Cleaning & Maintenance Management Online

Letters to the editor

September 19, 2010
Editor’s note: A recent letter to the editor discussed the level of cleanliness in U.S. hospitals.

Every year, an estimated 2 million patients contract infections while in hospitals; for about 100,000 of them, the infections are fatal.

As the issue becomes more prevalent, and more Americans continue suffering, many wonder how and why this is happening.

Studies show that just because something appears to be clean does not mean that it is in fact clean — looks can be, and often are deceiving.

Attention is required in hospital cleaning, but as Robert Robinson explains in the following letter, sometimes appearances don’t count.

Letter to the Editor:
Issues surrounding health care in the United States have been on center stage recently.

Some of this is due to the release of Sicko, Michael Moore’s documentary, a recent full-page editorial discussing American health care in The New York Times, and the 2008 presidential campaign.

However, little if any of the discussion focuses on hospital cleanliness.

Often this is because many hospitals look clean, but if you dig a little deeper, you find surfaces are covered with germs and bacteria.

According to data released in April 2007 by the Society for Healthcare Epidemiology of America, researchers examined 49 operating rooms at Boston University Hospital and found half of the objects and surfaces that should have been cleaned were overlooked.

And, a study of patient rooms in 20 hospitals in Connecticut, Massachusetts and Washington, D.C., found that half of the surfaces that should have been cleaned for new patients were dirty, posing serious infection risks.

This is probably why infections contracted in hospitals are the fourth-largest killer in America.

Every year in this country, an estimated 100,000 people die as a result — as many deaths as those caused by AIDS, breast cancer, and auto accidents combined.

Getting worse, not better
The problem of dirty hospitals appears to be getting worse, most likely because of these key factors:
  • Hospitals are not tested for cleanliness.
  • Patients, staff, and doctors often confuse appearance with cleanliness.
  • There are few cleaning standards accepted and followed by most health care facilities.
Hospitals once tested surfaces regularly for bacteria and germs.

But in 1970, the Centers for Disease Control and Prevention (CDC) and the American Hospital Association advised them to stop; they said it was no longer necessary or cost-effective.

Yet, since then, MRSA (methicillin-resistant Staphylococcus aurea) infections and other infections resistant to most antibiotics have increased by 32-fold and numerous studies now see a correlation between unclean hospital equipment and rooms and dangerous infections.

And although doctors, nurses, and other medical staff have long followed standard procedures to deal with a variety of health care issues, this does not necessarily apply to how a hospital is cleaned and maintained.

In fact, except for legally required procedures and products, most medical facilities develop their own cleaning systems based on their own needs or policies, and not what is universally recognized as a “best practice.”

Looks can be deceiving
Additionally, most people believe that if a hospital looks clean, it is clean.

In most situations, inspectors are brought in to inspect a hospital only if they are investigating complaints from the public, usually the result of visible debris or soiling on floors, walls, or surfaces.

Looking clean and being clean and healthy is not the same thing, but this confusion actually may be our industry’s fault.

Working with CIRI, ISSA, BSCAI, and other industry-focused organizations, we need to do a better job of educating people that surfaces — along with the systems and procedures used to clean them — must be tested for cleaning effectiveness.

Our industry can help turn this situation around.

Robert Robinson
President, Kaivac Inc.
ISSA board member