Mulvey, D. and Redding, P. and Robertson, Christopher and Woodall, C. and Kingsmore, P. and Bedwell, D. and Dancer, S. J. (2011) Finding a benchmark for monitoring hospital cleanliness. Journal of Hospital Infection, 77 (1). pp. 25-30. ISSN 0195-6701Full text not available in this repository. (Request a copy from the Strathclyde author)
This study evaluated three methods for monitoring hospital cleanliness. The aim was to find a benchmark that could indicate risk to patients from a contaminated environment. We performed visual monitoring, ATP bioluminescence and microbiological screening of five clinical surfaces before and after detergent-based cleaning on two wards over a four-week period. Five additional sites that were not featured in the routine domestic specification were also sampled. Measurements from all three methods were integrated and compared in order to choose appropriate levels for routine monitoring. We found that visual assessment did not reflect ATP values nor environmental contamination with microbial flora including Staphylococcus aureus and meticillin-resistant S. aureus (MRSA). There was a relationship between microbial growth categories and the proportion of ATP values exceeding a chosen benchmark but neither reliably predicted the presence of S. aureus or MRSA. ATP values were occasionally diverse. Detergent-based cleaning reduced levels of organic soil by 32% (95% confidence interval: 16-44%; P < 0.001) but did not necessarily eliminate indicator staphylococci, some of which survived the cleaning process. An ATP benchmark value of 100 relative light units offered the closest correlation with microbial growth levels < 2.5 cfu/cm(2) (receiver operating characteristic ROC curve sensitivity: 57%; specificity: 57%). In conclusion, microbiological and ATP monitoring confirmed environmental contamination, persistence of hospital pathogens and measured the effect on the environment from current cleaning practices. This study has provided provisional benchmarks to assist with future assessment of hospital cleanliness. Further work is required to refine practical sampling strategy and choice of benchmarks. (C) 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.
|Keywords:||atp, environmental monitoring, Hospital cleaning, meticillin-resistant staphylococcus aureus, Standards, resistant staphylococcus-aureas, environmental surfaces, aqcuitision, infection, standards, contamination, hygiene, Infectious Diseases, Microbiology (medical)|
|Department:||Faculty of Science > Physics
Faculty of Science > Mathematics and Statistics
|Depositing user:||Pure Administrator|
|Date Deposited:||07 Mar 2011 23:26|
|Last modified:||27 Apr 2016 16:22|