This paper discusses the term 'cleanliness' and applies it to healthcare. Ways of achieving cleanliness in premises where healthcare is delivered are explored. It is concluded that although once a world-leader in infection control practice and research, the United Kingdom is now lagging behind other countries. Traditionally hands have been regarded as the main vectors of healthcare-associated infection. However, hands can never be rendered entirely free of micro-organisms, so it is inevitable that healthcare-associated infection will always be a challenge. Decontamination of the healthcare environment, its fixtures, fittings and clinical equipment are also of pivotal importance in maintaining cleanliness, controlling infection and regaining consumer confidence in healthcare. Nurses play a major role in ensuring that appropriate decontamination processes and procedures are in place to meet required standards. To do so they must receive the appropriate education and training.