Healthcare Hygiene magazine July 2023 | Page 21

With any measurement and auditing process , it ’ s important to conduct trials to see what works best in your facility . Buy-in is also critical ; for example , we had a homegrown system that everyone unanimously agreed was not working because there were biases and that created some tension between a few of the departments .”
interpret the results ; debate exists around interpretation . From a teaching perspective , it ’ s not useful in real time because depending on what you ’ re testing , it can take up to three or four days for results ; otherwise , perhaps there is value for use in an outbreak scenario to identify the cause of a pathogen .”
Moving on to adenosine triphosphate bioluminescence ( ATP ) as a monitoring method , Bruce explained that it can indicate the presence of bioburden . First used in the food processing industry , it has since been used in healthcare environmental services over the last decade .
“ One of the nice things about this method is that it is a measurement tool that produces a number which is a surrogate for any microbial bioburden on surfaces , unlike the fluorescent environmental marking method where we ’ re looking at the level of friction used during cleaning . Relative light units reported by using ATP is , to many people , data that they can see trending over time . The idea is that a very low reading would indicate low bioburden or low microbial cell counts , colony counts , and then if there were high readings , it would indicate very high bioburden levels that could potentially contain viable microorganisms . Using ATP provides a quick and direct reading , so that it ’ s possible to provide feedback to EVS personnel and perform real-time correction of cleaning and disinfection practice . Perhaps the reading is high relative to the institutional benchmark , so EVS personnel can go back and clean the surfaces again . We must remember that it ’ s not a direct measure of the contamination , we cannot equate it , necessarily , with the adequacy of all surface areas that it is supposed to represent .”
The final method that Bruce addressed was an ethnographic approach to auditing . She explained that this method embraces a collaborative approach when auditing the healthcare environment , adding , “ My personal experience of an ethnographic auditing process that incorporated photography . We gave the unit team — which was comprised of nursing and EVS personnel — a phone and they took pictures of what their issues were ; then we had a discussion about those issues , grouping them around themes and identifying ways to address them .”
Bruce added , “ With any measurement and auditing process , it ’ s important to conduct trials to see what works best in your facility . Buy-in is also critical ; for example , we had a homegrown system that everyone unanimously agreed was not working because there were biases and that created some tension between a few