Improving environmental cleaning in operating theatre:staff education based on adenosine triphosphate readings

Ms Lina Yang1, Ms Jian Zhang1, Mr Qian Xiang1, Mr Yu LYU1, Ms Xiaohui Huang1, Ms Rong Tang1

1Sichuan provincial people’s hospital, Chengdu, China


In China,hospital cleaning is primarily assessed via visual inspection,which can be misleading.This prospective study was designed to establish a more suitable method of evaluating the cleanliness of surfaces in the operating theater.


The ATP luminescence method was designed to detect the environmental surface in operating theater,including 12 specify areas and 3 random areas.The time point of ATP testing included before the first surgery,after the second surgery completed and room cleaned.Then ATP readings were considered pass,meaning well cleaned,or fail,meaning non-cleaned,according to the following criteria: <300 relative light units(RLU) or not.The head nurse performed the test and shared ATP readings immediately with cleaners.In addition,a monthly report and classroom education for cleaners were conducted.


In 3 months,a total of 2250 tests were performed, after which 1557 (69.2%) surfaces were identified as well cleaned. The lowest proportion of non-pass and higher ATP readings was observed within specify areas. The test points with the lowest proportion of passes were bottom of negative pressure suction basket (42.7%), right side of the operating bed base(48.7%), shadowless lamp handle (56.7%) and middle of the operating mattress (58.7%). In the early stage of the study, the rate of non-pass after the second surgery was much higher than before the first surgery.As feedback and training progressed, the gap between the two continued to narrow, and the overall test passes was observed with a sustained increase.


There was an improvement in environmental cleaning due to monitoring of ATP on operating theater and staff education.


Lina Yang was born in China in 1987. After obtaining a master’s degree at West China School of Nursing, Sichuan University in 2011, I entered the Sichuan Provincial People’s Hospital.I have a nursing experience in the Department of Respiratory Medicine, Infectious Diseases, Pediatric Surgery, and Urology.Since 2013,I have been engaged in operating room nursing . I am mainly responsible for the cooperation of the operation room for gastrointestinal and transplantation, the management of instruments and equipment, and the development of new business and new technologies. I am currently presiding over one scientific research project in Sichuan Province, and participated in two provincial-level scientific research projects in the past three years. Last year I published my first SCI paper as a correspondent author.

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