Perioperative nurses use aseptic and sterile technique along with standard cleaning and disinfection practices to prevent surgical site infections. At our hospital, OR team members identified a clinical problem: the lack of a systematic approach to determine the type of postprocedure cleaning required between procedures involving patients with multi- drug resistant organisms or Clostridium difficile. Facility leaders developed a project to design and implement an evidence- based decision- making algorithm to help perioperative nurses rapidly identify the appropriate environmental cleaning procedures for these ORs. After the perioperative nurses were taught how to use the algorithm, it was put into use. Nineteen months later, the nurses completed a postimplementation survey. The results of the survey were generally positive, and the cleaning process was more standardized. We found that a decision- making algorithm was an effective tool to determine the proper postprocedure environmental cleaning between surgical procedures for patients with multi- drug resistant organisms or C difficile.
Key words: infection prevention, multi-drug resistant organism, transmission-based precautions, terminal cleaning, algorithm.