The effectiveness of existing and modified cleaning regimens in a Welsh hospital

Area of Science:

• Healthcare-associated infection control
• Environmental hygiene in healthcare settings
• Microbiology of hospital surfaces

Background:

• Hospital cleaning effectiveness is highly variable and a significant concern.
• Existing cleaning regimens often fail to adequately remove organic soil and reduce bacterial load.
• There is a need for improved, consistent, and effective hospital cleaning strategies.

Purpose of the Study:

• To assess the efficacy of an existing hospital ward-cleaning regimen.
• To evaluate the impact of modified cleaning protocols on bacterial counts and organic soil.
• To determine if a quaternary ammonium sanitiser improves cleaning efficacy compared to standard detergent.

Main Methods:

• Assessed an existing ward-cleaning regimen over 14 days at selected sites.
• Modified the cleaning regimen in two stages, incorporating a rinse stage and disposable paper towels.
• Compared cleaning efficacy using standard detergent versus a quaternary ammonium sanitiser, with adenosine triphosphate (ATP) detection for organic soil measurement.

Main Results:

• Modified cleaning regimens significantly reduced bacterial counts and demonstrated more consistent results.
• Adenosine triphosphate (ATP) failure rates decreased from 86-100% to 0-14% after modifications.
• Maximum ATP readings dropped substantially from 163,870 to 2289 relative light units (RLU), indicating improved cleanliness.

Conclusions:

• Simple modifications to existing hospital cleaning protocols, including a rinse stage and disposable paper towels, significantly enhance cleaning efficacy.
• The use of quaternary ammonium sanitisers offers a slight, though not statistically significant, additional improvement in cleaning effectiveness.
• Implementing these evidence-based cleaning improvements can lead to more consistent and effective hospital hygiene.