Abstract
Background: The transmission of pathogens between healthcare providers, the contaminated environment and patients has been identified as a significant cause of patient harm (Donskey, 2013; Han et al., 2015) yet preventable healthcare associated infections (HAI) continue to rise and are a major contributing factor to poor patient outcomes (Donaldson et al., 2000; Magill et al., 2014). HAI and patient colonisation with multi-drug resistant organism (MDRO) cause significant burden on the patient and healthcare facilities through increased mortality, morbidity, length of stay and antimicrobial resistance (AMR). Therefore, understanding interventions that reduce the environmental contamination and therefore prevent transmission of pathogenic organisms to patients in the hospital setting are essential in reducing this burden. Understanding the infection, prevention, and control (IpC) interventions that most effectively strengthen staff adherence to cleaning guidance for the patient environment and shared patient equipment is an important step in efforts to decrease contamination of hospital environments. Effective environmental decontamination lessens pathogenic microorganisms and reduces HAI incidence (Lacotte et al., 2020).
Aim: The aim of this review was to examine the published evidence on IpC interventions that improve cleaning and disinfection of the patient environment and shared patient equipment in an acute healthcare setting.
Methods: The integrative review was informed by the approach described by Whittemore and Knafl (2005) and was utilised to review published research examining IpC interventions for the cleaning and disinfection of the patient environment and shared patient equipment. A systematic search of electronic databases was undertaken, data evaluation and quality appraisal were completed using Joanna Briggs Institute (JBI) 2020 tools. Constant comparative analysis was used to draw and verify conclusions through data collection, display and reduction.
Findings: A constant comparative analysis approach produced three syntheses. The syntheses were i) The right intervention and education content are required to achieve the intended outcome; ii) Monitoring cleaning effectiveness is essential; iii) Engagement is required to facilitate change.
Conclusion: Interventions which included in-depth assessment of and response to staff educational needs and barriers were more successful at achieving long termed sustained improvements in cleaning and disinfection guidance adherence. Substantial cost savings can be achieved by investing in additional cleaning staff to reduce the incidence of HAI