Effectiveness of clinical surface cleaning and disinfection: evaluation methods

To discuss the methods employed to evaluate the effectiveness of clinical surface cleaning and disinfection (C&D). This is a theoretical reflection based on scientific studies and the experience of the authors. Knowledge and current gaps, the need for further studies, and practical application of the methods were approached. There are four main methods used to evaluate the effectiveness of clinical surface C&D: visual inspection, fluorescent markers, microbiological cultures, and adenosine triphosphate (ATP) bioluminescence. The first two are used to evaluate the process and to predict adherence to protocols by the staff, and the last two are employed to evaluate the results, therefore being the most relevant to assess the risk of infection. The ideal method was not found, because all of them showed limitations. There is a need for strategies to optimize the precision of these methods.