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Impact of Adenosine Triphosphate Detection and Feedback on Hospital Room Cleaning

  • Philip W. Smith (a1) (a2), Elizabeth Beam (a3), Harlan Sayles (a2), Mark E. Rupp (a1), R. Jennifer Cavalieri (a1), Shawn Gibbs (a2) and Angela Hewlett (a1) (a2)...



To assess the effect of adenosine triphosphate (ATP) device measurement of hospital room cleaning and feedback of pooled results to environmental service workers (EVS) to improve cleaning efficacy.


Nonrandomized controlled trial conducted over 20 months.


Three hospitals of varying size.


EVS workers, randomly selected on the basis of convenience sample of rooms.


Environmental cleanliness composite scores were combined with layered educational interventions and used to provide feedback to EVS workers on specific hospital units. Trends in cleaning efficacy were observed after the interventions.


Cleaning efficacy improved significantly with each intervention (P < .01) and decreased during the washout period.


The ATP detection device combined with educational feedback for EVS workers resulted in significant improvement in cleaning efficacy of the hospital room environment.


Corresponding author

College of Medicine, University of Nebraska Medical Center, 985400 Nebraska Medical Center, Omaha, NE 68198 (


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