Chen Ying-Chun, Huang Hui-Mei, Lin Pei-Yi, Shi Zhi-Yuan
Infection Control Center, Taichung Veterans General Hospital, Taichung, Taiwan.
Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan.
Am J Infect Control. 2021 Dec;49(12):1511-1514. doi: 10.1016/j.ajic.2021.07.011. Epub 2021 Jul 25.
Environmental cleaning is an effective measure to prevent infections. However, performance observation has been rarely delineated. This study aimed to compare correlations among visual inspection, performance observation, and effectiveness by using adenosine triphosphate bioluminescence (ATP bioluminescence) as a comparator to find out which method is better to assess hospital cleanliness.
This prospective study was conducted at a medical center from April 2019 to October 2020. Seven high-touch surfaces were evaluated during and after terminal cleaning by performance observation, visual inspection, and ATP bioluminescence.
The scores by performance observation, visual inspection, and ATP were 55.4%, 87.5%, and 26.6% after cleaning. The correlations between performance observation and visual inspection and between performance observation and ATP interpretation were weak positive (φ = 0.300, 0.324, P < .001). No correlation was between the visual inspection and ATP interpretation (φ=0.137). The median of ATP readings was lower in "compliant" group by performance observation and "clean" group by visual inspection than "not compliant" group and "not clean" group (P < .001).
Performance observation combined with ATP would be preferred to include to audit cleanliness on high-risk surfaces. Visual inspection would be a rapid and time-saving assessment tool on low-risk surfaces.
环境清洁是预防感染的有效措施。然而，很少有对清洁效果的具体观察描述。本研究旨在通过使用三磷酸腺苷生物发光法（ATP生物发光法）作为对照，比较视觉检查、清洁效果观察和清洁有效性之间的相关性，以找出哪种方法更适合评估医院清洁度。
本前瞻性研究于2019年4月至2020年10月在一家医疗中心进行。在终末清洁期间及之后，通过清洁效果观察、视觉检查和ATP生物发光法对七个高频接触表面进行评估。
清洁后，清洁效果观察、视觉检查和ATP检测的达标率分别为55.4%、87.5%和26.6%。清洁效果观察与视觉检查之间以及清洁效果观察与ATP检测结果之间的相关性呈弱正相关（φ = 0.300，0.324，P <.001）。视觉检查与ATP检测结果之间无相关性（φ = 0.137）。通过清洁效果观察评定为“合格”组以及通过视觉检查评定为“清洁”组的ATP读数中位数低于“不合格”组和“不清洁”组（P <.001）。
对于高风险表面的清洁度审核，清洁效果观察结合ATP检测可能是更好的方法。对于低风险表面，视觉检查将是一种快速且节省时间的评估工具。
