The implementation of a hygiene monitoring programme has provided the impetus for a number of changes that have taken place and has many uses in different departments.
Following 10 years of research, evaluation and use with healthcare, specific benchmarks and standards of cleanliness for ATP have been determined and are also established in official standards such as DS2451-10 2011 in Denmark and Sweden.
The evidence provided by the ATP monitoring system has justified that interventions are fit for purpose, provide good performance and offer value for money. The system and the objective data generated has now become part of the daily routine practiced by hospitals, and provides evidence of due diligence.
Earlier adopters such as North Tees and Hartlepool Trust have shown a consistent and marked improvement in cleanliness and reductions in infection rates since its introduction in 2008. The results have shown a >20% improvement in pass rates and a large reduction in fail scores to fewer than 5% with a corresponding decrease of 35% in C. difficile cases and a 39% reduction in infections per 10,000 occupied bed days. Monitoring officers, independent from nursing and environmental services staff, are assigned to act as project champions for individual facilities, reporting to departmental managers wherever poor cleaning was discovered and where corrective action is required. Monthly reports are circulated for cross-functional team meetings of nursing, facilities and infection control staff. This allows for open discussions on all cleaning and maintenance related issues and stimulates actions for improvement.
The Hygiena SystemSURE Plus received the highest recommendation for the Department of Health and Public Health England’s Rapid Review Panel in 2009 and it has many different applications within hospitals including the routine testing of patient room, identification of hotspots and hazard management, training of cleaning staff, and hand wash training and verification.
The benefits of the ATP cleaning verification system include a dramatic improvement in hospital cleanliness, optimised cleaning performance and personnel training, increased productivity, commitment and moral of cleaning staff and reduced infections rates.
Similar improvements are seen in USA where the CDC also recommends the use of ATP as part of the monitoring tool kit for environmental cleaning. The Environmental Services (EVS) manager (Gomez) at Deaconess Rehabilitation Hospital in Evansville, Indiana said “Realising that our surfaces were not as clean as we thought was—quite honestly—a slap in the face. But it was a good wakeup call for everyone, especially me. As EVS leaders we sometimes think our processes are flawless and we don’t make mistakes because we’ve been in the industry for so long. We become overly confident—and that can be our worst quality. We have to be open to the idea that we are bound to make mistakes. How we learn from those mistakes and improve our processes is what will help us to become confident and assertive leaders.”
“ATP testing has truly helped us become aware of our cleaning techniques,” Gomez says. “We now hold educational meetings to discuss the programme’s success and areas where we still have trouble—to make sure we’re quick to correct any problems that consistently show up in our ‘fails’ report.”
A review by an independent company rated the Evansville healthcare system the highest score for cleanliness among the more than 600 facilities the company surveyed. ATP testing played a significant role in that achievement.
The EVS department also reports results of ATP inspections to the infection control specialist and committee. “Our infection control specialist has actually watched us do our inspections to see how staff performs that duty. Our infection rates are very low—and that’s a credit to everyone.”
The NHS spends £100’s millions on cleaning each year but relies on a highly subjective visual assessment to measure its delivery despite the advice from the National Institute for Health Research that this is of ‘questionable value’. Visual inspection can only detect gross lapses of practice in hospital cleaning of which <40% are actually delivered in accordance with policies (Carling 2010).
It is time to get a better understanding and control of cleaning to start saving time, money and lives. Hygiena’s ATP SystemSURE has been shown to provide the answer.