Continuing performance feedback and use of the ultraviolet visible marker to assess cleaning compliance in the healthcare environment

Trajtman, Adriana; Manickam, K.; MacRae, Michelle; Bruning, Nealia S.; Alfa, Michelle J.

doi:10.1016/j.jhin.2013.03.004

Cited by 17 publications

(25 citation statements)

References 15 publications

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“…Clinical infection was reported as a primary and secondary outcome in 3 (80, 83, 90) and 2 (75, 76) studies, respectively. With regard to pathogen type, C. difficile and VRE were the primary focus of 3 (75, 80, 81) and 2 (85, 90) studies, respectively. The remaining studies focused on at least 2 pathogens of interest.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies (64, 76, 81, 84, 87) reporting on sustainability of preventive strategies described ongoing education, direct feedback, and commitment and flexibility of administrative leaders as key components to successful implementation.…”

Section: Resultsmentioning

confidence: 99%

“…Implementation and management tools were identified as key contextual factors and include staff education and training, dedicated training time, use of internal audit and feedback, and presence of internal or external persons responsible for implementation. Of the 24 studies (32%) that integrated implementation tools, education was reported as a key component in most ( n = 23 [96%]); 5 studies (21%) specifically reported on training staff (13–15, 77, 84) and 5 additional studies (21%), all published since 2012, described use of audits (14, 17, 81, 82, 84). …”

Section: Resultsmentioning

confidence: 99%

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Cleaning Hospital Room Surfaces to Prevent Health Care–Associated Infections

et al. 2015

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The cleaning of hard surfaces in hospital rooms is critical for reducing health care–associated infections. This review describes the evidence examining current methods of cleaning, disinfecting, and monitoring cleanliness of patient rooms, as well as contextual factors that may affect implementation and effectiveness. Key informants were interviewed, and a systematic search for publications since 1990 was done with the use of several bibliographic and gray literature resources. Studies examining surface contamination, colonization, or infection with Clostridium difficile, methicillin-resistant Staphylococcus aureus, or vancomycinresistant enterococci were included. Eighty studies were identified—76 primary studies and 4 systematic reviews. Forty-nine studies examined cleaning methods, 14 evaluated monitoring strategies, and 17 addressed challenges or facilitators to implementation. Only 5 studies were randomized, controlled trials, and surface contamination was the most commonly assessed outcome. Comparative effectiveness studies of disinfecting methods and monitoring strategies were uncommon. Future research should evaluate and compare newly emerging strategies, such as self-disinfecting coatings for disinfecting and adenosine triphosphate and ultraviolet/fluorescent surface markers for monitoring. Studies should also assess patient-centered outcomes, such as infection, when possible. Other challenges include identifying high-touch surfaces that confer the greatest risk for pathogen transmission; developing standard thresholds for defining cleanliness; and using methods to adjust for confounders, such as hand hygiene, when examining the effect of disinfecting methods.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Cleaning Hospital Room Surfaces to Prevent Health Care–Associated Infections

et al. 2015

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“…Dabei zeigten sich nicht nur Defizite in der Reinigung von Krankenhäusern insgesamt, es konnte auch nachgewiesen werden, dass insbesondere patientennahe Flächen und Flächen mit häufigem Handkontakt häufig schlecht aufbereitet wurden [33]. Prospektive Interventionsstudien konnten zeigen, dass mit der UVM-Methode erhebliche Verbesserungen erreicht wurden [27,28,[36][37][38][39][40][41][42]. Nach unserer Kenntnis wird die UVM-Methode zunehmend in Deutschland eingesetzt, selbst wenn hierzu erst eine Publikation aus Altenpflegeheimen in Frankfurt am Main vorliegt [43].…”

Section: Diskussion ▼unclassified

Flächenreinigung und Desinfektion im Krankenhaus. Verbesserung durch objektive Überwachung und Intervention

Woltering

Hoffmann²,

Isermann

et al. 2015

Gesundheitswesen

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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.

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“…5 The goal of any monitoring method is to provide feedback on cleaning failure to assist in the management and improvement of environment cleaning within health care settings. [6][7][8][9] The sampling approach taken for the monitoring of environment surfaces within health care settings is a constant problem. 10,11 The apparently random distribution of soils, including dry surface biofilms and pathogens, presents a challenge for any sampling plan investigating the nature of environment contamination, and is complicated by the presence high-touch objects.…”

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confidence: 99%