Surface Cleaning in Sterile Processing

Not only is the sterile processing department (SPD) responsible for the cleanliness of surgical instruments and medical device inventory used for patient procedures, but they are also often responsible for patient care equipment, and sterility of supplies needed for surgery. Who is responsible for keeping the environment and surfaces clean in and around the department? Whether your facility has a dedicated environmental care team who handles this or the reprocessing professionals that work the frontline every day, this blog is going to touch on some best practices for surface cleaning in the SP, and what to be on the lookout for during routine cleaning practices.

Just because the decontamination space is considered the “dirty” area of sterile processing, it should still be kept clean and shiny. Because this is where most microorganisms are found, surfaces are at a high risk of becoming contaminated. All areas of the SPD should be cleaned regularly, and routine practices should be put into place to ensure the surfaces are ready for the day’s work. Because there is so much time, dedication and steps put into our reprocessing program, why risk contaminating something you just cleaned, because the department is dirty, let alone items that have been sterilized or disinfected.

There are many different types of cleaning and disinfection products on the market. Let’s look at some best practices and things to consider when creating your cleaning procedures.

1. Level of Cleaning

Think about the level of cleaning you are trying to achieve. Are you simply wiping surfaces as spot cleaning throughout the day or are you doing a terminal clean with the end goal to kill microorganisms. The term fomite is something to be aware of, this includes objects or materials which are likely to carry infection, such as surfaces, doorknobs, light switches and pretty much everything found in decontamination. By first understanding what it is you are working to clean, and the level of cleanliness you need to achieve, you can create your protocol. Start by answering these questions:

Are you trying to kill anything? What level of disinfectant is needed?
Is this a daily routine cleaning or terminal cleaning?
What products do you have available to use?
How much time do you have to complete this?
Are you able to document the cleaning date, process, and cadence in a log?
Who is completing the cleaning process?

2. Material Make Up

Whether you are cleaning prep and pack workstations, or decontamination surfaces you will need to identify the material makeup of the surfaces you are cleaning. It’s important to understand what it is you are cleaning and what it’s comprised of so the appropriate cleaning solutions can be used. For example, stainless steel surfaces, such as a washer disinfector or ultrasonic equipment, will require the use of a particular cleaning solution, so there isn’t any damage, or scratches or streaking. Understanding what each surface is made of, will help the staff determine a consistent process that is safe and effective. Work with the facility to identify what the floors are made of workstations, doors, walls, equipment, and ceilings. All areas of the department will need to be cleaned and free from debris, even hard to reach areas.

3. Safety Considerations

Whether the facility has a dedicated environmental cleaning team who will take the responsibility of terminally cleaning your SPD, or your frontline staff will be completing this task, each responsible party will need to be trained on expectations and process for proper cleaning. Overall, you want a smooth, safe process that is easy for your team to follow regardless of the time of day or surface being cleaned. Here are somethings to consider.

What level of disinfection, if any, is being achieved or required with cleaning?
What is the known or expected surface contact wet time for the solutions being used. For instance, are you allowing your SP staff to wipe down their tables with 70% isopropyl alcohol to set up for the day?
Does the level of disinfectant or cleaning solution kill the microorganisms you need to kill?
Are there any harmful additives or fragrances that could disrupt the staff?
Have you chosen an eco-friendly product that won’t harm the environment?
Using an approved and compliant product for your staff to handle, store and discard when finished.

4. Standardization

Every healthcare organization or system has a dedicated environmental team and infection control team who drives decisions that are best for the organizations. Many times, you will be prompted to order, and utilize products that have been approved by the facility. In the instance of disinfecting or cleaning, approvals are usually put in place by a committee to determine the best products the organization will use as their standard. Regardless of the product that is approved, you might require the use of another product for specialty reasons or cases, such as a stainless-steel cleaner, or a higher level of disinfecting product. Reasons facilities desire to standardize cleaning products could include.

Cost effectiveness, and ease or ordering in bulk amounts for the entire hospital versus in smaller amounts.
Safety and safety data sheet (SDS) review and maintenance.
Ease of training and education on proper use.
Finding a product that is versatile and helps solve all cleaning needs across many departments.
Create a cleaning log that is used to log all cleaning processes. For instance, the weekly terminal cleaning, surface cleaning that is required in the SPD should be logged regularly.

5. Improper Use

More times than not we see departments using products improperly or for multiple uses that may not be intended by that product. For instance, using an intermediate level disinfectant on a surface, that requires 3 minutes of contact time but is wiped off after only 1 minute. Using adhesive remover that is intended for patient skin adhesive removal but being used on surgical instruments. Staff members using rubbing alcohol on surgical instruments improperly to “clean” the surface of the item that was contaminated. No matter what your role is in this cleaning process make sure you are following best practices and adhere to the instructions for use for all products.

Most importantly, be a role model for a “quality mindset” and dedication to patient safety for everyone you encounter in every decision you make.