According to Tamara Bristol, housekeeping supervisor at Divine Savior Healthcare in Portage, Wisconsin, bed rails are one of the most difficult items to clean in a patient room.

"We have to make sure we get our rags into every nook and cranny of the bed rail and leave the surface saturated for the recommended dwell time in order to properly disinfect everything," says Bristol. "For areas that are particularly soiled, we may need to use tools like scrapers and toothbrushes."

While crevices can be difficult to disinfect, bed rails are often neglected for an entirely different reason: patient privacy.

"Sometimes EVS technicians are hesitant to disinfect the bed and bed rails when it is occupied," says Solomon. "But they have the right and the responsibility to clean and disinfect the bed, even when the patient is in it."

Furthermore, she believes staff has the right to disinfect personal items, such as cell phones. At the least, technicians should move patients' items when necessary to clean and disinfect surfaces.

"Housekeeping is often afraid to move the patient's belongings or leave surfaces wet because the patient will complain, so generally those things aren't being cleaned and disinfected," says Darrel Hicks, an infection control consultant in St. Charles, Missouri. "Housekeepers need to give patients the message that they care about their health and ask for permission to move their stuff so that they can disinfect the tables and bed rails."

Cleaning patient rooms chock-full of medical equipment can be daunting for EVS workers who are short on time. Additionally, over-wetting electronics with disinfectant can damage components, while the wrong disinfectant can cause monitors to haze, rendering them unreadable.

Solomon recommends using a washable cover to protect keyboards and following the manufacturer's recommendations for cleaning touch screens. Indeed, housekeeping staff should rely on manufacturers' instructions for use when disinfecting all hard and soft surfaces as the wrong chemical could damage the product and void the warranty.

"The housekeeper has one disinfectant and that could damage plastics or optics," says Hicks. "They can't carry 10 disinfectants on their cart, so they need to step up and say ‘we're not responsible for disinfecting these items.'"

Surface compatibility should be taken into consideration when making purchasing decisions — and housekeeping should be involved in the process. Hicks recommends implementing a program to identify the parties responsible for disinfecting medical equipment, particularly computers on wheels.

"Patient care equipment serves as reservoirs for pathogens and microorganisms," says Hicks. "These devices move from room to room and never get disinfected because nursing thinks it's housekeeping's job when it isn't."

To avoid the blame game, consultants recommend collaboration between EVS and nursing. Hicks suggests using different color labels as a visual aid so that nursing and housekeeping staff know at a glance who is responsible for disinfecting each piece of equipment.

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