LIFE CARE HOSPITAL
First cleaning of the day (before cases begin)
This should be performed first, every morning irrespective of whether the OT will be used or not.
Wear a clean gown, cap, mask and clean utility
gloves
The surgeon/anaesthetist should not enter the OT
before cleaning is complete
Clean all horizontal surfaces by wet wiping with an
HLD Every horizontal surface should be cleaned•
Follow the sequence of cleaning (top to down; in to
out)
Clean all antiseptic bottles and the trays in which they
are kept. Clean the sterile containers
Ensure colour coded waste collection bags are
placed in the waste bins
Keep the OT closed for 10-15 min with ventilation
equipment on after cleaning
Wash the scrub basin and tap with soap and water.
Check for leakage and report immediately if seen.
Clean the soap and antiseptic bottles at the scrub
basin. Replace the bottles if empty
During cleaning, only cleaning personnel should be present in the OT and the doors should be kept closed
After cleaning is over, wash and remove utility gloves, gown and cap. Wash hands and disinfect them by
using an alcohol hand rub before proceeding to other work.
Cleaning Operating Rooms in between Cases
Keep ventilation equipment on and OT door closed
Wear OT dress, footwear and a cap
Place a cautionary ‘Wet Floor’ sign at the entrance of the room
Prepare fresh disinfectant solution
Clean hands and put on gloves
Collect and remove waste
Collect and remove all soiled linen segregating soiled and dry linen
Remove gloves and clean hands. Wear a different set of gloves
Use a cloth dampened in hospital-approved disinfectant solution to clean and disinfect surfaces that have
come in contact with a patient or body fluids, including tops of surgical lights, blood pressure cuffs,
tourniquets and leads
Clean suction canisters, reflective portion of surgical lights
Clean and disinfect OT table
Clean electronic equipment (i.e., monitors) according to manufacturer’s instructions
Damp mop floor in a 1 to 1.3 metre (3 to 4 feet) perimeter around the OT table (larger area if contamination
present)
Insert colour coded bags in waste bins
Damp-dust equipment from other areas such as X-ray machines, C-arm etc. before being brought into the
operating room and prior to leaving
When cleaning is complete, remove gloves and clean hands.
Procedure for Terminal Cleaning of Operating Rooms
Place a cautionary ‘Wet Floor’ sign at the entrance of the room
Prepare fresh hospital approved disinfectant solution according to manufacturer’s instructions
Clean hands and put on gloves
Collect and remove waste
Collect and remove all soiled linen
Clean hands and change gloves
Clean and disinfect lights and ceiling-mounted tracks
Clean and disinfect all door handles, push plates, light
switches and controls
Clean and disinfect telephones and computer
keyboards
Spot-check walls for cleanliness
Clean and disinfect all exterior surfaces of machines
and equipment (e.g., anaesthesia carts), allowing
adequate drying time for the disinfectant before storage
Clean and disinfect all furniture including
wheels/casters
Clean and disinfect exterior of cabinets and doors, especially around handles
Clean and disinfect all surfaces
Clean scrub sinks and surrounding walls
Mop floor, making sure the OT table is moved and
the floor is washed underneath; move all furniture to
the centre of the room and continue cleaning the
floor; apply a sufficient amount of
disinfectant/detergent to ensure that the floor
remains wet for five minutes; use a fresh mop/mop
head and fresh solution for each room
Replace all furniture and equipment to its proper
location
Wash the colour coded bins, dry them and put
colour coded bags once it is dried
Report any needed repairs
Clean and store cleaning equipment
Remove gloves and clean hands.
Detailed Wash-down of the OT Complex
A detailed wash-down should be done at least once a week for OTs that are used daily
For OTs that are used less frequently, detailed wash-down should be done at least once a month and before
any camp patients are operated.
Method
Wear utility gloves
Shift all movable equipment and materials out of the OT
Inspect the OT surfaces for cracks, loose tiles etc. If any maintenance work is required, perform the
maintenance before proceeding
In case the maintenance involves civil work that generates dust, then the cleaning and disinfection protocol
for cleaning and disinfection new OT should be followed after the maintenance work is completed.
Wipe all surfaces of the OT liberally with soap and water
Begin at the ceiling. Use a long handled mop to wipe the ceiling
Proceed down the walls. Clean all wall fixtures on the way down
Clean all ceiling mounted fixtures e.g., OT lamp
Then clean all fixed floor based equipment
Lastly scrub the floor with soap and water
Repeat cleaning until all visible dust is removed
Allow the OT to dry naturally
Then wipe all surfaces with HLD. Allow the disinfectant to dry naturally
Meanwhile, clean all the equipment moved outside with soap and water. Remove all dirt and dust. Clean
every surface of the equipment
Remove all materials stored on trolleys and clean the entire trolley. Also clean the bottles, containers, etc. by
wiping them on the outside to remove all soiling
Clean the wheels by running them 10-15 times over a Turkish towel soaked with soap and water
Wipe the equipment with HLD and allow to air dry
Move the equipment back into the OT. Wipe equipment with high-level disinfectant
Cover electronic equipment with properly fitting plastic covers and fog the OT with high-level disinfectant
until a fog is seen in the air
Keep the OT closed for at least one hour
Meanwhile, clean the rest of the OT complex (passages, other rooms) with soap and water followed by
wiping with high-level disinfectant. Clean and wipe from ceiling to floor. Clean all furniture
The OT may be used after it has remained closed for at least one hour.
Cleaning and Disinfection of New OT and after any Civil
Work
First ensure all civil work is completed
Ensure all movable equipment has been shifted out
Wear utility gloves
Wipe all surfaces of the OT using liberal amount of soap and water. Repeat wiping until all visible dust is
removed
Clean all fixed equipment like OT lamp with soap water until all visible dust is removed
The mechanical action of wiping is very important to remove spores and improve the action of
disinfectants used subsequently
Allow all surfaces to dry completely
Wipe all surfaces (including the ceiling) with a high-level disinfectant. Allow to dry completely
Wipe down all equipment to be moved into the OT with soap and water to remove all visible dust. Allow to
dry completely. Clean the wheels by running them 10-15 times over a Turkish towel soaked with soap and
water. This equipment cleaning is to be done outside the OT
Move the cleaned equipment into the OT
Wipe all surfaces (excluding the ceiling and walls up to the height the hands can reach) with highlevel
disinfectant
Allow to dry completely
Fog the OT with high-level disinfectant until a fog is seen in the air
Stop and remove the fogger and close the OT for at least one hour with any ventilation system/AC off
After 1-2 hours open the OT and take post fogging swabs. Change into OT dress, cap, mask and use sterile
gloves when performing the sampling. Only the person taking the samples should enter the OT.
Sample the following sites at the minimum
OT table upper surface
OT lights lower glass surface
Anesthesia machine (swab the area where medications are placed during use)
Sterile instruments trolley surface
Any two walls (sample sites above OT table height)
Floor (two samples on either side of the OT table
Air conditioner outlet louvers (if AC present)
After sampling close the OT. No one should enter the OT until next day
On second day, wear OT dress, footwear and cap; wipe all surfaces (including ceiling with a long handled
mop) once with soap water, allow drying and then wiping once with a high-level disinfectant
Keep OT closed for at least one hour with ventilation system/AC off
Repeat the OT swab sampling as mentioned above
On third day, repeat the entire procedure (third time) and sample the swabs (third sampling)
Wait for the OT swab reports. The OT can be used if all the three swabs reports show no growth of any
organisms OR sparse growth of skin commensals in any one out of nine swabs taken per sampling
In case growth of spore bearing organisms, pathogens (e.g. Staphylococcus aureus), aerobic gram negative
bacilli or fungus is seen, disinfectant wiping of the entire OT and fogging should be repeated and swabs
sampled again (once only)
