Tools and strategies for monitoring hospital environmental hygiene services

Abstract

Background: The hospital environment is a significant source of healthcare-associated infections, necessitating effective cleaning practices to mitigate risks. Various tools, including fluorescent markers, ATP assays, microbiological methods, and direct observation, are used for monitoring, but their comparative effectiveness remains unclear.

Aim: To identify and assess different monitoring approaches to inform evidence-based recommendations for healthcare facilities.

Methods: This scoping review followed Joanna Briggs Institute guidelines and PRISMA-ScR standards. Literature from 2000 to 2024 was sourced from PubMed, Web of Science, and Google Scholar, focusing on tools for monitoring hospital cleaning services. Twenty studies were included and analysed using a standardized data extraction framework.

Findings: Fluorescent markers and ATP assays were practical for routine monitoring and training but had limitations in detecting microbial contamination. Microbiological methods provided accurate contamination data but were resource intensive. Direct observation identified gaps in staff compliance but was subject to observer bias. Studies reported variability in standards, cleaning durations, and resource allocation, with limited data on full-time equivalents. Digital technologies, such as Artificial Intelligence and Internet of Things, offer potential for real-time monitoring and optimization.

Conclusion: A combination of visual inspection, ATP assays, and microbiological methods is recommended for effective monitoring. Collaborative efforts are needed to establish global standards, incorporating emerging technologies to address resource disparities and improve environmental hygiene practices, ultimately enhancing patient safety.

Keywords: Healthcare facility hygiene; Hospital environmental cleaning; Hygiene evaluation; In-house cleaning services; Monitoring hygiene; Outsourced environmental service.