Phenelle Segal, RN, CIC, is the president of Infection Control Consulting Services.
Q: One area where I consistently see a problem with cleaning involves the wheels on everything we use. I've seen bloody suture tails, pieces of tissue such as skin or fat, strips of plaster, dressing remnants, etc. And the problem is not in just one ambulatory surgery center, hospital or even geographical area; I have seen it in every place I've worked. What do we need to do to keep these wheels clean?
Phenelle Segal: As an infection control consultant, I would say that dirt and debris/protein material on wheels in a sterile suite is not aesthetically pleasing nor is it a comfortable thought as the environment does play a role in the spread of infection.
AORN's "Recommended Practices for Environmental Cleaning in the Perioperative Setting" goes into great detail about cleaning and addresses all aspects, including the risk of dust-carrying organisms, but it does not specifically address wheels on carts.
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As a consultant, I would tell a facility that has cruddy carts/wheels that they need to be replaced or cleaned regardless of the cost or manpower needed. I would not accept anything other than CLEANLINESS in an OR suite, and that includes the floor and wheels. We have to think about prevention of infection and the environment — more so now than ever — is implicated in transmission of organisms.
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