Study calls for examination into hospital cleaning standards

August 28th, 2015 Category: Local Authority & Housing

There needs to be more research into the best methods of cleaning hospitals, according to new findings.

A report by the University of Pennsylvania School of Medicine found that there is inconsistency when it comes to ascertaining the best hospital cleaning methods.

In a study published within the Annals of Internal Medicine, researchers claimed that there is a lack of evidence as to which method of cleaning high-touch surfaces such as trays, bed rails, light switches and toilets, is the best.

As part of the research, 80 related studies published between 1998 and 2014 were examined.

It found that comparative effectiveness studies were uncommon, despite the fact that they all directly compared different ways of cleaning, disinfecting and monitoring the cleanliness of hard surfaces.

Speaking about the findings, Jennifer Han MD, the study's lead author, said: "The cleaning of hard surfaces in hospital rooms is critical for reducing healthcare-associated infections. We found that the research to date does provide a good overall picture of the before and after results of particular cleaning agents and approaches to monitoring cleanliness. 

"Researchers now need to take the next step and compare the various ways of cleaning these surfaces and monitoring their cleanliness in order to determine which are the most effective in driving down the rate of hospital-acquired infections."

The report concluded that there were also relatively few studies that focused on measuring outcomes of most interest to patients, such as changes in infection rates and pathogens.

Furthermore, of all the previous studies looked at, only five were randomised controlled trials.

Figures published within the report showed that over 65 per cent of the studies assessed surface contamination, such as bacterial burden and colony counts, as the primary outcome. 

Less than 35 per cent reported on patient-centred outcomes such as hospital-acquired infection (HAI) rates or acquisition of a specific organism in the body, known as colonisation.

Although the number of studies that analyse infections within hospitals has increased over the last 15 years, there has been a growing number of patients dying as a result of HAIs.

For example, data obtained by the US Centers for Disease Control and Prevention (CDC) revealed that there were over 721,000 HAIs in the US in 2011.

Worryingly, some analysts believe that only half of surfaces are typically disinfected during cleaning of a patient's room.

Craig Umscheid MD, the study's senior author, said: "Our goal was to provide a comprehensive review of evidence in all three domains. While there is a clear need for more patient-centred and comparative effectiveness research, the findings that do exist provide a good place to start in terms of a hospital or healthcare entity seeking information on ways to mitigate healthcare-associated infections."

Ms Han added that technology could possibly play a leading role in helping to improve cleaning standards in hospitals and thereby reduce infections as a result, adding: "These include self-disinfecting coatings and increasingly used surface markers for monitoring the presence of pathogens. Other challenges include identifying high-touch surfaces that confer the greatest risk of pathogen transmission and developing standard thresholds for defining cleanliness."