What are the best methods for cleaning and disinfecting hospital rooms?

Researchers and healthcare practitioners are aware of a number of strategies for cleaning and disinfecting healthcare facilities, but determining which is the most effective in reducing hospital-acquired infections is a more challenging task.

Few studies of these cleaning strategies measure patient outcomes, focus on newer technologies or compare cleaning tactics against one another, according to a systematic overview published in the Annals of Internal Medicine.

The researchers aimed to evaluate three areas: which agents and methods were used to clean hard surfaces, which approaches were available to monitor the effectiveness of cleaning and what systems-level factors are needed for successful cleaning and monitoring.

"Our goal was to provide a comprehensive review of evidence in all three domains," Craig Umscheid, MD, the study's senior author, said in a statement. "While there is a clear need for more patient-centered 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."

The researchers concluded that:

• Only five studies were randomized controlled trials.
• The existing studies are largely before and after experiments.
• Studies that directly compared different ways of cleaning to determine which are most effective were uncommon.
• There were relatively few studies focused on measuring the outcomes patients are most interested in, such as changes in HAI rates or the presence of pathogens.
• Studies reflected falling Clostridium difficile rates associated with the use of bleach-based disinfectants, but not with a chlorine dioxide-based product.
• Future study questions should emphasize a focus on which surfaces present the greatest infection risk to patients, what benchmarks should be established for measuring cleanliness and other factors that affect the quality of routine disinfection practices.

More articles on infection control:
Now that's patient-centered care: Hospital bends rules to reunite inseparable couple
CDC report outlines new approach for HAI reduction
FDA releases new guidance for cleaning 'unsafe' scopes

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