Improving Cleaning of the Environment Surrounding Patients in 36 Acute Care Hospitals • (original) (raw)
Related papers
BMJ Quality Improvement Reports, 2014
Traditional environmental cleaning monitoring through visual assessment can identify gross lapses in practice. However, in recent years the limitations underlying this need for ongoing compliance with cleaning and disinfection policies in the patient's immediate surroundings have become widely recognised. The value of objectively monitoring and improving environmental cleaning and disinfection in healthcare settings is becoming increasingly identified as a crucial element of strategies to mitigate the transmission of healthcare-associated infections. Mafraq Hospital has adopted a new method using an invisible fluorescent marker system to target on surfaces in patient's immediate surroundings. Evaluation of at least 30 surfaces and objects in patient rooms revealed that only 11% of targets had been cleaned. Simulation training, educational interventions, empowerment, change involvement and acknowledgment were executed, leading to a sustained improvement of 77% in both quarter 2 and 3 of 2013 in cleaning and disinfecting of all surfaces and objects. Problem Patients with pathogens (eg, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, Acinetobacter) frequently contaminate environmental surfaces in their immediate surroundings. These organisms can remain viable in the environment for weeks and months. Items in patients' immediate vicinity are frequently contaminated, such as bed rails, bed linen, overbed tables, blood pressure cuffs, TV remote control, nurse call buttons, etc.[1,2,3] Baseline measurement The infection preventionists conducted a literature review to analyse the evidence-based practices that led to improved environment
Cleaning Hospital Room Surfaces to Prevent Health Care-Associated Infections A Technical Brief
The cleaning of hard surfaces in hospital rooms is critical for reducing health care-associated infections. This review describes the evidence examining current methods of cleaning, disinfecting, and monitoring cleanliness of patient rooms, as well as contextual factors that may affect implementation and effectiveness. Key informants were interviewed, and a systematic search for publications since 1990 was done with the use of several bibliographic and gray literature resources. Studies examining surface contamination, colonization, or infection with Clostridium difficile, methicillin-resistant Staphylococcus aureus, or vancomycinresistant enterococci were included. Eighty studies were identified-76 primary studies and 4 systematic reviews. Forty-nine studies examined cleaning methods, 14 evaluated monitoring strategies, and 17 addressed challenges or facilitators to implementation. Only 5 studies were randomized, controlled trials, and surface contamination was the most commonly assessed outcome. Comparative effectiveness studies of disinfecting methods and monitoring strategies were uncommon. Future research should evaluate and compare newly emerging strategies, such as self-disinfecting coatings for disinfecting and adenosine triphosphate and ultraviolet/fluorescent surface markers for monitoring. Studies should also assess patient-centered outcomes, such as infection, when possible. Other challenges include identifying high-touch surfaces that confer the greatest risk for pathogen transmission; developing standard thresholds for defining cleanliness; and using methods to adjust for confounders, such as hand hygiene, when examining the effect of disinfecting methods.
Cleaning Hospital Room Surfaces to Prevent Health Care–Associated Infections
The cleaning of hard surfaces in hospital rooms is critical for reducing health care-associated infections. This review describes the evidence examining current methods of cleaning, disinfecting, and monitoring cleanliness of patient rooms, as well as contextual factors that may affect implementation and effectiveness. Key informants were interviewed, and a systematic search for publications since 1990 was done with the use of several bibliographic and gray literature resources. Studies examining surface contamination, colonization, or infection with Clostridium difficile, methicillin-resistant Staphylococcus aureus, or vancomycinresistant enterococci were included.
An evaluation of patient area cleaning in 3 hospitals using a novel targeting methodology
American Journal of Infection Control, 2006
Background: Although environmental cleaning and disinfecting practices have become a cornerstone of patient care, assessment of actual compliance with such procedures has not been reported. Using a novel methodology, we developed a means to monitor directly such activities. Methods: A nontoxic target solution, which intensely fluoresces with a black light, was formulated to be inconspicuous yet readily removed by housekeeping products. Small volumes of material were confidentially applied to 12 target sites in patient rooms in 3 hospitals following terminal cleaning. The targets were reevaluated following terminal cleaning after several patients had occupied the room. Results: One hundred fifty-seven rooms and 1404 targets were evaluated. In the 3 hospitals studied, only 45%, 42%, and 56% of targets were removed by routine terminal cleaning/disinfecting activities. The frequency with which various individual sites were cleaned varied widely but was similar in all hospitals. Conclusion: The use of a novel target compound to evaluate housekeeping practices confirmed high rates of cleaning of traditional sites but poor cleaning of many sites that have significant potential for harboring and transmitting microbial pathogens. This methodology has the potential for being used to evaluate objectively the cleaning/disinfecting activities in various health care settings.
Journal of Hospital Administration, 2019
Background: Healthcare associated infections are a leading cause of illness and death in the United States and across the world. Environmental surfaces are considered non-critical, although recent evidence suggests that the built environment may contribute to the transmission of pathogens. Ineffective cleaning and disinfecting of environmental non-critical surfaces may increase risk of transmitting nosocomial pathogens leading to hospital acquired infections among hospital patients.Objective: This systematic review identifies elements of cleaning and disinfecting protocols, synthesizing the evidence to evaluate cleaning protocols that effectively reduce surface contamination and minimize risk of hospital acquired illness.Methods: A systematic literature review was conducted with a clearly formulated research question and systematic approach to identify publications, select relevant studies, critically appraise the research through analysis of reported data, and reported the results ...
Correlation Between Surface Cleaning and Disinfection Methods in an Emergency Room
2021
To evaluate the correlation between microbiological culture, ATP tests by bioluminescence and visual inspection for monitoring the surface cleaning and disinfection in an emergency room. Methods: This is a prospective, analytical study with a quantitative approach. Data analysis was guided by the following tests: Spearman's correlation, Fisher 's exact test and receiver operating characteristic (ROC) curve. Results: There was a correlation between ATP quantification methods and microbial count for the women's bathroom door handle (ρ = 0.526; p= 0.008). In this study, considering the ROC curve, the ATP value below 20 RLU is suggested to classify surfaces as approved in the emergency room. Conclusion: Using different methods of monitoring the cleaning and disinfection process is essential, considering that each method has a different purpose.
BMC Infectious Diseases
Background: Cleaning and disinfection processes must be improved so that there is a reduction in environmental contamination of frequent-contact surfaces. The objective of this study was to evaluate cleaning and disinfection of surfaces at a specialized healthcare unit after an intervention program. Methods: Exploratory, longitudinal, and correlational study carried out in a medium-complexity clinic. Two hundred and forty samples from five surfaces were collected during three phases: diagnosis; implementation of an intervention program; and evaluation of immediate and long-term effects. In total, 720 evaluations were made, performed through three monitoring methods: visual inspection; adenosine triphosphate bioluminescence assay (ATP); and aerobic colony count (ACC). The Wilcoxon, Mann-Whitney, and Fisher's Exact tests were run to analyze data statistically. Results: Cleaning and disinfection of surfaces were not being performed properly in most cases. Failure rates of surfaces reached 37.5 and 100% when the ATP and ACC procedures were used, respectively. However, after an intervention program, an improvement occurred. Success rates increased by 43.96% (ATP) and 12.46% (ACC) in phase I, by 70.6% (ATP) and 82.3% (ACC) immediately after interventions, and by 76.52% (ATP) and 85.76% (ACC) two months after the changes, showing that the program was effective. Conclusion: The present study reveals that implementing intervention actions with a cleaning and healthcare team brings benefits to prevent the spread of pathogenic agents through frequently touched hospital surfaces.
Infection Control & Hospital Epidemiology, 2008
Objectives.To evaluate the adequacy of discharge room cleaning and the impact of a cleaning intervention on the presence of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) on environmental surfaces in intensive care unit (ICU) rooms.Design.Prospective environmental study.Setting and sample.Convenience sample of ICU rooms in an academic hospital.Methods and intervention.The intervention consisted of (1) a change from the use of pour bottles to bucket immersion for applying disinfectant to cleaning cloths, (2) an educational campaign, and (3) feedback regarding adequacy of discharge cleaning. Cleaning of 15 surfaces was evaluated by inspecting for removal of a preapplied mark, visible only with an ultraviolet lamp (“black light”). Six surfaces were cultured for MRSA or VRE contamination. Outcomes of mark removal and culture positivity were evaluated by X2 testing and generalized linear mixed models, clustering by room.Results.The black-lig...