The risks and challenges associated with hospital-acquired infections (HAIs) are well known and emerging as a high-profile, high-priority public health issue. From the publication of the landmark study by the Institute of Medicine (IOM) titled “To Err is Human: Building a Safer Healthcare System,” to the Centers for Disease Control and Prevention (CDC)’s 2002 data estimating 90,000 deaths from bacterial infection per year in U.S. hospitals, to the Aug. 11, 2008 issue of The New Yorker reporting the mechanism of antimicrobial resistance, professionals have been continually unraveling the complexities of ensuring that our healthcare system is truly a safe and clean environment. And while drug-resistant bacteria continue to evolve, or arrive from around the globe, the basics of preventing cross-transmission remain constant.
One of the more challenging aspects of patient care is keeping important areas of a healthcare facility clean. No mission is more important than ensuring that a patient is not exposed to needless health dangers while in the care of the facility. And while preventable infection rates continue to be high, there have been dramatic developments in cleaning technologies that are proving to reduce and eliminate harmful bacteria from patient areas and other high-touch surfaces.
Microfiber has emerged as one of the most important technological developments for environmental services in this quest to prevent infections. It’s extremely important, however, to understand that there are many different types and qualities of microfiber on the market with vastly different capabilities in removing viruses, bacteria and spores from an environmental surface.
Microfiber, by definition, is any type of fiber with a diameter of less than 10 micrometers. Every item labeled “microfiber” does not constitute a superior cleaning product. Optimal bacterial, virus and spore removal is achieved through a type of material called “split microfiber.” This fiber is a blend of nylon (polyamide) and polyester that is extruded (like spaghetti). In the manufacturing process, the bonds between these two materials are chemically and mechanically split so that the fiber actually splits, or explodes, creating a web of ultra-fine filaments and microscopic pores. Split microfiber has a net positive charge and the ability to absorb up to eight times its weight in liquids.
In independent studies such as those published by the Environmental Protection Agency (EPA)1 and by Dr. William Rutala,2 extremely fine (.37 micrometer diameter) microfiber was both laboratory and clinically tested and proven to remove up to 98 percent of bacteria and 93 percent of viruses from a surface using only water (no chemicals). In comparison, traditional cotton fibers have been shown to only remove 30 percent of the bacteria and 23 percent of the viruses from a contaminated environmental surface.
When most environmental services professionals speak of microfiber, they are usually referring to a flat mop floor cleaning system. These products are highly visible, are one-quarter the weight of traditional mops, and allow the housekeeper to effectively clean a room 40 percent faster than they could with an old-fashioned string mop system. There’s no doubt that the use of these systems result in a much cleaner floor. And they permit a one-pad-per-room practice, to address cross-transmission.
Patients Do Get Sick from Surfaces
Microfiber cloths are commonly overlooked as a major tool for infection prevention in a healthcare facility. Consider the risk of hand and glove contamination after contact with a vancomycin-resistant Enterococcus (VRE)-positive patient environment; there are many touch surfaces (monitors, cabinet drawers, sink spouts and patient charts) in that patient’s room that can facilitate transmission. It’s essential that environmental services not only institute the use of data-supported split microfiber cloths in their cleaning process for proven cleaning efficacy, but also follow a clearly defined process to properly clean surfaces in the room.
Using a color-coded system for microfiber cloths ensures that a housekeeper uses the appropriate cloth to clean each area of the room: yellow for bathrooms, green for general purpose cleaning, red for beds and blue for glass and other reflective surfaces. And as part of that process, it should be noted that only one set of cloths per room should be used to avoid cross-transmission into a second room. Many facilities have started using disposable disinfectant wipes in an effort to reduce infections. This strategy may backfire, as British researchers have found that, “disinfectant wipes routinely used in hospitals may actually spread drug-resistant bacteria rather than kill the dangerous infections.”3
While most of the focus in preventing infections is on patient rooms, effective cleaning all areas of the facility provides a key opportunity for safeguarding patients and caregivers. Waiting rooms and the emergency room are high traffic areas where patients, visitors and employees can be exposed to a wide range of infections from the common rhinovirus to life-threatening Clostridium difficile. Following proper cleaning procedures in the dietary areas of the facility can help reduce exposure to E.coli and norovirus infections.
All Things Considered
Microfiber cleaning systems, when supported by comprehensive training and properly implemented, can play a major role in infection prevention throughout healthcare facilities. To realize the full benefits of microfiber, it’s essential for environmental services professionals to fully evaluate all of the product and supplier options, insisting on the following:
• Independently tested microbiological data to prove their
• A complete system that consists of everything needed
to clean the facility from carts to cloths
• A comprehensive training program to assist in both pre-sale
education and pose-sale support
Mark Hoyle is a senior product manager for Rubbermaid Commercial Products, LLC. As a member of the Microfiber Cleaning Group, he has been instrumental in the development and marketing of innovative microfiber cleaning products.
Bill Slezak is a national healthcare segment manager for Rubbermaid Commercial Products, LLC. As a member of the board of trustees for ASHES, he has also been on the forefront of infection prevention awareness regarding the process of healthcare facility cleanliness.
1. United States Environmental Protection Agency. Environmental Best Practices for Health Care Facilities: Using Microfiber Mops in Hospirtals. November 2002.
2. Rutala W, ed. Disinfection, Sterilization and Antisepsis. June 2006.
3. Kahn M. Antibacterial wipes can spread superbugs. June 3, 2008. Accessed at: