Applying a multi-faceted infection control strategy to improve hospital environmental cleaning quality

Hsin-An Lin; Hsin-Chung Lin; Lih-Chyang Chen; Kuo-Yang Huang; Jong-Long Guo

doi:10.1016/j.heliyon.2024.e24928

Applying a multi-faceted infection control strategy to improve hospital environmental cleaning quality

Heliyon. 2024 Jan 19;10(3):e24928. doi: 10.1016/j.heliyon.2024.e24928. eCollection 2024 Feb 15.

Authors

Hsin-An Lin^{1

2}, Hsin-Chung Lin^{3

4}, Lih-Chyang Chen⁵, Kuo-Yang Huang⁴, Jong-Long Guo²

Affiliations

¹ Division of Infection, Department of Medicine, Tri-Service General Hospital SongShan, Branch, National Defense Medical Center, Taipei City 114, Taiwan.
² Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei 106, Taiwan.
³ Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei City 114, Taiwan.
⁴ Graduate Institute of Pathology and Parasitology, National Defense Medical Center, Taipei 114, Taiwan.
⁵ Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan.

Abstract

Background: Along with existing infection control policies, repeated education and training of environmental service workers (ESWs) improves their compliance and ultimately reduces hospital-associated infection (HAI) rates. However, only limited studies have explored the health behavioral determinants of ESWs regarding their cleaning performance after implementing an educational intervention with multi-faceted infection control strategy.

Objective: To determine whether an educational intervention with multi-faceted infection control strategy improves the health behavioral determinants associated with ESWs' cleaning performance.

Methods: Twenty-eight ESWs who received an educational intervention with multi-faceted hospital infection control strategy were included. ESWs' knowledge, perceived benefits and barriers, self-efficacy, health literacy, and cleaning performance were evaluated at pre-intervention, post-intervention, and 3-month follow-up.

Results: HAI-related adenosine triphosphate (ATP) levels decreased significantly at post-intervention and 3-month follow-up compared with pre-intervention levels (all p < 0.05). All post-intervention ATP levels met the standard criterion after the 2nd environmental cleaning, with a median score of 267 (range, 71-386). High baseline ATP levels (odds ratio [OR] = 4.195, 95%CI 2.500-7.042, p < 0.05) were positively associated with qualified post-intervention ATP levels, while high education (OR = 0.480, 95%CI 0.276-0.833, p < 0.05) and high baseline knowledge scores (OR = 0.481, 95%CI 0.257-0.903, p = 0.023) were negatively associated with qualified post-intervention ATP levels.

Conclusion: Educational intervention using a multi-faceted infection control strategy improves health behavioral determinants (baseline education, knowledge scores and ATP levels) associated with ESWs' hospital cleaning performance. Receiving an educational intervention may increase HAI knowledge of environmental cleaning among ESWs with high education or low baseline HAI knowledge.

Keywords: Cleaning performance; Environmental service workers; Health literacy; Hospital acquired infection; Knowledge; Multi-faceted infection control strategy; Perceived benefits and barriers; Self-efficacy.