ARTICLE
Volume 10,Issue 7
13 March 2026
Evidence-Based Plan for Environmental Cleaning of Operating Room: Impact on High-Frequency Contact Surfaces
Liping Feng ,
Ke Lin ,
Binfang Hong ,
Qingluan Duan ,
Yuying Wang ,
Qi Fan ,
Jing Bai ,
Chengxin Sun
Show Less
1
The Second Affiliated Hospital of Kunming Medical University, Kunming 650000, Yunnan, China,
2
The Second Affiliated Hospital of Kunming Medical University, Kunming 650000, Yunnan, China; Zhaotong Municipal Hospital of Traditional Chinese Medicine, Zhaotong 657000, Yunnan, China,
3
The Second Affiliated Hospital of Kunming Medical University, Kunming 650000, Yunnan, China; Dali University, Dali 671003, Yunnan, China,
4
The Second Affiliated Hospital of Kunming Medical University, Kunming 650000, Yunnan, China; Department of Anesthesia and Surgery, Chongqing University Three Gorges Hospital, Chongqing 404100, China,
JCNR 2026 , 10(2), 374–384;
https://doi.org/10.26689/jcnr.v10i2.14219
© 2026 by the Authors. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract
Objective: To develop an evidence-based plan for cleaning operating room and evaluate the impact on high-frequency contact surfaces. Method: The evidence application model of the JBI Evidence-Based Nursing Center was utilized to create a strategy, which was implemented in a tertiary-level hospital in Yunnan Province. The adenosine triphosphate (ATP) biological biofluorescence detection method was used to assess the quality of cleaning before and after the intervention. Results: A total of 17 quality review indicators were established in this study. Following the application of evidence, the implementation rate for 16 quality review indicators increased significantly, from a range of 0–71.6% to 85.3–100%. Moreover, the pass rate of ATP bioluminescence detection on high-frequency contact surfaces increased from 14.07% to 47.10%, with significant difference (p < 0.05). Conclusion: The evidence-based environmental cleaning program proved to enhance the overall cleanliness of operating room and reduce the risk of surgical infections. This strategy holds promise for effective cleaning of operating room.
References
Leaper D, Edmiston C, 2017, World Health Organization: Global Guidelines for the Prevention of Surgical Site Infection. Journal of Hospital Infection, 95(2): 135–136.
Link T, 2021, Guidelines in Practice: Environmental Cleaning. AORN Journal, 113(5): 487–499.
Link T, 2019, Guideline Implementation: Design and Maintenance of the Surgical Suite. AORN Journal, 109(4): 479–491.
Jennings J, Johnson R, Brady A, et al., 2017, Effectiveness of Manual Terminal Cleaning Varies on High-Touch Surfaces Near the Operative Field. Arthroplasty Today, 22: 53–57.
Balter S, Rodriguez M, Pike J, et al., 2021, Microbial Contamination Risk and Disinfection of Radiation Protective Garments. Health Physics, 120(2): 123–130.
National Health and Family Planning Commission, 2016, Management Code for Environmental Surface Cleaning and Disinfection in Medical Institutions (No. 23, 2016).
Link T, Kleiner C, Mancuso M, et al., 2016, Determining High Touch Areas in the Operating Room with Levels of Contamination. American Journal of Infection Control, 44(11): 1350–1355.
Branch R, Amiri A, 2019, Environmental Surface Hygiene in the OR: Strategies for Reducing the Transmission of Health Care–Associated Infections. AORN Journal, 112(4): 327–342.
Luo J, Gu S, 2020, Investigation and Analysis of Quality Monitoring of End-Bed Unit and Nursing High Frequency Contact Surface Cleaning. Chinese Nursing Administration, 20(10): 1577–1580.
Lu Y, Hu G, Li Y, et al., 2016, Evaluation of Cleaning and Disinfection Effect of Environmental Objects in Medical Institutions by ATP Biofluorescence Method. Chinese Journal of Disinfection, 33(6): 530–532.
Zhu Z, Hu Y, Xing W, et al., 2017, The Composition of Different Types of Evidence-Based Questions. Journal of Advanced Nursing, 32(21): 1991–1994.
Anderson D, Chen L, Weber D, et al., 2017, Enhanced Terminal Room Disinfection and Acquisition and Infection Caused by Multidrug-Resistant Organisms and Clostridium difficile (The Benefits of Enhanced Terminal Room Disinfection Study): A Cluster-Randomised, Multicentre, Crossover Study. Lancet, 389(10071): 805–814.
Dallolio L, Raggi A, Sanna T, et al., 2018, Surveillance of Environmental and Procedural Measures of Infection Control in the Operating Theatre Setting. International Journal of Environmental Research and Public Health, 15(1): 46.
Ministry of Health of the People’s Republic of China, 2016, Technical Specification of Disinfection in Medical Institutions.
Rutala W, Weber D, 2019, Best Practices for Disinfection of Noncritical Environmental Surfaces and Equipment in Health Care Facilities: A Bundle Approach. American Journal of Infection Control, 47: A96–A105.
Conner R, Spruce L, Burlingame B, et al., 2013, Recommended Practices for Environmental Cleaning in the Perioperative Setting. In: Perioperative Standards and Recommended Practices. Denver: Association of PeriOperative Registered Nurses: 243–254.
DiCenso A, Bayley L, Haynes R, 2009, Accessing Pre-Appraised Evidence: Fine-Tuning the 5S Model Into a 6S Model. Evidence Based Nursing, 12(4): 99–101.
Centers for Disease Control and Prevention, 2023, Guideline for Disinfection and Sterilization in Healthcare Facilities.
AORN, 2020, Guideline Quick View: Environmental Cleaning. AORN Journal, 111(2): 252–257.
Zhuang Y, Zou L, Zheng Y, et al., 2022, Application of Best Evidence for Stage I Cardiac Rehabilitation in Patients with Transcatheter Aortic Valve Replacement. Chinese Journal of Nursing, 57(5): 563–569.
Wolfhagen N, Boldingh Q, Boermeester M, et al., 2022, Perioperative Care Bundles for the Prevention of Surgical-Site Infections: Meta-Analysis. British Journal of Surgery, 109(10): 933–942.
Ling M, Ching P, Widitaputra A, et al., 2018, APSIC Guidelines for Disinfection and Sterilization of Instruments in Health Care Facilities. Antimicrobial Resistance & Infection Control, 7: 25.
Gao X, Hu B, Shen Y, et al., 2012, Investigation on Environmental Cleaning, Disinfection and Monitoring in 71 Hospitals in Shanghai. Chinese Journal of Hospital Infectiology, 22(12): 2606–2608.
Share
Back to top
Bio-Byword Scientific Publishing Pty. Ltd.
We are committed to supporting the scientific community by publishing impactful research and fostering effective communication among scientists. We continuously seek ways to accelerate scientific progress while upholding transparency and open dialogue. Our goal is to make knowledge freely and barrier‑free accessible to all.
Contact us: info@bbwpublisher.com
Level 10, 50 Clarence Street Sydney, NSW 2000 Australia