Program Schedule

Enhanced Terminal Room Disinfection: A Qualitative Summary of Perspectives from Environmental Services (EVS) & Nurse Managers

Session: Poster Abstract Session: Cleaning and Disinfection in Healthcare Settings
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
  • EVS Nurse Questionnaire Poster_IDWeek 14 poster_FINAL_09-18-2014.pdf (420.0 kB)
  • Background: The hospital environment is an established cause of healthcare-associated infections (HAI).  Enhanced terminal room disinfection, including the use of UV-C emitting devices and/or bleach, has been proposed as a method to reduce the risk of HAI caused by environmental contamination, but implementation of these methods is poorly described.  We characterized the perceptions of EVS and nurses regarding enhanced disinfection strategies.  

    Methods: We administered surveys to EVS supervisors and nurse (RN) unit managers at the 9 hospitals in the BETR Disinfection study to assess perceptions about delays in room cleaning, odor, streaking, and other unintended consequences based on type of terminal room disinfection method employed (quaternary ammonium (reference group), quaternary ammonium with the UV-C emitting device, bleach alone, or bleach with UV-C).  We compared responses a) during the use of quaternary ammonium versus bleach and b) with and without UV-C.  Proportions were compared using the 2-tailed chi-square test.

    Results: 335 survey answers were provided from 137 EVS staff (77% response rate) and 198 nurse managers (61% response rate).  EVS supervisors, housekeepers, and RN managers all perceived an increase in room cleaning/decontamination delays with the use of UV-C than without UV-C (EVS: 52 v. 27%, p=0.006; housekeepers: 45 v. 29%, p=0.07; RN: 47 v. 34%, p=0.023).  RNs received more complaints from staff concerning odor with UV-C than without (62 v. 40%, p=0.005).  EVS supervisors received more complaints about delays from RNs (70 v. 42%, p=0.002) and bed control (58 v. 40%, p=0.04) with the use of UV-C than without UV-C.  Regardless of cleaning strategy, EVS believed that delays in the Emergency Department were the primary cause of delays in hospital room turnover, whereas RNs perceived that room disinfection was the principal source of delay.  RNs felt that rooms were not cleaned consistently with either disinfectant (59% each, p=0.90) and that rooms were not cleaner with UV-C (58 v. 61%, p=0.65).  Over one-third of RNs believed that room disinfection with any strategy frequently interfered with the timely care of patients.

    Conclusion: The successful implementation of enhanced terminal room disinfection strategies must address the barrier of perceived increases in cleaning/disinfection times among both EVS and nursing.

    Lauren Knelson, MSPH1, Luke F. Chen, MBBS, MPH, CIC, FRACP1,2, David J. Weber, MD, MPH, FIDSA, FSHEA3,4, Rebekah W. Moehring, MD, MPH1,5,6, Sarah S. Lewis, MD1,2, William Rutala, PhD, MPH, FSHEA3,4, Daniel J. Sexton, MD, FIDSA1,2, Deverick Anderson, MD, MPH1,2 and CDC Prevention Epicenters Program, (1)Division of Infectious Diseases, Duke University Medical Center, Durham, NC, (2)Duke Infection Control Outreach Network, Durham, NC, (3)Department of Hospital Epidemiology, University of North Carolina Health Care, Chapel Hill, NC, (4)Division of Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill, NC, (5)Duke Antimicrobial Stewardship Outreach Network, Durham, NC, (6)Durham VA Medical Center, Durham, NC


    L. Knelson, None

    L. F. Chen, None

    D. J. Weber, Clorox: Consultant, Consulting fee
    Johnson and Johnson: Consultant, Consulting fee
    Germitec: Consultant, Consulting fee

    R. W. Moehring, None

    S. S. Lewis, None

    W. Rutala, Clorox: Consultant, Consulting fee
    ASP: Consultant, Consulting fee

    D. J. Sexton, UpToDate: Editor, Royalties
    National Football League: Consultant, Consulting fee and Educational grant
    Cubist: Grant Investigator, Grant recipient
    Johnson and Johnson: Consultant, Consulting fee

    D. Anderson, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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