title: An evaluation of patient area cleaning in 3 hospitals using a novel targeting methodology.
abstract: BACKGROUND
  Although environmental cleaning and disinfecting practices have become a cornerstone of patient care, assessment of actual compliance with such procedures has not been reported. Using a novel methodology, we developed a means to monitor directly such activities.
  
  
  METHODS
  A nontoxic target solution, which intensely fluoresces with a black light, was formulated to be inconspicuous yet readily removed by housekeeping products. Small volumes of material were confidentially applied to 12 target sites in patient rooms in 3 hospitals following terminal cleaning. The targets were reevaluated following terminal cleaning after several patients had occupied the room.
  
  
  RESULTS
  One hundred fifty-seven rooms and 1404 targets were evaluated. In the 3 hospitals studied, only 45%, 42%, and 56% of targets were removed by routine terminal cleaning/disinfecting activities. The frequency with which various individual sites were cleaned varied widely but was similar in all hospitals.
  
  
  CONCLUSIONS
  The use of a novel target compound to evaluate housekeeping practices confirmed high rates of cleaning of traditional sites but poor cleaning of many sites that have significant potential for harboring and transmitting microbial pathogens. This methodology has the potential for being used to evaluate objectively the cleaning/disinfecting activities in various health care settings.
authors.affiliation: Department of Hospital Epidemiology, Carney Hospital, Boston 02124, USA. pcarling@cchcs.org <pcarling@cchcs.org>
authors.forename: Philip C
authors.initials: PC
authors.lastname: Carling
authors.forename: Janet
authors.initials: J
authors.lastname: Briggs
authors.forename: Deborah
authors.initials: D
authors.lastname: Hylander
authors.forename: Jeannette
authors.initials: J
authors.lastname: Perkins
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D004203:Disinfection; D005456:Fluorescent Dyes; D019983:Guideline Adherence; D019538:Health Care Surveys; D006761:Hospitals; D006797:Housekeeping, Hospital; D006801:Humans; D017053:Infection Control / Q000379:methods*; D011787:Quality of Health Care; D013194:Staining and Labeling
chemical_list: D005456:Fluorescent Dyes