Evidence-Based Plan for Environmental Cleaning of Operating Room: Impact on High-Frequency Contact Surfaces
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Keywords

Environmental cleaning scheme
High frequency contact table
Operating room
Evidence-based practice
Management

DOI

10.26689/jcnr.v10i2.14219

Submitted : 2026-02-13
Accepted : 2026-02-28
Published : 2026-03-15

Abstract

Objective: To develop an evidence-based plan for cleaning operating room and evaluate the impact on high-frequency contact surfaces. Method: The evidence application model of the JBI Evidence-Based Nursing Center was utilized to create a strategy, which was implemented in a tertiary-level hospital in Yunnan Province. The adenosine triphosphate (ATP) biological biofluorescence detection method was used to assess the quality of cleaning before and after the intervention. Results: A total of 17 quality review indicators were established in this study. Following the application of evidence, the implementation rate for 16 quality review indicators increased significantly, from a range of 0–71.6% to 85.3–100%. Moreover, the pass rate of ATP bioluminescence detection on high-frequency contact surfaces increased from 14.07% to 47.10%, with significant difference (p < 0.05). Conclusion: The evidence-based environmental cleaning program proved to enhance the overall cleanliness of operating room and reduce the risk of surgical infections. This strategy holds promise for effective cleaning of operating room.

References

Leaper D, Edmiston C, 2017, World Health Organization: Global Guidelines for the Prevention of Surgical Site Infection. Journal of Hospital Infection, 95(2): 135–136.

Link T, 2021, Guidelines in Practice: Environmental Cleaning. AORN Journal, 113(5): 487–499.

Link T, 2019, Guideline Implementation: Design and Maintenance of the Surgical Suite. AORN Journal, 109(4): 479–491.

Jennings J, Johnson R, Brady A, et al., 2017, Effectiveness of Manual Terminal Cleaning Varies on High-Touch Surfaces Near the Operative Field. Arthroplasty Today, 22: 53–57.

Balter S, Rodriguez M, Pike J, et al., 2021, Microbial Contamination Risk and Disinfection of Radiation Protective Garments. Health Physics, 120(2): 123–130.

National Health and Family Planning Commission, 2016, Management Code for Environmental Surface Cleaning and Disinfection in Medical Institutions (No. 23, 2016).

Link T, Kleiner C, Mancuso M, et al., 2016, Determining High Touch Areas in the Operating Room with Levels of Contamination. American Journal of Infection Control, 44(11): 1350–1355.

Branch R, Amiri A, 2019, Environmental Surface Hygiene in the OR: Strategies for Reducing the Transmission of Health Care–Associated Infections. AORN Journal, 112(4): 327–342.

Luo J, Gu S, 2020, Investigation and Analysis of Quality Monitoring of End-Bed Unit and Nursing High Frequency Contact Surface Cleaning. Chinese Nursing Administration, 20(10): 1577–1580.

Lu Y, Hu G, Li Y, et al., 2016, Evaluation of Cleaning and Disinfection Effect of Environmental Objects in Medical Institutions by ATP Biofluorescence Method. Chinese Journal of Disinfection, 33(6): 530–532.

Zhu Z, Hu Y, Xing W, et al., 2017, The Composition of Different Types of Evidence-Based Questions. Journal of Advanced Nursing, 32(21): 1991–1994.

Anderson D, Chen L, Weber D, et al., 2017, Enhanced Terminal Room Disinfection and Acquisition and Infection Caused by Multidrug-Resistant Organisms and Clostridium difficile (The Benefits of Enhanced Terminal Room Disinfection Study): A Cluster-Randomised, Multicentre, Crossover Study. Lancet, 389(10071): 805–814.

Dallolio L, Raggi A, Sanna T, et al., 2018, Surveillance of Environmental and Procedural Measures of Infection Control in the Operating Theatre Setting. International Journal of Environmental Research and Public Health, 15(1): 46.

Ministry of Health of the People’s Republic of China, 2016, Technical Specification of Disinfection in Medical Institutions.

Rutala W, Weber D, 2019, Best Practices for Disinfection of Noncritical Environmental Surfaces and Equipment in Health Care Facilities: A Bundle Approach. American Journal of Infection Control, 47: A96–A105.

Conner R, Spruce L, Burlingame B, et al., 2013, Recommended Practices for Environmental Cleaning in the Perioperative Setting. In: Perioperative Standards and Recommended Practices. Denver: Association of PeriOperative Registered Nurses: 243–254.

DiCenso A, Bayley L, Haynes R, 2009, Accessing Pre-Appraised Evidence: Fine-Tuning the 5S Model Into a 6S Model. Evidence Based Nursing, 12(4): 99–101.

Centers for Disease Control and Prevention, 2023, Guideline for Disinfection and Sterilization in Healthcare Facilities.

AORN, 2020, Guideline Quick View: Environmental Cleaning. AORN Journal, 111(2): 252–257.

Zhuang Y, Zou L, Zheng Y, et al., 2022, Application of Best Evidence for Stage I Cardiac Rehabilitation in Patients with Transcatheter Aortic Valve Replacement. Chinese Journal of Nursing, 57(5): 563–569.

Wolfhagen N, Boldingh Q, Boermeester M, et al., 2022, Perioperative Care Bundles for the Prevention of Surgical-Site Infections: Meta-Analysis. British Journal of Surgery, 109(10): 933–942.

Ling M, Ching P, Widitaputra A, et al., 2018, APSIC Guidelines for Disinfection and Sterilization of Instruments in Health Care Facilities. Antimicrobial Resistance & Infection Control, 7: 25.

Gao X, Hu B, Shen Y, et al., 2012, Investigation on Environmental Cleaning, Disinfection and Monitoring in 71 Hospitals in Shanghai. Chinese Journal of Hospital Infectiology, 22(12): 2606–2608.