Researchers Say Hospitals Use Unapproved Chemicals to Clean Hospital Beds

Research performed by students and faculty at Xavier University in Cincinnati reveals that current practices for cleaning of hospital beds involve the use of chemicals not approved by the Environmental Protection Agency (EPA) for use on mattresses and that most hospitals do not follow recommendations for appropriate use of these chemicals. The research was presented June 4 at the Association for Professionals in Infection Control and Epidemiology (APIC) annual meeting in San Antonio, Texas.

Among the findings:
- 84 percent of hospitals use quaternary ammonia compounds to clean hospital beds. These chemicals have been tested on hard surfaces only, and do not have EPA approval for use of soft surfaces such as hospital mattresses.
- 23 percent of these hospitals cleaned the mattress surface prior to using the disinfectant, as is recommended by both the bed and chemical manufacturers.
- 6 percent of these hospitals rinsed off the chemical disinfectant after disinfection, as recommended by the bed manufacturers, possibly exposing patients to residual disinfectant.

Kristen Jones, graduate student in Health Services Administration, and Dr. Edmond Hooker, associate professor in Health Services Administration, performed the research. The top 113 hospitals for 2011-2012, as listed in US News & World Report, were contacted by phone and asked about their cleaning procedures for hospital beds and mattresses. Each respondent from environmental services was asked five questions: What chemical do you clean your beds and mattresses with? How do you mix or dilute the chemical? How long do you leave the chemical on the bed or do you just let it dry on the bed? Do you use anything other than that chemical first, like soap and water? Do you rinse off the cleaner after you clean the bed?

Of the top hospitals, 69 (61 percent) agreed to answer the survey questions. Chemicals used to clean the beds included: quaternary ammonia compounds (84 percent), bleach compounds (10 percent), phenolic cleaners (4 percent), and hydrogen peroxide (1 percent). Only two hospitals were using disinfectants with a pH between 5 and 9, as recommended by the bed and fabric manufacturers. Only 16 (23 percent) of the hospitals reported cleaning the mattress prior to disinfection, and only 6 (9 percent) reported rinsing off the disinfectant after use.

Hooker says, Hospital-acquired infections are killing hundreds of people in the United States every day, and using unapproved chemicals, failing to clean beds prior to disinfection, and failing to rinse off these dangerous chemicals is just unacceptable. Previous research by Xavier University has demonstrated that hospitals are not getting beds clean, and this research may give a clue as to why.