Using Visual Cues Makes Hospital Rooms Nearly 70% Cleaner

A new study published in the American Journal of Infection Control The study compared the cleanliness of hospital rooms using standard disinfecting wipes and wipes containing a dye that allows users to see which surfaces have been disinfected. With the dye additive, rooms were 69.2% cleaner and could be cleaned in slightly less time than with standard wipes. The study was conducted at Griffin Hospital in Derby, Connecticut.

Properly disinfecting hospital rooms helps prevent the spread of germs from one patient to another. Healthcare-associated infections (HAIs) pose a significant risk to patients, and contaminated surfaces in hospitals have been linked to many of these infections. For example, one study found that hospitalized patients were nearly six times more likely to contract an HAI when they were in the bed of a previous patient who had the same infection. Many previous studies have shown that despite considerable effort and attention, hospital rooms are simply not as clean as they should be to prevent HAIs.

In this study, clinicians tested the outcomes of hospital room sanitation in two ways. First, they evaluated the status quo over a one-week period: Environmental services (EVS) teams used regular disinfectant wipes to clean surfaces in 10 randomly selected rooms. They then trained the EVS teams to use wipes containing a dye, which appears blue on surfaces during cleaning but fades to clear several minutes later when force and friction are used. This creates a strong visual cue to help users see what was cleaned with effective technique and what was not.

Finally, EVS teams cleaned 10 additional randomly selected rooms for one week using the wipes with the color additive. For both cleaning periods, non-EVS staff sampled 10 frequently touched surfaces for microbes before and after disinfecting the rooms. These surfaces included sink handles, bed rails, call remotes, light switches, telephones, and toilet seats. In addition, non-EVS staff monitored room turnover times to determine if the color additive played a role in cleaning process duration.

The results clearly demonstrated the effectiveness of using the dye additive. Over the two weeks of the study, 92% of the surfaces sampled before cleaning were positive for microbial colonies. After disinfection, rooms cleaned with standard wipes still had microbes on 60% of the sampled surfaces, while rooms cleaned with the dye additive saw microbial presence reduced to 31% of surfaces, a 48% improvement.

Further analysis of the microbes remaining after cleaning showed that using the color additive left parts 69.2% cleaner than standard wipes. Additionally, the additive slightly reduced the cleaning time required, from 39.1 minutes to 36.8 minutes.

“Our study is the first to evaluate hospital cleaning with color additives based on microbial load, and the first to measure the impact on cleaning times,” said Olayinka Oremade, MD, MPH, CIC, lead author of the study and chief of infection control at Griffin Hospital. “Collectively, our results show that providing a simple visual cue makes a huge difference in room cleanliness, and it also appears to allow cleaning teams to be a little more efficient in the room turnover process.”

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-added period. Bed rails 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 hospitalization department and in the medical-surgical hospitalization department.
• The change in room turnover time between methods, approximately 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 effective infection prevention and control in healthcare settings,” said Tania Bubb, PhD, RN, CIC, FAPIC, APIC 2024 President. “This study illustrates the idea that simple yet creative solutions can help us improve critical tasks associated with patient safety and health.”

Provided by the Association of Infection Control Professionals