In settings where hospital cleaning services are assigned to private sector contractors, the use of new no-touch technologies could be considered in outsourcing contracts as an improvement action in the event of non-compliance in the cleaning service. The dedicated personnel should be adequately trained not only on the cleaning protocols to be adopted but also on infection control issues, underlining the key role of cleaning procedures.

Among the appliable strategies for the improvement of cleaning and disinfection practices are the use of new materials and/or disinfectants, the training and audit of operators, and the use of new automated technologies, which are becoming increasingly important. In particular, no-touch disinfection technologies have the great advantage of not being dependent on the operator, ensuring process repeatability. Furthermore, their effectiveness has been demonstrated even on sites that are difficult to reach with manual intervention. Their use complements but does not replace ordinary cleaning and disinfection protocols. In the past few years, ultraviolet disinfection systems have been widely investigated and used as a way to improve standard cleaning protocols. Currently, ultraviolet devices are automated in order to guarantee process repeatability and reduce human errors. The application of UV devices as an addition to traditional environmental cleaning has become increasingly common due to their effectiveness in reducing the environmental microbial burden in a shorter time compared to other technologies using chemical products [

A prospective open-labelled cross-over study was conducted in a -bed teaching hospital in Italy from April to June . To evaluate the effectiveness of the UV-C disinfection robot in reducing environmental contamination, sampling was performed in four different critical areas: single occupancy ward room, intensive care unit (ICU) isolation room occupied for a minimum of h, and operating theaters (OTs).

The UV-C disinfection robot (Mediland Enterprise Corporation, Taoyuan City, Taiwan) uses amalgam lamps (UV lamp NNI / XL Niederdruck VUV Strahler) and protective reflector technology to generate high-energy, broad-spectrum ultraviolet light (UV-C &#x; nm). The manufacturer of the lamps declares in the technical data sheet that the lamps have a filter that blocks radiation between &#x; nm, eliminating the possibility of producing ozone as a by-product of UV-C radiation. The UV-C device uses min disinfection cycles and multiple positions with minimal distances from high-touch surfaces. Due to the use of high-intensity UV-C radiation, the device must operate in unoccupied rooms. There are multi-motion sensors that shut off the device if any movement is detected inside the room being disinfected or if the door is accidentally opened. When the robot operates in accordance with these procedures, the manufacturer declares that the amalgam lamps produce no ozone gas and leave no toxic residues.

Improving the cleaning and disinfection of high-touch surfaces is one of the core components of reducing healthcare-associated infections. The effectiveness of an enhanced protocol applying UV-C irradiation for terminal room disinfection between two successive patients was evaluated. Twenty high-touch surfaces in different critical areas were sampled according to ISO -, both immediately pre- and post-cleaning and disinfection standard operating protocol (SOP) and after UV-C disinfection ( sampling sites in each condition, in total). Dosimeters were applied at the sites to assess the dose emitted. A total of .% (/) of the sampling sites tested after SOP were positive, whereas only .% (/) were positive after UV-C. According to the national hygienic standards for health-care setting, .% (/) resulted in being non-compliant after SOP and only .% (/) were non-compliant after UV-C disinfection. Operation theaters was the setting that resulted in being less compliant with the standard limit (&#x; colony-forming unit/ cm