Background Inadequate hospital cleaning may contribute to cross-transmission of pathogens. It is important to implement effective cleaning for the safe hospital environment. We conducted a three-phase study using human factors engineering (HFE) approach to enhance environmental cleanliness. Methods This study was conducted using a prospective interventional trial, and 28 (33.3%) of 84 wards in a medical center were sampled. The three-phases included pre-intervention analysis (Phase 1), implementing interventions by HFE principles (Phase 2), and programmatic analysis (Phase 3). The evaluations of terminal cleaning and disinfection were performed using the fluorescent marker, the adenosine triphosphate bioluminescence assay, and the aerobic colony count method simultaneously in all phases. Effective terminal cleaning and disinfection was qualified with the aggregate outcome of the same 10 high-touch surfaces per room. A score for each high-touch surface was recorded, with 0 denoting a fail and 10 denoting a pass by the benchmark of the evaluation method, and the total terminal cleaning and disinfection score (TCD score) was a score out of 100. Results In each phase, 840 high-touch surfaces were collected from 84 rooms after terminal cleaning and disinfection. After the interventions, the TCD score by the three evaluation methods all showed significant improved. The carriage incidence of multidrug-resistant organism (MDRO) decreased significantly from 4.1 per 1000 patient-days to 3.6 per 1000 patient-days (P = .03). Conclusion The HFE approach can improve the thoroughness and the effectiveness of terminal cleaning and disinfection, and resulted in a reduction of patient carriage of MDRO at hospitals. Larger studies are necessary to establish whether such efforts of cleanliness can reduce the incidence of healthcare-associated infection.

中文翻译：

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实施人为因素工程方法以改善医疗中心的环境清洁和消毒。

背景技术医院清洁不足可能会导致病原体的交叉传播。为安全的医院环境实施有效清洁非常重要。我们使用人为因素工程（HFE）方法进行了为期三个阶段的研究，以提高环境清洁度。方法本研究采用前瞻性干预试验进行，在医疗中心对84个病房中的28个（33.3％）进行了抽样。这三个阶段包括干预前分析（阶段1），根据HFE原则实施干预（阶段2）和程序分析（阶段3）。在各个阶段同时使用荧光标记物，三磷酸腺苷生物发光测定法和需氧菌落计数法进行终末清洁和消毒的评估。有效的终端清洁和消毒符合每个房间相同的10个高接触表面的总体结果。记录每个高接触表面的分数，按评估方法的基准，0表示不合格，10表示合格，终端清洁和消毒总得分（TCD得分）为100分。结果在每个阶段，对终端机进行清洁和消毒后，从84个房间中收集了840个高接触表面。干预后，三种评估方法的TCD评分均明显提高。多药耐药生物（MDRO）的携带率从每千名患者天数4.1降至每千名患者天数3.6（P = .03）。结论HFE方法可提高终端清洁消毒的彻底性和有效性，并减少了医院对MDRO患者的运送。必须进行更大的研究才能确定这种清洁度是否可以减少医疗保健相关感染的发生率。