hospital beds infections

How to Ensure Hospital Mattresses Are Completed Disinfected? Interview with:

Edmond A. Hooker, MD, DrPH Professor, Department of Health Services Administration MHSA Associate Director for Accreditation Xavier University  Cincinnati, Ohio

Dr. Hooker

Edmond A. Hooker, MD, DrPH
Professor, Department of Health Services Administration
MHSA Associate Director for Accreditation
Xavier University
Cincinnati, Ohio What is the background for this study?

Response: Healthcare acquired infections are still a huge problem in the US. Most hospitals are not following the hospital bed manufacturers guidelines for cleaning these mattresses and bed decks (the metal bed frame). Many use only a single step, when the manufacturers recommend a 5-6 step process (pre-clean any obvious soil, clean, rinse off cleaner, disinfect, rinse off disinfectant, inspect mattress for damage). The problem is that, if done, this takes 45 minutes to 1 hours. Most hospitals turn over a hospital room in less than 30 minutes. The launderable bed cover allows the bed to be cleaned and turned over in minutes, not an hours. What are the main findings?

Response: The current study showed, that by using a laundry process, the cover returns completely disinfected (greater than a 6 log (99.9999%) reduction in bacteria. This simply cannot be achieved with a manual process, especially with single wipe processes. What should readers take away from your report?

Response: The only way to ensure that patients are provided a clean surface to lay on is to use the launderable cover. It is a repeatable and verifiable system. It is inspected at the laundry using a light table to ensure there is no damage. Many mattresses (at least on third) that are currently in use in the USA are damaged, and many have blood and body fluids in them. This lead to the FDA recommending routine inspection for damage ( The manufacturers recommend inspection after every patient.. The cover not only is clean (as demonstrated by this study). It also protects the mattress and bed deck from damage. What recommendations do you have for future research as a result of this work?

Response: I recommend that all hospitals immediately inspect all their mattresses. I am currently doing audits for some hospitals and finding large number of mattresses and bed decks that must be immediately taken out of service because of damage. A head to head study of the launderable cover could be done, but there are already two published articles showing the cover decreased HAIs (Hooker, E. A., Bochan, M., Reiff, T. T., Blackwell, C., Webb, K. W., & Hart, K. W. (2015). Decreasing Clostridium difficile health care–associated infections through use of a launderable mattress cover. American journal of infection control43(12), 1326-1330. And Hooker, E. A., Mallow, P. J., McKinney, C., Gnoni, M. L., & Gonzales, F. F. (2019). Use of a Launderable Bed Barrier and Antibiotic Stewardship to Decrease Hospital Onset Clostridioides difficile Infections in an Acute Care Hospital: A Retrospective Pre-Post Case Study. Journal of Health Economics and Outcomes Research6(3), 196-202.) Is there anything else you would like to add? 

Response: The currently used chemicals for cleaning mattresses are not approved for soft surfaces, that is why they are destroying the mattress. The manufacturers are only giving a 1 year warranty due this. People must rinse off these harsh chemicals.

Disclosures: I am the medical advisor to the manufacturer of the launderable barrier.  


Hooker, Edmond & Ulrich, David & Brooks, Dane. (2020). Successful Removal of Clostridioides Difficile Spores and Pathogenic Bacteria From a Launderable Barrier Using a Commercial Laundry Process. Infectious Diseases: Research and Treatment. 13. 10.1177/1178633720923657



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Last Updated on June 10, 2020 by Marie Benz MD FAAD