Assessment of the baseline thoroughness of cleaning at one hospital dialysis suite

Abstract

One fifth to one third of hemodialysis patients develop infections from bacterial and viral pathogens over the total course of their treatment, many of which are healthcare acquired, leading to significant morbidity and mortality. Over recent years, significant strides have been made to decrease the rate of healthcare-acquired infections (HAIs) by reducing the risk of transmission of pathogens, including increased compliance to hand-washing of healthcare workers (HCW) and improved quality of environmental cleaning. The goal of the project was to improve the thoroughness of cleaning of a hemodyalysis (HD) suite using objective monitoring and a program of education and feedback. To achieve this goal, the project was broken down into three aims: 1. Determine the baseline thoroughness of cleaning using a novel marker system; 2. Educate and provide feedback to hospital administration and environmental services staff involved in overseeing and in cleaning the HD suite, and; 3. Determine if the program improves the thoroughness of cleaning when compared to baseline. Due to institutional constraints, the third aim of the project was not performed. This investigation demonstrated a baseline thoroughness of cleaning for all high-touch surfaces to be 42% of surfaces cleaned, indicating there are opportunities for improvement in the sanitation practices of the hospital hemodialysis suite. Most individual surface types fell below the internal goal of 90% cleaned. Through presenting the baseline data to hospital administration and environmental services staff, areas of potential improvement in hemodialysis suite sanitation practices were identified, which included the assignment of the cleaning of individual surfaces to specific hospital departments. Though the follow-up testing could not be performed, it is likely that the identification of these areas for process improvement resulted in increased cleaning of overlooked surfaces.