How Long Does It Take to Clean and Disinfect Healthcare Surfaces?

We all know that cleaning and disinfection are essential in healthcare environments. But a question we rarely stop to ask is: How long does it take to effectively clean a patient room or shared medical equipment? Despite long‑standing guidance to “clean between use,” the true time burden has never been well quantified, until now.

In a recent webinar¹, Dr. Curtis Donskey referenced the work of Dr. John Boyce, who found wide variation in cleaning performance among EVS staff based on available time, number of wipes used, technique, and correct use of disinfectants.² Donskey’s own research echoes this: improper use of disinfectants remains a major contributor to suboptimal cleaning and disinfection.¹

The disconnect between protocol and practice: What’s really happening

During 26 hours of observed cleaning (post‑discharge, daily, and equipment), Donskey’s research team documented both the time spent cleaning and how appropriately products were used. Their findings underscore an issue that Infection Preventionists (IPs) and Environmental Services (EVS) leaders know well: that despite EVS staff’s best efforts and desire to do their jobs well, cleaning workflows are often fragmented, rushed, and inconsistent.

The preliminary findings of the study have showed¹:

• EVS carts frequently carry many different products (sporicidal and non sporicidal disinfectants, toilet bowl cleaner, glass cleaner, floor cleaner)
• During a terminal clean, staff spent only 38% of their time cleaning or disinfecting
• During daily cleaning, staff spent more time removing trash (33%) than cleaning/disinfecting (21%)
• Mobile equipment was rarely disinfected after use - only 16% of devices (4 of 25) were cleaned between patients
• In 36% of observations, equipment moved directly into another patient room without disinfection

This work echoes previously published data that highlights mobile equipment as a persistent source of pathogen transmission.³ Shared medical equipment (wheelchairs, commodes, IV poles, bladder scanners, medication carts) travels constantly between patients and each touchpoint creates an opportunity for pathogen transmission.³ Despite strong evidence that pathogens like C. auris, MRSA, VRE and C. difficile can survive on surfaces for prolonged periods, we’ve lacked data showing how long it takes to clean this equipment effectively. As Dr. Donskey put it, “You can’t improve what you don’t measure.”

A 2023 randomized controlled trial (the Cleaning and Enhanced Disinfection (CLEEN) study) demonstrated how improved cleaning and disinfection of shared medical equipment can reduce healthcare‑associated infections (HAIs).^4,5

The time it really takes to clean shared medical equipment

While the CLEEN study monitored the thoroughness of cleaning, it did not quantify the time required to achieve effective cleaning. To address this gap, a follow-up 2024 observational time‑and‑motion study was conducted by Matterson et al., where the researchers observed nursing students cleaning 12 types of shared medical equipment under realistic conditions.⁶ Each item was marked with 10 fluorescent dots, which were removed only with proper cleaning. Participants were trained using common hospital practices and used disinfectant wipes, simulating the standard workflow in many facilities. Cleaning was considered “effective” when ≥80% of dots were removed.

The researchers found that the time required for effective cleaning ranged from 50 seconds (blood glucose testing kits) to 3 minutes and 53 seconds (medication trolleys). IV stands were most effectively cleaned, with 100% of fluorescent dots removed on average. The most difficult to clean were bladder scanners, which required up to 12 cleaning attempts to meet the 80% threshold.

^{Source: https://doi.org/10.1016/j.jhin.2024.08.001}

This study confirms what we have long suspected: Some equipment is inherently more difficult to clean, and complex surfaces, curves, drawers, wheels and electronics all contribute to the challenge.

These findings raise important questions:

• Are we allocating realistic time for cleaning between use?
• Are cleaning expectations aligned with staffing capacity? _ Should we focus cleaning and disinfecting efforts more on shared equipment?
• Should the frequency of auditing increase?

Recommendations for Infection Prevention & Control (IPC)

To help address these concerns, IPs should consider advocating for the following strategies:

1. Training, Education and Competency: Ongoing training and competency assessment are essential to effective cleaning and disinfection practices. EVS and clinical staff should receive regular education on proper product selection, technique, contact times, and standardized workflows, especially when cleaning shared medical equipment.
2. Increased Monitoring: Enhanced auditing and feedback are proven to improve cleaning performance and can be cost‑effective.⁷ In the CLEEN study, enhanced cleaning and disinfection of shared medical equipment was linked to a reduction in HAIs and a $642,010 cost savings*, demonstrating that monitoring paired with education can improve outcomes while lowering overall costs.⁷
3. Consider Ready‑to‑Use (RTU) Disinfectants: Simplifying cleaning workflows can support both compliance and efficiency. Ready‑to‑use (RTU) disinfectants eliminate the need for mixing or dilution, helping ensure correct concentrations and reducing user error. RTUs can also save time for EVS teams and support consistent application, especially when cleaning shared medical equipment between patient uses.

The evidence is clear: Investing in enhanced cleaning and disinfection strategies, especially for shared equipment, can improve patient safety outcomes and deliver cost-savings for healthcare facilities.

As we continue to push for safer healthcare environments, I appreciate the researchers who help fill the fundamental gap in our understanding of the real-world requirements for effective cleaning and disinfection. Studies have shown that there is significant variability in cleaning time and thoroughness, which reinforces the value of clear training, consistent auditing, and structured workflows. By quantifying these time and cost-savings, and by identifying opportunities to improve efficiency, (including the use of RTU disinfectants), I hope that IPs and EVS leaders have the evidence they need to drive improvements in workflow design, staffing, training, and compliance.

^{* per 1,000 patients compared with usual care}