PRODUCT & SERVICE LINE REPORTS


do not have protocols or do not follow pro- tocols. It’s a combination of factors. It’s not so much about intensity, but rather how often/prevalent each issue is seen across the country based on the current environ- ment.” She ranks short staff that leads to rushing protocols at the top, followed by a lack of optimal products and services to do the job, followed by the lack of adhering to appropriate instructions and protocols. Even so, the room turnover demands add


pressure to what can be tense scheduling situations, according to Linda Lybert, Founder/Executive Director, Healthcare Surfaces Institute Inc. “Healthcare facilities


are typically faced with a time limit when turning over patient rooms, which rarely provides sufficient time to effectively clean and disinfect the beds and mat- tresses, let alone the rest of the room,” Lybert noted. “It


Such awareness motivated Cone Health to organize a project to oversee quality in this area, according to Waddell.


“I had the pleasure of leading a multi-


disciplinary team in a project called ‘The Clean Bed Initiative,’” he told HPN. “This body of work involved input from Nursing, Environmental Services, Patient Transport, Radiology and Repair Technicians. In cre- ating the work, we were able to track bed movement through all aspects of hospital workflow and observe movement of the patient from admission to discharge.” (For more details on Cone Health’s CBI, read “Cone Health elevates bed, mattress maintenance to higher priority” on page 52.)


Linda Lybert


is incredibly important that the manufacturer take this into consideration during design and provide instructions that support this process. Healthcare professionals often use the same type of disinfectant for everything they are cleaning. Testing and validating that these disinfectants can be used is needed. If not, there may be a process for getting the correct disinfectant approved.” Still, Don Rotter, RD&E Program Leader, Healthcare


Infection


Prevention, Ecolab Inc., credits healthcare staffers against the backdrop and context of their operating environment.


“I believe hospital staff have the best of intentions to ensure beds and mattresses are thoroughly cleaned, treated and maintained,” he said. “In recent years, the industry’s work of high- lighting the shortcomings of hospital bed and mattress maintenance and the risks they present to patient safety have helped increase awareness of these challenges. Despite this increased awareness, the incidence of the fluid ingress into patient mattresses and beds still occurs far too often. “Staff turnover will always present a chal-


Don Rotter


lenge around education and awareness,” Rotter continued. “Hospitals must prioritize and emphasize best practice as part of stan- dard protocol to ensure beds and mattresses can be properly cleaned and treated. This means following manufacturers’ instructions which often suggests avoiding oversatura- tion of the surfaces to prevent fluid ingress as well as wiping down the mattress surfaces with water after treatment and allowing the mattress to fully dry before placing it back on the bed or surgical table.”


Potential solutions HPN then asked experts how bed and mat- tress maintenance efforts and outcomes could be improved. They could choose more than one option among six potential selec- tions or generate one of their own. Not surprisingly, education topped the list as all chose “Provide more frequent and more in-depth inservice education and training on proper inspection and cleaning/ disinfecting/sterilizing/repair.” Next up involved calls for a specific type of product, as in “Provide cleaning/disinfecting/steril- izing products that don’t harm the bed and mattress (raw) materials while successfully destroying/killing infectious microbes.” Two viewpoints split third place with one


focusing on mattress composition and the other on enhancing the maintenance process. Half of respondents opted for “Manufacture beds and mattresses using (raw) materials that either can withstand or repel harsh chemicals in the cleaning/disinfecting/steril- izing products needed to destroy/kill infec- tious microbes,” while “Encourage going beyond manual wiping, visual inspection, single-step procedure,” captured another 50% response.


No one picked switching to disposables/


single-use products for everything or to out- source the entire process to an independent third-party service company.


Ecolab’s Rotter urges providers and sup- pliers alike to gain a “clear understanding of the factors that impact life expectancy of the patient equipment and the trade-offs” to get control of the process. “One of the most common challenges I hear from hospital staff preventing the fol- lowing of manufacturer instructions is the added burden and resources required to do so,” he said. “Staff, already under extreme time and resource constraints, simply do not feel it is feasible. They lack the support and buy-in from management to ensure these additional steps can be taken. Consequently, the hospital may bear the extra burden of replacement costs if they are not following


manufacturer instructions intended to maxi- mize the life expectancy of the equipment. “Manufacturers often establish life expec- tancy of equipment based on compatibility testing, expected use and treatment patterns using commonly available cleaning/disin- fecting agents in the regions [where] the products are sold,” Rotter continued. “This life expectancy determination is most likely based on best practices being utilized and extra steps being taken.” Rotter recognizes what providers


really want in context of the demands placed on them.


“The reality is, hospital staff want clean-


ing/disinfecting products that provide rapid kill of the organisms of concern, while being the most economical, lowest toxicity, in any format of choice, residue-free, compatible with as many surfaces possible and requir- ing only a one-step application,” he noted. “Such a product would be ideal, yet there always must be a compromise with these factors. The tradeoffs end users must choose, change with the chemistry used, the mate- rials of construction of the equipment, the desired hospital infection control strategies, available budget, or the need for hospitals to turn rooms uickly to maimize profits. This is where infection prevention must step in.


“What infection preventionists are charged


with is striking a balance as best they can, acknowledging there may never be the ideal process for all surfaces,” Rotter said. “This is not an easy task. pecifically for patient mattresses, the product selected for the degree of soiling might require removal of unsightly residues left behind, or a budget to support replacement costs of the mattresses that are not lasting as long, either because the chemistry chosen is too aggressive for the substrate, there is a lack of use of the best practices intended to prolong the life of the equipment, or a combination thereof.” Rotter credits manufacturers for trying to do their part as well. “Disinfectant and equipment manufac- turers alike continue to innovate, so there is hope that some of these challenges can be solved through new product offerings,” he said. “In the meantime, until the ideal scenario is achieved for patient mattresses specifically, awareness of these variables and ownership of those [that] can control are necessary for infection control strategies around patient beds. Patient safety is of the utmost importance. It should not take a back seat to hospital budgetary constraints.” Healthcare Surfaces Institute’s Lybert believes that providers should ask that bed and mattress manufacturers go one step fur- ther in their process.


“Request manufacturers test for surface disinfection compatibility,” she insisted.


hpnonline.com • HEALTHCARE PURCHASING NEWS • September 2022 45


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