An assessment of cleaning and disinfection in hospitals by the use of objective surveillance and review of mandatory corrective measures was undertaken. A prospective examination of the cleaning and disinfection of surfaces scheduled for daily cleaning in 5 general care hospitals by use of an ultraviolet fluorescence targeting method (UVM) was performed, followed by structured educational and procedural interventions. The survey was conducted in hospital wards, operating theatres and intensive care units. Cleaning performance was measured by complete removal of UVM. Training courses and reinforced self-monitoring were implemented after the first evaluation. 6 months later, we repeated the assessment for confirmation of success. The average cleaning performance was 34% (31/90) at base-line with significant differences between the 5 hospitals (11-67%). The best results were achieved in intensive care units (61%) and operating theatres (58%), the worst results in hospital wards (22%). The intervention significantly improved cleaning performance up to an average of 69% (65/94; +34.7%; 95% confidence interval (CI): 21.2-48.3; p<0.05), with differences between the hospitals (20-95%). The largest increase was achieved in hospital wards (+45%; CI 29.2-60.8; p<0.05). Improvements in operating theatres (+22.9%; CI 10.9-56.7) and intensive care units (+5.6%; CI 25.8-36.9) were statistically not significant. The monitoring of cleaning and disinfection of surfaces by fluorescence targeting is appropriate for evaluating hygiene regulations. An intervention can lead to a significant improvement of cleaning performance. As part of a strategy to improve infection control in hospitals, fluorescence targeting enables a simple inexpensive and effective surveillance of the cleaning performance and corrective measures.

Drinking water surveillance includes the use of spatial data. A geographic information system (GIS) is a practicable tool for work with spatial data in the health sector as well. Co-operation between the Institute of Public Health for North Rhine Westphalia, the local health authority of the Hoexter district and the Institute for Geoinformatics of the University of Muenster started a project testing the use of GIS for drinking water surveillance. A special application was programmed. It includes functions of retrieval and classification of the measured values of drinking water wells, in order to show time trends in a diagram and to visualise the location of the wells and the analysis data in a map. The members of the Public Health Office accepted the method and started using it regularly. In addition, the collaboration between the health authority and other local authorities was strengthened. Several data sets were included in the GIS, such as wells and results of water analysis, water protection areas, land use data, and topographical maps. Basing on to the experiences with this project, the development of a standard application is planned that is supposed to be communicated to all local health authorities in North Rhine Westphalia.