Smart Solutions for Perioperative Infection Control

Advanced technologies are driving safer surgeries at ASCs.

Infection prevention and control (IPC) has always been an integral part of perioperative leadership. Over time, its focus shifted from reactive outbreak management to proactive prevention strategies that emphasize surveillance, education, disinfection, sterilization and environmental hygiene. This evolution has been driven by emerging threats, regulatory changes and technological innovation.

Throughout my career managing perioperative facilities, I’ve seen firsthand how even small lapses in IPC can result in major consequences. One particular incident stands out — a norovirus outbreak that sidelined nearly my entire team in just hours.

It started with a quiet evening at home. I felt fine all day, but by nightfall I was hit with severe gastrointestinal symptoms. The next morning, while recovering in bed, the calls began. First, a nurse manager requested overtime to cover a sick staff member. Then came a request to close an OR early due to additional callouts. By the third call, it was clear: “Staff are dropping like flies,” the manager reported.

Houston, we have a problem!

My head was a flurry of thoughts and plans for next steps as I provided the manager guidance for immediate actions and a plan for us to reconnect soon. From my bed, I coordinated an emergency response with our infection preventionist, employee health nurse, environmental services director and nursing supervisor. Most of our ORs were closed due to staffing shortages, and testing began immediately.

The investigation revealed a gap in environmental services coverage. Administrative areas hadn’t been disinfected due to a staffing change. Norovirus was identified as the culprit, likely spread via contaminated surfaces and poor hand hygiene. One major suspect? The OR control station phone, used by dozens daily before the widespread use of cell phones.

Ultimately, the outbreak led to canceled surgeries, workers’ comp claims and frustrated staff and patients. It was a wake-up call that IPC isn’t just about sterile processing, sterile technique and HVAC systems. It’s about every surface, every space and every person.

Today, the landscape of infection prevention and control looks very different. Just as cell phones revolutionized communication, advanced technologies are transforming how we approach IPC. Today’s infection preventionists should take a proactive and comprehensive approach to evaluating IPC practices throughout their facilities. This means not only reinforcing core strategies such as hand hygiene, sharps safety and proper cleaning of equipment, instruments and environmental surfaces, but also staying informed about emerging technologies that can enhance IPC efforts.

One such innovation is Ultraviolet-C (UV-C) disinfection. I first encountered UV-C more than a decade ago at a presentation that showcased a mobile unit that could disinfect entire ORs in a very short time. At the time, I was skeptical — there wasn’t enough data to justify the investment, and our surgical site infection rate was almost nonexistent. No need to fix what isn’t broken, I thought.

What is UV-C disinfection?

UV-C refers to a specific band of ultraviolet light (200 to 280 nm) that possesses germicidal properties. It works by disrupting the DNA or RNA of microorganisms — bacteria, viruses and fungi — rendering them unable to replicate or cause infection.

I was reintroduced to UV-C disinfection methods during the COVID-19 pandemic, when it became a daily tool. We used cabinet models to disinfect N95 masks, extending their usability during shortages. Over time, we expanded UV-C use throughout the facility. (I even adopted it personally by using UV-C inserts to disinfect my performance-trainer son’s gym shoes. They eliminated odor-causing bacteria and extended the life of the shoes. The cost? About the same as a good pair of athletic shoes.)

UV-C is no longer just a pandemic-era solution. It’s scalable, evidence-based technology that’s increasingly accessible to facilities. Whether you’re considering mobile units for ORs or smaller devices for high-touch areas, UV-C offers a powerful layer of protection. Here are its benefits and limitations to consider:

• Broad-spectrum efficacy: Proven to eliminate a wide range of pathogens by disrupting their DNA, making it effective against bacteria, viruses and fungi, including MRSA, C. difficile and norovirus.
• Chemical-free operation: Leaves no residue or odor and is safe for use around sensitive medical equipment.
• Rapid turnaround: Short disinfection cycles support faster room turnover and improved operational efficiency.
• Built-in compliance tools: Many systems offer automated reporting features to support audit readiness and regulatory compliance.
• Enhanced safety: Modern units are equipped with motion sensors and safety protocols to prevent accidental exposure.
• Flexible applications: Suitable for disinfecting everything from large ORs to small instruments and high-touch surfaces.
• Line-of-sight dependency: UV-C light must directly reach surfaces to be effective, which may leave shadowed areas untreated.
• Supplemental use only: UV-C is designed to enhance, not replace, manual cleaning and disinfection protocols.
• Investment and training required: Implementation depends on upfront costs and comprehensive staff education for proper usage and safety.

UV-C technology alone isn’t enough, however. IPC success still hinges on the fundamentals: hand hygiene, disinfection and sterilization, environmental cleaning, staff education and leadership vigilance. When paired with smart solutions like UV-C, however, these efforts become even more powerful.

In the quest to promote IPC in healthcare facilities, we must stay ahead of the curve. That means embracing innovation, learning from past events and continuously refining our strategies. The norovirus outbreak taught me that IPC is never done — it’s a living, evolving discipline. With the right tools and mindset, we can create safer surgical environments for everyone.

Looking to strengthen your infection prevention strategies with evidence-based education? Explore AORN ASC Academy’s Infection Prevention Online Course, which is designed to equip perioperative professionals with the knowledge and skills to keep patients and staff safe, maintain compliance with regulatory requirements, and develop and manage an effective infection control program. Visit aorn.us/ipc. OSM