Evaluation of disinfection of surfaces at an outpatient unit before and after an intervention program (original) (raw)
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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.
Effectiveness of clinical surface cleaning and disinfection: evaluation methods
Revista Brasileira de Enfermagem
Objective: To discuss the methods employed to evaluate the effectiveness of clinical surface cleaning and disinfection (C&D). Method: This is a theoretical reflection based on scientific studies and the experience of the authors. Knowledge and current gaps, the need for further studies, and practical application of the methods were approached. Results: There are four main methods used to evaluate the effectiveness of clinical surface C&D: visual inspection, fluorescent markers, microbiological cultures, and adenosine triphosphate (ATP) bioluminescence. The first two are used to evaluate the process and to predict adherence to protocols by the staff, and the last two are employed to evaluate the results, therefore being the most relevant to assess the risk of infection. Final considerations: The ideal method was not found, because all of them showed limitations. There is a need for strategies to optimize the precision of these methods.
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 ...
Effectiveness of Surface Cleaning and Disinfection in a Brazilian Healthcare Facility
The open nursing journal, 2018
Failures in the processes of cleaning and disinfecting health service surfaces may result in the spread and transfer of pathogens that are often associated with healthcare-related infections and outbreaks. To assess the effectiveness of environmental surface cleaning and disinfection in a hospital clinic. The study was conducted in a nursing ward with 45 beds. A total of 80 samples from five high-touch surfaces were evaluated before and after cleaning and disinfection, using the following methods: visual inspection, adenosine triphosphate bioluminescence assay, aerobic colony count, colony count, and evaluation of resistance to methicillin. The data analysis used nonparametric comparative and correlative tests to observe any differences in the pre- and post- cleaning and disinfection results for the surfaces assessed. Effective cleaning and disinfection had a significant effect on only two surfaces when measured for the presence of adenosine triphosphate, the inner bathroom door han...
Efficiency of cleaning and disinfection of surfaces: correlation between assessment methods
Revista brasileira de enfermagem
to assess the correlation among the ATP-bioluminescence assay, visual inspection and microbiological culture in monitoring the efficiency of cleaning and disinfection (C&D) of high-touch clinical surfaces (HTCS) in a walk-in emergency care unit. a prospective and comparative study was carried out from March to June 2015, in which five HTCS were sampled before and after C&D by means of the three methods. The HTCS were considered dirty when dust, waste, humidity and stains were detected in visual inspection; when ≥2.5 colony forming units per cm2 were found in culture; when ≥5 relative light units per cm2 were found at the ATP-bioluminescence assay. 720 analyses were performed, 240 per method. The overall rates of clean surfaces per visual inspection, culture and ATP-bioluminescence assay were 8.3%, 20.8% and 44.2% before C&D, and 92.5%, 50% and 84.2% after C&D, respectively (p<0.001). There were only occasional statistically significant relationships between methods. the methods d...
Correlation between cleaning/disinfection surface monitoring methods in primary health care
2017
800x600 ABSTRACT Objective : to evaluate the correlation between the monitoring methods (visual inspection, adenosine triphosphate, and colony forming units) of the process of cleaning and disinfecting surfaces of a Family Health Strategy. Method : this is a prospective, analytical study with a quantitative approach. Data analysis was driven by Spearman correlation tests , Fisher exact test and receiver operating characteristic (ROC) curve. The choice of surfaces with a high frequency of contact with patients or professionals was chosen . Correlation evaluations considered the results of cleaning monitoring methods before and after performing cleaning/disinfection of five surfaces. Results : a significant correlation between ATP quantification and aerobic microbial counts was observed only for the patient´s bed surface (r=0.649, P=0.001). The accuracy of the visual inspection was low, so it would not be the ideal method to evaluate surface cleaning. Conclusion : there was a signific...
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
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.
Improving Cleaning of the Environment Surrounding Patients in 36 Acute Care Hospitals •
Infection Control and Hospital Epidemiology, 2008
Objective. The prevalence of serious infections caused by multidrug-resistant pathogens transmitted in the hospital setting has reached alarming levels, despite intensified interventions. In the context of mandates that hospitals ensure compliance with disinfection procedures of surfaces in the environment surrounding the patient, we implemented a multihospital project to both evaluate and improve current cleaning practices. Design. Prospective quasi-experimental, before-after, study. Setting. Thirty-six acute care hospitals in the United States ranging in size from 25 to 721 beds. Methods. We used a fluorescent targeting method to objectively evaluate the thoroughness of terminal room disinfection cleaning before and after structured educational and procedural interventions. Results. Of 20,646 standardized environmental surfaces (14 types of objects), only 9,910 (48%) were cleaned at baseline (95% confidence interval, 43.4-51.8). Thoroughness of cleaning at baseline correlated only...