In the U.S. each year, more people die from hospital infections than from AIDS, breast cancer, and auto accidents combined. These infections are the fourth leading cause of death, with current annual estimates of 2,000,000 infections, 100,000 deaths, and added costs of $40 billion. Somewhere between 5-10% of all patients admitted to a hospital acquire an infection while in that hospital. Even with such extreme statistics, many industry experts consider the problem to be severely underestimated.

Studies of cleanliness in hospitals repeatedly show that a majority of surfaces are not routinely disinfected (or, in some cases, even cleaned), with one study showing that over 60% of important surfaces were not even touched by the cleaning crew. When a new patient comes into a room, chances are very good that the room is still contaminated from prior patients. Dangerous microorganisms can live for up to five months on common hospital surfaces. Inadequately disinfected rooms lead to a 40% increase in the probability of infection if the prior patient was infected. The main culprits are high-touch surfaces such as remote controls, phones, bedrails, light switches and door knobs. These surfaces often harbor dangerous microorganisms that can easily spread from surface to patient directly or from surface to staff, nurses and doctors then onto patients.

Over the decades, there have been very few advances in the cleaning methods of hospital environments. Most hospitals use harsh chemicals that require a ten-minute contact time (without drying) to kill the full range of microorganisms, often having to remoisten surfaces at least 3 times. Study after study shows that current disinfection methods are inadequate. In a study of 23 acute care hospitals, only 49% of surfaces evaluated were actually cleaned. In a study of rooms previously occupied by patients with VRE, 71% tested positive after cleaning. Another study of 197 patient areas found only 57% of surfaces had been cleaned.

When the hospital environment is contaminated, disease spreads. Studies have even found that the home bathrooms of nurses may be contaminated with deadly bacteria from the hospital environment. Health care employees have made workers compensation claims based on infections acquired in the workplace. Visitors are also at risk for exposure to microorganisms in the healthcare setting. The public is growing increasingly intolerant of infections in hospitals. Citizens groups and professional associations have successfully lobbied state legislatures to required mandatory reporting of certain infections. The Centers for Medicare and Medicaid Services has passed new policy that refuses reimbursement for certain healthcare associated infections. Furthermore, the reputation among the public that hospitals are “dirty” or “dangerous” is growing, causing consumers to shun large hospitals and seek care elsewhere. In decades past, healthcare associated infections were an accepted by-product of medical treatment. Now, because the virulence of the microorganisms has increased while our ability to treat infections has decreased, many of these infections are life-threatening. Infections acquired in a healthcare setting represent a liability for the institution on multiple levels, including liability for patient who acquired an infection while in the hospital, liability for visitors, and workers’ compensation liability for the entire workforce.