Management at the Victoria General hospital in Halifax ordered a deep clean this week after patients complained of unchanged sheets, dirty toilets and beds.

CBC Radio's Mainstreet spoke with Dr. Dick Zoutman, a professor at the School of Medicine at Queen's University. He specializes in infectious diseases and is also the chief of staff at Quinte Health Care in southeastern Ontario.

Here's part of Zoutman's conversation with Preston Mulligan:

Mulligan: What are the main reasons it's so important that hospitals are clean?

Zoutman: Florence Nightingale taught us that … hospitals need to be clean and health-care areas need to be clean to be free of infection and we've known this for an awfully long time and it is very distressing to hear some of the emails and the commentary.

There's no doubt that hospital infections reside in the hospital. They lurk in the hospital. They hide in different places. And when you have that image of that chair with a hole in it, that gets contaminated and you can't clean that out when that chair's got a hole in it — tape or no tape.

The hospital environment is an absolutely important and critical factor in keeping patients — and maybe to some extent everybody in the hospital — safe.

Mulligan: What are the main health problems that can be caused by a dirty hospital?  

Zoutman: [They] come out as hospital infections with Methicillin-resistant Staphylococcus aureus, MRSA. It's a staph germ that's resistant to treatment and it's famous for spreading in hospitals.

And the one that has really swept the world has been Clostridium difficile. That's know as C. difficile and that's that germ that causes a very severe diarrhea. And that diarrhea can be associated with a significant mortality especially in the elderly and then it can also relapse in about a third of cases. And it's just a miserable problem.

There's a bunch of other infections [which] all have names attached to them. They're just various bacteria that are bowel bacteria that can cause problems in patients and the list is growing pretty quickly, particularly when you think about our patients who are on cancer treatment and have others forms of immune problems.  

Mulligan: The topic of hospital cleanliness is something that you've researched. Tell us more about what you've found.

Zoutman: I've been working in hospitals for almost 35 years and they're fascinating and wonderful places and can be sources of, great accomplishment and great healing, but they do need to be clean.

And so we undertook a study, a national study across Canada, we published in 2014. And we found that 40 per cent of infection controls experts did not judge their hospital to be sufficiently clean in Canada. Forty per cent did not feel their hospital was sufficiently clean to prevent infections.

That is the first time that's ever been identified and is a serious indictment of what we're doing in hospitals. And a great concern to me.

Mulligan: The hospital has said it's going to perform a deep clean after some of the complaints were raised. What do you make of that?

Zoutman: A deep clean is an old hospital process word. It means they're going to really get out there and clean things. And that's the right thing to do, and to go through particularly the patient care areas first and then the other areas second.

But also then you have to ask the question, 'OK, it's been cleaned today. That's fantastic. Well, what about tomorrow and the day after? What are you doing about that to make sure that it's going stay clean and what's your quality assurance program and your quality improvement program to demonstrate to the public and to everybody that you're keeping the hospital in the condition that it needs to be.'

And I will say, older hospitals are more difficult to maintain and at some point they come to the point in my experience that you just can't get them the way they need to be in terms of cleanliness any more.