單一地區醫院病房終期環境消毒落實度──以三磷酸腺苷（ATP）生物冷光檢測法探討清潔時間與人力模式之影響

Assessment of terminal room disinfection in a regional hospital: adenosine triphosphate (ATP)-based bioluminescence evaluation of cleaning time and staffing models

目標：醫療環境的清潔品質是感染控制與病人安全的關鍵。本研究旨在評估醫院病床終期消毒作業的落實度，並探討清潔時間與人力模式對清潔品質的影響。方法：本研究採用ATP生物冷光檢測法（adenosine triphosphate bioluminescence technique）作為稽核工具，於2024年1月至2024年10月，在南部某市立地區醫院之一般病房與加護病房（ICU）進行隨機床位抽測，探討清潔時間及人力模式（醫院自聘正職與外包人員）對終期消毒落實之影響。結果：檢測一般病房（N = 65）、加護病房（N = 24），研究顯示清潔時間顯著影響清潔成效（p < 0.001）。當作業時間小於20分鐘時，清潔異常率超過50%；超過25分鐘則合格率達95%以上。此外，人力模式亦具顯著影響（p = 0.005），自聘正職清潔人員合格率為100%，明顯優於外包人員的75.4%。結論：醫療機構應確保足夠的清潔作業時間，並慎重規劃人力模式，以提升環境清潔品質，降低醫療照護相關感染的風險。

Objectives: Environmental cleanliness in health-care settings is crucial for infection control and patient safety. This study investigated compliance with terminal room disinfection in hospital wards and analyzed the effects of cleaning duration and staffing models on cleaning quality. Methods: Audits were performed using an ATP-based bioluminescence test. From January to October 2024, random bed units were sampled in the general wards and intensive care units of a municipal regional hospital in southern Taiwan. The effects of cleaning time and staffing models—specifically, in-house full-time employees versus outsourced staff—on the quality of terminal disinfection were analyzed. Results: In total, 65 general ward beds and 24 intensive care unit beds were examined. Cleaning duration significantly influenced disinfection outcomes (p < .001). When cleaning was completed within 20 min, the failure rate exceeded 50%. However, when the cleaning duration was more than 25 min, the compliance rate exceeded 95%. Furthermore, staffing models significantly influenced compliance (p = .005): the compliance rate was 100% among in-house full-time employees but only 75.4% among outsourced staff. Conclusions: Health-care institutions should ensure adequate cleaning duration and adopt appropriate staffing models to enhance environmental hygiene and prevent health-care-associated infections.