EFEITO DE UMA INTERVENÇÃO EDUCATIVA NA LIMPEZA E DESINFECÇÃO DE SUPERFÍCIES DE SALAS OPERATÓRIAS: ESTUDO QUASE-EXPERIMENTAL

Abstract

Environmental surfaces in operating rooms (ORs) can become reservoirs for microorganisms during surgical procedures. In the absence of rigorous and systematic cleaning and disinfection (C/D) practices between procedures, there is a significant risk that these surfaces may contribute to cross-transmission of pathogens, thereby increasing the likelihood of healthcare-associated infections (HAIs) in subsequent patients. This study aimed to evaluate the effect of an educational intervention and the standardization of procedures on the C/D process of OR surfaces in a public hospital in Mato Grosso do Sul, Brazil. This was a quasi-experimental, non-randomized, single-group study employing a pre- and post-intervention design. C/D performance was assessed using visual inspection, ATP bioluminescence, microbiological culture, and fluorescent markers as evaluation indicators. Data were collected before and after cleaning from the following areas: granite countertop, anesthesia cart, auxiliary table, electrocautery unit, and mattress. The study was conducted in three phases: situational diagnosis, educational intervention, and short-term C/D monitoring. In the initial phase (situational diagnosis), 200 samples were evaluated through visual inspection, ATP testing, and microbiological culture, while 100 samples were assessed using fluorescent markers across five surfaces in 10 ORs. The educational intervention phase involved intensive training with 18 healthcare professionals (72.2% of whom were nursing technicians), covering basic microbiology concepts, C/D practices, and the use of standardized products. Practical demonstrations of surface cleaning were conducted using simulated contaminants. This process emphasized the importance of proper friction, correct disinfectant application, and the use of disposable cloths. Following the training, the Standard Operating Procedure (SOP) for concurrent OR C/D was revised. In the short-term monitoring phase, conducted one month after the intervention, the mean cleaning time (in minutes) ± standard deviation (SD) increased from 13.5±6.6 to 21.9±9.9 between the first and second rounds of sample collection (Mann-Whitney test, p=0.002). The mean ATP bioluminescence values (±SD) showed a more pronounced reduction in the second round of sampling, from 224.3±635.9 to 124.9±190.2, compared to the first collection, which decreased from 109.3±157.5 to 95.7±307.9 (Wilcoxon test, p=0.021 and p=0.002, respectively), demonstrating the effectiveness of the intervention. Comparison of monitoring methods indicated that the combination of ATP and fluorescent markers provided immediate feedback and was useful in promoting behavioral changes, although microbiological culture remained the gold standard for assessing C/D efficacy. In conclusion, the educational intervention significantly improved the C/D performance of OR surfaces, underscoring the importance of education and the standardization of hospital cleaning practices. The continuous adoption of evidence-based C/D protocols such as appropriate disinfectant use—combined with training and procedure standardization, proved effective in enhancing OR cleaning and disinfection, thereby contributing to patient safety.

Descriptors: operating rooms; housekeeping, hospital; disinfection; health education; infection control.