Operating Room Terminal Cleaning Notes

Objectives

Safely handle soiled linen
Safely dispose of medical and nonmedical waste
Perform high dusting
Clean high touch surfaces
Clean the Operating Room table
Clean the ceiling and walls
Clean the Operating Room floor
Accurately check and inspect your work

Roles, Access, and Room Setup

The circulator generally gives direction to enter the Operating Room once the case is over and the room is clear.
When directed, move your cart to just outside the Operating Room that you will clean. Do not roll your cart into the room. Stage it just outside the door for the cleaning process.
This cart and equipment is for operating room cleaning only, and should not be used in any other area of the hospital.

Personal Protective Equipment (PPE) and Entry Protocol

Your personal safety is of the utmost importance. Always wear the appropriate PPE: scrubs, shoe covers, hair covering, and a mask with eye protection.
All jewelry and personal effects should be left in your locker.
Thoroughly wash your hands and arms before entering the Operating Room to prevent possible shedding of skin or hair.
An alternative is to wear a long sleeve warm up jacket that is buttoned or snapped closed.
Once you have put on a fresh set of gloves, you are ready to enter the Operating Room.
The Operating Room door should remain closed while you clean the room.

Linen Handling and Initial Containment

Begin by rolling a Rubbermaid linen hamper up to the Operating Room table.
Fold the linen corners into the middle of the table, forming a small bundle.
Lift the bundle so that it does not touch your body, and place it into the linen hamper.
Remember, treat all linen as though it could contain sharps or medical waste.
After securing the top closures, pick up the used suction container from the suction carousel, and place it into the kick bucket.
The kick bucket should be double lined with red medical waste polyliners.
Gather the inner liner, roll the outer liner down, and securely double tie it before removing the liners from the kick bucket.
Always carry waste away from your body. Lift the liners and take them out of the Operating Room to the central pickup point for medical waste.
Remember, always treat every bag of waste as if it could have a sharp object in it.
Reline the kick bucket with two red medical liners. We recommend using a Rubbermaid Lobby Pro dustpan and cleaning wand to gather and pick up large debris on the floor.
The squeegee wand is preferred over a traditional broom in an Operating Room because it does not create airborne particles, is easier to clean and disinfect, and can gather both wet and dry waste.
Once all debris is collected into the dustpan, easily dump it into a Rubbermaid step-on container that has been lined with the red medical waste bag.

General Waste Handling and Waste Segregation

Gather all other waste from the Operating Room by picking up trash around waste containers.
After all trash is collected, roll the poly liner closed and double tie the top for disposal.
Never compress waste materials down into the container with your hands (a sharp item could be in the waste container).
Always treat all waste as if it contains sharps. Handle waste for the least amount of time possible, and carry the bags away from your body.
After emptying a waste container, reline it with the correct size and color poly liner as directed by your supervisor. Secure the liner in place by tying a knot in one of the corners.
Do not mix general polybag waste (identified by a see-through or translucent liner) with red bag medical waste; these two types are handled differently and have different disposal costs.

High Dusting: Tools and Techniques

We recommend the Rubbermaid Hygiene flexible dusting wand, a high performance dusting sleeve, and an adjustable length handle for high dusting.
Start by attaching the flexible wand to the adjustable length handle.
Bend the flexible wand to the desired shape, and extend the handle to the desired height.
Begin by cleaning the boom arm for the light, and any other equipment suspended from the ceiling.
Always start at the highest point, and work your way down. While dusting at the ceiling level, clean all fixtures and hoses that would normally be out of reach. Hoses are frequently missed and can shed dust and lint when moved during surgery.
Finally, bend the flexible wand to help dust across the top of all cabinets and shelves.
For high touch areas, use the green Rubbermaid Hygiene microfiber cloth.

High Touch Surface Cleaning – Microfiber Cloths and Cloth Care

Bring the green five-quart pail of microfiber cloths into the Operating Room. These cloths have been pre-moistened in cleaning solution. Directions for preparing the cloths can be found in the cart preparation chapter.
Remove a green microfiber cloth from the pail, and wring out any excess cleaning solution.
Start with the overhead arm: reach up to the point farthest from the light, and wipe down all surfaces with the green cloth.
Pivot the light fixture so the top surface faces you, and continue cleaning. Turn and fold the cloth frequently for optimal results. Blood or bodily fluids on the light should be scrubbed to thoroughly clean the surface.
Repeat these steps on the second overhead light.
Continue using the green cloth to clean the work tables and Mayo stand surfaces. Frequently turn the cloth using the eight-sided fold method (details in the Rubbermaid hygiene product use manual).
Thoroughly clean all surfaces of the Mayo stands and tables, including legs and base. Turn the cloth frequently. Be mindful of the underside of tables and stands and their legs. Use smooth side-to-side wiping motions for complete coverage.
Never place a used microfiber cloth back into a pail to avoid cross contamination.
When finished with the cloth, place it in the linen bag for laundering.
For glass or reflective surfaces, use the light blue Rubbermaid Hygiene microfiber cloth, damp or dry for streak-free cleaning.
For cleaning the operating table, use the red microfiber cloth from the red pail. Remove one red cloth, use the eight-side fold method to maximize cloth usage.
To effectively clean the operating table, disassemble and move its attachments to thoroughly inspect and clean all surfaces. Start by washing the top, sides, and bottom of the table pads. Do not stack a cleaned pad on an unclean surface. Wipe down the top and bottom of each removable component as you lift it from the base.
Always wipe the area of the bed beneath removable platforms before reinstalling them. With practice, this becomes second nature. Frequently turn the cloth during cleaning.
After cleaning the surface of the operating table, clean the base area, including the legs and casters. When finished, place the red microfiber cloth in your laundry bag, and return the pails to the cleaning cart.
We recommend Rubbermaid Hygiene 18 inches wet mop, 18 inches frame, an adjustable length handle, and a charging bucket for wall and ceiling cleaning.
The yellow charging bucket contains microfiber damp mops that have been pre-moistened with supervisor-approved cleaning solution. Directions for preparing wet mops are in the cart preparation chapter and the product use manual.
Open the lid of the bucket, and press the 18 inch frame down onto the top microfiber pad to secure it to the frame via a hook-and-loop attachment.
Extend the handle to reach the ceiling. Clean the ceiling by pulling the mop from one end of the room to the other with straight strokes. Be careful not to snag fixtures or sprinkler heads. Each mop should cover approximately 250 ext{ ft}^2. To remove a mop when finished, step on the edge of the mop and the edge of the frame with your other foot, then lift. Place the used mop in the linen bag for laundering.
Rubbermaid hygiene damp mops and cloths are bleach-safe, which is helpful after cases where a patient may have had C. difficile or another pathogen requiring chlorine bleach to disinfect.
To clean walls, pick up a new damp mop from the charging bucket, and start at the ceiling. Clean in a top-to-bottom pattern with smooth vertical strokes, keeping the mop in contact with the wall. Next, clean the lower half of the wall with long horizontal strokes in a side-to-side pattern, keeping the mop in contact with the wall. Never let the mop contact the floor. Shorten the handle for better control. The final step is to mop across the baseboard. When finished, place the wet mop in the linen bag for laundering.

Wall Cleaning and Floor Cleaning – Walls, Baseboards, and Ceiling

For terminal cleaning, move all furnishings and equipment to one side of the room. Have a floor plan discussed with your supervisor.
Use a floor scrubber on the open half of the floor following the manufacturer’s directions. Then move furnishings and equipment to the other side, rolling casters through the cleaning solution and using the floor scrubber on the other half.
When the floor is dry, move all furnishings and equipment back to their starting point.
Take a final look at the room to check for any missed spots.
Review the cleaning process checklist to ensure no steps were missed.
A green Rubbermaid Hygiene cloth is perfect for last-minute touch-ups on frequently touched items like the phone, light switch, wall-mounted panels, and door handles.
Never place a used cloth back into a pail; place used cloths in the linen bag for laundering.

Final Steps – PPE Removal, Hand Hygiene, and Verification

Properly remove and dispose of your personal protective equipment.
Let the circulator know you have completed the terminal cleaning of the operating room.
Before moving to the next operating room, thoroughly wash your hands. Hand washing is one of the most important things you can do to reduce cross transmission.
Handwashing steps:
- Wet your hands thoroughly before applying soap.
- Lather your hands, wrists, and fingers with soap for at least 20 ext{ s}.
- Rinse all surfaces of your wrists, hands, and fingers.
- Dry your hands and wrists with a clean, dry paper towel, and dispose of the towel.
Your facility may have different cleaning procedures. If you have any questions, ask your supervisor.

Notes on Safety, Ethics, and Real-World Relevance

Treat all linen and waste as potentially contaminated; always shield your body when handling waste and linens.
Maintain separation of waste streams to control disposal costs and environmental impact.
Use appropriate disinfectants and PPE to minimize cross-contamination and pathogen transmission (e.g., C. difficile considerations).
Follow your facility’s specific cart preparation and product use manuals; consult supervisors if uncertain.
These procedures emphasize a stepwise, top-down cleaning approach to ensure no areas are overlooked and to reduce risk to staff and subsequent patients.