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Environmental Cleaning: Monitoring Cleaning
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healthcare-associated infections (HAI) program
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Environmental Cleaning: Role of Environmental Surfaces
Environmental Cleaning: Effective Cleaning Strategies
Environmental Cleaning: Monitoring Cleaning
Environmental Cleaning: Emerging Technologies
Environmental Cleaning: Barriers to Effective Cleaning and Disinfection
Environmental Cleaning Homepage
Monitoring Cleaning
Monitoring FAQs
How do we know when a hospital room is clean?
How do we know when a hospital room is clean?
Visually clean or finger-swipe clean
Fast and inexpensive, but lacks objectivity
Confirm using technology, e.g. ultra-violet (UV) light or ATP bioluminescence
Increasingly becoming the community standard
Revisting Environmental Hygiene and Hospital-Acquired Infections
(PDF) (article via Infectious Disease Special Edition)
Bartley et al.
Clinical Microbiology Newsletter. 2008
(article via Clinical Microbiology Newsletter)
UMC Health System EVS & Step Cleaning Procedure
(opens in YouTube)
What technologies are available to monitor environmental cleaning?
What technologies are available to monitor environmental cleaning?
Fluorescence or UV light
An environmental marker is used prior to cleaning
The marker is visible to UV light if still present after cleaning
Adenosine Triphosphate (ATP) monitoring
Measures residual organic matter left on a surface after cleaning
CDC Options for Evaluating Environmental Cleaning
What are the pros and cons of monitoring technologies?
What are the pros and cons of monitoring technologies?
Comparison of Methods
Method
Visual
Fluorescence
ATP
1. What id measured?
impression of cleanliness
whether fluorescence residual has been removedd
bilogical matter remaining on surface after cleaning
2. Can it be used by persons of differing skill levels?
no technical training required
some technical training needed
some technical training needed
3. How objective is the method? (Can reuslts be changed to appear more positive?)
can be subjective
objective, but marks could have been removed prior to reading
very objective
4. Can the amount of time spent on monitoring be minimized?
yes
room mustbe pre-marked and read after cleaning
yes
5. How are results presented?
pass/fail
pass/fail
numeric value
6. Is software needed for the monitoring process?
no
can be used, but not required
yes
7. How well can it be used for a training tool?
results immediate with visual cues
results immediate with visual cues
results delayed, no visual cues, usually available from surface
8. How affordable is the method?
no monetary investment
materials inexpensive, if formal program including staff education is purchased, expenses will be higher
cost of machine and swabs is substantial
Why should we assess adequacy of environmental cleaning?
Why should we assess adequacy of environmental cleaning?
High-touch surfaces are frequently overlooked by hospital environmental services staff.
In one study, the adequacy of cleaning of high-touch surfaces was found to be 48% in 36 hospitals
Assessing adequacy of environmental cleaning is essential
Feedback to cleaning assessment data to environmental services personnel can drive performance improvement
Carling et al.ICHE 2008 (read article via
PubMed
)
Can use of monitoring technology help improve adequacy of room cleaning?
Can use of monitoring technology help improve adequacy of room cleaning?
Monitoring technology can be used to assess adequacy of environmental cleaning and inform staff education and administrative interventions.
In one study, 36 hospitals used a fluorescent monitoring method to evaluate the thoroughness of patient room disinfection.
Each hospital met with administrative personnel to review monitoring technology findings and develop intervention plans
Education of and feedback to environmental services personnel resulted in significant improvements in environmental cleaning
Carling. ICHE. 2008 (
Improving cleaning of the environment surrounding patients in 36 acute care hospitals
article via PubMed)
Summary of Key Points
Summary of Key Points
A properly cleaned care environment is essential to prevent or contain HAIs
A surface must be physically cleaned before it can be disinfected
Consistent use of best practices and clarity of roles should be emphasized
Use of technologies such as microfiber, monitoring systems, and whole-room disinfection after cleaning are increasingly becoming the community standard of care
EVS staff should be valued and supported so they can maximize their unique contributions to preventing HAI
Environmental Cleaning Resources
CDC/HICPAC Guidelines for Environmental Infection Control in Health-Care Facilities, 2003
(PDF)
CDC/HICPAC Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008
(PDF)
CDC Options for Evaluating Environmental Cleaning Toolkit
(PDF)
CDC Environmental Checklist for Monitoring Terminal Cleaning
(PDF)
CDC Environmental Checklist
(scroll to bottom of page and download word doc)
CDC Environmental Cleaning Eval Worksheet
(scroll to bottom of page and download excel doc)
CDC/HICPAC Guidelines for Hand Hygiene in Healthcare Settings Published 2002
(PDF)
WHO Guidelines on Hand Hygiene in Healthcare (2009)
(PDF)
Page Last Updated :
April 30, 2024