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.

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