How Clean Are the Clinics? Assessment of Environmental Cleanliness in Ambulatory Care

Abstract

Background The patient care environment plays an important role in the transmission of potential pathogens. Efforts to improve the thoroughness of environmental cleaning and disinfection have largely concentrated on ICUs and other inpatient units. The purpose of this study was to ascertain baseline data on the thoroughness of cleaning in ambulatory care clinics.Methods High touch surfaces (exam tables, chair arms, light switches, etc.) in patient rooms, waiting rooms, and clinic common areas were marked with an invisible, UV-tagged gel (DAZO®, Ecolab) in the AM and PM to assess thoroughness of cleaning by both Environmental Services (EVS) workers and clinical care medical assistants (MA). Surveys were conducted in 8 ambulatory care clinics for five consecutive days (Monday–Friday).ResultsResults are summarized in Table 1. A total of 14,288 environmental surfaces were assessed in the 8 ambulatory clinics and the overall rate of cleaning ranged from 31% to 74%, 29% to 77%, and 0% to 22% for examination rooms, common clinic areas, and waiting rooms, respectively. The thoroughness of cleaning for EVS workers vs. Medical Assistants (MA) was 49% vs. 46% (examination rooms) and 46% vs. 43% (common clinical areas). Waiting room surfaces were cleaned at a rate of only 6.8%. While many high touch objects were regularly cleaned, some were consistently missed by both groups (eg ophthalmoscopes, keyboards, and stethoscopes).% Surfaces cleanedExam roomsClinic common areasClinicClinic rooms (N)EVSMed AssisEVSMed AssisWaiting roomsA354238373422B14423342338C284026352416D12382333218E9945792670F26665759500G9455937540H33446840430ConclusionIn ambulatory care clinics there is wide variability in the thoroughness of cleaning from clinic-to-clinic and between EVS workers and MAs as well as great room for improvement.Disclosures P. Carling, Ecolab: Consultant, Royalty