title: Mechanical vs. manual cleaning of hospital beds: a prospective intervention study.
abstract: BACKGROUND
  Cleaning regimens for hospital beds were evaluated in the context of a rising prevalence of highly resistant micro-organisms and increasing financial pressure on healthcare systems. Dutch hospitals have to choose between standardized, mechanical bed-washers advised in national guidance and manual cleaning.
  
  
  OBJECTIVE
  To evaluate the quality of mechanical and manual bed-cleaning regimens.
  
  
  METHODS
  The multi-faceted analysis of bed-cleaning regimens consisted of three steps. In Step 1, the training of the domestic service team was evaluated. In Step 2, the cleaning quality of manual and mechanical regimens was assessed. Soiled beds, obtained at random, from different departments were evaluated using microbiological analysis (N = 40) and ATP (N = 20). ATP and microbiological contamination were measured in five predetermined locations on all beds. In Step 3, manual cleaning was introduced over a two-month pilot study at the surgical short-stay unit, and beds from other departments were processed according to the 'gold standard' mechanical cleaning. ATP levels were evaluated in three locations on 300 beds after cleaning.
  
  
  RESULTS
  Training was found to improve the quality of cleaning significantly. Mechanical cleaning resulted in significantly lower ATP levels than manual cleaning.
  
  
  CONCLUSIONS
  Mechanical cleaning shows less variation and results in consistently lower ATP levels than manual cleaning.
authors: Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands. Electronic address: Joost.Hopman@radboudumc.nl.
authors: J
authors: J
authors: Hopman
authors: Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: M
authors: M
authors: Nillesen
authors: Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: E
authors: E
authors: de Both
authors: Department of Process Improvement and Innovation, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: J
authors: J
authors: Witte
authors: Scientific Institute for Quality of Healthcare, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands; Department for Health Evidence, Section of Biostatistics, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: S
authors: S
authors: Teerenstra
authors: Scientific Institute for Quality of Healthcare, IQ Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: M
authors: M
authors: Hulscher
authors: Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
authors: A
authors: A
authors: Voss
mesh_terms: D001513:Beds / Q000382:microbiology*; D003428:Cross Infection / Q000517:prevention & control*; D004203:Disinfection / Q000379:methods*; D006797:Housekeeping, Hospital / Q000379:methods*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D009426:Netherlands; D010865:Pilot Projects; D011446:Prospective Studies
keywords: ATP bioluminescence; Beds; Cleaning; Clinical environment; Equipment