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RESULTS: Table 1 shows the TDC scores measured by hospital site and location, before and after terminal cleaning. In operating rooms, before cleaning, scores varied widely from a high of 62% to a low of 14%. After cleaning, the observed scores improve but still vary considerably: 82%-22%. In patient rooms, before cleaning, scores range from 64% to 27%. After cleaning, the range is 91%-52%. Importantly, we note that at given sites (1,2,3) cleaning in operating rooms results in neglible improvements in scores (average increase overall is only 11%), and only one site (6) scores above 80%. In patient rooms, cleaning results in greater improvements (average is +34%), but only two sites score above 80% (4,5 Phase 2). For site 2 there was a clear improvement in patient rooms scores as a result of including bleach wipes as part of the cleaning protocol; in operating rooms, were there was no change between phases, scores were similar. For site 6, scores obtained using CFUs were higher than those determined with ATP. In general, sites that had established monitoring programs (ATP or surface marking) fared better. CONCLUSIONS: The results of this study provide new insights into the effectiveness of terminal cleaning from hospital to hospital and in different locations of the hospital. More emphasis should be placed on effectively cleaning operating rooms, although obtaining high TDC scores is difficult, independent of location. Quality improvement efforts can result in sizable gains. |
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