By John Mahlmeister / Special to Healthcare Facilities Today

Ice machines are often an unsung hero in the healthcare world. Most facilities have multiple ice machines in various locations to treat patients and to keep them hydrated. You can also find ice machines in waiting rooms, visitor centers, and cafeterias. But are they safe?

There are several authorities that monitor safety within a hospital, including the Center of Medicaid and Medicare Services (CMS) and state site surveyors. These agencies focus heavily on reducing the spread of infection and educating facilities on best practices and regulations. Repeat violations of their regulations can lead to citations or a loss of accreditation from The Joint Commission. 

Additionally, county health inspectors monitor the safety of food equipment and other appliances – which include ice machines. Excessive mold growth in an ice machine can result in health code violations and monetary fines – especially for cafeterias and other food establishments within the hospital. 

What could be lurking in your ice machine?

Ice machines provide a damp and dark environment which is ideal for mold to grow. Mold grows more rapidly when introduced to organic nutrients in the air, like paper shavings or dust. In cafeterias and other eateries, yeast from bread making can rapidly increase the growth of mold in an ice machine.

Left unchecked, these contaminants can cause complications for patients with respiratory issues, such as asthma. Some patients are also allergic to various types of mold, which can cause nose and throat irritation.

Ice machines can also become contaminated with bacterial and viruses, however these pathogens are often introduced by a person using the ice machine – not the machine itself. This type of contamination is usually the result of unsafe ice handling where germs are transferred from the user to the ice machine. Rarely, bacteria can be introduced through the water supply, as was the case in 2013 at UPMC Presbyterian Hospital in Pittsburgh. Three patients were exposed to Legionella through a contaminated ice machine and contracted Legionnaires Disease.

Most bacteria do not multiply in ice, but they can survive at these low temperatures. Most frequently it is improper ice handling procedures that introduce contamination to the surface of the machine.  To combat bacterial or viral contamination, it is important to maintain proper ice handling procedures, and have ice machines disinfected and sanitized regularly.

Ice handling best practices

Proper ice handling is the best way healthcare workers can prevent the spread of bacterial and viral infections stemming from an ice machine. 

Many hospitals prefer using a dispenser-style ice machine for patient floors. These models are far more hygienic than ice machines where employees must reach into a bin. Instead, users simply press a button and allow ice to drop directly into glassware. While these models are safer alternatives to traditional ice machines, they still can transport germs if misused. 

Healthcare workers can introduce infection to an ice machine by bringing used drinkware from a patient's room back to the ice machine. Anything a hospital patient touches should be considered contaminated. Touching that drinkware and then pressing a dispensing button or lever can spread germs to the machine – and on to the next user. If a patient needs more ice, grab a fresh, clean cup and bring it to them. 

Visitors can also unwittingly spread infection by attempting to be helpful when a patient asks them for ice. For this reason, it's always best to prevent the public from accessing the ice machine.

 To limit the spread of infection, make sure employees wash their hands regularly. Encourage your employees to keep the machine sanitized by placing a supply of disinfecting wipes or spray near the unit. Employees can spray or wipe the area after each use. Placing hand sanitizing stations near the machine is also a great way to encourage proper hygiene around the ice machine. 

For cafeterias and eateries that use an ice machine and bin, employees should also wash their hands regularly – especially after using the restroom. Employees should only handle ice using an ice scoop. When done, the scoop needs to be stored in a clean container outside of the ice bin. Finally, disinfect the scoop every night with an EPA-approved disinfecting agent and rinse it with potable water. You can also disinfect the ice scoop by placing it in a commercial washing machine and running it along with dishware. 

Keeping your ice machine free of contaminants

Cleaning, disinfecting, and sanitizing an ice machine will help eliminate mold, bacteria, viruses, and other contaminants from the machine's surface and the inside of the bin. 

It's a good idea to clean the entire exterior of the machine weekly to eliminate contaminants. The inside of the bin should also be cleaned anytime there is mold growth present. 

While it’s important to have your ice machines disinfected, and sanitized regularly by a professional, there are some simple steps you can follow to clean your ice machine between preventive maintenance visits:

To clean:

1. Use soap and water to clean high-touch surfaces of the ice machine (dispensing button and levers, bin doors, handles, etc).

2. Rinse the area with water.

To disinfect:

1. Once clean, use an EPA-registered disinfectant on the area

2. Make sure to follow the directions on the label for safe and efficient use (dilution rates, contact times, etc.)

3. After the contact time has elapsed, rinse the area with water

To sanitize:

1. Use an EPA-registered sanitizer on the surface (Note: many disinfectants double as sanitizers at a lower dilution rate)

2 Follow the instructions for “sanitizing” on the label for safe and efficient use

3. Allow the solution to air dry

What if your ice machine shuts down?

As with anything, prevention is the best medicine. Ice machine manufacturers recommend at least two preventive maintenance visits per year from a qualified ice machine technician. The technician will optimize the machine's systems and identify any potential problems before the machine breaks down.

If your ice machine does break down, you should call a reputable ice machine service. They can help you determine if the ice machine is leaking or if any steps need to be taken before they arrive. A dependable service provider will send a technician right away to diagnose the problem and begin any necessary repairs. 

If your ice machine is not producing and you need ice right away, consider transporting ice from an ice machine on another floor. If you have a freezer available, you can store larger amounts of ice there. Be sure to practice proper ice handling techniques when serving the ice. If it's in a bucket or bag, make sure to use an ice scoop when dispensing ice into drinkware, and always store the scoop outside of the ice supply.

The bottom line

Every hospital’s main concern is to keep patients and employees safe. While an ice machine isn't a typical piece of medical equipment, it can still lead to accidental infections. Ice machines are often overlooked, but they have the potential to cause issues if they aren't cleaned and cared for. Following proper ice handling techniques and cleaning your machine regularly will help keep your hospital safe as can be.

John Mahlmeister is the Chief Operating Officer and Co-Founder of Easy Ice. For more information, please visit www.easyice.com.