By using visual signals, hospital rooms become almost 70% cleaner

A new one study published in the American Journal of Infection Control reports a comparison of hospital room cleanliness using standard disinfectant wipes versus wipes with a color additive that allows users to see which surfaces have been disinfected. With the color additive, rooms were 69.2% cleaner and could be cleaned in slightly less time compared to cleaning with standard wipes. The study was conducted at Griffin Hospital in Derby, Conn.

Proper disinfection of hospital rooms helps prevent the spread of germs from one patient to another. Healthcare-associated infections (HAIs) pose a significant risk to patients, and contaminated surfaces in hospitals have been linked to many of these infections. For example, one study found that hospital patients were almost six times as likely to contract a HAI if they stayed in the bed of a former patient who had the same infection. Many previous studies have shown that despite significant effort and attention, hospital rooms are simply not as clean as they need to be to prevent HAIs.

In this study, doctors tested the results of hospital room sanitation in two ways. First, they evaluated the status quo over a one-week period: Environmental Services (EVS) teams used regular disinfectant wipes to clean surfaces in 10 randomly selected rooms. They then taught the EVS teams about using wipes with a color additive, which appears blue on surfaces during cleaning, but fades and turns clear minutes later when force and friction are used. This creates a strong visual cue to help users see what has been cleaned with effective technique and what has not.

Finally, the EVS teams cleaned another 10 randomly selected rooms with the wipes containing the color additive for a week. For both cleaning periods, non-EVS staff sampled 10 frequently touched surfaces for the presence of microbes before and after the rooms were disinfected. Such surfaces include sink handles, bed rails, call remote controls, light switches, telephones and toilet seats. In addition, non-EVS employees monitored the room’s turnaround time to determine if the color additive played a role in the duration of the cleaning process.

The results clearly showed the effectiveness of using the color additive. In both weeks of the study, 92% of surfaces sampled before cleaning were positive for microbial colonies. After disinfection, rooms cleaned with standard wipes still had microbes present on 60% of surfaces sampled, while in rooms cleaned with the color additive, microbial presence dropped to 31% of surfaces, an improvement of 48%.

A deeper analysis of the microbes left behind after cleaning showed that using the color additive made the rooms 69.2% cleaner than standard wipes. In addition, the additive slightly reduced the cleaning time required, from 39.1 minutes to 36.8 minutes.

“Our study is the first to evaluate color additive-assisted hospital cleaning based on microbial load, and the first to measure the impact on cleaning times,” said Olayinka Oremade, MD, MPH, CIC, lead author of the study and infection control manager at Griffin- Hopital. “Collectively, our results show that providing a simple visual cue makes a huge difference in the cleanliness of the room, and it appears that cleaning teams can also be a bit more efficient in the room turnover process.”

Additional details from the study include:

• During the study, microbial samples were taken from 400 surfaces, 200 for the control period and 200 for the color additive period. Bed rails were the most sampled surface, while cabinets, headboards, faucet handles, and infusion pumps were the least sampled.
• The rooms cleaned in this study were located in the telemetry admissions department and the medical-surgical admissions department.
• The change in chamber turnover time between methods, approximately 6%, was not found to be statistically significant.
• The color additive used in this study is compatible with many commercially available disinfectant products.

“Effective disinfection protocols are essential for successful infection prevention and control in healthcare settings,” said Tania Bubb, Ph.D., RN, CIC, FAPIC, 2024 APIC president. “This study illustrates the idea that simple but creative solutions can help us improve critical tasks related to keeping patients safe and healthy.”

Offered by the Association for Professionals in Infection Control