Using ATP Testing to Promote Staff Engagement and Proper Disinfection Procedures in the Perioperative Setting

Abstract

BACKGROUND: Adenosine Triphosphate (ATP) is present in all organic matter. ATP levels are measured in relative light units (RLUs) via a numeric value, based on the amount of ATP present on the collection swabs. The purpose of this study is to describe how ATP testing was used to improve disinfection processes in the perioperative area by promoting staff engagement and accountability in our infection prevention practices. METHODS: Over a period of three months, over 100 ATP samples were collected from three high touch surfaces in the operating rooms (ORs) of our small, acute-care hospital. Consistency among ATP collection technique was maintained throughout the study. Direct observation of cleaning processes was also conducted to evaluate disinfection practices among various staff. RESULTS: According to manufacturer recommendations, the ATP levels in the ORs were consistently greater than six times the recommended level. Direct observation of the cleaning process demonstrated that alcohol-based disinfectant wipes were not consistently being used according to manufacturer recommendations for surface contact time. Staff feedback revealed multiple wipes are required to keep the surface wet for the entire recommended contact time and it is challenging for staff to maintain surface wetness during fast-paced room turnovers. Based on staff feedback, a new disinfectant wipe was introduced to the OR with a shorter contact time. Since implementation of the new product, the average RLUs for the same high touch surfaces has decreased drastically and now consistently remains under the manufacturer's recommended limit. CONCLUSIONS: This study demonstrates how the use of ATP testing improved the disinfection process in our ORs. When developing a process improvement plan for disinfection procedures, consideration should be given to providing staff with numeric data to promote engagement and accountability. The success of this project was directly related to staff?engagement gained from the communication of ATP testing results. BACKGROUND: Adenosine Triphosphate (ATP) is present in all organic matter. ATP levels are measured in relative light units (RLUs) via a numeric value, based on the amount of ATP present on the collection swabs. The purpose of this study is to describe how ATP testing was used to improve disinfection processes in the perioperative area by promoting staff engagement and accountability in our infection prevention practices. METHODS: Over a period of three months, over 100 ATP samples were collected from three high touch surfaces in the operating rooms (ORs) of our small, acute-care hospital. Consistency among ATP collection technique was maintained throughout the study. Direct observation of cleaning processes was also conducted to evaluate disinfection practices among various staff. RESULTS: According to manufacturer recommendations, the ATP levels in the ORs were consistently greater than six times the recommended level. Direct observation of the cleaning process demonstrated that alcohol-based disinfectant wipes were not consistently being used according to manufacturer recommendations for surface contact time. Staff feedback revealed multiple wipes are required to keep the surface wet for the entire recommended contact time and it is challenging for staff to maintain surface wetness during fast-paced room turnovers. Based on staff feedback, a new disinfectant wipe was introduced to the OR with a shorter contact time. Since implementation of the new product, the average RLUs for the same high touch surfaces has decreased drastically and now consistently remains under the manufacturer's recommended limit. CONCLUSIONS: This study demonstrates how the use of ATP testing improved the disinfection process in our ORs. When developing a process improvement plan for disinfection procedures, consideration should be given to providing staff with numeric data to promote engagement and accountability. The success of this project was directly related to staff?engagement gained from the communication of ATP testing results.