With the use of visual cues, hospital rooms get nearly 70% cleaner

With the Use of Visual Cues, Hospital Rooms Get Nearly 70% Cleaner

New study shows that a simple color additive in disinfectant wipes dramatically improved room cleanliness and even reduced time needed for cleaning

Arlington, Va. — September 19, 2024 — A new study published today in the American Journal of Infection Control (AJIC) reports a comparison of hospital room cleanliness using standard disinfectant wipes versus wipes with a color additive that allows users to see which surfaces have been sanitized. With the color additive, rooms were 69.2% cleaner and were able to be cleaned in slightly less time compared to cleaning with standard wipes. The study was performed at Griffin Hospital in Derby, Conn.

Proper disinfection of hospital rooms helps prevent the spread of germs from one patient to another. Healthcare-associated infections (HAIs) are a significant risk to patients, and contaminated surfaces in hospitals have been linked to many of these infections. For example, one study found that hospital patients were nearly 6 times as likely to acquire an HAI when staying in the bed of a former patient who had that same infection.¹ Many prior studies have shown that despite substantial effort and attention, hospital rooms are simply not as clean as they need to be to prevent HAIs.

In this study, clinicians tested the outcomes of hospital room sanitation performed two ways. First, they evaluated the status quo for a one-week period: environmental services (EVS) teams used regular disinfectant wipes to clean surfaces in 10 randomly selected rooms. They then educated the EVS teams about using wipes with a color additive, which shows up on surfaces as blue during cleaning but fades to clear several minutes later when force and friction is used. This creates a strong visual cue to help users see what has been cleaned with effective technique and what has not. Finally, the EVS teams cleaned another 10 randomly chosen rooms for a week using the wipes with the color additive. For both cleaning periods, non-EVS personnel sampled 10 frequently touched surfaces for the presence of microbes before and after rooms were sanitized. Such surfaces included sink handles, bedrails, call remotes, light switches, phones, and toilet seats, among others. In addition, non-EVS staff members monitored room turnover time to determine whether the color additive had any role in the length of the cleaning process.

Results clearly demonstrated the effectiveness of using the color additive. In both weeks of the study, 92% of surfaces sampled prior to cleaning were positive for microbial colonies. After disinfection, rooms cleaned with standard wipes still had microbes present on 60% of surfaces sampled, while rooms cleaned using the color additive saw the microbial presence reduced to 31% of surfaces, a 48% improvement. A deeper analysis of the microbes that remained after cleaning showed that the use of the color additive left rooms 69.2% cleaner than the standard wipes. In addition, the additive slightly reduced the cleaning time needed, from 39.1 minutes to 36.8 minutes.

“Our study is the first to evaluate color additive-supported hospital cleaning based on microbial burden, and the first to measure impact on cleaning times,” said Olayinka Oremade, MD, MPH, CIC, lead author of the study and infection control manager at Griffin Hospital. “Collectively, our results show that providing a simple visual cue makes an enormous difference in room cleanliness, and it seems to allow cleaning teams to be a bit more efficient in the room turnover process as well.”

Additional details from the study include:

• Throughout the study, microbial sampling was performed on 400 surfaces, 200 for the control period and 200 for the color additive period. Bedrails were the most frequently sampled surface while cabinets, headboards, faucet handles, and infusion pumps were the least sampled.
• The rooms cleaned in this study were located in the telemetry inpatient ward and in the medical surgical inpatient ward.
• The change in room turnover time between methods, about 6%, was not found to be statistically significant.
• The color additive used in this study is compatible with many commercially available disinfectant products.

“Effective disinfection protocols are essential for successful infection prevention and control in healthcare settings,” said Tania Bubb, PhD, RN, CIC, FAPIC, 2024 APIC president. “This study exemplifies the idea that simple but creative solutions can help us improve critical tasks associated with keeping patients safe and healthy.”

About APIC

Founded in 1972, the Association for Professionals in Infection Control and Epidemiology (APIC) is the leading association for infection preventionists and epidemiologists. With more than 15,000 members, APIC advances the science and practice of infection prevention and control. APIC carries out its mission through research, advocacy, and patient safety; education, credentialing, and certification; and fostering development of the infection prevention and control workforce of the future. Together with our members and partners, we are working toward a safer world through the prevention of infection. Join us and learn more at apic.org.

About AJIC

As the official peer-reviewed journal of APIC, The American Journal of Infection Control (AJIC) is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. Published by Elsevier, AJIC also publishes infection control guidelines from APIC and the CDC. AJIC is included in Index Medicus and CINAHL. Visit AJIC at ajicjournal.org.

NOTES FOR EDITORS

“The impact of a novel color additive for disinfectant wipes on room cleanliness and turnover time,” by Olayinka Oremade, Barbara Odac, Jinzy George, and Frederick Browne, was published online in AJIC on September 19, 2024. Available at:  https://doi.org/10.1016/j.ajic.2024.07.009

AUTHORS

Olayinka Oremade, MD, MPH, CIC (corresponding author: yyoremade@gmail.com), Griffin Hospital

Barbara Odac, MD, Griffin Hospital

Jinzy George, MD, Griffin Hospital

Frederick Browne, MD, MBA, FACP, GSHEA FASAM, Griffin Hospital

Reference

1. Cohen, B., Liu, J., Cohen, A. R., & Larson, E. (2018). Association Between Healthcare-Associated Infection and Exposure to Hospital Roommates and Previous Bed Occupants with the Same Organism. Infection Control and Hospital Epidemiology, 39(5), 541–546. https://doi.org/10.1017/ice.2018.22

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