Impact of UV-Light Use on the Quality of Manual Cleaning and Room Turnover Times at a Large Tertiary-Care Hospital, 2019

Abstract

Background: Manual cleaning is the recommended method of environmental disinfection; it plays a key role in the prevention of healthcare-associated infections. Recently, automated no-touch disinfection technologies, such as ultraviolet (UV) light, have been proposed as a supplement to manual cleaning. However, UV light adds time to the cleaning process and may decrease the quality of manual cleaning. We evaluated the impact of adding UV light on the quality of manual cleaning and on room turnover times. Methods: During January–September 2019, we assessed the thoroughness of disinfection cleaning (TDC) of environmental surfaces in rooms identified for discharge. According to hospital policy, contact precautions rooms use UV light after manual cleaning with an EPA-approved sporicidal agent (bleach). Non–contact precautions rooms are disinfected using quaternary ammonium only. Rooms were identified after patient admission, selected randomly, and marked once discharge orders were placed. Fluorescent markers were applied on high-touch surfaces before discharge and were assessed after the cleaning process was completed. TDC scores were defined as the percentage of cleaned surfaces of the total of examined surfaces. UV-light disinfection time is determined automatically based on room size. We compared TDC scores and manual cleaning times between contact precautions rooms and noncontact precautions rooms. We also calculated UV-light cycle durations. Results: We assessed 2,383 surfaces in 24 contact precautions rooms with UV-light disinfection and 201 noncontact precautions rooms without UV-light disinfection. The TDC score was similar in contact precautions rooms (243 of 273 surfaces) and noncontact precautions rooms (1,835 of 2,110 surfaces; 89% vs 87%). The median manual cleaning time for contact precautions rooms was 56 minutes (IQR, 37–79), and for noncontact precautions rooms the median manual cleaning time was 33 minutes (IQR, 22–43). UV-light use added a median of 49 minutes (IQR, 35–67) to the overall cleaning process. The median turnover time for contact precautions rooms was 156 minutes (IQR, 87–216) versus 58 minutes (IQR, 40–86) in noncontact precautions room. Conclusions: In a setting with an objective assessment of environmental cleaning, there was no difference in quality of manual cleaning between contact precautions rooms (UV light) and noncontact precautions rooms (UV light). Adding UV light following manual disinfection increased the overall cleaning time and delayed room availability.Funding: NoneDisclosures: None