Can measuring environmental cleanliness using ATP aid in the monitoring of wards with periods of increased incidence of Clostridium difficile?

Management of periods of increased incidence of Clostridium difficile (PIIs) on a ward have become multi-factorial and involve isolation of patients, typing of the isolates, antibiotic audit and a weekly environmental audit completed until three consecutive weekly passes are obtained. The aim of this study was to establish if monitoring the environment using adenosine triphosphate (ATP) could aid in reducing the length of time the wards remained on the weekly environmental audit. Secondly, it was to establish if certain pieces of equipment had continually high ATP scores requiring wider interventions. The study took place across three hospital sites covered by one infection control team over a 22 month period. There were three study periods, with the only difference being that ATP monitoring was conducted during period B. There was a difference in the length of time the wards remained on the audit between the first period and the ATP period; however this decrease was sustained in the third period when ATP monitoring ceased. There was an increase in the percentage of sites achieving a pass with ATP week on week. ATP monitoring provided the staff with non-subjective results and immediate feedback that facilitated discussions about cleaning regimes. ATP monitoring was a useful adjunct to environmental audits.