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Environmental cleaning resources and activities in Canadian acute care hospitals

      Background

      Environmental cleaning interventions have increased cleaning effectiveness and reduced antibiotic-resistant organisms in hospitals. This study examined cleaning in Canadian acute care hospitals with the goal of developing strategies to improve cleaning and reduce antibiotic-resistant organism rates.

      Methods

      Managers most responsible for environmental services (EVS) completed an extensive online survey that assessed EVS resources and cleaning practices.

      Results

      The response rate was 50.5%; 96 surveys were completed, representing 103 of 204 hospitals. Whereas 86.3% (82/95) of managers responsible for EVS reported their staff was adequately trained and 76.0% (73/96) that supplies and equipment budgets were sufficient, only 46.9% (45/96) reported that EVS had enough personnel to satisfactorily clean their hospital. A substantial minority (36.8%, 35/95) of EVS departments did not audit the cleaning of medical surgical patient rooms on at least a monthly basis. Cleaning audits of medical surgical patient rooms frequently included environmental marking methods in only one third (33.3%, 31/93) of hospitals and frequently included the measurement of residual bioburden in only 13.8% (13/94).

      Conclusion

      There was a general need for increased and improved auditing of environmental cleaning in Canadian hospitals, and there were perceived EVS staffing deficits in the majority of hospitals.

      Key Words

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      References

        • Zoutman D.E.
        • Ford B.D.
        A comparison of infection control program resources, activities, and antibiotic resistant organism rates in Canadian acute care hospitals in 1999and 2005: pre- and post-severe acute respiratory syndrome.
        Am J Infect Control. 2008; 36: 711-717
        • Simor A.E.
        • Williams V.
        • McGeer A.
        • Raboud J.
        • Larios O.
        • Weiss K.
        • et al.
        • Community and Hospital Infection Control Association-Canada
        Prevalence of colonization and infection with methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus and of Clostridium difficile infection in canadian hospitals.
        Infect Control Hosp Epidemiol. 2013; 34: 687-693
        • Rodríguez-Baño J.
        • García L.
        • Ramírez E.
        • Martínez-Martínez L.
        • Muniain M.A.
        • Fernández-Cuenca F.
        • et al.
        Long-term control of hospital wide, endemic multidrug-resistant Acinetobacter baumannii through a comprehensive “bundle” approach.
        Am J Infect Control. 2009; 37: 715-722
        • Dancer S.J.
        The role of environmental cleaning in the control of hospital-acquired infection.
        J Hosp Infect. 2009; 73: 378-385
      1. Centers for Disease Control and Prevention, Healthcare Infection Control Practices Advisory Committee. Guidelines for environmental infection control in health-care facilities. MMWR 2003;(RR-107):52:1-48.

        • Provincial Infectious Disease Advisory Committee (PIDAC)
        Best practices for cleaning, disinfection, and sterilization in all health care settings.
        Ministry of Health and Long-term Care, Toronto2006
        • Otter J.A.
        • Yezli S.
        • Salkeld J.A.G.
        • French G.L.
        Evidence that contaminated surfaces contribute to the transmission of hospital pathogens and an overview of strategies to address contaminated surfaces in hospital settings.
        Am J Infect Control. 2013; 41: S6-S11
        • Weber D.J.
        • Anderson D.J.
        • Sexton D.J.
        • Rutala W.A.
        Role of the environment in the transmission of Clostridium difficile in health care facilities.
        Am J Infect Control. 2013; 41: S105-S110
        • Carling P.C.
        • Parry M.F.
        • Von Beheren S.M.
        • Healthcare Environmental Hygiene Study Group
        Identifying opportunities to enhance environmental cleaning in 23 acute care hospitals.
        Infect Control Hosp Epidemiol. 2008; 29: 1-7
        • Carling P.C.
        • Parry M.M.
        • Rupp M.E.
        • Po J.L.
        • Dick B.
        • Von Beheren S.
        • Healthcare Environmental Hygiene Study Group
        Improving cleaning of the environment surrounding patients in 36 acute care hospitals.
        Infect Control Hosp Epidemiol. 2008; 29: 1035-1041
        • Carling P.C.
        • Parry M.F.
        • Bruno-Murtha L.A.
        • Dick B.
        Improving environmental hygiene in 27 intensive care units to decrease multidrug-resistant bacterial transmission.
        Crit Care Med. 2010; 38: 1054-1059
        • Goodman E.R.
        • Platt R.
        • Bass R.
        • Onderdonk A.B.
        • Yokoe D.S.
        • Huang S.S.
        Impact of an environmental cleaning intervention on the presence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci on surfaces in intensive care unit rooms.
        Infect Control Hosp Epidemiol. 2008; 29: 593-599
        • Donskey C.J.
        Does improving surface cleaning and disinfection reduce health care-associated infections?.
        Am J Infect Control. 2013; 41: S12-S19
        • Guerrero D.M.
        • Carling P.C.
        • Jury L.A.
        • Ponnada S.
        • Nerandzic M.M.
        • Donskey C.J.
        Beyond the Hawthorne effect: reduction of Clostridium difficile environmental contamination through active intervention to improve cleaning practices.
        Infect Control Hosp Epidemiol. 2013; 34: 524-526
        • Dancer S.J.
        • White L.F.
        • Lamb J.
        • Girvan E.K.
        • Robertson C.
        Measuring the effect of enhanced cleaning in a UK hospital: a prospective cross-over study.
        BMC Med. 2009; 7: 28
        • Zoutman D.E.
        • Ford B.D.
        • Sopha K.
        The working relationships of infection prevention and control programs and environmental services and associations with antibiotic-resistant organisms in Canadian acute care hospitals.
        Am J Infect Control. 2014; 42: 349-352
        • Anderson R.E.
        • Young V.
        • Stewart M.
        • Robertson C.
        • Dancer S.J.
        Cleanliness audit of clinical surfaces and equipment: who cleans what?.
        J Hosp Infect. 2011; 78: 178-181