The Effectiveness of ATP Testing

After its success in the EVS field, ATP testing has become a method used across all industries to better measure cleanliness and overall cleaning performance. Implementing an ATP Testing program lays the foundation for increased accountability when measuring the success of your cleaning processes.

Before ATP Testing, visual inspections and fluorescent markers were some of the most commonplace practices in place to inspect an area’s cleanliness. In hindsight, neither practice allows for proper objectivity or consistency, not to mention that the latter option is an inefficient use of time.

The list of ‘objective methods’ the CDC encouraged hospitals to monitor their cleaning performance by in 2010 include:

• Visual Inspection: A process in which an EVS Supervisor or other staff member checks a room to determine whether it “looks” clean. Visual Inspections are an inexpensive and efficient method, but are at risk to impartial assessments.
• Fluorescent Markers/Gels: The process in which a surface is marked with an approved glow-in-the-dark product before EVS staff perform their cleaning duties of a room. Once the cleaning is completed, another supervisor or staff member performs an inspection by shining a black light on the surfaces that were marked. If the glow-in-the-dark substance is still visible, it is a sign that the surface may not have been properly cleaned.
• Microbiology Testing: Perhaps the most accurate method in this list is the process taking samples from a cleaned surface, usually via swab, and sending it to the hospital lab to test for pathogens that may still be present. The drawback of this process is that cultures take two to four days to grow and typically require interpretation by a microbiologist. “Although swab cultures are easy to use, the cost of processing, including isolate identification, the delay in results, the need to determine pre-cleaning levels of contamination for each object evaluated in order to accurately assess cleaning practice, and the limited feasibility of monitoring multiple surfaces in multiple patient rooms as part of an ongoing monitoring program represents issues which could limit the broad application of this system,” the CDC toolkit states (Guh and Carling, 2010)

Most recently, ATP Testing has emerged as not only a more effective and accurate method of measuring cleanliness, but it is also time-efficient and objective.

What is ATP Testing?

ATP Testing measures residual organic matter that may remain after a surface device or piece of equipment is cleaned.

• Adenosine triphosphate (ATP) is an enzyme that is present in all organic matter- living and once-living- including blood, saliva, and bacteria.

How is ATP Testing conducted?

A person conducting ATP Testing swabs the surface being tested and inserts the swab into a handheld unit called a luminometer. Results are made available in seconds.

• Additionally, all ATP Testing systems typically provide software that allows the user to track analytics such as EVS personnel performance and overall cleaning thoroughness.

Are there any drawbacks to ATP Testing?

ATP testing is sometimes mistaken to be a microorganism detection method- the only method that can detect that is microbiology testing. ATP Testing does not detect the type of bio-burden or pathogens left on the tested surface.

However, since any type of organic residue is food for bacteria, knowing a surface’s overall cleanliness is just as valuable for cleaning, and ATP Testing specializes in that.

In closing, ATP Testing has combined the efficiency of visual inspections with the accuracy of scientifically-proven testing methods. Knowing what we know today, hand hygiene programs are simply not enough to prevent the spread of bacterial infections in a facility. Studies conducted in 2010 concluded that 20 to 40% of all HAI’s are from unclean surfaces and the hands of healthcare workers (Weber, 2010) and only 34–40% of hospital surfaces are cleaned to policy standards (Carling, 2010).

These two conclusions alone are enough to understand that without a proper assessment program like ATP Testing to measure overall cleaning effectiveness, a facility is simply subjecting its occupants to unnecessary bacterial exposure.

That’s why, as leaders in the business of creating atmospheres of Workplace Wellness, we hold high conviction in not only providing elevated cleaning services, but also measuring our performances continually with ATP Testing. We are dedicated to improving each and every day by not only educating our employees, but also educating our clients as to how they can make the decisions that best protect their workplace occupants.

References

Boyce JM, et al. (2009) Monitoring the effectiveness of hospital cleaning practices by use of an adenosine triphosphate bioluminescence assay.

Carling PC and Bartley JM. (2010). Evaluating hygienic cleaning in health care settings: What you do not know can harm your patients.

Guh A and Carling PC. options for Evaluating Environmental Cleaning. Centers for Disease Control and Prevention. 2010. Available at: http://www.cdc.gov/hai/toolkits/Evaluating-Environmental-Cleaning.html.

Weber DJ, et al. (2010). Role of hospital surfaces in the transmission of emerging healthcare-associated pathogens: Norovirus, Clostridium difficile, and Acinetobacter species.