Highlights
- •A multitude of factors can affect cleaning efficacy.
- •Some areas within the ward were consistently clean, and others were consistently dirty.
- •Surfaces with lower colony-forming unit counts before cleaning became more contaminated following cleaning, than surfaces with higher initial colony-forming unit counts.
- •Personal perceptions of cleanability and risk to patients, surface material, who was delegated to clean, and staff groups interacting with the surfaces had an impact on cleaning efficacy.
- •Interactions among these factors are complex, and consideration must be given to them when designing cleaning interventions.
- •The findings from this study can be used to inform and improve cleaning training programs.
Background
The objectives of this study were to assess the number of organisms present on different
surfaces within a clinical environment before and after cleaning took place, and to
identify the impact of cleaning. The study involved extensive 2-week microbiological
environmental monitoring of an entire ward before and after cleaning; the ward was
located within a pediatric hematology-oncology ward comprised of a day unit and outpatient
ward.
Methods
Tryptone soya agar contact plates were used to take a total of 1,160 surface samples
before and after cleaning from 55 predetermined sites. Samples were taken from representative
surfaces throughout the ward representing a variety of materials, surface heights,
functions, and distances from patients, as well as both high-touch and infrequently
touched surfaces.
Results
After surface cleaning was undertaken within the ward, there was a significant difference
between the amount of colony-forming units (CFUs) recovered before and after cleaning
(P < .0001). Cleaning produced an average CFU reduction of 68% throughout the ward environment.
The corridor was the most contaminated area within the ward. There were differences
in the CFUs among the various areas within the ward, which were cleaned with varying
efficiency. The surface material, who interacted with the surface, levels of initial
contamination, perceived risk, and perceived cleanability were all found to have a
varying impact on the cleaning effectiveness.
Conclusions
To the authors’ current knowledge, this is the only study to assess cleaning within
a pediatric ward by taking samples directly before and after cleaning. The standard
of cleaning undertaken within the ward is open for discussion, and these data highlight
the need for an improved cleaning intervention and can provide insight into the multitude
of factors that must be considered when designing an effective training protocol.
Key Words
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Article info
Publication history
Published online: December 06, 2019
Footnotes
Conflicts of interest: None to report.
Identification
Copyright
© 2019 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
