Starting in July 2011, Environmental Services (EVS) supervisors and Infection Control began routinely monitoring room cleanliness at discharge by applying a gel to high touch surfaces that under normal light is invisible, but under UV light emits a distinctive glow. These high touch surfaces include door handles, call buttons, tables, sink and rails among many others. When high touch surfaces are effectively cleaned, the surface of the marked spot doesn’t fluoresce. When it hasn’t been appropriately cleaned with a disinfectant, the fluorescence remains as shown below.
This program is used as a proxy or indicator of overall cleanliness. In other words, if 9 or 10 out of 10 high touch surfaces are spot free (clean) the room is probably 90%+ clean and ready for the next patient. However, if 4 or 5 out of 10 high touch areas still have spots, those areas were not cleaned and this indicates that the room is probably not sufficiently prepared for the next patient.
This program is used extensively for training, assessment and education with our EVS team members. Currently, we are expanding the number of high touch surfaces and rooms we monitor in an effort to target specific clinical areas where patients with Clostridium difficile infection (CDI) are more common because C. difficile survives in the environment more easily than other organisms.
When a room has been determined to not be sufficiently cleaned, terminal cleaning may need to be performed again before it is acceptable for a patient to be admitted to it. This will hopefully be rare and decrease in frequency over time, but when it happens, it may impede/delay an admission to the unit.