Improving patient area disinfection cleaning in 34 acute care hospitals
Abstract number: P1107
Objectives: It has become increasingly recognised that microbial contamination of the patient's immediate environment plays a significant role in the transmission of many healthcare associated pathogens. Despite the recent recommendation that hospitals experiencing increased transmission of MDROs ``Monitor (i.e., supervise and inspect) cleaning performance to ensure consistent cleaning and disinfection of surfaces in close proximity to the patient and likely to be touched by the patient and healthcare professionals'' (CDC 2006; Category 1B), there currently exists no practical means of evaluating and improving the effectiveness of these activities.
Methods: An invisible fluorescent targeting method was used to confidentially evaluate the cleaning of 14 standardised high-touch objects. Rooms were marked following terminal cleaning and re-evaluated after one to two patients had occupied the room and it had been again terminally cleaned.
Results: 1511 rooms and 19,361 objects were evaluated in 34 hospitals ranging in size from 25 to 721 beds. The mean proportion of objects cleaned was 48.5% (95% CI 42.9 to 47.5) prior to educational interventions. While sinks and toilet seats were relatively well cleaned (79.5%), consistently low rates of cleaning were documented for objects at high risk for microbial contamination including bedpan cleaners, toilet area handholds, bathroom and room doorknobs and bathroom light switches (23.3%). Following educational programs and process improvement feedback the cleaning of 448 rooms and 5386 objects were evaluated in the same manner. Overall thoroughness of cleaning improved to 77% (95% CI 78.5% to 89.2%) or 62% from baseline. All hospitals realised significant improvement over pre-intervention results (P 0.0001).
Conclusion: The use of an objective targeting method in 34 acute care hospitals disclosed substantial opportunities for improving room cleaning/disinfecting activities. Following educational interventions and ongoing performance feedback to the environmental services staff, highly significant enhancement of near-patient environmental cleaning was objectively documented in all hospitals.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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