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 hand hygiene page examines the practice of hand hygiene, from the proper methods to adherence among hospital staff. Will greater recognition of hand hygiene’s importance in curbing the spread of infections translate into better adherence among hospital staff and the public? This page features videos that demonstrate exactly how to conduct hand hygiene properly, articles recapping peer-reviewed literature on the latest advances in monitoring and adherence, as well as the popular "Bug of the Month" feature. 

The disbanding of HICPAC has left infection prevention experts scrambling to preserve national standards and ensure continuity amid growing concern over science-driven public health policy. Connie Steed, MSN, RN, CIC, FAPIC, speaks with ICT. 

In the Wake of HICPAC: How APIC is Leading the Fight to Preserve National Infection Prevention Standards

NFID 2025 Report Reveals Alarming Gaps in Hand Hygiene Practices Among US Adults

Despite their protective role, gloves are often misused in health care settings—undermining hand hygiene, risking patient safety, and worsening environmental impact. Alexandra Peters, PhD, points out that this misuse deserves urgent attention, especially today, World Hand Hygiene Day. 

Happy Hand Hygiene Day! Rethinking Glove Use for Safer, Cleaner, and More Ethical Health Care

Veterinary infection control experts Leslie Kollmann, BS, AAS, CVT, CIC, Denise Waiting, LVT, and Leslie Landis, LVT, BS, discuss challenges, zoonotic disease risks, and the importance of education, collaboration, and resource development in animal care facilities.

The Guardians of Animal Health: Who Are Veterinary Infection Preventionists?

The Bug of the Month helps educate readers about existing and emerging pathogens that are clinically important in today's health care facilities.

Bug of the Month: Rising From the Rainforests

Inconsistent cleaning and disinfection practices continue to pose significant risks to patient safety in health care environments. Despite broadly aligned guidelines from agencies like the CDC, the World Health Organization, the Association for Professionals in Infection Control and Epidemiology (APIC), and the Association of periOperative Registered Nurses (AORN), critical operational differences and accessibility barriers persist. 

This article examines the need for internal standardization, the role of professional memberships, regulatory frameworks from The Joint Commission, Centers for Medicare & Medicaid Services (CMS), The Occupational Safety and Health Administration (OSHA), and US Environmental Protection Agency (EPA), and the vital importance of viewing cleaning as a clinical service, not a commodity. Grounded in both personal experience and real-world examples, it emphasizes that 

 and offers a blueprint for health care facilities to lead with safety, consistency, and trust.

Introduction: Why Standardization Matters

Environmental cleaning and disinfection are foundational pillars of infection prevention. Yet, while the clinical community emphasizes protocols and stewardship, the healthcare environment itself remains vulnerable to inconsistencies. Even among recognized leaders like the CDC,¹ WHO,² APIC,³ and AORN,⁴ guidance varies enough to create confusion on the front lines.
In today's environment of emerging and reemerging pathogens, 

, and heightened regulatory oversight, internal standardization of cleaning and disinfection practices is not optional. It is a foundational investment in patient safety, staff confidence, and organizational resilience. Simply stated, 

all surfaces matter in the war on pathogen transmission in health care and community settings

A Landscape of Best Intentions—and Missed Alignment


Even minor inconsistencies around cleaning frequency, chemical selection, training expectations, and auditing methods can lead to operational drift, unless a facility sets and enforces its own consistent standard.

Access to Standards Is Always Best Practice, Not a Barrier

While foundational guidelines from agencies like the CDC¹ and WHO² are freely accessible, health care-specific cleaning standards often require membership or purchase:

AORN’s perioperative cleaning guidelines

⁴: membership or purchase required, updated annually.

¹³: surface safety, materials compatibility, validated cleaning protocols.

Disclosure: The author serves on the Healthcare Surfaces Institute Advisory Council under ISSA.


Membership isn’t a hurdle; it’s a strategic investment.
Direct access connects facilities to validated education, best practices, and peer collaboration critical for resilient infection prevention programs.

Real-World Consequences (with HealthPlus Case Study and National CMS Deficiency Data)

Case Study: HealthPlus Surgery Center, Saddle Brook, New Jersey⁹

In 2018, HealthPlus Surgery Center temporarily closed after the NJ Department of Health found critical lapses in sterilization and infection prevention protocols. Over 3,700 patients were notified of potential exposure to HIV, Hepatitis B, and Hepatitis C. While sterilization was a primary issue, inadequate environmental hygiene also surfaced as a major breakdown.


Failure to verify and enforce infection control protocols, including cleaning and disinfection, can escalate rapidly into a patient safety crisis.

National Trends: CMS Data on ASC Deficiencies⁸

CMS data from 2023 to 2024 shows infection prevention failures are the most frequently cited deficiencies across ambulatory surgical centers.

Failure to follow standardized cleaning protocols

Lack of documentation for terminal and between-case cleaning

Improper disinfectant use and dwell time compliance


Infection prevention lapses, including improper cleaning, are systemic risks, not isolated mistakes.

Agencies Advancing Health Care Cleaning Standards

Recognizing environmental hygiene as a pillar of patient safety, national and global organizations lead initiatives to close gaps:

: Certifications (CHEST, CSCT, CHESP) advancing healthcare cleaning competence.

International Sanitary Supply Association (ISSA) + Healthcare Standards Institute (HSI) + International Executive Housekeepers Association (IEHA)

: Interdisciplinary surface safety and facility leadership training.

: STAR Facility Accreditation, outbreak preparedness and response.

: International collaboration for health care hygiene research and advocacy.


Active participation with these agencies represents a strategic investment in health care excellence and resilience.

Regulatory Standards Reinforce the Need for Consistency

Regulatory agencies shape health care cleaning requirements:

: Mandates cleanliness validation under the Environment of Care standards.

: Requires safe, sanitary environments under Conditions of Participation.

: Bloodborne pathogens, PPE, and chemical handling safety.

: Disinfectant registration (List N, List K) ensuring efficacy against health care pathogens.


Compliance fulfills the fundamental obligation to protect patients, staff, and the community.

Facilities must own their environmental hygiene processes:

: Use EPA-registered, pathogen-appropriate disinfectants (tuberculocidal, fungicidal, sporicidal as needed).

: Implement two-step cleaning, validated dwell times, and clear Standard Operating Procedures (SOPs).

: Certification, annual competencies, ongoing education.

: Membership and direct access to standards ensure adherence to current best practices.

: Regular inspections benchmarked against internal SOPs, not industry averages.

Collaborative relationships with a medical laboratory

 for microbiological sampling and understanding of the pathogen burdens with the facility.


Standardization empowers staff, strengthens infection prevention, and builds operational resilience.

In-House or Outsourced, Cleaning Is Patient Care

Whether environmental services are in-house or contracted, cleaning is a 

Are staff health care-certified (CHEST, CSCT)?

Are SOPs aligned with the CDC, AORN, and CMS?

Is association engagement (ISSA, AHE, HSI) maintained?

Are outbreak response protocols established?


Having worked as both a customer and a provider, we’ve seen firsthand that too often, facilities contract cleaning services to the lowest bidder, overlooking the real costs: increased health care-associated infections, surgical site infections, readmissions, reputational damage, and patient harm.


Environmental cleaning is not a commodity. It is patient care.


Outsourcing does not outsource responsibility for patient safety.
Facilities that treat environmental hygiene as clinical care will achieve stronger outcomes, safer environments, and greater community trust.

Environmental cleaning must be recognized as a frontline health care service—essential to infection prevention, patient outcomes, and healthcare resilience.

Standardization is not bureaucracy.
Standardization is protection.

Facilities that invest in clear, accessible cleaning protocols, supported by training, membership, and strategic partnerships, will lead in safety, innovation, and patient trust.

Outsourcing does not absolve responsibility.
Internal teams do not guarantee readiness.
Only a culture of continuous education, accountability, and excellence sustains real infection prevention.

We have spent our careers on both sides: as customers and now as service providers.
The lesson remains clear:

Cleaning is not ancillary to patient care.
Cleaning is patient care.

https://www.cdc.gov/healthcare-associated-infections/media/pdfs/environmental-cleaning-rls-508.pdf

Guidelines on Core Components of Infection Prevention and Control Programmes at the National and Acute Health Care Facility Level

. World Health Organization. 2016. Accessed May 12, 2025. 

https://www.who.int/publications/i/item/9789241549929

Infection prevention: a perioperative nurse’s

guide to preventing infections in surgical settings

https://www.aorn.org/article/infection-prevention--a-perioperative-nurses-guide-to-preventing-surgical-site-infections

Association of periOperative Registered Nurses. 

Guidelines for Perioperative Practice: Environmental Cleaning

https://aornguidelines.org/guidelines/content?sectionid=173715702&view=book

Occupational Safety and Health Administration. 

. 29 CFR §1910.1030. U.S. Department of Labor. Accessed May 12, 2025. 

https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030

List N: Disinfectants for Emerging Viral Pathogens (COVID-19)

https://www.epa.gov/pesticide-registration/list-n-disinfectants-coronavirus-covid-19

List K: EPA’s Registered Antimicrobial Products Effective Against Clostridium difficile Spores

https://www.epa.gov/pesticide-registration/list-k-epas-registered-antimicrobial-products-effective-against-clostridium

Centers for Medicare & Medicaid Services. 

Ambulatory Surgical Center Top Deficiencies Report, 2023–2024

. CMS. https://www.cms.gov/medicare/provider-enrollment-and-certification/guidanceforlawsandregulations/surveycertificationgeninfo. Accessed May 12, 2025.

NBC News, Time Magazine, New Jersey Department of Health. 

. Various media sources. Accessed May 12, 2025. 

https://www.nbcnews.com/health/health-news/n-j-surgery-center-possibly-exposed-thousands-hiv-had-rusty-n952971

https://gbac.issa.com/gbac-star-facility-accreditation/

CHEST, CSCT, and CHESP Certifications and Resources

HSI Programs under ISSA Partnership Initiatives

. Healthcare Surfaces Institute. Accessed May 12, 2025. 

https://www.healthcaresurfacesinstitute.org

Lybert L. & Rohde RE. Why Surface Materials Matter in Health Care Settings American Society for Microbiology, 

January 25, 2024. Accessed May 13, 2025. 

https://asm.org/Articles/2024/January/Why-Surface-Materials-Matter-in-Health-Care-Settin

Inconsistent cleaning practices continue to jeopardize patient safety. Experts urge health care leaders to treat cleaning as clinical care—essential, standardized, and foundational to infection prevention.









The Case for Standardizing Cleaning and Disinfection: Why Consistency Is Critical to Patient Safety

Bridging the Gap: Infection Prevention in Veterinary Medicine

Infection prevention and control (IPC) is a critical part of health care, and veterinary medicine is no exception. Danielle Banks, BSc (Hons) RVN GradDipVN, is a registered veterinary nurse for Davies Veterinary Specialists, based in the north of London, England, in Hitchin Hertfordshire.

She is at the forefront of advancing IPC in animal care. With over 20 years of experience, Banks has dedicated her career to improving infection control protocols in veterinary hospitals, which traditionally lag behind human health care.

) to discuss her role and its importance, not only with animals, but with the broader One Health initiative. 

 is a relatively new field, but it is gaining traction due to the growing concerns over antimicrobial resistance and the One Health approach—recognizing the interconnection between human, animal, and environmental health. While hospitals and clinics in human medicine have well-established IPC protocols, veterinary practices must often adapt research and guidelines from human health care to fit their unique settings.

“My role as an IP veterinary nurse is really rare.  I'm fortunate to have this role. So, within the veterinary group, I certainly work for most clinics. Rather than having a dedicated IP nurse, we would have infection control representatives. So they're effectively, there's someone who champions IP within their clinic, and that might be a lead nurse or a clinician who has that additional responsibility on top of their existing role. They're championing hand hygiene. They will be the ones to help inspire and create that necessary positive culture around hand hygiene. They will be doing the training, the education piece, those compliance checks, and, of course, those gentle reminders, which are important."

Bank continues, "The other thing that I see certainly is that that leadership and management support, that that's right, vital, so that you know staff on the clinic floor can see leaders practicing that hand hygiene so then others follow, and it embeds IP and hand hygiene as part of patient and staff safety.”

A typical day for Banks involves staff training, policy development, environmental cleaning oversight, patient placement, and monitoring infection rates. She also works on outbreak management and collaborates with public health officials when necessary. Banks helps shape IPC strategies across multiple veterinary clinics as part of a UK-wide veterinary group, ensuring standardized best practices.

One major challenge in veterinary IPC is antimicrobial resistance. Banks emphasizes the importance of educating pet owners about responsible antibiotic use and the risks of overprescribing. She also highlights the need for improved hand hygiene adherence, an issue that parallels human health care settings.

Banks envisions a future where veterinary IPC is more structured, with dedicated training courses and professional networks similar to human healthcare. With increasing awareness and collaboration, veterinary infection control will continue to evolve, benefiting both animal and human health.

Danielle Banks, a UK-based veterinary nurse, discusses the growing importance of infection prevention in animal care, tackling antimicrobial resistance, hand hygiene, and adapting human health care protocols.

Who Are Veterinary Infection Preventionists?

Infection Control in Dentistry

Marie Fluent, DDS, dental infection control consultant and speaker at MarieFluent.com, spoke with 

) after her first presentation at the Chicago Dental Society Midwinter Meeting held in Chicago from February 19 to 22, 2025. Her topic was titled “Infection Control Update.”

Fluent, whose dental career spans 35 years, spoke in depth on everything from hand hygiene to waterlines. She is passionate about infection control, especially in dental.

“I love the topic of infection control. It's great public health service. And unlike other topics in dentistry, it's not sexy. In other words, if you adopt a new infection control program, nobody cares. If you got a new CEREC machine, everybody would sit around who and marvel at the technology and the time savings and the chair time savings that would be incorporated in adopting that new piece of technology. But if you have a new infection control program, nobody cares, but I consider it kind of like cleaning your house. If you do clean your house, nobody cares. But if you don't clean your house, everybody notices, and everybody cares. Infection control is in that same category, and it's like a public health service and endeavor that you do out at the bottom of your heart for the goodness of the community, your patients, and the safety and protection of your dental team.”

In the often funny and always engaging presentation, Fluent emphasized vaccinations and how to discuss them with patients and health care workers. “All clinical personnel in the dental setting are at risk for exposure to disease agents and other environmental hazards,” Fluent said. “With attention to infection control CDC guidelines, risks to yourself, your patients, and other dental team members can be minimized…No [vaccines] are perfect. Think of them as “bulletproof” vests. They will not protect 100% of the time, but they do help a great deal.”

At the 2025 Chicago Dental Society Midwinter Meeting, Dr. Marie Fluent passionately discussed infection control, emphasizing hand hygiene, waterlines, and the critical role of vaccinations in dental settings.

Conference

Infection Control in Dentistry: Marie Fluent, DDS, Champions Safety and Public Health at Midwinter Meeting

Jenny Hayes, MSN, RN, CIC, CAIP, CASSPT, the director of infection prevention at Jefferson Health East Region in New Jersey

's) Editorial Board members—a diverse group of professionals dedicated to advancing infection prevention and control practices. This series highlights each member's unique expertise and contributions to the field.

From groundbreaking research to innovative strategies, these experts are at the forefront of enhancing health care safety. Join us as we learn their insights, experiences, and visions for the future, providing valuable knowledge and inspiration to elevate infection control protocols. Meet Jenny Hayes, MSN, RN, CIC, CAIP, CASSPT, the director of infection prevention for Jefferson Health—East Region, in Stratford, New Jersey.

MSN, RN, CIC, CAIP, CASSPT, the director of infection prevention at Jefferson Health East Region in New Jersey, has built an impressive career dedicated to infection control. Her journey began early in nursing when she noticed critical gaps in basic hygiene practices. Starting as an LPN and eventually advancing to a master's degree, Hayes observed firsthand the severe consequences of infection in different healthcare settings, including dialysis and critical care, where patients faced high risks of bloodstream infections. Her experiences shaped her commitment to infection prevention and led her to specialize in this field.

Meet the experts shaping infection prevention: Infection Control Today's Editorial Board members share insights, experiences, and cutting-edge strategies to enhance health care safety and quality. Meet Jenny Hayes, MSN, RN, CIC, CAIP, CASSPT. 


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