Attitude, Perception of Hospital Staff Hinders Cleaning of Pediatric Wards

June 29, 2020

Sometimes the surfaces that are deemed easiest to keep clean in a hospital pediatric ward wind up being the most contaminated after cleaning. Preconceived notions may play a part.

Preconceived notions play a huge part in how clean hospitals can keep their pediatric wards, according to a study in the American Journal of Infection Control that looks at surfaces of a pediatric ward before and after cleaning. “The findings from this study suggest that perceptions of risk to the patient and cleanability are important factors in cleaning efficacy,” the study states.

Investigators with University College London and Great Ormond Street Hospital NHS Foundation Trust in London collected 1160 tryptone soya agar (TSA) contact plate samples from 55 sites within the hematology-oncology ward at Great Ormond Street Hospital. The samples were taken over a 2-week period in the ward, which comprised 6 consultation rooms, 2 reception areas, 3 separate 4-bed bays, 3 single rooms with bathrooms, 4 treatment rooms, a playroom, and a height and weight room. They measured the difference in the amount of colony forming units (CFUs).

Overall, CFUs in the entire ward were reduced by 68% after cleaning.

“The corridor was the most contaminated area within the ward,” the study states. “There were differences in the CFUs among the various areas within the ward, which were cleaned with varying efficiency. The surface material, who interacted with the surface, levels of initial contamination, perceived risk, and perceived cleanability were all found to have a varying impact on the cleaning effectiveness.”

Metal surfaces should be easier to clean than other types of surfaces, but this knowledge may have contributed to a lack of cleaning efficiency. The CFU loads on metal surfaces increased 167.68% after cleaning. Of the 10 metal surfaces, 5 were said to be easy to clean, 4 difficult to clean, and 1 moderate.

“Surfaces considered to be easy to clean were shown to have the greatest increase in CFUs (+34.12) after cleaning,” the study states. “Surfaces made from plastic and coated wood had an overall reduction, potentially due to the majority of plastic surfaces being considered as high risk and because wood surfaces have been shown to be linked to a decrease in contamination.”

The surfaces cleaned by environmental services (EVS) were more contaminated after cleaning than those surfaces that were cleaned by clinicians.

“Some areas were consistently clean, both before and after cleaning, including surfaces in the height and weight room,” the study states. “Some areas were cleaned more effectively than others; for example, the treatment room, on average, showed an 80% reduction in contamination levels following cleaning, while the out-patient reception area saw an increase of 12% following cleaning. Some areas, such as the sluice, were cleaner than others both before and after cleaning, but other individual surfaces had consistently higher CFU counts, including a bookcase in the corridor and a play-room shelf.”

The investigators hope that their findings might lead to better training for those responsible for cleaning pediatric wards. The investigators believe that theirs is the only study that looks at the cleanliness of surfaces in a pediatric ward before and after cleaning.