Studies On Hospital Cleanliness Lack Evidence
New reports say that there is little hard data to support why roughly one in 25 hospital patients acquires an infection during their stay. Many environmental services departments target hospital-acquired infections (HAIs) using a multifaceted approach including hand hygiene programs, antimicrobial stewardship and environmental cleaning and disinfecting. Also, MedPageToday reports that an increased interest in preventative cleaning methods such as environmental cleaning — removing organic and inorganic materials, followed by disinfecting and ongoing monitoring for effectiveness — over the last year is driving the discussion even further.
But, according to Annals of Internal Medicine, many of the previous studies about cleaning hospital surfaces have been devoid of evidence-based practices, comparative studies of different cleaning methods and patient-centered outcomes. So the Agency for Healthcare Research and Quality commissioned and funded a review that examined 80 studies, of which 76 were primary studies, and four were systemic reviews. Forty-nine examined cleaning methods, 14 evaluated monitoring strategies, and 17 addressed challenges to implementation of different cleaning methods. Of the 80 studies, only five were randomized.
Researchers found that the evidence in these studies was fairly inconsistent, and thorough analysis of the data around cleaning is rare. They were also disappointed by the lack of patient-centered outcomes in the studies and disheartened by the emphasis on surface contamination in each of them.
That said, researchers say that there have been some positive studies around newer cleaning technologies such as automated, no-touch modalities, ultraviolet light disinfection and hydrogen peroxide vapor. The same is true for technologies for monitoring contamination, such as ATP bioluminescence and ultraviolet fluorescent surface markers.
Researchers express hope in that there will be better studies on hospital cleaning in the future. They’d also like to see more studies that are benchmarked around evidence-based healthcare and that have clearer metrics of success for different cleaning methods.
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