加護病房環境終期消毒後ATP 檢測：比較COVID-19 與非COVID-19 病室

Adenosine Triphosphate Bioluminescence Assay for Monitoring the Effectiveness of Post-Environmental Terminal Disinfection in Intensive Care Units: Comparison of Wards With and Without Coronavirus Disease 2019

落實醫院環境清潔可減少環境中的致病菌存在，減少醫療照顧相關感染，為有效控管醫療環境清潔品質，需對環境清潔步驟與結果進行各類檢視，以提供量化及可見數據。於北部某醫學中心，自2020年6月24日至2021年6月23日於內外科加護病房，以ATP冷光檢測儀於完成終期消毒後進行環境採檢。分為加護病房的COVID-19病室及其護理工作單位，以及非COVID-19病室及其護理工作單位，病室有12個採集點，共計81次採集數；護理工作單位有3個採集點，共計21次採集數。COVID-19病室及其護理工作單位完成環境終期消毒後，所有採集點ATP冷光反應環境檢測數值皆< 100 RLU，加護病房的非COVID-19病室及其護理工作單位完成環境終期消毒後清潔合格率各為58.7%和41.7%；比較兩種已完成環境終期消毒的病室及護理工作單位環境檢測，發現除監測器螢幕外，其餘項目檢測平均數在統計上皆達顯著差異(p < .05)。新冠肺炎疫情期間醫療及清潔工作人員對於新冠病毒傳染力謹記在心，增加了執行清潔工作嚴謹度，故建議臨床上或可制定環境終期消毒方式以一個介面使用一張擦拭巾為原則，以達到清潔良好的要求，有效的清潔措施應將風險分級、清潔方法及清潔頻率納入感染管制考量，方能達到良好的環境清潔消毒。

Implementing hospital environmental cleaning can reduce the presence of pathogenic bacteria in the environment and medical care-related infections. To effectively control the quality of medical environmental cleaning, various inspections of the environmental cleaning steps and results are required to provide quantitative and visible data. From June 24, 2020, to June 23, 2021, we collected 102 samples from a mixed intensive care unit (ICU) in a medical center in northern Taiwan. After completion of the terminal disinfection, we used an adenosine triphosphate (ATP) bioluminescence assay to conduct an environmental inspection. Environmental collection and inspection were divided into the ICU wards and their nursing units with and without coronavirus disease 2019 (COVID-19). The ICU wards had a total of 12 collection points and 81 samples, whereas the nursing work unit had three collection points and a total of 21 samples. The qualified rates of final disinfection and cleaning of the COVID-19 wards and nursing work units were 58.7% and 41.7%, respectively. All ATP collectionpoint values were <100 RLU in the COVID-19 wards and nursing work units. When the environmental inspections of the two ICU wards and their nursing work units that had completed the final environmental disinfection were performed, except for the monitor screen, the average number of tests for other items was significantly different (p <.05). During the period of COVID-19, medical and cleaning staffs are more cautious, increasing the rigor of cleaning work. Therefore, clinical terminal disinfection methods should be developed based on the principle of using one wipe for each interface to achieve cleanliness. Effective cleaning measures should consider risk classification, cleaning methods, and cleaning frequency for infection control to achieve good environmental cleaning and disinfection.