Problem Solvers

Keeping Things Clean

Ensuring a support surface stays clean could go deeper than providers might initially think. Can they improve?

• By David Kopf
• May 01, 2014

Support surfaces represent a cornerstone of many provider businesses patient relationships and revenues, but unlike many DME offerings, mattresses are often rented out and stay with the provider when not with a patient (until they reach the end of the usability). This represents an important healthcare requirement: keeping things clean.

And when it comes to support surfaces, keeping things clean can be a more exacting business than one might initially expect. How can providers ensure they are living up to the proper clean healthcare requirements?

The most important thing to understand is there is a vast gulf between clean and disinfected, says Karl Soderquist, president of The Hubscrub Company, which manufactures high-performance, automated cleaning and infection prevention systems for durable medical equipment and other equipment requiring the same level of cleanliness.

“Oftentimes a clean surface isn’t known to be free of any kind of infections,” he says. “When you’re in a more hospital environment, that clean image is seen as not that it is okay to touch it, but that it hasn’t been disinfected. Some of these things that hang around have shelf lives of up to five months.”

That said, regular cleaning — while not disinfecting — is important Soderquist says, because it is akin to frequently washing your hands. It is going to reduce the risk of some contamination issues.

“The cleaning will obviously help,” he explains. “But no cleaning detergent can claim that it can kill certain viruses or bacteria.”

Creating Cleaning Procedures

When it comes to the primary cleaning issues that providers must deal with when getting a mattress back the biggest factor is process, says Daniel O’Malley, regional vice president of Pressure Prevention Sales for medical equipment maker Drive Medical.

“Providers should have a protocol in place for cleaning a returned mattress when it comes back to them from a patient’s home or facility,” he states. “They must use either a quaternary or phenolic solution that is properly diluted to ensure disinfectant. The mattress is cleansed with the appropriate solution and allowed to set for a short amount of time. Providers must be careful not to leave the cleansing agent too long to prevent damaging the mattress fabric.

Of course, there are times that when a mattress comes back, it has become too soiled to use again.

“If the mattress cover has been compromised and is no longer protecting the inner components of the mattress, then the mattress should be disposed of,” O’Malley notes.

When a provider has an order for a support surface and needs to send it out for rental, it must follow the correct cleanliness and hygiene standards before sending it out to a patient. Providers must follow and be in accordance to the DMEPOS provider manual for cleaning mattresses between patient use, O’Malley says.

And this is important, because mattresses and therapeutic support surfaces might get cleaned before going into inventory, but they might not stay that way. The best solution in this case is prevention, because a second cleaning is costly and unnecessary if providers are following the right protocols and procedures.

“Mattresses can become dirty while in storage and it is required that all clean, unused mattresses must be stored in a protective bags or liners,” O’Malley explains. “Clear or colored heavy duty mattress transport bags will protect the mattress while in storage.”

Helping Patients Stay Clean

When the mattress is in he home, ensuring the mattress stays as clean as possible comes down to patient and caregiver access says, and Karen Lerner, regional vice president of Pressure Prevention for Drive Medical.

“Providers can instruct patients and their family members to spot clean the mattresses by using household mild soap and water,” she says. “Some mattress covers can even be removed and machine washed then air dried.”

Going back to the hand-washing example, Soderquist says cleaning hands might be a key point of instruction for providers to give patients and their families and caregivers, because it has a global benefit.

“In hospitals, with the staff, doctors, patients an visitors, cleaning hands is turning out to be a very step to help prevent infections and cross-contamination,” he says. “But when you go to other organizations, such as medical equipment providers, service businesses, and even some of the nursing homes they’re not really practicing that in a way that I could say compares to hospitals.”

And, as it happens, the in-home cleaning aspect of support surfaces can represent an additional revenue generating opportunity for providers that also eases cleaning for the caregiver, depending on the circumstance.

“Although Medicare will not pay for the patient to have a back up mattress cover, many private insurers and Medicaid will pay for a second mattress cover,” Lerner notes. “This will allow the patient to clean one cover while the other cover protects the mattress.”

Looking for a Better Way

But as rental costs go up and reimbursement goes down, Soderquist says he sees an opportunity to for providers to sharpen their game. Cleaning things with disinfectant spray will kill contaminants, but implementing more efficient and more effective cleaning and disinfecting procedures on the back end will ultimate save them money through reduced labor costs, boost patient and referral partner trust, and hopefully improve outcomes.

“Since I am very close to DME, through rehab equipment, I can see technicians will take a spray bottle and maybe they give it six squirts of disinfection,” he explains. “As an industry that has to improve. It’s slowly getting there, but it has it long way to go.”

That manual process entails costs and risks infection, and it’s why Soderquist’s company is angling to create an automated, mechanical process for cleaning and disinfection. “From my perspective,” he says, “that’s a way to address the kinds of problems that they’re having from having a manual process to clean and disinfect.”

This article originally appeared in the May 2014 issue of HME Business.