Non-microbiological System to Improve Hospital Hygiene in a Critical Care Unit (CCU)

Background: It is known that patient's flora contaminates the environment favoring microorganism's dissemination. Hospital Hygiene is therefore critical as an infection control measure. Aiming to improve it we decided to measure it and give feed-back to the cleaning staff in order to stimulate them. We also tried to assess if effectiveness gained was maintained through time. Methods & Materials: Prospective before-after study in the 30-bed CCU of a private hospital in Buenos Aires, Argentina (Ten intensive care beds, 10 intermediate care beds and 10 coronary care beds). Pre-intervention (3 months): With an invisible-ink pen we made ten marks in different surfaces of each room and controlled if they persisted 24 hours later. We calculated percentage of marks vanished. Intervention: We showed the results to the cleaning-staff and reviewed the right technique with them. Post-intervention (3 months): During the first 3 months, we evaluated the hygiene monthly and informed the results obtained. The cleaning staff was asked to complete a satisfaction survey. Follow up: After 9 months without controls we began to perform them every 3 months to assess continuity. Results: Cleaning efficacy improved statistically significant after the intervention Percentage of marks cleaned The less cleaned components were the infusion pumps (84%) and the ends of the beds (87%). The 84% of the survey-responders thought cleaning had improved and 79% perceived their work was more appreciated. Continuous controls are required to sustain achievements through time. Conclusion: To retrieve results is a beneficial strategy to improve cleaning. To analyze data together with the staff allows finding out real and specific goals. Control is essential to sustain results through time.