The role of the environment, particularly of high-touch surfaces in the patients room (e.g., bedrails, over-bed tables, and call-buttons) and reusable care equipment that is moved between rooms, has been demonstrated to be fundamental in the transmission of healthcare-related infections. Together with standard precautions and the application of good practices in invasive procedures, environmental cleaning and disinfection represents one of the three pillars of infection risk prevention in healthcare settings.
Although the dose measurement system used in our study (FastCheck Mediland, Taoyuan City , Taiwan) is semi-quantitative, it allowed us to detect if the dose reached adequate values for disinfection and to repeat the application when the value was not satisfactory. However, each dose value exceeded the expected value. This demonstrates that the device was positioned correctly in order to avoid shadow areas, although it was necessary to properly place furniture and equipment to improve the irradiation of all surfaces. In the study conducted by Wong et al., the R-D Rapid Disinfector system (Steriliz, Rochester, NY, USA) was used in a tertiary care hospital to evaluate the incremental benefit of UV-C disinfection in isolation rooms after the discharge of infected patients. The employed robot used four detached sensors to directly measure the UV-C light [
Hospitalized patients security in intensive care units should be ensured using protective devices, which may be evaluated for human security during UV-C emission at specific dosages and times. Considering the lack of literature data about these possible strategies, the use of a UV-C robot in the presence of persons still represents a critical issue that may be taken into account for the development of safe and effective technologies.
Monitoring data feedback to cleaning staff through periodic audits can be a valid aid for improving cleaning and disinfection procedures and adherence to protocols. This strategy was adopted in our study and, thanks to the collaboration between the infection control team and the outsourced cleaning company, it was possible to identify the critical issues and take corrective actions. To this end, environmental monitoring is essential for process verification.
The cleaning procedure is not only dependent on the chemicals used but also on the personnel performing it. As reported by Toffollutti et al., there are differences between housekeeping and outsourcing cleaning staff in ensuring adequate levels of hygiene; outsourcing cleaning services was associated with a greater incidence of meticillin-resistant Staphylococcus aureus (MRSA) and worse patient perceptions of cleanliness [