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Hospital cleaning standards


  • Decontamination

The process used to make an object safe for its intended use. A

decontamination process will consist of cleaning and disinfection or sterilisation


(Ayliff et al 1993).

  • Cleaning

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



  • Disinfection

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).

  • Sterilisation

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.


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.


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.



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

paper towel.

- If the water test fails and there is staining, remove mattress as it is not fit

for purpose.

- If pass, re-zip mattress cover and dry surface where water test had been

carried out.

- 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.


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

Last modified on Saturday, 04 February 2017 17:38


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