(Ayliff et al 1993).
A process that removes micro-organisms and the organic material on which they
thrive. It is a prerequisite for effective disinfection or sterilisation (O’Connor
A process used to reduce the number of micro-organisms but not usually
removal of bacterial spores. It does not necessarily kill all micro-organisms but
reduces them to a level that is not harmful to health (O’Connor 2000).
A process used to render an object free of viable and bacterial spores (Lewis and
Meese 1997). Also refer to the Northern Health and Social Care Trust (NHSCT)
Disinfectant Policy - Infection Control Policy Manual.
DEFINITION OF A BED
The hospital bed consists of a bed frame, mattress, pillows and bed clothes
(Krankenhaus 2005). The bed frame includes the undercarriage, hydraulics,
wheels, elevation levers and accessories attached such as bed rails and monkey
poles. These are usually made of metal or steel. Newer beds usually have an
open mesh base to allow air to circulate between the base and the mattress and
therefore prevent the build up of moisture, although solid base beds are still in
Mattresses are made of foam with a cover which should be impermeable to fluids
but permeable to vapour.
Pillows consist of an inner foam, encased in PVC, plastic or vinyl cover. Pillows
are encased in a pillow cover when in use.
Bed linen consists of sheets, blankets and counterpane or duvet. Cotton is the
preferred fabric to use. Duvets are usually made of a fibre filling encased in a
washable or impermeable cover.
FREQUENCY OF CLEANING
It is recommended that the bed, including the frame, undercarriage, mattress and
base, should be decontaminated between each patient and once per week if bed
is occupied by same patient (Patel 2005). This aims to prevent dust collecting
and helps to prevent the harbouring of micro-organisms (O’Connor 2000).
On discharge or transfer of patient, the locker, bed table, nurse call systems, bed
controls, patient chair, oxygen and suction canister and tubing system also need
to be included in this decontamination process.
TESTING OF MATTRESS PERMEABILTY
A visual inspection of the mattress and mattress cover should be undertaken
weekly or following discharge of a patient.
The cover should be checked to detect any signs of wear, rips, staining or loss of
permeability (Wilson 2001). Both sides of the mattress need to be examined.
A full monthly audit needs to be carried out on each static mattress and
documentation of the procedure completed.
Audit results to be sent to Directorate Lead Nurse on completion.
- Remove bed clothes.
- Carry out visual inspection as above.
- Unzip mattress and place a paper towel under the surface of the mattress,
close to where the patient’s buttocks would be positioned.
- Pour small amount of water (20-30mls) over the outside cover and press
mattress firmly. Leave for 30 seconds and inspect for leakage through to
- If the water test fails and there is staining, remove mattress as it is not fit
- If pass, re-zip mattress cover and dry surface where water test had been
- Remake bed.
- Mattress should be turned monthly to reduce excessive wear in any one
For reference - Levels of cleaning available in Ward Cleaning Manual 2009.
PROCEDURE FOR DISCHARGE CLEAN CARRIED OUT BY NURSING
This is a procedure for environmental cleaning of a room / bed space following
discharge or transfer of a patient with no indication of colonisation or infection
requiring isolation precautions.
- Cleaning must not be commenced until the bed space has been vacated.
- Decontaminate hands before and after carrying out procedure.
- Put on aprons and disposable gloves.
- All linen should be placed in the appropriate colour coded bag as specified
in The Northern Linen Services Laundry Policy.
- Using the appropriate Trust approved disinfectant solution, clean all
surfaces, fixtures and fittings in the patient’s immediate environment.
- All items of nursing or medical equipment should also be thoroughly
cleaned with the solution.
- Clean bed, bed frame, undercarriage and both sides of the mattress.
- The mattress should be turned as per cycle.
- Always use disposable cloth. Do not return cloth to solution. Replace
cloth frequently (minimum of 3 per bed).
- Attach and date green assurance label on bed when procedure
- Domestic Duties – Request to spot check walls, clean ensuite facilities if
appropriate, empty waste bin, replenish towels and soap if necessary and
check toilet brush and replace if necessary