Reducing healthcare-associated infections (HAIs) is a challenge in Intensive Care Units (ICUs), where multidrug-resistant bacteria (MDR) are more prevalent. These microorganisms, by forming biofilms, can survive on surfaces for weeks to months. Proper and frequent environmental cleaning of surfaces and equipment near the patient is recommended to control microbial load; however, adherence to cleaning protocols is low. Possible causes include workload overload, lack of appreciation and knowledge regarding the protocol, as well as inadequate supplies and materials for proper execution.

To evaluate the impact of a multimodal intervention on nursing staff adherence to the concurrent cleaning protocol in an ICU.

A quasi-experimental study conducted in an Adult ICU of a Tertiary University Hospital in the metropolitan region of São Paulo. The study was carried out in three periods: pre-intervention (08/01/23–10/31/23), multimodal intervention (11/01/23–04/31/24), and post-intervention (05/01/24–10/31/24). During the first period, professionals maintained their usual cleaning routine. During the intervention, training sessions were conducted, supplies were provided for cleaning practices (one disinfectant solution per bed [quaternary ammonium/biguanide] and disposable multi-use wipes), and feedback on cleaning assessments was shared with staff participation. In the post-intervention period, the implemented measures were maintained. Cleaning assessment used a fluorescent marker applied to 10 pre-established high-touch points and evaluated with an ultraviolet light flashlight. The practice was considered “compliant” when all marked points showed no fluorescence under UV light or demonstrated substantial reduction of the fluorescent marker.

A total of 250 concurrent cleaning assessments were performed. The average adherence by study period was, respectively: 3.1%, 11%, and 25%. Average adherence by work shift across study periods was: morning (0%; 6.5%; 24%), afternoon (7.15%; 11.5%; 34.5%), and night (0%; 15.4%; 16%).

Monitoring cleaning using fluorescent markers, combined with a multimodal educational program, contributed to increased adherence to the environmental cleaning protocol of high-touch surfaces by the nursing staff.