An audit of cleaning effectiveness using adenosine triphosphate (ATP) bioluminescence assay following outbreaks of infection

Abstract

The role of cleaning as an effective tool in the control of hospital acquired infections has generated much interest. Moreover, the role of cleaning personnel has been identified as being a more important factor in ensuring cleanliness than cleaning product. Adenosine triphosphate (ATP) is present in all types of organic matter and its measurement provides an indication of microbial and non microbial soil. This audit was undertaken at a large NHS university teaching hospital using ATP measurements to assess the effectiveness of the post outbreak cleaning regime. Two wards were assessed following outbreaks of norovirus and 23% of swabs failed to reach a previously established benchmark of 100 RLU. Nurse call bells were one of the most common failures (40%). Observation of practices during the audit revealed poor compliance with the cleaning procedure and confusion over cleaning responsibilities. The cleaning procedure at the Trust has been simplified as a result. Further work is required to establish acceptable cleanliness benchmarks using this technology.