What cleaning professionals need to know about HAIs

Tuesday, October 23, 2018
By Robert Kravitz

Hospital-acquired infections (HAIs) are infections people can get as a result of being in a hospital. According to the Coalition for Healthcare Acquired Infection Reduction (CHAIR) 1 out of 10 Canadian patients acquire an infection from the hospital – that’s 200,000 people each year and five percent of those patients die, that’s 10,000 Canadians.

Cleaning professionals can play a significant role in helping to reduce these numbers. But before we discuss that, along with the personal toll, here are some direct and indirect costs associated with HAIs in Canada:

  • Many hospitals have a shortage of beds. When a patient contracts an HAI, what might have been planned to be a short hospital stay of a day or two can turn into a stay of several days, even weeks. This can delay the hospitalization and treatment of other patients.
  • Patients who contract HAIs require a lot of medical time and attention from doctors and staff, often taking time away from treating other patients.
  • According to the (CHAIR) Canada, it costs Canadians $4 billion to $5 billion each year to treat HAIs.
  • HAIs can delay a person’s return to work by several days, even weeks; often this results in lost wages. Further, many HAI patients have health complications after they have contracted an HAI, which can cost them their jobs.

To help protect human health and minimize the number of people in Canada contracting HAIs, cleaning professionals need to focus on three things:

  1. Identification of possible germs and bacteria that can cause HAIs
  2. The proper use of disinfectants
  3. Updated procedures used to clean surfaces in healthcare settings, specifically floors


One of the most significant advances in the professional cleaning industry has been the use of handheld adenosine triphosphate (ATP) monitoring systems. These ATP rapid monitoring systems detect if living cells are present on a surface. While they cannot identify the cells, indicating whether they are harmful or safe, a high ATP reading is viewed as a warning that the surface in question should be cleaned.

In recent years, imaging technologies have also been introduced to help identify the location of living organisms on a surface. Again, they cannot indicate whether these organisms are safe or harmful, but what they do provide is a map: they map out the locations of these cells on a surface and indicate, by using different colours, their intensity.


A fundamental problem we find in the professional cleaning industry when it comes to the use of disinfectants is “off-label” use. This is when cleaning staff do not follow the manufacturer’s instructions as to how to dilute the product; how long it should “dwell” or sit wet on a surface; and kill claims, which indicate what types of pathogens the disinfectant is designed to kill.

Cleaning professionals also use disinfectants in areas where they are not needed. Not only is this wasteful and costly, but evidence suggests pathogens develop immunities to disinfectants over time, just as people can develop immunities to certain antibiotics. This means, even if cleaning professionals are using these products properly, they still may not be effective because pathogens on surfaces have built up defenses to the disinfectants. To help prevent pathogens from becoming immune to certain types of disinfectants, some cleaning experts now suggest that disinfectants be rotated. Using disinfectants with different formulations can help reduce the possibility of an immune response.


Today, there are “no-mop” cleaning options such as the following:

Automatic scrubbers:  These machines scrub floors as the name implies and should not spread disease.  However, they can be costly to purchase and maintain.  Further, they can be difficult to use in small areas such as patient rooms, classrooms, etc.

Auto Vacs:  Less costly and more flexible than scrubbers, these machines automate the floor cleaning process by applying fresh cleaning solution directly to the floor, loosening soils as the machine is walked over the floor, and then vacuuming up the moisture and soils.

Vacuum powered systems: These systems dispense cleaning solution directly to the floor; using a wand, the solution/floor area can be agitated to loosen soils, which are vacuumed up in same the process.

The bottom line is that HAIs have serious ramifications, not only in how many people must suffer from these infections but also in how many die. Further, the costs, direct and indirect, associated with these diseases can be substantial. Cleaning professionals can play a significant role in reducing how many people contract infections while staying in a hospital.

Robert Kravitz is a writer for the professional cleaning industry.

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