Environmental cleaning and disinfection of hospital rooms: A nationwide survey

Abstract

Background: As an important reservoir for hospital-acquired infections, environmental surfaces have long been targeted by interventions to improve cleaning and disinfection. Differences in disinfection practices across US hospitals, however, are still unclear.

Methods: We conducted a nationwide survey of environmental services (EVS) personnel in the United States regarding their environmental surface disinfection practices from January 2019 to June 2019. We developed and pilot tested the survey in conjunction with EVS specialists. Survey questions inquired about choices of disinfectants and cleaning equipment during daily and terminal disinfection of both contact isolation and non-contact isolation rooms. We contacted 273 EVS personnel by phone and email to participate in the survey.

Results: Fourty-seven EVS personnel representing different hospitals from 26 US states were included in the analysis. Hypochlorite (bleach) and quaternary ammonium compounds were the most frequently used disinfectants. Most respondents reported using microfiber-based cloths and mops to carry out disinfection. High-touch surfaces in contact isolation rooms were frequently disinfected using bleach (81%, n = 38); floors, however, were not disinfected as frequently in patient rooms. The vast majority of respondents reported use of sporicidal disinfectants for contact isolation rooms but not regular rooms.

Conclusions: While frequently used to disinfectant contact isolation rooms, sporicidal agents are rarely used to disinfect regular rooms. Patient room floors are inconsistently disinfected compared to high-touch surfaces.

Keywords: Cleaning; Disinfection practice; Environmental disinfection; Hospital-acquired infections; Infection control; Sporicidal disinfection.