At the 2024 Infection Prevention Society (IPS) conference, GAMA Healthcare revealed results from a landmark randomised controlled trial (RCT) called CLEEN1 (CLEaning and Enhanced disiNfection), recently published in The Lancet, one of the world’s most respected medical journals. A randomised control trial (RCT) is the gold standard of evidence conducted in such a way that as many sources of bias as possible are removed from the process.
The CLEEN study set out to determine whether enhanced cleaning protocols could reduce hospital-acquired infections (HAIs). The findings were striking: an additional three hours of cleaning shared medical equipment on each ward, together with training and auditing, resulted in a substantial 34.5% reduction in all HAIs.
Key Products Used in CLEEN
The study deployed four core products from GAMA Healthcare:
- Clinell Universal Wipes: Used for decontaminating all shared medical equipment at least once daily.
- Clinell PAA Wipes: Specifically for decontaminating commodes each day.
- Clinell EvalucleanTM: A fluorescent marker hygiene monitoring tool for auditing and training purposes.
- Clinell Indicator Notes: These provided visual assurance of equipment cleanliness.
Study Overview
Under the leadership of Professor Brett Mitchell, this stepped-wedge RCT was conducted over 36 weeks across 10 wards in an Australian acute-care hospital. Its goal was clear: to quantify the impact of enhancing both the frequency and quality of shared equipment cleaning on reducing HAIs. The intervention included three primary elements: (1) additional cleaning time; (2) targeted education; and (3) audit and feedback mechanisms.
The study introduced three extra hours of daily cleaning using Clinell Universal and PAA wipes, focusing on cleaning all shared medical equipment such as, but not limited to, commodes, drip stands and computer on wheels.
By focusing resources on all shared medical equipment, which are often missed in routine cleaning, the study underscored the often-overlooked role these surfaces play in infection spread.
Implications and Insights
The CLEEN study’s findings are transformative. The authors concluded in a recent blog2 that the study was cost-effective, saving hospitals money as well as improving important patient outcomes. They go on to say that a hospital decision maker that forgoes the opportunity to invest in this intervention risks wasting health care money and the opportunity to reduce risks for patients.
Cleaning of shared equipment takes considerable time. The reliance on clinical staff as the only cleaners of shared medical equipment runs the risk of this cleaning not occurring, a key finding from the control phase of the study.
A Call to Action
In the era of antimicrobial resistance, prevention of infections is key, the CLEEN study authors call for health services around the world to find ways to improve the cleaning and disinfection of shared medical equipment. When cleaning is improved, it is now proven that it will reduce the risk of HAIs for patients as well as freeing up valuable bed days used to treat patients with infections.
For those interested in adopting this life saving and cost saving intervention, GAMA Healthcare can offer support and guidance. Connect with your local GAMA Healthcare sales representative or contact us at: https://gamahealthcare.com/contact-us/
To further explore the science behind the CLEEN study, a webinar by Professor Brett Mitchell is available here:
http://bit.ly/4e2RQ2X
For a deeper dive into the study’s findings, read the authors blog “Wiping infections away with the CLEEN study” on Insight+2
References
- Brown et al. Investigating the effect of enhanced cleaning and disinfection of shared medical equipment on health-care-associated infections in Australia (CLEEN): a stepped-wedge, cluster randomised, controlled trial. Lancet Infectious Diseases August 13, 2024 https://doi.org/10.1016/S1473-3099(24)00399-2
- https://insightplus.mja.com.au/2024/38/wiping-infections-away-with-the-cleen-study/