Program Schedule

1368
Assessment of Environmental Cleanliness in Outpatient Clinics

Session: Poster Abstract Session: Cleaning and Disinfection in Healthcare Settings
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • Assessment of Environmental Cleanliness in Outpatient clinics IDSA poster PDF.pdf (334.6 kB)
  • Background: Environmental contamination appears to be a risk factor for acquisition of hospital-associated pathogens.  Although the environment is likely a source of transmission of pathogens in settings other than acute care hospitals, few data are available on environmental contamination in non-hospital settings.  This project sought to evaluate the cleanliness of high-touch surfaces in outpatient clinics.

    Methods: Three clinics (total of 81 patient care rooms) in a large outpatient complex adjacent to a 621-bed academic medical center participated in the project.  Five patient care rooms in each clinic were evaluated during 3 time periods on a single day (prior to clinic opening, noon, and after clinic closing).  Five high-touch environmental surfaces in each room were sampled using the Clean Trace ATP system (3M St. Paul, MN), which measures ATP using relative light units (RLU).  Swabs were simultaneously collected for culture to determine the number of colony forming units (CFU) on each surface.    

    Results: A total of 208 environmental surfaces were sampled.  Mean RLU and CFU for each surface and time period are shown in table 1.  Mean composite RLUs prior to clinic opening, at noon, and after clinic closing were 388, 1025, and 628, respectively.  There was significant correlation between RLU and CFU measurements across all 3 clinics over all time periods for every environmental surface.

    Conclusion: Significant environmental contamination is present on high-touch surfaces in outpatient clinics, likely due to the lack of standardized cleaning protocols in this setting.  The chairs, which were not routinely cleaned, were shown to harbor large amounts of ATP and bacteria.  Horizontal surfaces had low RLU values prior to clinic opening, but became contaminated throughout the day.  The results of this quality improvement project highlight the need to enhance environmental cleanliness in the outpatient setting.

    Table 1: Mean relative light units (RLU) and colony forming units (CFU) on 5 surfaces by time period

    Period

    Surface

    Mean RLU

    Mean CFU

     

    Prior to clinic opening

    Chair

    835

    48

    Chair Arm

    710

    49

    Computer Table

    284

    13

    Counter

    75

    1

    Exam Table

    238

    15

     

     Noon

    Chair

    831

    56

    Chair Arm

    3127

    126

    Computer Table

    772

    10

    Counter

    255

    5

    Exam Table

    701

    38

     

     After clinic closing

    Chair

    504

    59

    Chair Arm

    975

    66

    Computer Table

    539

    18

    Counter

    464

    3

    Exam Table

    752

    13

    Angela Hewlett, MD, MS1,2,3, John Lowe, PhD3, Gregory Ely, BA4, Ibironke Dada, MPH BSC5, Kate Tyner, RN2, Elizabeth Lyden, MS3 and Mark E. Rupp, MD1,2, (1)Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, (2)Department of Infection Control & Epidemiology, The Nebraska Medical Center, Omaha, NE, (3)College of Public Health, University of Nebraska Medical Center, Omaha, NE, (4)School of Medicine, University of Nebraska Medical Center, Omaha, NE, (5)International Foundation Against Infectious Disease in Nigeria, Omaha, NE

    Disclosures:

    A. Hewlett, None

    J. Lowe, None

    G. Ely, None

    I. Dada, None

    K. Tyner, None

    E. Lyden, None

    M. E. Rupp, 3M: Consultant and Grant Investigator, Consulting fee and Research grant

    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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