Prevention of healthcare-acquired infections (HAIs) is a priority challenge. The exact degree to which hospital surfaces influence the transmission of HAIs is not well understood. Current cleaning procedures such as sanitation of surfaces in hospital rooms with dilute sodium hypochlorite (bleach) and the use of ultraviolet light, while efficacious in reducing surface contamination episodically, do not provide continuous antibacterial activity. Furthermore, due to inadequate manual cleaning, antibiotic-resistant pathogens, such as methicillin- resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C. diff) can live on surfaces for several months. Copper has antimicrobial properties against important antibiotic-resistant pathogen. Implementing copper and copper alloys in surfaces has the promise of continuous microbial killing power in the background as adjunct to current effective (although intermittent) strategies. This implementation study will explore the benefit of converting high touch surfaces in patient rooms to a novel self-sanitizing copper oxide-impregnated solid surface (SSS-Cu) manufactured by EOSCu Surfaces LLC, Norfolk, Virginia. The SSS-Cu has a uniform distribution of 16%-20% copper oxide. SSS-Cu has proven to be 99.9% bactericidal within 2 hours in a laboratory setting, has been registered with the Environmental Protection Agency (EPA) as environmentally safe, and has been associated with a significant decline in HAIs in a prior study at the Sentara Leigh Hospital, Norfolk, Virginia. The specific aims of our proposed study are to (1) establish real world effectiveness of SSS-Cu in the prevention of bio-burden accumulation in occupied patient rooms; (2) establish the effect of SSS-Cu as an adjunct to standard disinfection protocols on HAI rates for patients admitted to the study hospital; and (3) determine the economic impact of the use of SSS-Cu in the hospital setting. A prospective pre-post study design is proposed to compare hospital surface bio-burden and HAI rates between patient room environments with and without SSS-Cu surfaces. With the installation of SSS-Cu in acute and critical care rooms, environmental bioburden will be compared before copper surface installation to after copper surface installation. Further additional samples will be taken at 18 months and 36 months to evaluate continued efficacy of copper over time. HAI rates among all patients admitted to the hospital for a three-year period prior to installation of SSS-Cu will be compared to HAI rates among all patients admitted to the hospital for a three-year period following the completion of installation of SSS-Cu in all acute and critical care rooms. The setting for this study is a 120-bed inpatient facility that is part of an integrated VA health care system in Temple, Texas. We expect that SSS-Cu materials will lower environmental bio-burden, lower HAI rates, and result in significant decreases in infection-associated inpatient healthcare expend...