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 disinfection of the air with UV-C is performed by irradiating the upper-room air only, the whole room when unoccupied, or the air flowing inside the air-handling units. The study conducted by McGinn et al. demonstrated the feasibility of using a UV-C robotic system to disinfect both air and surfaces in a radiology environment, where it was two and four times faster than currently used chemical approaches [
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 ( colony-forming unit/ cm
In this hospital, cleaning services were outsourced. According to the contract and the cleaning and disinfection standard operating protocol (SOP), during terminal disinfection, the housekeeping staff applied a chlorine-based detergent, Antisapril Detergent %, Angelini, followed by a chlorine-based disinfectant (Deornet Clor (COSÌ, Forlì-Cesena, Italy), active chlorine mgr/L) on furniture surfaces and electromedical devices.
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.