outside, and re-line with plastic liners.

Step 13. Clean door handles and push plates before leaving the room.

Step 14. Inspect your work.

Step 15. Limit access to the room to "as needed," meaning only staff who need to re-enter the room can do so.

Step 16. Disassemble and clean auto scrubbers with germicidal solution and let air dry.

Rinse and repeat
All patients potentially are infected with bloodborne and other pathogens. You must therefore consider all surgical procedures to be potentially infectious and implement the same environmental cleaning protocols for all procedures. Enforcing a clean environment at your facility will not only keep the regulators at bay, but will also reduce the number of microorganisms that could harm your patients and staff. Make sure your facility's policies and procedures for terminal cleaning are written down, readily available to staff and reviewed annually.