The mattress audit, also known as a mattress inventory, is an important part of creating a safe environment for patients. Since a seemingly clean mattress can hide both bacteria and mould under the mattress cover, it risks becoming a Trojan horse. The pictures above show what it can look like when you take a closer look at a healthcare mattress.
Unclean mattresses are more common than you might think.
Most patients spend up to 90 per cent of their illness in bed, placing the mattress at the heart of the rehabilitation process. The mattress is not just a place to rest; it also serves as a medical device.
During the period 2017-18, Järven Health Care initiated a comprehensive mattress inventory at a medium-sized Swedish county council. All mattresses at the county council's three hospitals were carefully reviewed through a structured procedure where the surface layer was assessed for any damage, discolouration or signs of contamination.
Only 318 of the 724 inventoried mattresses were approved, which is less than half. Of the failed mattresses, 115 were considered to be in such poor condition that they had to be replaced immediately.
A similar cross-country inspection was carried out between 2016 and 2018 and included 2046 beds. The results showed that 36% of the mattresses had damaged surfaces, and 28% of these also had visible stains. As healthcare policies, procedures and budgets are compared across counties, this report gives a clear indication of the extent of the mattress problem nationally.
In general, there is a lack of knowledge about mattresses in terms of lifespan and care. With a good mattress audit, each department can get a clear overview for future planning; how many mattresses need to be replaced on average each year to maintain high quality.
The mattress audit is a necessary measure to improve the rehabilitation environment and raise standards in healthcare nationally.
How are Sweden's healthcare mattresses doing?
There are no national statistics on mattress hygiene in healthcare, but in 2017-2018 a comprehensive mattress inventory was carried out at a medium-sized Swedish county council. All mattresses in the county council's three hospitals were examined using a procedure where the surface layer was assessed for damage, discolouration or signs of contamination. The results were alarming.
406 mattresses out of 724 inventoried mattresses were submitted.
115 mattresses were considered to be in such poor condition that they had to be replaced immediately.
In the period 2016-2018, a similar, county-wide inspection was carried out which included 2 046 beds.
36 per cent of mattresses have damaged surfaces.
28 per cent of them also had visible stains.
As healthcare rules, practices and budgets are comparable from county to county, this report gives a clear indication of the extent of the mattress problem at a national level.
How a mattress audit works
The inventory of the hospital's healthcare mattresses is carried out in a structured and organised manner. The surface of the mattress was assessed for damage, discolouration or signs of contamination. Then the mattress itself is assessed for age, wear, comfort and degree of contamination. The overall assessment then results in one of three possible ratings:
Green Good condition, functional and hygienic.
Yellow Clean but in deteriorated condition. Should be replaced in the future.
Red Contaminated. Must be replaced immediately.
Järven Health Care has extensive experience in conducting mattress audits and helps Swedish hospitals free of charge with this important part of the work for a safer care site. Contact us for more information about our mattress audits.
The guidelines produced by Region Skåne state:
"The mattress cover can be damaged by wear and tear and improper handling. Small cracks in the mattress cover can occur and are not always detected during a superficial visual inspection. The cracks let body fluids through to the mattress with the risk of spreading infection.
The mattress cover shall be checked, cleaned and disinfected between each patient during the final cleaning and preparation of the bed, and as necessary, to prevent the spread of infection."
Regional guideline on mattress inspection and inspection, cleaning and disinfection of mattress covers.