University of Nebraska Medical Center

Philip W. Smith, MD: Research on Hospital Environmental Cleanliness

Above, a study nurse obtains an environmental study sample.

Above, a study nurse obtains an environmental study sample.

Spotlight on Research at COPH – Dr. Smith’s major current research project relates to detection of hospital environmental cleanliness. Centers for Disease Control and Prevention data shows that hospitalization is potentially hazardous, with approximately 1.7 million infections occurring in hospitalized patients in the United States annually. The environment in a hospital may look clean but harbor dangerous bacteria, such as MRSA, that may be transmitted to patients.

Looking for environmental contamination in the past has usually involved taking samples from surfaces and analyzing them in the microbiology laboratory, a process that takes several days. Dr. Smith’s research, in collaboration with Dr. Shawn Gibbs, Harlan Sayles, and Dr. Angela Hewlett (also of the College of Public Health), is evaluating a new rapid test for environmental contamination with a device developed by 3M. The device gives results within minutes in the room, allowing more immediate feedback to be given to environmental service personnel.

Dr. Smith’s group is comparing the new, rapid technique to the standard, labor-intensive method of sampling bacteria on hospital surfaces in a number of settings, including UNMC and outstate hospitals (Columbus Community Hospital and Regional West Medical Center in Scottsbluff, Nebraska). The research team is also working in the laboratory, with 10 different bacteria that cause hospital infections, and on a dozen different surfaces (e.g., steel, plastic, vinyl, carpet).

Another phase of the research project involves comparing different educational interventions with environmental services personnel to see whether environmental cleaning scores can be improved using the new 3M device. Providing feedback through cleaning scores is a powerful incentive to optimize cleaning. The study is also looking at other interventions, such as on-site demonstrations of the device, presentation of the cleaning scores on specific high-risk sites in the room, and other forms of positive feedback. In addition, the study is piloting a gaming device based on scores developed by Beth Beam and Stephen Smith of the UNMC College of Nursing.

The study has been very well received by environmental service personnel at The Nebraska Medical Center, and the research team is looking for additional applications of the rapid detection device.


Philip W. Smith, MD, is co-director of the Center for Preparedness Education, a joint endeavor between Creighton University Medical Center and The Nebraska Medical Center that resides in the UNMC COPH. Dr. Smith is a professor in the UNMC College of Medicine Department of Internal Medicine, in the Division of Infectious Diseases, and a professor in the UNMC COPH Department of Epidemiology.

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