Can Bedpans Spread HAIs?

A researcher from the Netherlands says that more investigation into the role of bedpans as a vector for disease is needed. In a presentation at the International Conference on Prevention & Infection Control (ICPIC) held in Geneva, Switzerland June 29-July 2, 2011, investigator G.G. Van Knippenberg-Gordebeke explained that in the Netherlands, bedpans are regarded as semi-critical items, unlike Spauldings scheme where bedpans are categorized as non-critical items. Knippenberg-Gordebeke says that washer-disinfectors (WDs) were used incorrectly for a long time, and that a survey in 1990 showed poor final cleaning and disinfection results. The Dutch Working Party Infection Prevention made guidelines for WDs (1998), and in 2006 the International Organization for Standardization (ISO) introduced the Standard 15883 for WDs that specifies requirements intended to be used for emptying, flushing, cleaning and thermal disinfection of bedpans. Knippenberg-Gordebeke repeated the survey in the Netherlands in 2010.

A survey was sent to infection preventionists in 120 Dutch hospitals. The questions covered the following data: kind of bedpans, methods of emptying, cleaning and disinfection, awareness and use of national or international guidelines for WDs and the validation and maintenance of WDs. Other questions focused on the role for bedpans or WDs as a source for outbreaks.

The response rate in 2010 was 77/120 hospitals (64.1 percent). Guidelines improved practice and maintenance and validation of the WDs showed good improvements. Knippenberg-Gordebeke reported that 94 percent of respondents never searched for WDs or bedpans causing outbreaks or healthcare-associated infections(HAIs), while 6.5 percent reported outbreaks with the following microorganisms: Clostridium difficile, norovirus, Pseudomonas aeruginosa, Salmonella species and Acinetobacter baumannii.

Knippenberg-Gordebeke concluded that validated, well-maintained WDs improve patient safety, contributes to occupational health, and prevent staff from unpleasant jobs. Although bedpans can contain pathogens which can be easily spread, the majority of healthcare professionals never searches for (handling) bedpans and WDs as a source for HAIs. More study is needed for validated data about this risk.

Reference: Van Knippenberg-Gordebeke GG. Dutch surveys bedpan management (1990 & 2010): progress in correct use of washer disinfectors. Presentation at the International Conference on Prevention & Infection Control (ICPIC). BMC Proceedings 2011, 5(Suppl 6):P308doi:10.1186/1753-6561-5-S6-P308