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Identifying Opportunities to Enhance Environmental Cleaning in 23 Acute Care Hospitals

Published online by Cambridge University Press:  02 January 2015

P. C. Carling ,
M. F. Parry ,
S. M. Von Beheren  and
Healthcare Environmental Hygiene Study Group
P. C. Carling*
Affiliation:
Infectious Diseases Section, Caritas Carney Hospital, Boston, Massachusetts Boston University School of Medicine, Boston, Massachusetts
M. F. Parry
Affiliation:
Department of Infectious Diseases, Stamford Hospital, Stamford, Connecticut Columbia University College of Physicians and Surgeons, Columbia University, New York, New York
S. M. Von Beheren
Affiliation:
Program of Hospital Epidemiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa
*
Infectious Diseases Section, Caritas Carney Hospital, 2100 Dorchester Avenue, Boston, MA 02124 (pcarling@cchcs.org)
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Abstract

Objective.

The quality of environmental hygiene in hospitals is under increasing scrutiny from both healthcare providers and consumers because the prevalence of serious infections due to multidrug-resistant pathogens has reached alarming levels. On the basis of the results from a small number of hospitals, we undertook a study to evaluate the thoroughness of disinfection and cleaning in the patient's immediate environment and to identify opportunities for improvement in a diverse group of acute care hospitals.

Methods.

Prospective multicenter study to evaluate the thoroughness of terminal room cleaning in hospitals using a novel targeting method to mimic the surface contamination of objects in the patient's immediate environment.

Setting.

Twenty-three acute care hospitals.

Results.

The overall thoroughness of terminal cleaning, expressed as a percentage of surfaces evaluated, was 49% (range for all 23 hospitals, 35%-81%). Despite the tight clustering of overall cleaning rates in 21 of the hospitals, there was marked variation within object categories, which was particularly notable with respect to the cleaning of toilet handholds, bedpan cleaners, light switches, and door knobs (mean cleaning rates, less than 30%; institutional ranges, 0%-90%). Sinks, toilet seats, and tray tables, in contrast, were consistently relatively well cleaned (mean cleaning rates, over 75%). Patient telephones, nurse call devices, and bedside rails were inconsistently cleaned.

Conclusion.

We identified significant opportunities in all participating hospitals to improve the cleaning of frequently touched objects in the patient's immediate environment. The information obtained from such assessments can be used to develop focused administrative and educational interventions that incorporate ongoing feedback to the environmental services staff, to improve cleaning and disinfection practices in healthcare institutions.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 29 , Issue 1 , January 2008 , pp. 1 - 7
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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