Mrs. Michelle Bolte1, Ms Kymberly Watkins1
1Tamworth Rural Referral Hospital, Tamworth, Australia
Biography:
Michelle Bolte is a Clinical Nurse Consultant in Infection Prevention at Tamworth Rural Referral Hospital. She leads the Infection Prevention Connect program and has won ACIPC Best Poster awards in 2021, 2023, and 2024. Michelle is passionate about rural innovation, leadership development, and improving patient outcomes through evidence-based practice.
Abstract:
Environmental cleaning in operating theatres is a cornerstone of infection prevention, yet compliance is influenced by multiple interrelated factors. At the halfway point of a quality improvement project at a Rural Referral Hospital, a comprehensive review of cleaning practices has revealed a complex web of contributors to cleaning outcomes—what we call a “circle of influence.”
Key factors include stock placement and storage, staff education and awareness, structured cleaning schedules, equipment maintenance, and the physical theatre environment. Each element contributes to either reinforcing or undermining cleanliness standards. By acknowledging these interdependencies, the project shifts from isolated interventions to a systems-level approach.
Interventions to date include the introduction of a structured learning package during staff orientation, ongoing refresher training for current staff, improved maintenance of cleaning tools, and a redesign of stock management processes to reduce clutter and minimise airborne contaminants.
This evidence-informed approach draws equally from best practice guidelines and frontline staff experience—placing practice-based evidence at the heart of the strategy. The project's goal is to enhance understanding of the role environmental hygiene plays in reducing surgical site infections and to foster sustainable improvements through engaged, informed practice.
At this midpoint, early indicators suggest an increase in staff awareness, improved cleaning practices, and greater interdepartmental collaboration. This project exemplifies the power of aligning evidence-based protocols with lived clinical realities—strengthening both circles of influence for safer surgical environments.