The Effect of Training and Monitoring of Environmental Cleaning on The Rates of Intensive Care Unit Acquired Infections in A University Hospital

• DOI: 10.1016/j.jgar.2024.10.205
• Publication Date: 2024-12-26T04:15:22Z
• Authors: Gamze Kalin Unuvar; Tulay Orhan Kuloglu; Meltem Gunes; Kevser Yucel Karasu; Recep Civan Yuksel; Aynur Karayol Akin; Ayşegul Ulu Kilic; Emine Alp
• Keywords: incidence of infection; Environmental cleaning; control; Microbiology; antibiotics; QR1-502

AIM: To evaluate the effect of training and monitoring of environmental cleaning (EC) on the incidence of intensive care acquired infections and the utilization of antibiotics in the Medical Intensive Care Unit (MICU)and the Anesthesia Intensive Care Unit (AICU). BACKGROUND: Implementing adequate environmental cleaning by training and monitoring in ICUs can help to reduce HAI rates and antibiotic usage. METHODS: A prospective intervention study was carried out from October 2023 to June 2024 to improve EC in ICUs.EC was performed twice daily using hydrogen peroxide, a high-level disinfectant.Fluorescent marking was used to monitor EC.In the first three months, monitoring of EC was done without prior notice and feedback.After January 2024, staff received information about monitoring and underwent weekly training with feedback (intervention period).Infection rates, the incidence of multidrug-resistant bacteria, antibiotic use and hand hygiene rates in intervention period were compared with preintervention period. RESULTS: During the intervention period,EC rates significantly increased in both ICUs (Table 1).ICU-acquired infection rates and device-associated infection rates decreased in both ICUs (Table 2).Furthermore, the rates of A.baumannii, E.coli, and Enterococci among causative microorganisms per 1000 patient days decreased during the intervention period (Table 3).A reduction in the use of carbapenem, vancomycin, piperacillin-tazobactam, colistin in the MICU,and a reduction in carbapenem,piperacillin-tazobactam, and daptomycin in the AICU was observed(Table 4).Hand hygiene rates also increased for most indications during the intervention period (Figure 1). CONCLUSIONS: A multi-modal strategy (build, teach, check, sell, live it)for EC will enhance cleaning effectiveness, reduce infection rates, and decrease antibiotic use in ICUs.