利用荧光评估医院清洁效果:概念验证研究和ATP测试的比较。

IF 3.1 3区 医学 Q1 INFECTIOUS DISEASES
Sarah Fieldhouse, Benhur Bakhtiari Bastaki, Andrea Ledgerton, Paul Clarke, Trystan Lewis
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引用次数: 0

摘要

目视检查用于评估医院清洁度,因为可见污染可能带来健康风险并影响对护理质量的看法。问题是,许多污染物是肉眼看不见的,限制了视觉检查的可靠性。然而,许多不可见的物质在吸收电磁辐射后发出荧光。便携式手电筒可以“就地”检测荧光物质,提供了一种加强清洁实践的潜在方法。本研究评估了荧光作为识别医院清洁后一般不可见污染的工具。使用便携式高强度蓝光和紫外线手电筒检查了两家NHS医院的七个单人病房和两个六床病房的明显清洁表面。将荧光和非荧光区域的三磷酸腺苷水平作为公认的清洁监测工具,并使用Wilcoxon sign - rank检验进行统计分析。肉眼看不见的荧光污染在每个表面都被发现。与非荧光物质相比,荧光物质中的ATP相对光单位(RLU)水平有统计学差异(更高)(p≤0.05),对患者椅子、床架、床头柜、床头柜和枕头的影响较大,但对厕所、水槽或盥洗室没有影响。荧光区平均RLU值为161,对照组为33。荧光检测到可能对人类造成毒性风险的替代污染,可能是清洁液和/或药物污染残留物,它们通常含有荧光成分。这是一个重要的发现,因为仅仅依靠ATP检测可能会忽略重大的污染风险。鼓励进一步的工作来评估该方法作为清洁助剂的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessing Hospital Cleaning Effectiveness Using Fluorescence: A Proof-of-Concept Study and Comparison to ATP Testing.

Visual inspections are used to assess hospital cleanliness as visible contamination may present health risks and influence perceptions of care quality. Problematically, many contaminants are invisible to the naked eye, limiting the reliability of visual checks. Many invisible substances, however, fluoresce - emit visible light after absorbing electromagnetic radiation. Portable torches can detect fluorescent substances 'in situ', offering a potential method to enhance cleaning practices. This study has evaluated fluorescence as a tool for identifying general invisible contamination after hospital cleaning. Visibly clean surfaces in seven single-occupancy patient rooms and two six-bed wards across two NHS hospitals were examined using a portable high-intensity blue and UV light torch. Adenosine triphosphate levels in fluorescent and non-fluorescent areas were taken as a recognised cleaning monitoring tool and statistically analysed using Wilcoxon Signed-Rank tests. Fluorescent contamination that was invisible to the naked eye was found on every surface. ATP Relative Light Unit (RLU) levels were statistically different (higher) in fluorescent substances compared to non-fluorescent (p ≤ 0.05) with large effect sizes on patient chairs, bed frames, overbed tables, bedside units, and pillows, but not toilets, sinks, or commodes. The mean RLU measurement was 161 in fluorescent areas compared to 33 RLU in the control areas. Fluorescence detected alternative contamination which could present toxic risk to humans, possibly cleaning fluid and/or drug contaminated residue, which frequently contain fluorescent constituents. This was an important finding since relying solely on ATP detection may overlook significant contamination risks. Further work to evaluate the method as a cleaning aid is encouraged.

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来源期刊
Journal of Hospital Infection
Journal of Hospital Infection 医学-传染病学
CiteScore
12.70
自引率
5.80%
发文量
271
审稿时长
19 days
期刊介绍: The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.
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