Can Launderable Mattress Covers Be the Key to Lowering C. diff Rates in Hospitals?

Edmond Hooker, MD, DrPH, professor, Health Services Administration at Xavier University, and emergency physician at the University of Cincinnati, discusses the use of a launderable mattress cover to reduce C. diff rates in hospitals.

Interview Transcript (modified slightly for readability):

“The Trinity Guardion Patient Barrier System is a really cool idea. The idea is, you need a verifiable process that’s repeatable and doesn’t depend on workers doing things right or wrong. The cover is made of the material used in high-end mattresses—it’s breathable; it helps prevent pressure ulcers just like the high-end mattresses. We cover the mattress, and we also cover the bed deck—the metal that the mattress sits on. When you bleed, or you have urine, or feces—all of these things get on the mattress and where does it go? Right off the end of the bed and right into the bed deck. Well, guess what. We’ve got that covered, so when that happens, it all leaves the room with the patient.

You have this cover, you put it on—it takes about 1 minute to put on—it’s reverse-rolled, with the patient contact surface inside, so you don’t touch that mattress with anything, and you cover it all. Then, once the patient leaves, you just roll it back up and send it out to the laundry; it can be done in any laundry in the United States, any health care laundry can do this. We’ve got multiple laundries all over the United States now doing it; it’s no problem. These are computers now in the laundries that just dial up our special formula. We wash with chlorine—and I told you that chlorine is dangerous for these mattress surfaces, but it’s not in this case because we rinse it off and we use lower concentrations. And because we are using heat in the process, guess what happens—it makes the chlorine much more effective. And so, that chlorine works, even at that lower 150 ppm; this means that I’m not putting that 5,000 ppm all over the mattress. Chlorine is great. I love chlorine. We need lots of chlorine, but you don’t need to use so much and you’ve got to rinse it. Well, this does all of that. You clean it, you rinse it, you use chlorine, you rinse it, and then you dry it with heat. Bacteria do not like heat; that’s one point that cannot be argued—heat kills bacteria.

After we kill the bacteria, we inspect every mattress. I told you I’m worried about failures of mattresses. Up to one-third of mattresses in multiple, huge studies, have been found to have visible cracks in them, and about 5% to 10% were found to have blood and secretions inside of them. That’s not going to happen with this product because we are inspecting it every time. Just like operating room linens are inspected because we can’t have cracks in those, it’s the same idea; we inspect all of ours.

This thing comes back, it’s reverse-rolled; it’s in a little bundle. Then you just open it up and you can put it back on a mattress in 1 minute; it takes about 30 seconds to 1 minute to put on and 30 seconds to 1 minute to take off. Very simple, very repeatable. And very importantly, it’s got clips and it’s made individually for each bed. And so, if you have an X manufacturer’s XYZ brand, and you say, ‘I need a cover for that bed,’ because every bed is manufactured a little differently, all the clips make sure that the cover stays on and doesn’t move. If you go out to Walmart and buy a cheap little plastic cover and you say, ‘That’s going to work,’ well, first of all, you’re going to sweat like mad and you’re going to get pressure ulcers. Second of all, it’s going to pop right off. Mattresses come up, they articulate, they turn into beds—you can’t do that. We tried it; we were curious to see how it worked, and it doesn’t. That’s why you have to have a system that actually connects to the bed deck and that keeps it from moving. And every time, you get a verifiable process. The cover is actually bar coded, and so, I can tell you how many times it has been used; I know exactly where it’s going; I know where it’s supposed to be. I can tell you, ‘Oh my gosh, that thing is at the end of life.’ We’ve shown that we can run it through at least 150 washes without degradation; we plan to run that up to 400.

Also, it doesn’t cost that much for the cover. You’ve got some time in putting it on and off, but I’ve already told you that you need 30 minutes at least to clean the bed correctly, and this takes 1 to 2 minutes. Now, you’re still going to have to clean the hand rails, and so, you’re probably going to have 10 minutes of cleaning handrails and stuff like that but the actual cleaning of the mattress takes at least 20 minutes, and that’s not worrying about the rest of the stuff. You can do that in 1 minute by just putting a new cover on. And so, it’s very simple to use and it can be put on any kind of bed. I can put it on any manufacturer’s bed; I can put it on emergency room stretchers, operating room stretchers; I can provide clean wherever you want it.

They cost about $450 dollars. And so, if you say 150 uses, that’s about $3 a turn—that’s not bad. It costs about $5 to $6 to clean them, because they’ve got to be cleaned well. Obviously, you don’t want to just take them and wipe them off. Then, you’ve got the same problem that you had before. And so, they have to be laundered and that’s about $5 to $6. All hospital laundry is paid by the pound and this thing is not light; it’s a little bit heavier, and so, it does cost about $5 or $6 to clean.”