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Decreasing Operating Room Environmental Pathogen Contamination through Improved Cleaning Practice

Published online by Cambridge University Press:  02 January 2015

L. Silvia Munoz-Price
Affiliation:
Department of Medicine, University of Miami, Miami, Florida Department of Epidemiology and Public Health, University of Miami, Miami, Florida Jackson Memorial Hospital, Miami, Florida
David J. Birnbach
Affiliation:
Department of Epidemiology and Public Health, University of Miami, Miami, Florida Department of Anesthesiology, University of Miami, Miami, Florida
David A. Lubarsky
Affiliation:
Department of Anesthesiology, University of Miami, Miami, Florida
Kristopher L. Arheart
Affiliation:
Department of Epidemiology and Public Health, University of Miami, Miami, Florida Division of Biostatistics, University of Miami, Miami, Florida
Yovanit Fajardo-Aquino
Affiliation:
Jackson Memorial Hospital, Miami, Florida
Mara Rosalsky
Affiliation:
Jackson Memorial Hospital, Miami, Florida
Timothy Cleary
Affiliation:
Department of Pathology, University of Miami, Miami, Florida
Dennise DePascale
Affiliation:
Jackson Memorial Hospital, Miami, Florida
Gabriel Coro
Affiliation:
Jackson Memorial Hospital, Miami, Florida
Nicholas Namias
Affiliation:
Department of Surgery, Miller School of Medicine, University of Miami, Miami, Florida
Philip Carling
Affiliation:
Carney Hospital and Boston University School of Medicine, Boston, Massachusetts Boston University School of Medicine, Boston, Massachusetts
Corresponding
E-mail address:

Abstract

Objective.

Potential transmission of organisms from the environment to patients is a concern, especially in enclosed settings, such as operating rooms, in which there are multiple and frequent contacts between patients, provider's hands, and environmental surfaces. Therefore, adequate disinfection of operating rooms is essential. We aimed to determine the change in both the thoroughness of environmental cleaning and the proportion of environmental surfaces within operating rooms from which pathogenic organisms were recovered.

Design.

Prospective environmental study using feedback with UV markers and environmental cultures.

Setting.

A 1,500-bed county teaching hospital.

Participants.

Environmental service personnel, hospital administration, and medical and nursing leadership

Results.

The proportion of UV markers removed (cleaned) increased from 0.47 (284 of 600 markers; 95% confidence interval [CI], 0.42-0.53) at baseline to 0.82 (634 of 777 markers; 95% CI, 0.77-0.85) during the last month of observations (P < .0001). Nevertheless, the percentage of samples from which pathogenic organisms (gram-negative bacilli, Staphylococcus aureus, and Enterococcus species) were recovered did not change throughout our study. Pathogens were identified on 16.6% of surfaces at baseline and 12.5% of surfaces during the follow-up period (P = .998). However, the percentage of surfaces from which gram-negative bacilli were recovered decreased from 10.7% at baseline to 2.3% during the follow-up period (P = .015).

Conclusions.

Feedback using Gram staining of environmental cultures and UV markers was successful at improving the degree of cleaning in our operating rooms.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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