Hand hygiene is clearly the most effective intervention in the prevention of healthcare-associated infections (HAIs). This cannot be disputed. The progress is impressive with HAI rates declining, but I have concerns with the disconnect between this initiative and the surface hygiene of equipment used outside of the patient room.

According to the World Health Organization (WHO), there are 5 key “moments” a healthcare worker needs to clean their hands:

  1. Before touching a patient
  2. Before clean/aseptic procedures
  3. After body fluid exposure/risk
  4. After touching a patient
  5. After touching patient surroundings


Let’s focus on #5 – After touching patient surroundings (i.e., surfaces touched by a healthcare worker, patient, or visitor). If patient surroundings are important enough to be a key “moment” in which you need to wash your hands, shouldn’t the surface hygiene of equipment used outside of the patient room carry the same concern?

In most cases, equipment moving throughout the facility has much less rigorous protocols for cleaning and disinfection than that of equipment residing in a patient room. As a keen observer of the healthcare environment for the past 20 years, this is a major flaw in the system.

Even if you have 100% compliance to the 5 key “moments”, you diminish these efforts if your cleaning and disinfection of surfaces outside of the patient room are not effective enough to rid them of infection-causing pathogens. There is clear evidence in peer-reviewed clinical publications that we have a problem. IT’S TIME FOR ACTION.