Could a Hospital Mattress be an Infection Prevention Risk?

Could a Hospital Mattress be an Infection Prevention Risk?

There is an important term that’s being heard more often in your world: strike-through.The term is applied to soft surfaces and textiles, ant the fluids and microorganisms that can cross a barrier surface, or strike through it.

According to, strike-through contamination is defined as “contamination…that occurs through the passage of fluid through, or a puncture in, a microbial barrier.” In hospitals, this term is used in relation to such things as surgical drapes, surgical gowns, wound dressings and mattress surfaces.

Healthcare providers have recently begun to realize that there is a more widespread infection risk associated with the loss of barrier integrity of hospital mattress surfaces. Strike-through in this case goes in both directions: sending pathogenic contamination into the mattress substrates from the invasion of body fluids, skin cells and organisms of an infectious patient lying on the mattress; sending organisms and other contaminated cells and particles back out by applying pressure (sitting, lying down or moving around) on damaged surfaces (see photo) that forces the contaminants back through the cover material and aerosolizes them. Strike-through can increase infection risk for every patient who uses that bed and mattress, and can add to the bio-burden already already colonizing on it.

There are no EPA-registered disinfectants on the market with a kill claim for mattresses. The label on these disinfectants reads “For hard, non-porous surfaces.”At best, these chemicals reduce the bio-burden by 80-85%. The remaining 15-20% of bacteria replicates within hours of the mattress being wiped by the cleaning crew and reaches pre-cleaning levels very quickly. Even if a product has a kill claim for soft surfaces, mattresses are not included on any manufacturer’s list of soft surfaces. This presents a serious infection prevention risk since there is a mere, thin sheet separating the patient from the pathogens that lie beneath.

Even though bed makers have developed some durable mattress surface textiles, they cannot guarantee to prevent strike-though, and the currently required disinfection process (with harsh chemicals [i.e., sodium hypochlorite, hydrogen peroxide and peracitic acid] designed for hard surfaces) still has the potential to degrade the surface over time while, at the same time, voiding the manufacturer’s warranty.

The ability to “slipcover” the entire mattress and bed deck with a custom-fitted, fluid-impermeable textile that maintains its strike-through resistance through 150 CDC-compliant laundering and high temperature drying cycles adds another layer of protection for each patient and for the mattress. Regardless of its current condition, a mattress covered with a Trinity Guardion patient protection system no longer serves as a vector for cross-contamination.

Moreover, each time the patient protection system is properly removed for laundering after a patient is discharged, significant bio-burden is removed from the bed and the room and sent to the washing machine. And, since the soap-and-water cleaning of the mattress is recommended when the patient protection system is in use, the gentler cleaning process is less likely to cause mattress damage.

It’s Halloween. When you have the right engineering controls, strike-through doesn’t sound as scary. Go to Trinity Guardion to reduce your infection prevention risk.

About Darrel Hicks

J. Darrel Hicks, B.A., is the author of Wiley Publishing's "Infection Prevention For Dummies", and is nationally recognized as one of the top experts in infection control. Darrel Hicks is also the Past President of the IEHA and is an active member in AHE where he holds the designation of CHESP. View all posts by Darrel Hicks

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