Does Cleaning Time Matter? A Study to Determine the Effect of Unlimited vs. Limited Time for Terminal Disinfection

BACKGROUND: Although the national target for the amount of time dedicated to cleaning a hospital room following patient discharge is 45 minutes, there is no conclusive evidence that cleaning duration is related to the quality of clean in terms of microbial load. Using data from a larger study on hospital room disinfection we examined the relationship between manual cleaning time and microbial burden as assessed by aerobic bacterial colony (ABC) count on high-touch surfaces. METHODS: Six hundred pre-clean and post-clean samples were taken from 5 different high-touch surfaces (bedrail, tray table, call button, toilet seat, and bathroom handrail) in 44 different patient rooms. Three cleaning time categories were studied: Time limited to 25 minutes; unlimited cleaning time where the housekeeper took <45 minutes; and unlimited cleaning time where the housekeeper took ≥45 minutes. The relationship between cleaning time category and post-manual clean ABC count was assessed using a conditional inference regression tree that was modeled for the outcome variable ABC count and the predictors cleaning time category and other potential confounders. RESULTS: There was no difference in ABC count for hydrogen peroxide and sodium hypochlorite 10% between the different categories of cleaning time. For quaternary ammonium compound and soap and water, the limited cleaning time category showed lower ABC counts than the unlimited time categories for samples taken from isolation rooms, P = 0.009. For 150 soap and water samples, 61 showed an increase in ABC count from the pre-clean sample to post-clean sample. CONCLUSION: Cleaning time was not related to post-clean ABC count for sodium hypochlorite 10% or Hydrogen Peroxide. Limited cleaning time was more effective in lowering ABC counts for quaternary ammonium compound and for soap and water. For soap and water, post-clean ABC counts were actually higher than pre-clean ABC counts for numerous samples. This may be due to the spreading organisms across the surface while cleaning, without adequate disinfection. DISCLOSURES: C. Jinadatha, Xenex Healthcare Services: CRADA, Research support