Remote Video Auditing to Verify OR Cleaning: A Quality Improvement Project

Abstract

There are many sources of contamination in the perioperative environment. Patient experience can be negatively affected by the presence of environmental contamination, especially if it is the cause of a surgical site infection. Perioperative and environmental services staff members and leaders are tasked with ensuring a clean and safe environment for their patients while maintaining an awareness of time and budgetary constraints. In addition, leaders are responsible for the competency of their staff members and must address performance issues when needed. New technological advances designed to streamline monitoring and reporting processes related to OR cleanliness are available for use. This article describes the quality improvement project that one multifacility organization completed related to the use of remote video auditing and the positive effect it had on the organization's environmental contamination.

Environmental cleaning and disinfection in the operating room: a systematic scoping review through a human factors and systems engineering lens

“…Neil et al 54 54 to formal training with group lessons and one-on-one coaching reviewing the features of operatingroom cleaning and disinfection. 55 Auditing with feedback and training reduced the number of visible contaminated surfaces by 97% 54 and sustained cleaning compliance 53 and thoroughness 55 increased to >90%. Furthermore, improvement in cleaning thoroughness was associated with a 10-year decline in overall healthcareacquired infection rates (by 75%), surgical-site infection rates (by 55%), and rates of hospital-acquired C. difficile (by 70%).…”

“…According to the SEIPS-based analysis, 20 of the 28 studies focused on tools and technologies: 12 on ultraviolet disinfection systems, [30][31][32][33][34][35][36][37][38][39][40][41] 4 on disinfectant fogging systems, [42][43][44][45] 2 on chemical surface disinfectants, 46,47 and 2 on other cleaning tools. 48,49 The remaining 8 studies investigated interventions adapting cleaning and disinfection tasks, [50][51][52] implementing cleaning and disinfection audit and feedback/training systems, [53][54][55] or targeting multiple work-system factors (ie, multifaceted interventions). 56,57 Ultraviolet disinfection systems Different ultraviolet disinfection systems were examined to improve operating-room disinfection, including pulsed xenon-based ultraviolet-C lights, [33][34][35]38,39 continuous ultraviolet-C lights, 36 a proprietary focused multivector ultraviolet technology, 30,32 ultraviolet lightemitting diodes, 40 low-intensity ultraviolet lights, 37 and continuous near ultraviolet lights.…”

Data-Driven Technologies as Enablers for Value Creation in the Prevention of Surgical Site Infections: a Systematic Review

“…Out of the 59 reviewed articles, 31 described methods or techniques based on DDTs to prevent SSIs, without developing or launching any new technology. For example, Armellino et al [76] developed an auditing method based on remote monitoring to assess compliance with good cleaning practices in operating rooms, while Campillo-Gimenez et al [56] proposed a model to compare the advantages of data mining techniques with manual surveillance methods. Therefore, these solutions can be classified in the TRL1 level, where basic principles are observed and reported through primary research.…”

“…Procedure-related data refers to the data that is directly or indirectly related to the healthcare staff behaviour and can influence in the SSI incidence. Direct behavioural data is obtained by the monitoring of routines, such as cleaning procedures [76], duration of surgical procedures [58], and staff movements in the operating room [94]. Indirect behavioural data is obtained by the monitoring of environmental conditions that are affected by human actions, such as the air quality in the operating room [82] and the level of noise during surgical procedures [54].…”

Decreasing Surgical Procedure–Related Infections Using Culture, Collaboration, and Communication

“…Furthermore, there is a focus on consistency and standardization that is dependent on the OR culture. The article “Remote video auditing to verify OR cleaning: a quality improvement project” by Armellino et al examines high reliability and consistency of end‐of‐day OR cleaning using remote video auditing with feedback. This innovative technique allows for consistent measurement of compliance with end‐of‐day cleaning practices, timely feedback, and standardization of practice.…”