Each hospital should have an infection control team aiming to evaluate the risk factors involved in healthcare infection occurrences with a multidisciplinary and dynamic approach. Epidemiological infection control in hospital may detect all of the critical points of the healthcare procedures performed by nurses, healthcare workers, physicians, students, and external staff. This evaluation may also include the sanitization process and its management. An appropriate evaluation of the whole sanitization process, including the reprocessing of cleaning materials, would be the best practice.

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 [

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 [

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.

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.