Hospital environmental hygiene is a complex process because it is influenced by several variables, such as the type of surface, incorrect disinfectant contact times, excessive dilution of disinfectant solutions, and potential biocide/antibiotic cross-resistance. In addition, it has been shown that the use of contaminated cloths and/or solutions promotes the spread of microorganisms between different environments [

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 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.

The role of the environment, particularly of high-touch surfaces in the patient&#x;s 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.

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