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Canada has the highest rate of hospital acquired infections in the developed world, and Canada's consumer watchdog wants to know why. Erica Johnson puts hospital cleanliness to the test, and finds a mess that is making you sick. With hidden cameras, including Canada's first hidden camera glo gel test, insider interviews and expert opinions, Marketplace uncovers why people in Canadian hospitals are too often getting sicker instead of better.

I work for a Niagara area hospital, obviously I won't say which one as to not risk my job but our housekeeping manager directs us to take no longer than 15 minutes to clean a room. If you take an hour (the actual time it should take, as this video proves) good luck keeping your job.

the consumer show Marketplace visited several hospitals in Ontario and British Columbia

revealed many instances where cleaning had not been carried out, and that sparked a response from the Niagara Health System (NHS), the biggest in the country, whose hospitals have suffered a recent Clostridium difficile outbreak. It has decided to end its relationship with the private U.S. cleaning company Aramark.

will be adding "the equivalent of 18 new full-time cleaning positions."

Despite Ontario Health Minister Deb Matthews’ defence of her government’s patient safety record, Ontario hospitals are not required to report medical errors. After years of community-labour campaigns, hospital-acquired infections are now subject to “mandatory reporting” by hospitals, but not resulting deaths.

If only the Ontario government would follow other countries that invest in increasing staff ratios, reducing Ontario’s dangerously high bed-occupancy rates and bringing environmental cleaning services back in-house (as Niagara has been forced to do) and resourcing them adequately, it would reduce adverse events in hospitals substantially.

Medical mistakes kill, maim and injure thousands of Ontarians each year, cost the province billions and will only be made worse under the health care restraint now squeezing the system, author William Charney says.

“The austerity approach is exactly the wrong thing to do,” Charney, an occupational health specialist and former environmental health director of San Francisco’s public health department, said.

He was speaking at a Queen’s Park news conference sponsored by the Canadian Union of Public Employees and the Ontario Council of Hospital Unions.

The bacteria is linked in hospital records to more than 30,000 deaths a year in the United States

William Jarvis, who spent 17 years heading the health care infection division at the U.S. Centers for Disease Control and Prevention. "We know what to do (to lower rates). It's not rocket science. And we know the barrier is cost."

more than 9% of C. diff-related hospitalizations end in death — nearly five times the rate for other hospital stays

The privacy curtains that separate care spaces in hospitals and clinics are frequently contaminated with potentially dangerous bacteria, according to a U.S. study.

There is growing recognition that the hospital environment plays an important role in the transmission of infections in the health care setting

In their study, Dr. Ohl and his team took 180 swab cultures from 43 privacy curtains twice a week for three weeks.

a disturbing new form of drug-resistant bacterium - highly contagious, and dangerous because of its ability to copy and transfer its resistance to other bacteria

August 2010

KPC-producing Klebsiella pneumoniae

The families of patients who died after contracting C. difficile at a Quebec hospital in 2006 will each receive about $25,000 in compensation.

Seventy patients were infected and 16 died during the outbreak of C. difficile

The patients who survived the infection are also included in the settlement, but will receive a lesser amount.

Marketplace episode about the overuse of antibiotics in chickens.

In that episode, Marketplace tested 100 samples of chicken from major grocery stores across Canada and found widespread contamination with superbugs — bacteria resistant to antibiotics crucial to human health.

There is no federal program to track just how often or how many antibiotics are fed to feed animals, despite calls for such a program from numerous environmental and health experts.

Conversion to single rooms can substantially reduce the rate at which patients acquire infectious organisms while in the ICU.

Hospitalized patients who become infected with C. difficile need to stay in hospital for an average of six days longer than those free of the superbug, a new study suggests.

Dr. Alan Forster of the Ottawa Hospital Research Institute analyzed data on admissions to the hospital between 2002 and 2009

A total of 1,393 patients acquired C. difficile in hospital during this time, and these patients spent 34 days in hospital compared with eight days for patients who did not have C. difficile.

The Centers for Disease Control and Prevention (CDC) recommends that environmental services personnel "pay close attention to cleaning and disinfection of high‐touch surfaces in patient‐care areas," and that hospitals must "ensure compliance by housekeeping staff with cleaning and disinfecting procedures." The challenge for infection preventionists is to continue to convey this message to environmental services managers and personnel so that variations in cleaning methods can be addressed and a better system of monitoring can be implemented.

The key to establishing better communication and collaboration between infection preventionists and hospital environmental services professionals, according to Phillips, is "establishing better communication is incorporating environmental services into the patient care unit team – and they are a critical member of the team."

Kenneley reminds infection preventionists that "Adult learners learn best by 'doing' rather than being lectured to," she says. "One of the most compelling methods to convey an educational message is to present a real-life scenario and then troubleshoot the problems as a team. Also, for adult learners many times presenting the facts goes a long way. Some of the facts from environmental studies can be used to highlight the reasons for high touch surfaces to be cleaned while linking appropriate methodologies for optimal cleaning.

A new study suggests emergency departments may be a source of infections for seniors who turn to them for care, and a potential starting point for some of the infectious outbreaks that make their way through long-term care facilities.

those who had been to Emerg were nearly four times more likely to have a respiratory or gastrointestinal infection in the week after the hospital visit than seniors who had not been to the hospital

take additional precautions for the week upon their return to the long-term care facility — in particular during the winter months."

The Canadian Standards Association (CSA) argues that a move toward single patient rooms is vital as nosocomial infections are becoming a deadly concern

There’s an 11% increase in the risk of Clostridium difficile infection, a 10% increase in the risk of methicillin-resistant Staphylococcus aureus, and an 11% higher risk of vancomycin-resistant Enterococcus  infection with each exposure to a new hospital roommate

While opting to align Canada’s guidelines with those of the United States, the United Kingdom and several Scandinavian nations, the CSA indicated there may be clinical circumstances in which patients would benefit from the social and psychological advantages of shared rooms.

Preventive measures are required to reduce both acquisition of C. difficile and infection in people colonized by the organism. A “care bundle” approach has worked to reduce the number of cases in both Canada6 and the United Kingdom.7 Evidence-based national guidelines demand that all elements of the bundle be adhered to at all times.8 These elements include prudent prescribing of antibiotic medications, proper hand hygiene, use of personal protective equipment, early isolation of patients who have been colonized or infected and environmental cleaning.

Environmental decontamination using chlorine-containing compounds (≥ 1000 ppm available chlorine) is more effective than using detergent alone.8 In addition, hydrogen peroxide as a dry mist or vapour is emerging as an effective alternative for reducing environmental contamination.10

The reporting of cases of C. difficile is now mandatory in a number of American states and four Canadian provinces, but no national datasets exist.13,14 The US has subsequently set a target to reduce the onset of cases in health care facilities by 30% before 2013.15

several evidence-based interventions for improving outcomes including: the construction of single-bed rooms rather than multi-bed rooms (www.cmaj.ca/lookup/doi/10.1503/cmaj.109-4077); a good acoustic environment; the value of daylight and views of nature; appropriate lighting; better ergonomics; acuity-adaptable rooms; as well as improved floor layouts and work settings.

The Royal Jubilee had three pillars for design, says Rudi van den Broek, chief project officer and general manager of special projects at the Vancouver Island Health Authority. “The first was to be elder friendly — a hospital designed for the needs of older adult … the second, to attract and retain staff to provide the services for those older adults and the third was a focus on sustainability.”

“We used colour contrast out of the dementia research field to make sure that older adults can pick out where the walls and the ceilings start, where handrails are,”