Blog / Focus: Infection Control

Often overlooked "un-washable” surfaces in healthcare facilities harbor bacteria

By Beatrix Babcock / Special to Healthcare Facilities Today
September 3, 2019

In 1847, it was first discovered that hand washing could help stop the spread of infection, but it wasn't until the 1960s that hospitals began monitoring and developing their infection control programs, which every facility is required to have in place today. Despite current, widespread awareness for the need for infection control, the CDC estimates that on any given day, about one in 31 hospital patients has at least one healthcare-associated infection.[1] 

The impact of these infections is high: healthcare-acquired infections or aealthcare-associated Infections (HAIs) are a leading cause of death in the United States.

• One study shows that the hospital environment is the third leading source of infectious agents that can cause HAIs. [2]

• A quarter of all nursing home residents are colonized with drug-resident bacteria, according to a recent study at the Columbia University School of Nursing.[3]

• Moreover, research shows that nearly three-quarters of nursing homes have been cited for lapses in infection control, more than any other type of health violation, with infections causing a quarter of the medical injuries experienced in nursing homes.[4]

Hand washing remains the most important step to contain the spread of HAIs, but there are many other areas for improvement when looking at the cleaning techniques in healthcare environments. For instance, it’s estimated that half of all healthcare environments are filled with soft surfaces like upholstered furniture, rugs and throw pillows, yet these “un-washable” items that harbor bacteria are often the most overlooked surfaces because there is not a clear or consistent soft surface cleaning protocol. 

What’s un-washable?

In the past, laundering has been used to disinfect washable soft items (linens, towels, etc.) while other measures, like high-temperature steam cleaning or harsh disinfectants like bleach, were used on the un-washable items that couldn’t be laundered.

These methods often damage or didn’t truly sanitize soft items such as throw pillows, rugs, curtains, mattresses, upholstered chairs, and other furniture. All need regular cleaning, yet in many facilities, there are no standards or effective methods in place to do that. These soft surfaces can harbor harmful bacteria, viruses, and mold or mildew, but can be difficult to sanitize.

Being familiar with the surfaces in a typical room that need to be cleaned and disinfected can help in understanding what type of product is needed to get the work done safely and effectively. Some products are designed for hard surface disinfection, and others are formulated to kill pathogens on soft surfaces.

Knowing the difference is important, as is examining the labels, manufacturer’s directions and checking to make sure the product is registered with the EPA for its intended use. Some products used for hard surfaces can damage soft surfaces and vice versa. Look for multipurpose disinfectant products that can help your staff get the job done more efficiently and effectively, and work with your cleaning supplier to help assemble the most appropriate products for the job and train your staff on how and when to use these products correctly. 

Areas of concern

Recent research has heightened awareness around the need to launder privacy curtains in hospital facilities on a scheduled basis, as well as how contaminated white coats can act as a ride for germs, potentially undermining existing disinfection routines. Common soft surfaces that can harbor bacteria in healthcare environments include:

•  Hospital beds - a surface that patients, residents, visitors, and staff all come into contact with at some point in every healthcare facility - are often an epicenter of contamination, with the patient being the source. When a patient’s visitor, touches the bed (or the patient) before sitting on an upholstered chair in the room, the visitor transfers germs from one surface to the next. Similarly, when a nurse or staff member comes in to check the patient’s vitals or bring them medication, germs are transferred to the privacy curtain[5] when it is opened as they leave.

[2] Gastmeier, P.; Stamm-Balderjahn, S.; Hansen, S.; Nitzschke-Tiemann, F.; Zuschneid, I.; Groneberg, K.; Rüden, H. How outbreaks can contribute to prevention of nosocomial infection: Analysis of 1,022 outbreaks. Infect. Control Hosp. Epidem. 2005, 26, 357–361.

[3] Sainfer Aliyu, Arlene Smaldone, and Elaine Larson. “Prevalence of multidrug-resistant gram-negative bacteria among nursing home residents: A systematic review and meta-analysis.” American Journal of Infection Control, volume 45, issue 5 (May 2017)


Beatrix Babcock, MS-HSA, LPN, owns HCI Consulting Group and currently serves on the P&G Professional Advisory Council.

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