Infection Control In The Bathroom

Bathrooms at healthcare and nursing facilities are used by many people. Therefore, it tends to be moist for long periods of time, making it an environment conducive to the proliferation of gram-negative bacteria and mold^1,2. Furthermore, dead skin cells and sebum washed away from the body may remain on the environmental surface, and this dirt and moisture may become a breeding ground for microorganisms. If these microorganisms enter through mucous membranes or wounds through contact or splashing water, they can cause infections in people with weak resistance, such as the elderly. There have been cases in nursing facilities where residents have died after being infected by bathwater contaminated with Legionella, a gram-negative bacteria³. In this opportunity, why don't you think about the bathroom hygiene and infection control?

Potential Infection Risk Areas

1. Shower stools and stretchers

   The underside of a shower stool tends to stay wet, often overlooked in cleaning, and can easily harbour dirt and molds². In addition, the sponge-like material often used in bath products such as shower stools, wheelchairs, and stretchers has a porous structure, making it difficult to clean and disinfect thoroughly, and prone to the proliferation of microorganisms^1,2,4.

2. Body soap and shampoo

   Adding liquid to the bottle may cause the growth of gram-negative bacteria.

3. Drains

   Hair, soap scum, and dirt tend to accumulate in drains, and they are difficult to clean and dry. This situation is leading to the proliferation of microorganisms and odors².

4. Bathtubs

   Bathtubs with uneven surfaces or structures are difficult to clean and disinfect, and are prone to slime formation and the proliferation of Legionella⁴.

Hygiene and infection control methods

Here are some examples of hygiene and infection control methods for bathrooms. Please take into consideration the characteristics of the bathroom in your facility and carry out appropriate management.

Daily environmental maintenance

Clean the bathroom floors, walls, and other environmental surfaces every day using detergents and cleaning tools^1,5,6. The fat components of soap react with the metal in tap water or sebum, and adhere to the environmental surfaces. The longer they are left, the harder they become to remove, so be sure to clean frequently². To prevent the proliferation and establishment of microorganisms, be careful not to leave any slime behind when cleaning^3,4,6. It has been reported that brush cleaning with detergents is effective for removing slime during daily cleaning⁴. Amphoteric surfactants that can be used for cleaning and disinfection are recommended². When the last use of the day is completed, remove dirt from the drain and clean it¹. Regular ventilation and drying of the bathroom are also important to prevent the proliferation of microorganisms. If ventilation is difficult, use a dry towel to wipe off the water after cleaning².

Bathwater management

In Japan, bathwater is disinfected with chlorine-based chemicals, and the residual chlorine concentration in the bathwater is usually kept at about 0.4 mg/L^3,5. The bathwater should always be kept full in a bathtub to allow overflowing hot water to wash away any floating debris on the surface. As a general rule, the bathwater should be drained, cleaned, and replaced every day after use.

Item management

Body soap and shampoo should be disposable. If refilled, the bottles should be washed and dried, and managed appropriately. Bath products such as shower stools/wheelchairs and stretchers should avoid sponge-like materials^1,2, and after use, they should be washed, disinfected, and dried with a cleaning agent¹. Keep the number of items in the bathroom to a minimum to allow undisturbed cleaning and drying².

For hygiene and infection control in the Bathroom

Bathroom Cleaning Manual

Products

Cleaning Procedure