Absolutely. While hand hygiene remains the most important factor in germ transmission, it is impossible to maintain clean hands if the environment is not adequately disinfected. Weber et al. reported that 20-40% of HAI’s have been attributed to cross infection via the hands of care staff,34 highlighting the importance of hand hygiene. However, hands become contaminated not only from direct contact with the patient, but also by touching contaminated environmental surfaces. In fact, Guerrero et al. showed that gloved hands pick up C. diff from commonly touched environmental surfaces just as easily as they do from commonly examined skin sites.35 As research shows, mattresses very often remain contaminated even after terminal cleaning.1-5 Since mattresses are the 2nd most touched surface by caregivers in the ICU and 4th most touched on med-surg units,36 it’s easy to see how hands can become contaminated when caring for the patient. Therefore, transmission to the patient via the hands of hospital staff can occur even when following the WHO’s recommendations on hand hygiene if the mattress is not adequately disinfected.37 In addition to this dilemma, transmission could also occur directly from the mattress to the patient if the mattress remains contaminated from previous patients. Because patients have intimate contact with the mattress throughout their entire stay, it is critical that we provide them with a clean and safe mattress surface to prevent germ transmission.
FOLLOW-UP: Read the published research demonstrating that mattresses remain contaminated after terminal cleaning1-5 and can contribute to outbreaks in hospitals.6-9