Improving environmental cleaning in clinical areas: staff education based on adenosine triphosphate readings
Intended for healthcare professionals
Evidence & Practice    

Improving environmental cleaning in clinical areas: staff education based on adenosine triphosphate readings

Ariadna Villanueva Infection control practitioner, The Cuban Hospital, Infection Control Department, Dukhan, Qatar
Humberto Guanche Hospital epidemiologist, The Cuban Hospital, Dukhan, Qatar

To describe the effect of education on environmental cleaning in patient care areas using adenosine triphosphate (ATP) readings.


A quality improvement initiative was developed in a community hospital in Qatar. Over a two-month period, an infection-control practitioner monitored ATP readings in patient care areas, at any time and regardless of the time of the previous disinfection. The initiative included staff education, use of ATP readings and the drawing up of quarterly quality reports. The ATP readings were considered ‘pass’, meaning well cleaned, or ‘fail’, meaning non-cleaned, according to the following standards: >250 relative light units (RLU) in non-critical units and <200RLU for critical units. The proportion of test passes was calculated per 100 tests performed.


A total of 1,617 tests were performed, after which 1,259 (78%) surfaces were identified as well cleaned. The lowest proportion of non-pass and higher ATP readings was observed in non-critical areas. The test points with the lowest proportion of passes were telephones (40.5%), a medication dispensing system (58.5%), an oximeter (66.7%) and callbox buttons (67.6%). A sustained increase in test passes was observed during the study period.


There was an improvement in environmental cleaning due to monitoring of ATP on surfaces and staff education.

Nursing Management. doi: 10.7748/nm.2016.e1543


Peer review

This article has been subject to double-blind review and has been checked for plagiarism using automated software

Received: 06 June 2016

Accepted: 25 August 2016

Published online: 19 October 2016

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