'Enhanced cleaning' cuts hospital-acquired infections by one-third

An estimated 7500 Australian deaths are associated with hospital-acquired infections each year, with the most common including pneumonia, urinary tract infections and wound infections after surgery. With extant research suggesting medical equipment such as blood pressure machines, dressing trolleys and drip stands could be a common source of infection, a team of Australian researchers, including from Monash University, ran an experiment — introducing a program of ‘enhanced cleaning and disinfection’ measures onto several NSW hospital wards.

Instead of clinical staff, who are normally responsible for the cleaning of shared equipment, the researchers deployed designated cleaners specifically trained to clean and disinfect sensitive medical equipment. Regular training and feedback was given throughout the program, and the start date for cleaning on each ward was randomly selected. Economic costs were to be considered as well, weighing the cost of the program against healthcare costs saved should there be a reduction in infections.

The researchers monitored thoroughness of cleaning before and after enhanced cleaning through the application of a fluorescent gel marker to shared equipment. The gel is easily removed if the surface is cleaned well and cannot be seen without a special light. Patient infections on the wards were also monitored before and after the introduction of the program. More than 5000 patients passed through these wards while the program was being run. Findings from the experiment being published last year in The Lancet Infectious Diseases (doi.org/10.1016/S1473-3099(24)00399-2).

With reference to the gel marker, it was found that the enhanced cleaning improved thoroughness by 24–66% and that hospital-acquired infections dropped by approximately one-third following the introduction of the cleaning program — from 14.9% of patients to 9.8%. A reduction in the range of infections was also observed. Factoring in the cost of the designated cleaners, their cleaning products and the saved costs of the reduced number of infections, the researchers estimate that the intervention could save a hospital $642,000 for every 1000 patients.

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