The HealthCare-Associated Infection Risk Hiding in Plain Sight

Healthcare-associated infections (HAI) remain a significant issue in medical facilities. The Centers for Disease Control and Prevention (CDC) estimates that 1 in 31 hospital patients have an HAI on any given day.

The CDC estimated there were 687,000 HAIs in US acute care hospitals in 2015, and about 72,000 hospital patients with HAIs died during their hospitalizations.

Within these facilities remains numerous touchpoints that can harbor germs and bacteria that can be transmitted from patient to patient. One area within these facilities that is often overlooked is the patient mattress. HAI can be attributed to this high touchpoint and according to one new study, they remain neglected to the point of needed repair or replacement.

Edmond A. Hooker, MD, DrPH, professor, Department of Health Services Administration, MHSA associate director for Accreditation, Xavier University says with a majority of hospitals running at or over 100% capacity the ability to clean mattresses in a timely, efficient manner while disinfecting them is challenging.

“Hospitals want to get these beds turned over; a typical hospital is giving environmental services less than 30 minutes to clean a room, and it’s just not possible,” Hooker said.

Not only is it a time issue, but Hooker says the mattresses have changed. He explains that the material of the mattresses underwent a transformation in the 1990s that helped prevent bed sores, but the material made them much more susceptible for germs and decreased their durability significantly. “The old vinyl mattresses lasted forever…and they were easy to clean because they weren’t porous,” Hooker said. “…We are not cleaning the thing which is probably the biggest source of infection—the mattress.” 

Hooker was the investigator on a study published in Infection Control & Hospital Epidemiology which examined hospital mattresses. His study showed a very high failure rate for mattresses in 4 hospitals within 1 hospital system.

“In total, 727 beds and mattresses were evaluated, and 523 (72%) had damage: 340 (47%) required mattress cover replacement and 183 (25%) required replacement of the entire mattress,” Hooker wrote in the study.

Contagion spoke to Hooker who offered some insights into his study, the hidden dangers within mattresses including why he thinks it has been “the big miss” in avoiding HAI, and how we are doing overall at infection prevention measures.