“Nationwide,” writes The Wall Street Journal (June 5,2012), ” about one in 20 patients entering a hospital will get a potentially deadly 
infection, accounting for some $33 billion in preventable costs.” Dangers lurk not only in vulnerable places like operating rooms, but from sink faucets and TV remote controls, which can harbor the most deadly bacteria. (By the way, it is not just hospitals that transmit deadly germs. TV remotes are now being sanitized and plastic-wrapped in 2,200 Best Western Hotels).
For decades, US hospitals have based room cleaning quality on visual checks. These “are no longer sufficient,” says the infection prevention director at New Jersey’s Hunterdon Medical Center. That hospital conducts random audits of 300 surfaces a month with a new swabbing device (shown in photo). Over 95% of checks get a passing grade, up from only 75% 3 years ago. Hunterdon also cut its rate of C. diff (Clostridium difficile) infections by 79% and reduced MRSA infections by 66% in the past 5 years. A bug called VRE that was on the rise for several years dropped 23% at Hunterdon last year. (C.diff is linked to 14,000 US deaths a year.)
Helping to spur action, the US government has set a goal of reducing hospital infections and other preventable problems by 40% by next year from 2010 levels. Medicare has stopped paying to treat some infections acquired in the hospital. And facilities with the highest rates of hospital-acquired conditions will face reduced federal payments starting in 2015.
What are hospitals doing? We now know that C. diff can survive for weeks on a doorknob, alcohol-based sanitizers don’t kill it, and hand washing is not sufficient. Cleaning crews need to use bleach and hydrogen peroxide, rooms have to be scrubbed carefully (even in corners), and “high-touch” surfaces carefully disinfected.
Discussion questions:
1. Why haven’t hospitals mastered quality control of cleaning?
2. How can the tools in Chapter 6 be used in this process?
3. Is 95% cleaning quality sufficient?