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Is Bleach the Best Way to Clean Patient Rooms?

Bleach is often considered a timeless household cleaning tool. Whether it’s used for laundry, to clean toilets, or to sanitize toys, the options seem endless. 

However, the use of bleach in a hospital setting is much more debatable. While it may be considered one of the most effective disinfectants available, it comes with notable drawbacks to patients, healthcare workers, and equipment — especially in patient rooms. 

Still, finding the safest, most effective disinfectant is critical in prioritizing patient safety and preventing hospital-associated infections (HAIs). 

 

How Common Are Hospital-Associated Infections?
Every day, 1 in 25 patients in the US contracts a hospital-associated infection, resulting in 90,000 deaths each year.
Source: Healthcare Finance 


 

When determining appropriate cleaning protocols, infection prevention and environmental services (EVS) teams have a lot to consider, and there are times and locations in which bleach is the best approach. 

However, in an effort to keep patients, team members, and equipment safe, bleach should not be relied upon for facility-wide disinfection — and especially not for patient rooms. 

 

The Unique Setting of the Patient Room

Patients being admitted and discharged, visitors dropping in to see their loved ones, teams of healthcare workers caring for patients — the patient room is one of the mostly highly trafficked areas in a hospital. As a result, cleaning protocols need to be safe for a large volume of people with a varying set of health conditions. 

In addition, patient rooms house plenty of important equipment, such as computers to access medical records and phones to connect with other areas of the hospital. Approaches to cleaning these items need to factor in these machines’ fragility as well as their variability. 

It is critical to keep patient rooms clean to prevent infection, but bleach may do more harm than good. Not only can it be harmful to the people and equipment around it — it may not even be as effective as its reputation suggests. 

 

3 Reasons Bleach Should Not Be Used for Patient Rooms

1. Bleach can be harmful to the people around it.

Patient rooms serve high volumes of mixed patient populations who are in and out of the hospital on a regular basis. In addition, there are plenty of visitors, healthcare professionals, and EVS teams who enter patient rooms frequently. 

Unfortunately, bleach comes with harmful health risks to those that are exposed to its vapors. It can form airborne particles that cause irritation to: 

  • Mucous membranes, such as ones on the nose, mouth, and lungs
  • Skin
  • Airways, which carry oxygen-rich air to the lungs 

If bleach is mixed with other cleaning products, such as limonenes found in common citrus cleaners, these tiny particles become especially harmful. 

Risks from bleach vapors are exacerbated if a person has asthma or heart disease, and they could potentially lead to hospital admission or even death. Also, if a person is exposed to these vapors over long periods of time, such as with EVS workers, it can lead to chronic bronchitis and increased risk of death from lung cancer or heart disease. 

2. Bleach does not prevent infection from biofilm.

One major cause of infection is a substance called biofilm, which are complex groups of microorganisms that serve as coatings to protect themselves from things like heat, antibacterial drugs, and disinfectant chemicals — including bleach. 

Appearing as slime or discoloration, biofilm is common in sinks, on floor drains, and around leaky faucets. It can also show up in more hidden areas, such as air conditioning evaporating trays, water cooling towers, and fountains. 

Despite bleach's reputation of being a strong disinfectant, it doesn't stand a chance against biofilm. This means that despite every effort of EVS teams to clean patient rooms, by only using bleach, they're not addressing infections that can be caused by biofilm.

 

The Connection Between Biofilm and Infection
According to the Centers for Disease Control and Prevention, up to 70% of human bacterial infections in the Western world are a result of biofilm.
Source: American Scientist


 

Without proper removal, biofilm can lead to serious complications, such as: 

  • Prostatitis
  • Kidney infections
  • Pneumonia
  • Infective endocarditis
  • Illnesses from implanted medical devices 

Because of how it forms to protect itself, biofilm requires much further disruption than bleach to eradicate it, such as scrubbing, high-pressure spraying, or steam. 

3. Bleach can damage important equipment.

From computers to phones to scales, patient rooms often require frequent usage of equipment, especially of an electronic nature. Unfortunately, bleach can corrode metal and damage electronics. 

Plus, patient rooms often contain plastic items, including storage containers and chairs. If bleach is used to clean them, it can actually damage the plastic over time. 

Finally, patient rooms may be painted — or contain items that have been painted, such as a chair. Bleach is not gentle on painted surfaces, and it can harm them, as well. 

The equipment located in patient rooms is essential to care — but it can be costly. The damage from bleach may require equipment to be frequently replaced, which is neither efficient for care or cost-friendly. 

 

Bleach Vs. Other Disinfectants

Bleach is not the enemy. There are times and locations in which the use of bleach is the considered best practice, such as: 

  • In isolation rooms with:
    • Confirmed cases of C. difficile or Norovirus
    • Patients with enteric (relating to the intestines) precautions
    • Demand for trusted, time-tested disinfectant
  • During extreme outbreaks
  • If patients are experiencing symptoms associated with C. difficile or Norovirus

However, in lower-risk and high-traffic areas like patient rooms, avoid relying on bleach. There are other effective disinfectants that are just as — if not more — effective. For instance, hypochlorous acid (HOCI) can kill biofilm, all while remaining safe for patients, workers, and certain equipment. 

Infection prevention is critical to everyone’s safety — but it can be complicated. Fortunately, environmental services teams are specially trained and up to the challenge of keeping everyone in your hospital healthy in the cleanest environment possible. 

Do you have questions about effective and safe cleaning protocols? Learn about Protecta

July 22, 2020

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