Related Experiment Video
Updated: May 1, 2026

A Method to Test the Efficacy of Handwashing for the Removal of Emerging Infectious Pathogens
Published on: June 7, 2017
Improving hospital staff compliance with environmental cleaning behavior
Lilly Ramphal1, Sumhiro Suzuki1, Izah Mercy McCracken1
1Cook Children's Hospital, Fort Worth, Texas (Ramphal); and the Departments of Environmental Health (Ramphal, Addai) and Biostatistics (Suzuki, McCracken), the University of North Texas School of Public Health. Dr. Ramphal is now with Blue Cross Blue Shield.
Abstract:
Reducing the incidence of healthcare-associated infections requires proper environmental cleanliness of frequently touched objects within the hospital environment. An intervention was launched in June 2012 and repeated in February 2013 and August 2013 to increase hospital room cleanliness with repeated education and training of nursing and environmental services staff to reduce healthcare-associated infections at Cook Children's Medical Center. Random rooms were tested, staff were trained about proper cleaning, rooms were retested for surface cleanliness, and preintervention and postintervention values were compared. The percentage of cleaned surfaces improved incrementally between the three trials-with values of 20%, 49%, and 82% showing that repeat training favorably changed behavior in the staff (P = 0.007). During the study period, during which other infection control interventions were also introduced, there was a decline from 0.27 to 0.21 per 1000 patient days for Clostridium difficile infection, 0.43 to 0.21 per 1000 patient days for ventilator-associated infections, 1.8% to 1.2% for surgical site infections, and 1.2 to 0.7 per 1000 central venous line days for central line-associated bloodstream infections.
Related Concept Videos
Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
Hand hygiene
Hand washing...
Obedience
Standard Precaution
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
Cleaning, Sterilization, and Disinfection
Cleaning
The cleaning process usually involves using water with detergents or enzymatic cleaner and removing foreign material from objects and surfaces, including organic material such as body fluids or inorganic material like soil. Cleaning is performed before high-level disinfection and sterilization because foreign materials on the cover of the devices interfere with process...
Handwashing I: Introduction and Types of Equipment
Hand wash basins in clinical areas should have faucets that can be turned on and off without using the hands; that is, they should be non-touch or lever-operated....

