Environment of Care

Purpose

This document provides guidance for maintaining a safe environment of care for patients and perioperative personnel. The recommendations include information on

• clinical alarms and alert alarms,

• occupational injuries (ie, slips, trips, and falls),

• fire safety,

• electrical equipment,

• blanket and fluid warming cabinets,

• medical gas cylinders,

• waste anesthetic gases,

• a latex-safe environment,

• hazardous chemicals, and

• waste management.

The following topics are outside the scope of this document:

• chemotherapeutic agents and disposal of medications (See the AORN Guideline for Medication Safety¹ );

• environmental stewardship (See the AORN Guideline for Design and Maintenance of the Surgical Suite²  and the AORN Position Statement on Environmental Responsibility³ )

• heating, ventilation, and air conditioning (See the AORN Guideline for Design and Maintenance of the Surgical Suite² );

• use of lifting equipment and moving patients (See the AORN Guideline for Safe Patient Handling and Mobility⁴ );

• noise and distractions (See the AORN Guideline for Team Communication⁵  and the AORN Position Statement on Managing Distractions and Noise During Perioperative Patient Care⁶ );

• patient injuries related to incorrect tubing connections (See the AORN Guideline for Medication Safety¹ );

• personnel injuries related to exposure to bloodborne pathogens (See the AORN Guideline for Transmission-Based Precautions⁷  and Guideline for Sharps Safety⁸ );

• product evaluation (See the AORN Guideline for Medical Device and Product Evaluation⁹ );

• radiation safety (See the AORN Guideline for Radiation Safety¹⁰ );

• handling and disposal of radionuclides and radiopharmaceuticals (See the AORN Guideline for Radiation Safety¹⁰ );

• sterilization methods using hydrogen peroxide, peracetic acid, ozone, and ethylene oxide (See the AORN Guideline for Sterilization¹¹ );

• high-level disinfectants and liquid chemical sterilants used for processing flexible endoscopes (See the AORN Guideline for Processing Flexible Endoscopes¹²  and Guideline for Manual High-Level Disinfection¹³ )

• surgical smoke (See the AORN Guideline for Surgical Smoke Safety¹⁴ ); and

• workplace violence (eg, active shooter, lateral violence).