The Effectiveness of ATP Testing

  • 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)
  • Adenosine triphosphate (ATP) is an enzyme that is present in all organic matter- living and once-living- including blood, saliva, and bacteria.
  • Additionally, all ATP Testing systems typically provide software that allows the user to track analytics such as EVS personnel performance and overall cleaning thoroughness.

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