Assessment of disinfection of hospital surfaces using different monitoring methods.

Adriano Menis Ferreira,Aires Garcia Dos Santos Junior,Denise De Andrade,Odanir Garcia Guerra,Margarete Teresa Gottardo De Almeida,Marcelo Alessandro Rigotti

doi:10.1590/0104-1169.0094.2577

Abstract

OBJECTIVE: to assess the efficiency of cleaning/disinfection of surfaces of an Intensive Care Unit. METHOD: descriptive-exploratory study with quantitative approach conducted over the course of four weeks. Visual inspection, bioluminescence adenosine triphosphate and microbiological indicators were used to indicate cleanliness/disinfection. Five surfaces (bed rails, bedside tables, infusion pumps, nurses' counter, and medical prescription table) were assessed before and after the use of rubbing alcohol at 70% (w/v), totaling 160 samples for each method. Non-parametric tests were used considering statistically significant differences at p<0.05. RESULTS: after the cleaning/disinfection process, 87.5, 79.4 and 87.5% of the surfaces were considered clean using the visual inspection, bioluminescence adenosine triphosphate and microbiological analyses, respectively. A statistically significant decrease was observed in the disapproval rates after the cleaning process considering the three assessment methods; the visual inspection was the least reliable. CONCLUSION: the cleaning/disinfection method was efficient in reducing microbial load and organic matter of surfaces, however, these findings require further study to clarify aspects related to the efficiency of friction, its frequency, and whether or not there is association with other inputs to achieve improved results of the cleaning/disinfection process.

Highlights

MethodIt is indisputable that environmental contamination involving important microorganisms – MethicillinResistant Staphylococcus Aureus (MRSA), VancomycinResistant Enterococus, Acinetobacter spp., and Clostridium difficile, among others – represents a risk to patients and professionals
Acknowledging the importance the environment plays in the transmission of microorganisms, the Centers for Disease Control and Prevention and the Health Care Infection Control Practices Advisory Committee recommend surfaces in proximity to patients, which are frequently touched, be properly cleaned and disinfected and that health care facilities ensure its professionals adhere to such procedures(7-8)
It can include methods to monitor the efficiency of cleaning/disinfection processes, such as visual inspection, culture testing for microorganisms, and to detect organic matter by verifying the presence of Adenosine triphosphate (ATP) using bioluminescence, methods that have been available for more than 30 years(3,6,9-13)

Summary

Introduction

MethodIt is indisputable that environmental contamination involving important microorganisms – MethicillinResistant Staphylococcus Aureus (MRSA), VancomycinResistant Enterococus, Acinetobacter spp., and Clostridium difficile, among others – represents a risk to patients and professionals. Acknowledging the importance the environment plays in the transmission of microorganisms, the Centers for Disease Control and Prevention and the Health Care Infection Control Practices Advisory Committee recommend surfaces in proximity to patients, which are frequently touched, be properly cleaned and disinfected and that health care facilities ensure its professionals adhere to such procedures(7-8). In this sense, the efficiency of cleaning and disinfection processes of inanimate surfaces, denoted here as the cleaning/disinfection procedure, should be investigated as a scientific process with measurable results. It can include methods to monitor the efficiency of cleaning/disinfection processes, such as visual inspection, culture testing for microorganisms, and to detect organic matter by verifying the presence of Adenosine triphosphate (ATP) using bioluminescence, methods that have been available for more than 30 years(3,6,9-13)

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Discussion

Conclusion