William A. Rutala Research Award; Blue Ribbon Abstract Award: A Novel Method for Evaluating the Effectiveness of Environmental Cleaning/Disinfection in Healthcare Facilities

William A. Rutala Research Award; Blue Ribbon Abstract Award: A Novel Method for Evaluating the Effectiveness of Environmental Cleaning/Disinfection in Healthcare Facilities Pages E9-E10 J. Briggs*, P. Carling Close Close preview | Purchase PDF (62 K) | Related articles | Related reference work articles AbstractAbstract Abstract BACKGROUND/OBJECTIVES: Although the use of environmental disinfectants in conjunction with appropriate housekeeping 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 directly monitor such activities. METHODS: A nontoxic target solution which intensely fluoresces under a hand-held black light was formulated to be environmentally stable yet readily removed by housekeeping products. Small volumes of material were confidentially applied to target sites in patient care rooms following terminal cleaning. Marked rooms were subsequently evaluated following terminal cleaning after between one and three patients had occupied the room. A target site was considered “cleaned” if the target material was removed or substantially disturbed. RESULTS: Forty-four rooms and 339 targets were evaluated during two study periods, separated by 3 months. Although 40% of all targets were cleaned, a wide difference was observed between cleaning of toilet surfaces (92%), sinks (91%), toilet flush handles (85%), and tray tables (81%), compared to telephones (18%), bedpan cleaners (13%), call boxes (12%), doorknobs (4.7%), and toilet handholds (0%) (p<0.001). CONCLUSIONS: The use of a novel target compound to evaluate housekeeping and environmental management practices revealed high rates of cleaning of traditional sites but poor cleaning of many sites that have significant potential for harboring and transmitting microbial pathogens. The methodology has the potential for being used to objectively evaluate cleaning /disinfecting activities in hospitals.