Do beds stored on hospital corridors have an increased bacterial.docx
1. Do beds stored on hospital corridors have an increased bacterial load
than beds in use on acute hospital wards? Using ATP bioluminescence
testing, is there evidence to suggest that unused beds need to be stored
in a clean environment rather than busy hospital corridors.
IntroductionSpace is at a premium in many NHS organisations. Corridors are magnets for
unused items both in and outside of healthcare settings (Keyes 2015). Many items of
clinical and none clinical equipment migrate to corridors outside hospital wards due to a
significant lack of storage within the clinical ward area (Keyes 2015). Keyes (2015)
highlights this as a problem from a health and safety perspective, but Reboux et al (2014)
outline the principle of hospital corridors being a significant risk of contamination from an
infection control point of view, highlighting a much heightened risk of both bacterial and
fungal contamination on equipment stored on corridors.Within the Children’ s Hospital
trust in which I work there are many types of bed to cater for the various ages of children
attending the hospital. These range from bassinet cots to cot beds and to standard size
hospital beds. It is very difficult to predict which age of child will be admitted, so inevitably
there are more beds in the building than bed spaces to put them in. Invariably corridors are
used daily to store the varying types of bed until ward staff know the age of the patient to be
admitted. These beds stored in corridors are regularly ‘ touched’ by passers-by including
visitors and staff alike.Although questioned in its efficacy by Brown and Eder (2010),
adenosine triphosphate (ATP) bioluminescence measurements have been used in
healthcare and in food hygiene areas for many years and are used as a method to rapidly
test an area or piece of equipment to assess level of cleanliness (Omidabakhsh et al,
2014). Background/literature reviewUsing both internet search engines such as Google and
Bing, I have extensively used library resources at the universities in both Dundee and
Sheffield. Keyword searches included hospital corridors, hospital beds, cleaning, ATP
testing and hand bacterial transmission.There is a wealth of literature relating both to the
bacterial contamination of hospital beds and their subsequent cleaning within hospital
environments (Sjoberg et al 2013 and Attaway et al 2012) and also the contamination of
hospital equipment whilst within ward areas (Havill et al 2011). Research has also been
completed highlighting an increased risk of bacterial and fungal transmission whilst
hospital environments undergo restoration or rebuilding (Rollins 2013) – the trust
2. involved in this study is currently undergoing a large rebuild and renovation project.I have
been unable to find any piece of work than pertains directly to the issue that beds whilst
being stored on hospital corridors gain an increased bioload due to a combination of
bacterial shedding from passers-by and the increased risk that the beds themselves are
used to hold on to and touched by varying staff and visitor groups whilst in situ.My concern
in this instance is that these beds are put straight back into use once a ward has
confirmation of the age of a patient being admitted without an extra clean once being
moved from corridor to ward. Purpose/significanceUsing the ATP system of bioluminescent
monitoring, the aim of this research is to prove that beds on corridors do have a higher
bioload than their equivalent counterparts within ward areas with the main research
question being: Do beds stored on corridors in a Children’ s NHS Hospital trust become
more bacterially contaminated that those beds in use within the hospital’ s ward
environments?All findings from this study will be used directly within the trust to amend or
change practice with view to creating a clean bed store and instigate an adequate cleaning
programme.All findings/results will be disseminated to all relevant staff within the
trust. Description of proposed researchI am proposing to use an experimental type research
model as I plan to find out an ‘ objective reality’ as detailed by DePoy and Gitlin (1994).
This has been chosen as the research type to use as the information gathered will be
numeric values which can be used to hypothesise problems whilst the ATP numeric values
obtained can represent a reality of the current state of bed ‘ cleanliness’ .The study itself
will involve using ATP monitors to get base line readings of all beds on corridors – without
any prior cleaning. Once all readings have been obtained, the plan is to complete another set
of readings on beds within each acute ward (there are 5 main wards within the hospital).All
data received with be collected and recorded appropriately and reports/graphs completed.
All results will be reported to trust board members and I the infection control committee
once provisional and final results have been obtained. All results will also be fed back to the
hotel services team who manage domestic services.All data will be used directly to address
cleaning effectiveness and frequency within this busy children’ s hospital.Ethical
considerationsThis research project has already been discussed with the infection control
team and Nurse Director and has been added to the agenda of the next Infection Control
Committee meeting for ratification. Reference List ATTAWAY, H.H., et al, 2012. Intrinsic
bacterial burden associated with intensive care unit hospital beds: Effects of disinfection on
population recovery and mitigation of potential infection risk. American Journal of Infection
Control. Vol. 40, pp 907-912 BROWN, E. et al, 2009. Do surface and cleaning chemistries
interfere with ATP measurement systems for monitoring patient room hygiene? The
Hospital Infection Society. Vol. 72, No. 2, pp 193-195 HAVILL, N.L., et al, 2011. Cleanliness of
portable medical equipment disinfected by nursing staff. American Journal of Infection
Control. Vol. 39, No. 7, pp 602-604 HOPMAN, J., et al, 2015. Mechanical vs manual cleaning
of hospital beds: a prospective intervention study. Journal of Hospital Infection. Vol. 90, pp
142-146 KEYES, B., 2015. Confessions of a former life safety specialist: Corridor clutter in
among common tour snags. Strategies for Nurse Managers.
http://www.strategiesfornursemanagers.com/ce_detail/236414.cfm (accessed
05/09/15) OMIDBAKHSH, N., et al, 2014. How reliable are ATP bioluminescence meters in
3. assessing decontamination of environmental surfaces in healthcare settings? Plos One. Vol.
9, issue 6 REBOUX, G., et al, 2014. A 10 year survey of fungal aerocontamination in hospital
corridors: a reliable sentinel to predict fungal exposure risk? Journal of Hospital Infection.
Vol. 87, pp 34-40 ROLLINS, M., 2013. Dirty Work in Clean Hospitals. European Medical
Hygiene Magazine. http://emhmagazine.com/article.php?article_id=926 (accesses
04/09/15) SJOBERG, M., et al, 2013. Transmission of Clostridium difficile spores in isolation
room environments and through hospital beds. Acta Pathologica, Microbiologica et
Immunologica Scandinavia. Vol. 122, pp 800-803
