Abstract
Background:Failures in the processes of cleaning and disinfecting health service surfaces may result in the spread and transfer of pathogens that are often associated with healthcare-related infections and outbreaks.Aims:To assess the effectiveness of environmental surface cleaning and disinfection in a hospital clinic.Method:The study was conducted in a nursing ward with 45 beds. A total of 80 samples from five high-touch surfaces were evaluated before and after cleaning and disinfection, using the following methods: visual inspection, adenosine triphosphate bioluminescence assay, aerobic colony count, Staphylococcus aureus colony count, and evaluation of resistance to methicillin. The data analysis used nonparametric comparative and correlative tests to observe any differences in the pre- and post- cleaning and disinfection results for the surfaces assessed.Results:Effective cleaning and disinfection had a significant effect on only two surfaces when measured for the presence of adenosine triphosphate, the inner bathroom door handle (p=0.007) and the toilet bowl (p=0.01). When evaluated for Staphylococcus aureus colony count, the toilet flush handle also demonstrated a significant effect (p=0.04).Conclusion:The effectiveness of cleaning and disinfection of the surfaces tested was not satisfactory. An educational intervention is recommended for the cleaning and disinfection staff and the nursing team at the healthcare facility.Relevance to Clinical Practice:The data in the study revealed that daily hospital cleaning and disinfection in the sampled sites are not sufficient in medical and surgical wards. Hospital cleanliness must be reevaluated from the point of view of materials, such as an adequate supply of clean cloths, in addition to establishing more precise cleanliness protocols and accurate monitoring systems.
Highlights
Cleaning and disinfection of surfaces in health care are strategies to minimize the occurrence of healthcareassociated infections (HAIs) [1 - 3]
There was no significant correlation between the adenosine triphosphate (ATP) measurement and S. aureus colony count or between the ATP measurement and aerobic colony counts (ACC)
In the healthcare facility of the present study, the failure rates for visual inspection before and after cleaning and disinfection were higher than those in other studies [1, 3]. These rates cannot be solely related to the cleaning and disinfection process; aspects related to deterioration of the surfaces tested need to be taken into account, since most had scratches, cracks, peeling paint, ink stains and glue
Summary
Cleaning and disinfection of surfaces in health care are strategies to minimize the occurrence of healthcareassociated infections (HAIs) [1 - 3]. It is recommended that the cleaning and disinfection process should be intensified on high-touch surfaces close to patients, since these surfaces contribute to the transmission of pathogens through hand contamination of health professionals who afterwards come into contact with patients. Examples of these surfaces are: toilets, door handles, bedside tables, telephones, nurse call buttons, and patient chairs, etc [5]. Failures in the processes of cleaning and disinfecting health service surfaces may result in the spread and transfer of pathogens that are often associated with healthcare-related infections and outbreaks
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