Pillow Talk: Examining Pillow Cores in a Regional Burn Center

BACKGROUND/OBJECTIVES: Hospital acquired infection is a signficant problem in patients with burns leading to increased length of stay and increased mortality. Reducing the risk of nosocomial infection is a primary goal of several national healthcare improvement initiatives. An 8 bed Midwestern regional burn centerʹs focus on patient-centered safety, clinical effectiveness, and quality of care promoted processes to improve patient care at the bedside. METHODS: When inspecting pillows used on the burn unit, nurses discovered patient pillows varied in weight and detected stains on some pillow covers. Nurses questioned whether the presence of small manufactured openings, which allow for air exchange within the pillow core, might also allow for wound drainage and transfer of microorganisms, increasing patient risk for acquired infection. An interdisciplinary team was formed that included members from nursing, infection control, and laundry services to assemble and review the evidence related to the role of pillows in harboring microorganisms and their contribution to hospital acquired infection. Three patient pillows and 1 control pillow were sent to an independent microbiology laboratory for examination of pillow cores. RESULTS: Manufactured pillow openings were not found to be a mechanism for pillow core contamination. Pillow seams and pillow label tags were found to be a mechanism for pillow contamination allowing for drainage wicking from outside the pillow to the pillow core. Multiple infectious organisms were found growing within pillow cores of all 3 patient pillows. These organisms had correlation to organisms from colonized and infected patients, e.g. acinobacter cultured from a patient with acinobacter colonization of the face. No organisms were found growing within the pillow core of the control pillow. The unit instituted an intervention that replaced reusable pillows with disposable pillows for all burn patients. CONCLUSIONS: In the regional burn center, the processes of bedside communication, interdisciplinary teamwork, and evidence-based decision making contributed to the patient safety goal of reducing hospital acquired infection and improving patient care at the bedside.