Surface sampling within a pediatric ward—how multiple factors affect cleaning efficacy

Abstract

To assess the number of organisms present on different surfaces within a clinical environment before and after cleaning has taken place, and to identify the impact of cleaning. Design and Setting Extensive 2-week microbiological environmental monitoring of an entire ward before and after cleaning, within a pediatric hematology-oncology ward comprised of a day unit and outpatients ward. Methods Tryptone soya agar (TSA) contact plates were used to take a total of 1,160 surface samples before and after cleaning from 55 predetermined sites. Samples were taken from representative surfaces throughout the ward, including different materials, surfaces with varying heights, different functions, distance from patients, and both high-touch and infrequently touched surfaces. Results. Surface cleaning has been undertaken within the ward and there is a significant difference between CFU recovered before and after cleaning (P<0.0001). Cleaning produced an average reduction of 68% throughout the ward environment. The corridor was the most contaminated area within the ward. There is a difference in CFU between the different areas within the ward, and these were cleaned with varying efficiency. Surface material, who interacts with the surface, levels of initial contamination, perceived risk and perceived cleanability were all found to have a varying impact on how well cleaning was undertaken. Conclusions. To the authors current knowledge, this is the only study assessing cleaning within a pediatric ward taking samples directly before and after cleaning. The standard of 3 cleaning undertaken within the ward is open for discussion, and these data highlight the need for an improved cleaning intervention, and can provide insight into the multitude of factors that must be considered when designing an effective training protocol.

Does size matter? The impact of a small but targeted cleaning training intervention within a paediatric ward

“…The increasing reliance on subcontracted services within the NHS has only worsened this issue. Other studies have shown how easy it can be to change the attitudes of the cleaners by ensuring they know they are valued [ 30 ] while emphasising how their personal perception of their environment can have an active impact on cleaning efficacy [ 31 ]. It has also been shown by multiple studies that feedback of cleaning efforts have a positive impact on cleaning efficacy [ 30 ].…”