EC 55 - Implementation of Fluorescent Gel Marking to Measure Thoroughness of Terminal Cleaning Compliance in an Acute Care Facility

Background: Contaminated surfaces in patient care areas contribute to the transmission of multidrug resistant organisms (MDROs) and increase the risk of infection in patients. Our current process did not include an objective validation measure for how thoroughly the surfaces in patient rooms were terminally cleaned. Fluorescent gel marking was implemented to quantify the thoroughness of terminal cleaning being performed after patient discharge.

Methods: A standardized checklist of 21 high touch surfaces were marked with fluorescent gel prior to terminal cleaning. The surfaces were assessed for the physical removal of the fluorescent gel using a black light after terminal cleaning was completed. A compliance score was calculated based on the number of surfaces the fluorescent gel was successfully removed from. Infection Prevention (IP) staff performed audits on a sample of 10% of total patient rooms in Quarter 1 and Quarter 2 of 2022. Baseline data collected in Quarter 1 was reviewed with Environmental Services (EVS) leaders and IP staff. EVS leaders implemented daily huddles, hands-on retraining for EVS staff, and updated terminal cleaning checklists. IP staff created visual aids of non-compliant surfaces after each audit for on-going EVS staff education.

Results: Thoroughness of terminal cleaning compliance was 53.1% (n=23) in Quarter 1 of 2022 and 70.6% (n=23) in Quarter 2 of 2022. A 17.5% increase in thoroughness of terminal cleaning was observed between Quarter 1 and Quarter 2 of 2022.

Conclusions: Fluorescent gel marking was successfully implemented as an objective method to measure the thoroughness of terminal cleaning compliance. Terminal cleaning compliance audits improve collaboration between the IP and EVS departments and provide accountability and influence education interventions for EVS staff.