title: Assessment of hospital daily cleaning practices using ATP bioluminescence in a developing country.
abstract: Visual assessment of surfaces may not be enough to document the level of cleanliness in the hospital setting. It is necessary to introduce quantitative methods to document the results of this practice.
  
  
  OBJECTIVE
  To evaluate the efficacy of hospital terminal cleaning procedures, using an adenosine triphosphate (ATP) bioluminescence method in a teaching hospital.
  
  
  METHODS
  During 2008 we conducted an evaluation using ATP bioluminescence LIGHTNING MVP™ (Arquimed) of external and internal housekeeping service. After conducting an initial evaluation we implemented education of cleaning practices and finally we did a post intervention evaluation. Using chi-square method we compared prior versus after cleaning, quality of cleaning performed by external versus internal personnel, single versus double terminal cleaning procedures and prior versus after intervention. A finding of three RLU or less was considered a clean surface.
  
  
  RESULTS
  We performed 198 evaluations in 33 patient units and nine OR. Internal personnel accomplished 25.37% of clean surfaces before and 80% after the education intervention (p=0.01). In contrast, external personnel obtained 68.8% before and 73.33% after intervention (p=0.3).
  
  
  CONCLUSIONS
  This study suggests that visual assessment is not enough to ensure quality of the process and it is necessary to document the level of cleanliness by quantitative methods.
authors.affiliation: Infection Prevention and Control Committee, Hospital Clínico y Clínica UC Lira, Red de Salud, UC-CHRISTUS, Santiago, Chile.
authors.forename: Alejandra A
authors.initials: AA
authors.lastname: Zambrano
authors.affiliation: Department of Infectious Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Alex
authors.initials: A
authors.lastname: Jones
authors.affiliation: Universidad Peruana Cayetano Heredia, Peru.
authors.forename: Paula
authors.initials: P
authors.lastname: Otero
authors.affiliation: Infection Prevention and Control Committee, Hospital Clínico y Clínica UC Lira, Red de Salud, UC-CHRISTUS, Santiago, Chile; Department of Infectious Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Ajenjo
authors.affiliation: Infection Prevention and Control Committee, Hospital Clínico y Clínica UC Lira, Red de Salud, UC-CHRISTUS, Santiago, Chile; Department of Infectious Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. Electronic address: jlabarca@med.puc.cl.
authors.forename: Jaime A
authors.initials: JA
authors.lastname: Labarca
mesh_terms: D000255:Adenosine Triphosphate / Q000032:analysis; D002677:Chile; D004203:Disinfection / Q000592:standards*; D006784:Hospitals, Teaching / Q000592:standards*; D006797:Housekeeping, Hospital / Q000592:standards*; D006801:Humans; D008163:Luminescent Measurements
chemical_list: D000255:Adenosine Triphosphate
keywords: ATP bioluminescence; Bacterial resistance; Cleaning; Nosocomial infections