One of the most common causes of healthcare associated infections (HAIs) is due to environmental contamination of surfaces in the patient care areas. Cleaning and disinfection of these surfaces has been shown to reduce the incidence of HAIs and contributes to the overall hospital cleanliness. Currently, hospital cleanliness is publicly reported through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey that is sent to all patients discharged from a healthcare facility. There is very limited research on if the perception of hospital cleanliness is related to the incidence of HAIs in a healthcare facility as defined by the facility's performance in the Healthcare Acquired Conditions (HAC) program.
A retrospective correlational study was performed to examine the relationship of patient perception of hospital cleanliness and the incidence of Clostridioides difficile (C. difficile) and Methicillin Resistant Staphylococcus aureus (MRSA) HAIs defined by the facility's HAC score. Multiple Center for Medicare and Medicaid Services (CMS) datasets were utilized for the study. There were approximately 2300 acute care facilities included that reported data on the patient perception of room cleanliness question, and either C. difficile or MRSA standardized infection ratio (SIR) for the time period of October 1, 2018 to September 30, 2019. Basic descriptive statistics and Spearman's correlational analyses were performed to analyze the relationships between the HAI HAC scores and the HCAHPS answer description to measure the potential association. The study found that as the percentage of patients who reported that their room was “always” clean increased, the hospital’s CDI or MRSA SIR decreased (r= -0.228,p= 0.00; r= -0.130,p= 0.00). The analysis also revealed that as the percentage of patients who reported their room was "never" clean increased, the facility's CDI or MRSA SIR increased (r= 0.180, p = 0.00; r=0.140, p= 0.00). This study found that a hospital’s HCAHP performance on patient perception of cleanliness is related to their performance on certain HAIs as defined by performance on HAC scores. Further research is needed to determine if there are specific factors that influence patient perception of cleanliness.
Open Forum Infectious Diseases, Volume 9, Issue Supplement_2, December 2022, ofac492.1038, https://doi.org/10.1093/ofid/ofac492.1038