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Infection Prevention and Control
BEST PRACTICE GUIDELINES
Reference:
Subject/Title:
Selection, Cleaning and Disinfection and Maintenance of Patient Care
Tubs
Authorized by:
Infection Prevention and Control
Effective Date:
August 2010:
Revised:
December 2013
PURPOSE
The purpose of this guideline is to ensure the selection, cleaning and maintenance of patient care tubs meets Infection
Prevention and Control (IPC) guidelines and standards in all Alberta Health Services (AHS) facilities. This document
addresses tubs used for bathing (e.g. bath tubs, sitz baths). This document does not address hydrotherapy equipment or
cleaning/disinfection of jetted tubs.
BEST PRACTICE GUIDELINES
Literature has shown that patient tubs pose a risk of infection to clients in both acute care settings and facility living
environments if not properly cleaned, disinfected and maintained. Hollyoak, Boyd, and Freeman (1995) inspected
seventeen whirlpool baths used in Durham nursing homes and found that water samples from all baths showed heavy
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growth of Pseudomonas aeruginosa. Berrouane et al (2000) investigated a prolonged outbreak of hospital acquired
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infections with the same organism and discovered that a whirlpool bathtub was the source.
Product Evaluation
IPC recommendations for selection of tubs for healthcare settings:
1. New tubs purchased for use in healthcare facilities must be non-jetted. This includes air and water jets. Do not
purchase tubs with jets or whirlpools.
2. The surface of the tubs should be constructed of a smooth, non porous material that will facilitate frequent,
vigorous cleaning and disinfection. Non-slip surfaces must allow for effective cleaning and disinfection.
3. Tubs with dispensing systems for personal care product should use replaceable bottles for the products instead of
reservoirs.
4. Detailed cleaning, disinfection procedures and preventative maintenance information must be provided in writing
by the manufacturer. Manufacturer’s recommended disinfection products must have a DIN from Health Canada
and be approved for use in AHS.
Cleaning, Low level Disinfection and Maintenance of Patient Care Tubs
1. There must be a written procedure for daily cleaning and low level disinfection of tubs that follows the
manufacturer’s instructions. Responsibility for daily cleaning and disinfection must be identified in the procedure.
Daily cleaning of tubs must be documented. Instructions should be posted and/or readily available to staff.
2. There must be a written procedure for cleaning and low level disinfection of tubs and lifting devices between
patients that follows the manufacturer’s instructions. Responsibility for cleaning and disinfection between
patients must be identified in the procedure. The procedure should be posted and the information readily available
to staff.
3. There must be a written procedure for routine and preventative maintenance of tubs that follows the
manufacturer’s instructions. Responsible person(s)/departments for preventative maintenance must be identified
in the procedure. Maintenance of tubs must be documented, the procedure should be followed and the
information readily available for maintenance staff.
4. Multi-patient use product bottles in tub dispensing systems (e.g. body soap, hair shampoo and/or other personal
care products) must be disposable and must be discarded when empty; and not refilled or topped up
5. If the tub has a reusable reservoir for dispensing personal care products, the reservoir must be cleaned and dried
before refilling.
Best Practice IPC Guidelines for Selection, Cleaning, Disinfection and Maintenance
of Patient Care Tubs. Revised December 2013
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Infection Prevention and Control
BEST PRACTICE GUIDELINES
Reference:
Subject/Title:
Selection, Cleaning and Disinfection and Maintenance of Patient Care
Tubs
Authorized by:
Infection Prevention and Control
Effective Date:
August 2010:
Revised:
December 2013
References
1. Hollyoak V, Boyd P, & Freeman R. (1995). Whirlpool baths in nursing homes: Use, maintenance and contamination
with Pseudomonas aeruginosa. Communicable Disease Report, 5(7), 102-104.
2. Berrouane YF, McNutt LA, Buschelman BJ, Rhomber PR, et al (2000). Outbreak of severe Pseudomonas aeruginosa
infections caused by a contaminated drain in a whirlpool bathtub. Clinical Infectious Diseases. Vol. 31, No. 6: 13311337.
3. Health Canada/Public Health Agency of Canada. Infection Control Guidelines: Hand Washing, Cleaning, Disinfection
and Sterilization in Health Care. (1998) Canadian Communicable Disease Report. 24 (Suppl. 8):1-55.
http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/98pdf/cdr24s8e.pdf.
4. Ontario Ministry of Health and Long-Term Care. Provincial Infectious Diseases Advisory Committee. (May 2012)
Best Practices for Environmental Cleaning in All Health Care Settings.
http://www.publichealthontario.ca/en/eRepository/Best_Practices_Environmental_Cleaning_2012.pdf
5. Sehulster L, Chinn RY. (2003) Guidelines for environmental infection control in health-care facilities.
Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR
Recomm Rep. 52 (RR-10):1-42. http://www.cdc.gov/mmWR/preview/mmwrhtml/rr5210a1.htm.
6. Calgary Health Region. (2003, December 2) Infection Prevention and Control. Standards and recommendations for
tub purchase, use, cleaning and disinfection.
Best Practice IPC Guidelines for Selection, Cleaning, Disinfection and Maintenance
of Patient Care Tubs. Revised December 2013
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