Table 1 Comparison of key aspects of England's NHS and Germany's DIN guidelines

Audit and inspection method

Visual only; subjective. Equipment and items cleaned by the clinical staff are part of audit

Comprehensive description of methods including visual, ATP, Fluorescent marking, microbiological. Clinical items not explicitly included

Audit results delivery

Star rating visually displayed in each area. Star ratings vary by a complex functional risk system

Results need to be communicated to the employees at execution level in an understandable and practical form and left to local delivery method

Evidence base

No literature review; recommendations not supported by evidence in the scientific literature

No literature review; recommendations supported by evidence in the scientific literature

Guidance applicable to

NHS in England only, not Wales, Scotland or independent healthcare providers

All healthcare providers in Germany

Involvement of specialists

Professional cleaning organisations and public institutions; not endorsed by nursing or infection prevention-related professional societies

Collaborative between professional infection prevention-related societies, public institutions, companies in the cleaning industry, their suppliers and associations

Outline of responsibilities

Role of professional cleaners is described. Clear statements about the role of clinical staff in decontamination of clinical equipment

Comprehensive; client/service recipient defines interfaces for defining a separation of devices

Training needs

Mentioned but little detail provided

Comprehensive; outlines detail on training, requirement for expertise and stating that the content of training should be monitored

Colour coding used to separate different areas

Yes

Yes

Use of ‘novel’ technologies such as UV, Gaseous decontamination

Not mentioned

Not mentioned