TY - JOUR
T1 - Evaluation of daily environmental cleaning and disinfection practices in veterans affairs acute and long-term care facilities
T2 - A mixed methods study
AU - McKinley, L.
AU - Goedken, C. C.
AU - Balkenende, E.
AU - Clore, G.
AU - Hockett, Sherlock S.
AU - Bartel, R.
AU - Bradley, S.
AU - Judd, J.
AU - Lyons, Goedken
AU - Rock, C.
AU - Rubin, M.
AU - Shaughnessy, C.
AU - Reisinger, H. S.
AU - Perencevich, E.
AU - Safdar, N.
N1 - Published by Elsevier Inc.
PY - 2023/2
Y1 - 2023/2
N2 - Objectives: To describe daily environmental cleaning and disinfection practices and their associations with cleaning rates while exploring contextual factors experienced by healthcare workers involved in the cleaning process. Methods: A convergent mixed methods approach using quantitative observations (ie, direct observation of environmental service staff performing environmental cleaning using a standardized observation form) and qualitative interviews (ie, semistructured interviews of key healthcare workers) across 3 Veterans Affairs acute and long-term care facilities. Results: Between December 2018 and May 2019 a total of sixty-two room observations (N = 3602 surfaces) were conducted. The average observed surface cleaning rate during daily cleaning in patient rooms was 33.6% for all environmental surfaces and 60.0% for high-touch surfaces (HTS). Higher cleaning rates were observed with bathroom surfaces (Odds Ratio OR = 3.23), HTSs (OR = 1.57), and reusable medical equipment (RME) (OR = 1.40). Lower cleaning rates were observed when cleaning semiprivate rooms (OR = 0.71) and rooms in AC (OR = 0.56). In analysis stratified by patient presence (ie, present, or absent) in the room during cleaning, patient absence was associated with higher cleaning rates for HTSs (OR = 1.71). In addition, the odds that bathroom surfaces being cleaned more frequently than bedroom surfaces decreased (OR = 1.97) as well as the odds that private rooms being cleaned more frequently than semi-private rooms also decreased (OR = 0.26; 0.07-0.93). Between January and June 2019 eighteen qualitative interviews were conducted and found key themes (ie, patient presence and semiprivate rooms) as potential barriers to cleaning; this supports findings from the quantitative analysis. Conclusion: Overall observed rates of daily cleaning of environmental surfaces in both acute and long-term care was low. Standardized environmental cleaning practices to address known barriers, specifically cleaning practices when patients are present in rooms and semi-private rooms are needed to achieve improvements in cleaning rates.
AB - Objectives: To describe daily environmental cleaning and disinfection practices and their associations with cleaning rates while exploring contextual factors experienced by healthcare workers involved in the cleaning process. Methods: A convergent mixed methods approach using quantitative observations (ie, direct observation of environmental service staff performing environmental cleaning using a standardized observation form) and qualitative interviews (ie, semistructured interviews of key healthcare workers) across 3 Veterans Affairs acute and long-term care facilities. Results: Between December 2018 and May 2019 a total of sixty-two room observations (N = 3602 surfaces) were conducted. The average observed surface cleaning rate during daily cleaning in patient rooms was 33.6% for all environmental surfaces and 60.0% for high-touch surfaces (HTS). Higher cleaning rates were observed with bathroom surfaces (Odds Ratio OR = 3.23), HTSs (OR = 1.57), and reusable medical equipment (RME) (OR = 1.40). Lower cleaning rates were observed when cleaning semiprivate rooms (OR = 0.71) and rooms in AC (OR = 0.56). In analysis stratified by patient presence (ie, present, or absent) in the room during cleaning, patient absence was associated with higher cleaning rates for HTSs (OR = 1.71). In addition, the odds that bathroom surfaces being cleaned more frequently than bedroom surfaces decreased (OR = 1.97) as well as the odds that private rooms being cleaned more frequently than semi-private rooms also decreased (OR = 0.26; 0.07-0.93). Between January and June 2019 eighteen qualitative interviews were conducted and found key themes (ie, patient presence and semiprivate rooms) as potential barriers to cleaning; this supports findings from the quantitative analysis. Conclusion: Overall observed rates of daily cleaning of environmental surfaces in both acute and long-term care was low. Standardized environmental cleaning practices to address known barriers, specifically cleaning practices when patients are present in rooms and semi-private rooms are needed to achieve improvements in cleaning rates.
KW - Audit and feedback
KW - Environment of care
KW - Healthcare-associated infections
KW - Qualitative research
KW - Health Facilities
KW - Veterans
KW - Humans
KW - Disinfection/methods
KW - Long-Term Care
KW - Cross Infection/prevention & control
KW - Patients' Rooms
UR - http://www.scopus.com/inward/record.url?scp=85133362182&partnerID=8YFLogxK
U2 - 10.1016/j.ajic.2022.05.014
DO - 10.1016/j.ajic.2022.05.014
M3 - Article
C2 - 35644297
AN - SCOPUS:85133362182
SN - 0196-6553
VL - 51
SP - 205
EP - 213
JO - American Journal of Infection Control
JF - American Journal of Infection Control
IS - 2
ER -
