Hospital cleaning

Abstract

The aim of this narrative review is to present up-to-date facts concerning hospital cleaning (HC). HC is essential in the prevention of healthcare associated infections (HAI). If a proper HC is followed by a proper use of disinfectants even the HAI caused by the most dangerous nosocomial pathogens like methicillin-resistant Staphylococcus aureus, vancomycin- resistant Enterococcus, carbapenem-resistant Pseudomonas aeruginosa and multidrug-resistant Acinetobacter baumannii may be stopped without closing the ward or placing the patients in isolation. Critical hospital surfaces that may be highly contaminated with pathogens include toilet seats and bowels, toilet flush handles, doorhandles, furniture, hospital equipment, linen, clothes, buttons, switches, computers, printers, shelves, cellphones, curtains, patient chairs, nurse call-buttons and bed rails. Hand-touch sites at bedside pose the highest risk of HAI for patients and these should be targeted with continuous and detail cleaning. The most used methods for the assessment of hospital cleanliness are visual inspection, aerobic colony counts, adenosine triphosphate (ATP) bioluminescence and fluorescent markers. Together with soaps and detergents the environmental-friendly disinfectants like hydrogen peroxide, high-pressure steam, electrolyzed water, ozone, probiotic cleaners and microfiber cloths have a priority in hospital cleaning. Recent advances in the methods of hospital cleaning together with the continuous education of cleaning staff and nurses significantly contribute to the prevention and control of hospital outbreaks.