The environmental services team at Summit Health, a rural Pennsylvania hospital, has used a 175-item terminal cleaning checklist since 2012.

After each terminal cleaning, five surfaces are swabbed using adenosine triphosphate (ATP) testing to ensure general cleanliness. The list was designed to ensure that a number of high-touch items, such as wall-mounted patient communication dry-erase boards, were cleaned properly. However, it was not created to eliminate the need to clean unlisted items. Last year, the hospital decided to target other high-touch items located in the patient rooms to determine if they were being cleaned as thoroughly as items on the checklist.

In an inspection of 55 cleaned and prepared patient rooms, 39 whiteboard markers and 52 erasers were identified and tested for the presence of ATP. All of the markers and 50 of the erasers failed the test. For items on the list, however, 95 percent of those surfaces passed the test.

“Because these are a main communication tool for nurses, cleaning them properly is of great significance to improving infection prevention,” says Ericka Kalp, Ph.D., MPH, CIC, FAPIC, lead study author and director of epidemiology and infection prevention at Summit Health.

Markers and erasers have since been added to the list.



Dry-erase markers are among the overlooked items that must be cleaned.

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