Becker's ASC Review

21 Executive Briefing: Lastly, leadership should make their terminal cleaning policy sustainable by fostering a mindset among staff that it is everybody's job to ensure the facility is cleaned properly. This also involves regular staff training to keep everyone up to date on terminal cleaning policy. Staff should also understand that cleaning chemicals are not created equal — each chemical is designed to be used in a certain way with a set dwell time to inactivate different microorganisms. Dwell time — or the amount of time it takes for a chemical to take effect — is a key part of executing a terminal cleaning policy. "If it says five minutes on the bottle and you wipe a surface down three minutes after, then you've done nothing," Ms. Cox said. "Staff should know exactly how a chemical works. Always follow the manufacturer's instructions for use." When cleaning chemicals aren't used properly, staff wastes both their time and the chemical as a result. In addition to dwell time, some chemicals must reach a certain temperature level to be effective. "If you're using something outside of its scope, it's as if you did nothing at all," Ms. Cox said. Timing is important when sterilizing instruments as well — proper timing ensures that instruments are sterilized effectively. Staff should pay attention to both bioburden — the material left behind after a surgery such as blood clots and paper waste —- and biofilm, the substance that "hides" contaminants that fosters bacteria growth. Before taking instruments to the sterile processing department, staff should eliminate as much bioburden as possible. "The time frame really counts when taking instruments from the operating room to decontamination — staff should adopt a 'first in, first out' mentality when putting instruments through the washer to ensure proper sterilization." Additionally, if a facility uses a group purchasing organization to buy its cleaning chemicals, it's important to keep staff apprised of the specific chemicals the organization purchases. Because these organizations operate on contracts, they may change out cleaning chemicals without all the proper staff being at the table to choose them. If a facility's group purchasing organization orders new chemicals, staff need to dedicate time to determine the product's instructions for use. If use instructions have changed, facility leadership should update staff on the new procedures. The importance of leadership in staff education and training Similar to other aspects of healthcare, staff education and training for terminal cleaning policies works best when a facility adopts an interdisciplinary team approach. This means involving all stakeholders within a healthcare facility in terminal cleaning policies, including infection control, operating room and environmental services staff. When it comes to the role of leadership in education and training, leading by example is one way to get staff on board. "If staff sees how important terminal cleaning is to you, then it will become important to them," Ms. Cox said. Staff training and education on terminal cleaning policies should be prioritized. Leadership can stress the importance of a terminal cleaning policy by being involved in staff meetings, setting the bar for staff performance. Leadership should also strive to keep training consistent for new hires. Often when new staff members are brought into a facility, there is a mindset they will pick up on cleaning policies and procedures without much guidance from leadership. However, leaders should make it a priority to ensure new hires are well trained on the facility's terminal cleaning policy. "Lack of consistency is what organizations often get wrong about terminal cleaning policies," Ms. Cox said. "It goes back to making sure that as new people are brought on, they are trained on policies instead of just having the expectation that they'll simply get it. Training and education should be a topic of discussion at staff meetings as well." How to hold staff accountable for inspections Ms. Cox recommended adopting an internal auditing system to ensure staff is ready for cleaning inspections. This system works by assigning anonymous staff members to watch over areas and check if policies are being followed. In this situation, staff can also adopt AORN's pit crew mentality, with each staff member responsible for a specific aspect of the policy. Directly involving staff in inspections and assessments can empower these specific team members to follow the policies themselves. Making a point to praise staff when they do a good job can encourage staff further. "Praise can do wonders for staff," Ms. Cox said. "Thanking them for going above and beyond can help with performance in assessments and inspections." If leadership shows they're willing to be accountable for the cleanliness of the facility, it can help encourage staff to do the same. For example, if leadership offers to help clean one to two rooms a day, it can help stress how important the facility's cleanliness is to them. Inspections and terminal cleaning are tasks that shouldn't rest on a single staff member's shoulders — it should be a priority for all stakeholders in a healthcare facility. "Terminal cleaning is everybody's job no matter what," Ms. Cox said. "Everybody is capable of mopping the floor. All staff should have an active role in maintaining the cleanliness of the facility." n STERIS IMS partners with your team to optimize your budget, avoid regulatory citations, and help you be procedure ready. The Instrument Processing Solutions Team assesses, manages, and trains SPDs to help ensure safe and efficient work environments that meet regulatory standards as well as your own. Our Instrument Management Services repair team provides both lab and field-based surgical device, surgical instrument, and rolling stock maintenance programs. STERIS IMS also offers testing and protection products for your devices and instruments, as well as certified pre-owned surgical equipment to enhance your inventory. Visit us: www.steris-ims.com. We help keep your OR moving.

• Cover