YOU CAN’T FIND WHAT YOU DON’T LOOK FOR

There is ample proof that a fingerprint-size hole in a mattress surface provides an entry point for body fluids and multidrug-resistant organisms; enough fluid to contaminate the foam support of a mattress.

But you’ll never find that hole if you don’t look for it. It’s called willful blindness because finding a hole in a hospital mattress demands that you repair or replace the mattress. Replacing mattresses instead of repairing them is very costly and unnecessary.

If blood or body fluids from one patient penetrate and get absorbed into a mattress, the fluids can leak out when the mattress is compressed by the weight of the next patient. Contact with these fluids poses a risk of infection to patients using the bed and has led to lawsuits.

“There is no question there has been report after report after report of, ‘We had this outbreak. We killed all these people.’ There was just a report that came out on 18 people who were sick in a French hospital; they were on beds manufactured here in America, and 4 people were killed before they finally realized that it was the mattresses. They took all of the mattresses out of service and stopped the outbreak,” Edmond A. Hooker, MD, DrPH, professor in the Department of Health Administration at Xavier University, told?Contagion???in an exclusive?interview. “There’s a reason that it’s an underreported problem; hospitals don’t want to say, ‘Hey, we just killed a bunch of people’. We kill 29,000 people a year with?C. difficile?infections. Do you hear that? I mean, that’s like crashing a plane every day and we do nothing about it. We just act like it didn’t happen.”

“But, if I look for and find a damaged mattress, I have to replace it.”??

At a time when “money is tight” in healthcare due to razor-thin margins, replacing a damaged mattress on a stretcher or patient bed is not on the radar of the Chief Finance Officer.

One published study found that 56% of >5,000 mattresses in acute care hospitals had holes, rips or tears and had to be replaced. When confronted with the Food and Drug Administration’s (FDA) notice for hospitals to pay close attention to patient risks from damaged mattresses in 2014, a hospital leader quipped, “If I look for and find a damaged mattress, I have to replace it. Because I can’t replace every damaged mattress in the house, I don’t look for any."

Repair it, don’t replace it unnecessarily.

A portering supervisor at a major Canadian hospital reported, “I pulled aside mattresses that could be repaired with CleanPatch. Once I received clearance from IP&C, I was able to repair 20 mattresses and return them to service for a cost savings of over $6,000.”

An adhesive patch for the repair of damaged mattress covers was introduced to the healthcare market in 2014. This product is registered with Health Canada and the FDA as a Class 1 medical device, is impervious to fluids, is durable in a healthcare environment, and has been shown to be equivalent to the mattress surface in terms of microbial growth before and after terminal cleaning.

The patch is applied by a peel-and-stick method and is manufactured with medical-grade biocompatible materials. The replacement costs of bed and stretcher mattresses ranges from a few hundred to $11,000, depending on the mattress type, brand, and composition.

“We placed one of the two-inch round patches on the CT scanner mattress to cover a pencil/pen-sized hole. It was imperative that the patch hold up, as the section in the mattress will always pass through the CT gantry and be in the scan range for the majority of the images. The great news is that the patch does not show on images. Also, this mattress is wiped down with Oxivir wipes more than 100 times per 8-hour shift. This CT machine is operational 24 hours a day…A great investment considering a new mattress is over $4,500.” (Manager—CT General & Interventional Radiology, Mammography, Diagnostic Imaging…Thunder Bay Regional Health Sciences Center.

Some bed mattresses have replaceable covers, but this CT scanner mattress does not have a zippered opening so it must be replaced if there is a hole or tear in it. It was able to be repaired for tens of dollars instead.?

Be survey-ready by repairing holes, rips, and tears in mattresses.

The Joint Commission standard EC.02.06.01 EP 26 requires that furnishings and equipment are safe and in good repair. The organization must develop a program through assessment to maintain on-going compliance. Avoid tears or holes in upholstery or mattresses. Patch any holes or tears with an approved product that can be cleaned and disinfected (that is, no tape). The Joint Commission does not endorse products and focuses on processes instead. TJC is comfortable with mattress repair as long as it is done with a clinically validated product under a protocol.

CleanPatch is the only product that meets the TJC requirements.

CDC will recognize a mattress repair product if it is impervious to fluids. “If the FDA-cleared patch is intended specifically for mattress/mattress cover repair and if there are instructions for use and you can test in your laundry whether or not the patch effectively seals the tear or hole, it should be suitable for use provided the repair is truly impermeable.”

What should a prudent person do?

You can no longer remain willfully blind. The CDC and the FDA have stated their position on repairing hospital mattresses to prevent the risk of infection to patients.

But did you know that the OSHA General Duty Clause, by definition, means that “employers must protect employees from any serious hazard once they're aware of it – whether OSHA's rules specifically address it or not”? This was a recent news story about labor and delivery mattresses leaking blood and exposing nurses to bloodborne pathogens.

A prudent person would have a comprehensive inspection and timely repair or replacement program for medical mattresses as an important part of the facility’s infection prevention program. Engaged infection prevention clinicians should be able to recognize signs of mattress failure, and facilities should have a process to repair or replace damaged mattresses.

Be a prudent person. Protect your patients and staff. Repair damaged mattresses. Save lives and the bottom line.

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