Cleanliness audit of clinical surfaces and equipment: who cleans what?

Current guidelines recommend regular cleaning of clinical equipment. We monitored items on a surgical ward for predominant user, hand-touch frequency, cleaning responsibilities and measurement of organic soil. Equipment was assessed in triplicate against a cleanliness benchmark of 100 relative light units (RLU) using the Hygiena® ATP system. There were 44 items, of which 21 were cleaned by clinical support workers (CSWs), five by domestic staff; three by nurses, three by doctors, and 12 with no designated cleaning responsibility. Geometric mean RLUs ranged from 60 to 550/100 cm² for small items such as hand-gel containers, bed control, blood pressure cuff and clinical notes; with similar values of 80-540/100 cm² RLU for larger items such as electrocardiogram machine, defibrillator, trolleys and tables. Overall geometric mean was 249/100 cm² RLU for all surfaces, with 84% (37 of 44) items exceeding the 100RLU benchmark. Of 27 items cleaned by clinical staff, 24 (89%) failed the benchmark. Of 12 sites with no cleaning specification, 11 (92%) failed the benchmark. Three of seven 'clean' sites (