PRODUCT & SERVICE LINE REPORTS
“Disinfection is the process of eliminat- ing or reducing harmful microorganisms from the surfaces, while sterilization is the process of killing all microorganisms,” she continued. “End users can also tell the dif- ference by adhering to the wet contact time needed to eliminate the stated pathogens of a cleaner. Oftentimes, the customer may not actually be keeping a surface wet enough or using enough wipes/solution to achieve the attended kill. We see The Joint Commission prompting audit guidelines to incorporate more stringent cleaning protocols.” Approximately 70% of all mattress failures – including stretchers – occur through physi- cal damage, the remaining 30% result from chemical, according to David Willoughby, Vice President, Marketing & Business Development, Medtrica Solutions Ltd. “Most common physical damage is caused by punc- tures, tears and abrasions, which if left undetected, overlooked or improperly repaired, lead to serious cross contamination risks for current patients, incom- ing patients and staff,” he said. “Damaged soft surfaces can never be properly cleaned regardless of how good your CDP is. When the integrity of a mattress cover is compromised the there is always a high risk of occult damage occurring from fluid ingress of blood and body fluids.
David Willoughby
Thanks to the Clean Bed Initiative (CBI) at Cone Health, clinicians and administrators underwent a great awakening to the need for proper bed and mattress decontamina- tion, according to James B. Waddell, BLS, ICRA, CSCMP, SW Patient Care Support Manager, Nursing Administration. (For more details on Cone Health’s CBI, read the sidebar on p. 52.) ne of the main issues identified was that repair technicians often discovered that downed beds were delivered and not properly cleaned,” he said. “Our [CBI] work group discovered that receiving depart- ments (patient care or repair) trusted that beds came already cleaned and disinfected. owever, it was an aha moment, finding that was not always the case. This became a highlighted standard work point of focus.”
What should manufacturers do? Experts believe manufacturers can help improve this process in several ways but stop short of placing blame or pointing fin- gers at anyone. Proper bed and mattress maintenance generates hygienic and economic benefits, according to Surface Medical’s Lam. “Manufacturers should place greater emphasis on the importance of equipment
maintenance to protect the health and safety of vulnerable patients,” he noted. “Because hospital mattress covers are one of the high- est touchpoints in the patient environment, comprehensive cleaning practices are essen- tial to reduce the spread of dangerous patho- gens to patients and staff. Hospital mattress covers must be maintained in an intact state to be effectively cleaned, so manufacturing guidelines should reinforce the importance of frequent mattress cover inspection for signs of damage. Clear and focused messag- ing from manufacturers on the importance of maintaining equipment in good working condition, would support infection preven- tion protocols that address cleaning, disin- fecting, sterilizing, and repair of mattresses. “Because the immediate replacement of damaged hospital mattresses is not always logistically or economically feasible, surface repair with an approved product enables healthcare facilities greater control over the timing of equipment replacement, while ensuring that the mattress surface can be safely used by patients,” Lam added. Ecolab’s Rotter acknowledges that manu-
factures emphasize proper care and mainte- nance for beds and mattresses but recognizes that more could be done.
“Most bed and mattress manufactur- ers provide a great deal of emphasis on the cleaning and disinfection process of equipment surfaces including cautionary language against practices, procedures or use of products that might adversely affect the equipment,” he said. “Manufacturers should continue to try to improve upon these instructions, so they are clear and cover comprehensively the various types of cleaning/disinfecting agents available in the marketplace that are either suitable or contraindicated. Unfortunately, end users can be left confused when specific classes of ingredients or actives in disinfec- tant cleaners are neither recommended nor contraindicated in manufacturer’s instruc- tions for use.” otter admits the difficulty hospital staff-
ers may face here, which is why manufactur- ers should step up.
“Mattresses are challenging to inspect with failure of the moisture barrier commonly only being noticed after fluid ingress, he noted. “Manufacturers should stress the importance of routine inspection and how to properly inspect the equipment for signs of needing repair or service. Products showing any sign of degradation should be removed from service.”
Manufacturers must keep customers front of mind when they release products and IFUs, according to Stryker’s Mathieson. “Manufacturers should provide clear and in-depth information on cleaning protocols and accepted chemicals/products that can
50 September 2022 • HEALTHCARE PURCHASING NEWS •
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be used for cleaning/disinfecting/sterilizing and repair when making a sale,” she indi- cated. “We believe in transparency and ease of use for our customers, and that includes how to take care of our products. “Our customers motivate us to make cleaning/disinfecting/sterilizing/repair instructions and protocols clear,” Mathieson continued. “Through our partnership with customers, we’ve found that operations manuals are not always as straightforward as one may think for busy staff. We go beyond ‘good enough’ by creating cleaning videos that showcase best practices when taking proper care of our products. The customers should be at the forefront of all manufacturers motivation to provide quality products and information – maintenance being one of them.” Medtrica’s Willoughby contends that content is king. “Manufacturers should always provide very detailed IFU for the proper storage, use and maintenance of the mattress – cover and core,” he insisted. “However, these recommendations are not designed to replace cleaning and disinfection protocols implemented and managed by infection control andor the hygiene officer of the hospital overseeing soft-surface infection prevention.”
Xavier University’s Hooker places great
value on manufacturer IFUs making a difference. “The hospital bed and mattress manufac-
turers need to emphasize the importance of hospital personnel following the MIFUs every time they clean (reprocess) the bed and mattress for the next patient,” he empha- sized. “The salespeople do not explain the importance of proper reprocessing not only for patient protection [but also] to extend the life of the bed/mattress. Most hospitals incorrectly assume that they can use a one- step cleaning processing, which is simply inadequate. Also, The Joint Commission requires hospitals to follow the MIFUs.” Hooker further notes that “newer MIFUs have been required by the FDA Reprocessing Guidance for Reusable Medical Devices since 2015. Per the FDA Guidance the pro- cess must have established efficacy against key organisms, including myco-bacteria, state a process to achieve those results as well as the expected life of the device (outer mattress cover) using those processes.” Lybert from Health Surfaces Institute urges that maintenance issues logically be explored at the very beginning. “Of all medical devices the bed is what
the patient has the most contact with,” she noted. “Cleaning and disinfection should be one of the top three most important design features and should be evaluated with a team of Infection Preventionists and
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