The hospital environment is a breeding ground for the transmission of microorganisms – but a new study published in the Lancet, shows that when environmental services (EVS) teams across 11 Australian acute-care hospitals implemented a specific bundled approach to cleaning their facilities, healthcare-associated infection rates began to drop significantly.
The study focused on introducing EVS to the “REACH” cleaning bundle, a multimodal intervention, focusing on optimizing product use, technique, staff training, auditing with feedback, and communication, for routine cleaning. Between May 9, 2016, and July 30, 2017, the hospitals used the cleaning bundle which was successful at improving cleaning thoroughness and showed great promise in reducing vancomycin-resistant enterococci infections.
Previous studies have shown that switching to more powerful disinfectants, introducing automated room decontamination, or making changes to environmental hygiene protocols (e.g., by increasing the frequency of cleaning or disinfection) can reduce transmission or healthcare-associated infection, or both. However, this is the first randomized controlled trial to investigate the effect of a systematic bundle of interventions to improve environmental hygiene, targeting both routine daily cleaning and cleaning and disinfection at patient discharge.
The primary outcomes in this study were incidences of healthcare-associated Staphylococcus aureus bacteremia, Clostridium difficile infection, and vancomycin-resistant enterococci infection. The secondary outcome was the thoroughness of cleaning of frequent touch points, assessed by a fluorescent marking gel.
“Our work will inform hospital cleaning policy and practice, highlighting the value of investment in both routine and discharge cleaning practice,” the researchers wrote.
