HHM Compatibility Special Edition Feb/Mar 2020 HHM Compatibility Special Edition Feb:Mar 2020 | Page 19

‘clean washing,’ similar to ‘green washing’ in the world of
sustainability claims that are hard to substantiate. Having
a certification would ensure that if a healthcare system
bought a new ultrasound, it has the best chance of being
cleaned effectively with a wide range of disinfectants and
protocols and will be as durable as current technology will
enable. This will require manufacturers of materials, devices
and equipment to thoroughly test materials, create more
thoughtful designs, and track manufacturing processes to
ensure healthcare ‘gets what they pay for.’”
“The desired path for standards and testing methodologies
around the use of chemical disinfectants on medical devices
and surfaces is to be put at the forefront of healthcare
organizations,” Graham says. “This is an extremely important
issue for healthcare organizations to achieve optimal patient
outcomes while reducing overall costs. Clinicians and
healthcare leadership needs to raise their voice within the
industry to challenge manufacturers of chemical disinfectants,
manufacturers of various components or materials used to
make medical devices/surfaces as well as the medical device
manufacturers to establish a common ground of working
together to tackle this ever growing issue. All participants
within the healthcare arena need to be involved in partnering
together to solve this issue which ultimately can either
negatively or positively impact patient care.”
References:
ECRI Institute. Top 10 Health Technology Hazards for 2017.
Guidelines for Design and Construction of Healthcare Facilities, The Facility
Guidelines Institute 2010 Edition.
Lybert L and Mitchell A. Applying the Hierarchy of Controls to the Seven
Aspects of Surface Selection™. Healthcare Hygiene magazine. October 2019.
AHE Guidance
T
he Association for the Healthcare Environment
(AHE)’s guidance, Health Care Furniture Design -
Guidelines for Cleanability (2017) provides guidance to
furniture manufacturers and healthcare professionals in
understanding typical cleaners, disinfectants, cleaning
methods, and performance of furniture when exposed
to these cleaners and disinfectants. It also offers standard
test methodologies and specific performance recommen-
dations to which manufacturers can test; and to which
users may evaluate relative product performance.
As the guideline states, “Materials and finishes
must be compatible with hospital-grade detergents,
cleaners and disinfectants for best results.” It adds
that “Furniture manufacturers are encouraged to test
surface materials using products that are EPA-registered
hospital-grade disinfectants.”
The guideline offers the following Furniture
Cleanability Design Considerations for Surfaces in Health
Care Settings:
• Non-upholstered surfaces should be capable of
being easily cleaned; minimize surface joints and seams.
Joints and seams complicate effective cleaning, creating
organism reservoirs that can further the spread of contact
transmitted healthcare associated infections.
• Nonporous, smooth solid surfaces such as laminate
or poly resin products facilitate effective cleaning. Textured
surfaces may result in additional cleaner dwell time or
cleaning cycles, however, they may also decrease skin/
surface contact area, which may lead to decreased
bacterial transmission.
• Finishes on hard surfaces that are scratched or
chipped allow for accumulation of microorganisms and
make them more difficult to clean and disinfect.
• Furnishings must be able to withstand cleaning and
be compatible with clinical practice and hospital-grade
detergents, cleaners and disinfectants.
• Organic substrates (e.g., unfinished wood) should
be avoided in hospital areas with immunocompromised
patients; all exposed wood surfaces should be sealed/
finished such that they are and remain nonporous.
• Surfaces that require high levels of cleaning/disin-
fecting, such as armrests, should have large radii along
edges. Inside radii on adjacent (cove) surfaces to avoid
entrapment of materials and permit effective cleaning;
larger inside radii are preferred.
• Abutting surfaces should have minimal radii to avoid
creation of crevices that are difficult to clean.
• Effective cleaning can be facilitated using support
surfaces that can be cleaned from both sides, and/or
by using materials that do not absorb or hold fluids/
moisture, etc.
• Upholstered surfaces used in patient care areas
should be impervious (nonporous); untreated (non-high
performance) woven fabrics should not be used.
• Upholstered surfaces should be durable and resist
tearing, peeling, cracking or splitting; damaged surfaces
are more difficult to clean effectively.
• Upholstered furniture in patient care areas should be
covered with fabrics that are fluid-resistant, non-porous
and can withstand cleaning with hospital-grade disin-
fectants; microorganisms have been shown to survive
on porous fabrics such as cotton, cotton terry, nylon
and polyester, and on plastics such as polyurethane and
polypropylene.
• Upholstery fabrics that are flatter (or have minimal
texture) are preferable and easier to clean.
• Surfaces should also be uninterrupted whenever
possible. Avoid crevices, reveals, piping, zippers and
other areas that trap dust, dirt and other contaminants.
• Products should be designed for ease of cleanability.
Where possible, parts (cushions, arm pads, etc.) should
be easily removable and/or have removable covers to
facilitate cleaning or replacement. 
Source: Association for the Healthcare Environment (AHE). Health
Care Furniture Design - Guidelines for Cleanability. April 11, 2017
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