Methods to evaluate environmental cleanliness in healthcare facilities

Mitchell, Brett G; Wilson, Fiona; Dancer, S.J.; McGregor, Alistair

doi:10.1071/hi12047

Cited by 56 publications

(60 citation statements)

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“…After these benchmarks have been established, routine monitoring should be able to highlight problem areas or trends illustrating the dynamic balance between hospital cleanliness, staff deficit, and workload. Most importantly, awareness of a sudden accumulation of soil might initiate extra cleaning before patients are exposed to a risk of infection or even an outbreak (42,238,240). As previously stated, several studies have already shown the association between bioburden on health care surfaces and HAI rates, whether due to overall HAI or specific pathogens (42,43,45,63,74,253).…”

Section: Atp Bioluminescence Systemsmentioning

confidence: 75%

“…Collecting data using microbiological and chemical tools provides an opportunity to choose an appropriate benchmark for routine surface monitoring. This benchmark should signify whether hospital cleanliness levels indicate a clinical infection risk or not (42,240). Health care staff, including housekeepers, would welcome an evidence-based cleanliness standard, thus allowing them to review, change, or target cleaning practices before an outbreak becomes inevitable (1).…”

Section: How To Measure Cleanlinessmentioning

confidence: 99%

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Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

2014

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SUMMARY There is increasing interest in the role of cleaning for managing hospital-acquired infections (HAI). Pathogens such as vancomycin-resistant enterococci (VRE), methicillin-resistant Staphylococcus aureus (MRSA), multiresistant Gram-negative bacilli, norovirus, and Clostridium difficile persist in the health care environment for days. Both detergent- and disinfectant-based cleaning can help control these pathogens, although difficulties with measuring cleanliness have compromised the quality of published evidence. Traditional cleaning methods are notoriously inefficient for decontamination, and new approaches have been proposed, including disinfectants, steam, automated dispersal systems, and antimicrobial surfaces. These methods are difficult to evaluate for cost-effectiveness because environmental data are not usually modeled against patient outcome. Recent studies have reported the value of physically removing soil using detergent, compared with more expensive (and toxic) disinfectants. Simple cleaning methods should be evaluated against nonmanual disinfection using standardized sampling and surveillance. Given worldwide concern over escalating antimicrobial resistance, it is clear that more studies on health care decontamination are required. Cleaning schedules should be adapted to reflect clinical risk, location, type of site, and hand touch frequency and should be evaluated for cost versus benefit for both routine and outbreak situations. Forthcoming evidence on the role of antimicrobial surfaces could supplement infection prevention strategies for health care environments, including those targeting multidrug-resistant pathogens.

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Section: Atp Bioluminescence Systemsmentioning

confidence: 75%

Section: How To Measure Cleanlinessmentioning

confidence: 99%

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

2014

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“…For the aerobic colony counting (ACC), an electronic and digital colony counter was used (Logen ® LS6000). The surfaces were considered clean when the ACC was <2.5 CFU/cm 2 , that is, <60 CFU/plate (3,(9)(10) .…”

Section: Microbiological Culturesmentioning

confidence: 99%

“…The plates were labeled, pressed for 10 seconds against the surfaces at ~25 g/cm 2 , without any sideways movement, and incubated at 37ºC for 24-48h (6,(10)(11) . For the aerobic colony counting (ACC), an electronic and digital colony counter was used (Logen ® LS6000).…”

Section: Microbiological Culturesmentioning

confidence: 99%

“…Microbiological cultures present great sensitivity and specificity, but they take time. They are expensive and require different equipment and supplies, a microbiology laboratory and specialized staff (2) . Over the last decade, the measurement of organic adenosine triphosphate (ATP) in HTCS with ATP-bioluminescence assay gained popularity, due to its speed, objectivity, sale, provision of quantitative data, possibility of immediate feedback on results and ability to improve C&D practices with a minor level of technical training.…”

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Efficiency of cleaning and disinfection of surfaces: correlation between assessment methods

et al. 2017

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Approval: 02-02-2017 ABSTRACT Objective: 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. Method: 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. Results: 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. Conclusion: the methods did not present a good correlation, neither quantitative nor qualitatively. Descriptors: Equipment Contamination; Housekeeping; Nursing Audit; Health Facility Environment; Infectious Disease Transmission. RESUMO Objetivo: avaliar a correlação do teste de ATP-bioluminescência com inspeção visual e cultura microbiológica na monitorização da eficiência da limpeza e desinfecção (L&D) de superfícies clínicas altamente tocadas (SCAT) em unidade de pronto atendimento. Métodos: estudo comparativo, prospectivo, conduzido de março a junho de 2015, de forma que cinco SCAT foram amostradas antes e depois da L&D de rotina pelos três métodos. As SCAT foram consideradas sujas quando apresentaram: na inspeção visual, poeira, dejetos, umidade e manchas; na cultura, ≥2,5 unidades formadoras de colônias por cm 2 e; no ATP-bioluminescência, ≥5 Unidades Relativas de Luz por cm 2 . Resultados: foram realizadas 720 avaliações, sendo 240 por método. A taxa global de superfícies limpas por inspeção visual, cultura e ATP-bioluminescência foi, respectivamente, de 8,3%, 20,8% e 44,2% antes da L&D e de 92,5%, 50% e 84,2% após (p<0,001). Houve apenas associações pontuais estatisticamente significativas entre os métodos. Conclusão: os métodos nem apresentaram boa correlação quantitativa, nem, qualitativa. Efficiency of cleaning and disinfection of surfaces: correlation between assessment methods Frota OP, et al.

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Cleaning and decontamination of the healthcare environment

Hall

Mitchell

2020

Decontamination in Hospitals and Healthcare

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Methods to evaluate environmental cleanliness in healthcare facilities

Cited by 56 publications

References 54 publications

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

Controlling Hospital-Acquired Infection: Focus on the Role of the Environment and New Technologies for Decontamination

Efficiency of cleaning and disinfection of surfaces: correlation between assessment methods

Cleaning and decontamination of the healthcare environment

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