Evaluation of Intensive Care Patient Bed Cleanliness by ATP Bioluminescence

INTRODUCTION: One of the most important causes of intensive care infections is cross-contamination, and priority is given to hand hygiene and environmental cleanliness in preventing it. Adenosine 5 triphospatebioluminescence (ATP) can measure the content of invisible contamination by measuring microorganism organic content. ATP produces results fast. In this study, we aim to evaluate the ATP measurement results retrospectively to observe environmental contamination at a time when infection rates have increased in our clinic.
METHODS: We retrospectively evaluated the results of measurements performed on three different days in December 2017. The measurements were made when all 20 beds in our clinic were occupied. Measurements were made in a region of 5x20 cm on the side of each bed before and after cleaning using ATP Clean Trace (3M Company-USA) device, and the results were recorded in the relative light unit (RLU). Although there are studies that have adopted a surface cleanliness threshold of 100-500 RLU, in our clinic, we consider the most commonly used 250 RLU for similar surface cleanliness as a threshold value. The threshold value for surface cleaning is accepted to be 250 RLU. If the value is above 250 RLU after cleaning, the cleaning is repeated, and the measurements are made again.
RESULTS: During the first measurement, three beds had to be cleaned a second time and during the third measurement, eight beds had to be cleaned a second time. Post-cleaning values were significantly lower than the pre-cleaning days (p<0.05).
DISCUSSION AND CONCLUSION: Consistent with the literature, we found that satisfactory cleanliness of the sides of the bed, which we think have been cleaned visually, cannot be sometimes achieved and they required to be cleaned again. We believe that it is important to quantify cleanliness inspection in intermittent periods in the prevention of contamination in intensive care.