Cleaning the MRI scanner and equipment is an important task that has come to light in recent years, and should be done between patients in magnetic resonance imaging exam rooms. This could be accomplished when all staff are informed on objectives, based on a MRI Cleaning Policy and a regularly assigned schedule. Additionally, a checklist for deep cleaning to be performed on a regular basis is just as important. Holding the staff is accountable is part of the formula for success, but cleaning the MRI exam room has its downsides. If equipment enters the room that is not MRI compatible, then a chance for disaster can happen causing downtime, damage to the MRI, and possible injury (or death) to an uninformed cleaning person.
The question often comes down to “who” is going to take responsibility for cleaning the mri, the exam room, the coil hardware, the table, the furniture and the floors?
Many site operators are very cautious about who they allow into their MRI exam room, so they either specifically train certain cleaning personnel, or the MRI technologists clean the room and equipment on a daily basis.
It is recommended that sites have infection control policies along with cleaning policies for the exam rooms also, and those policies should include the contributions of an Infection Control Nurse or other equally qualified personnel in development. Some MRI technologists are not completely versed in “Infection control procedures” and therefore, should be fully educated on them through a qualified program. The education should be documented and would best be reviewed on a yearly basis, along with MRI safety protocols.
Other radiology exam rooms such as fluoroscopy, CT Scan exam rooms and ultrasound rooms have floors that are cleaned on a nightly basis, so why would an MRI scan exam room be any different? Additionally, cleaning the MRI bore, the MRI table and all coil hardware that each patient contacts should be cleaned between each patient. Some believe it is advantageous for the site’s reputation if patients witness the cleaning and the staff washing their hands thoroughly between patients.
Dr. Peter Rothschild wrote about the story in AuntMinnie, and a protocol for cleaning the MRI suite after a procedure went badly for his inpatient wife, also a physician. She felt pressured by the staff to have the necessary MRI study in order to be discharged, despite her mentioning the room had not been cleaned between the prior patient and her. The prior patient had come from an isolation room, when she also witnessed all of the attending staff wearing infection control gowns and gloves. With MRSA as a serious concern, (methicillin-resistant Staphylococcus aureus) among other infections, she requested the staff clean the room and head coil. As is typical in many MRI departments, they were running behind schedule. According to Dr. Rothschild, his wife was told if she would not get on the table right away, they would just scan the next patient, and she would have to explain to her doctor and insurance company why she refused her MRI. Under this kind of pressure, she succumbed, but ended up crying when she was removed from the scanner. (We at MRI Optimize Consultants say “Shame on this technologist for handling the situation in this manner and distressing his patient.”)
If the tech had taken the necessary time to clean the room and hardware, which might have only taken a few minutes, and this had been done in front of the patient (we imagine her in a wheelchair outside the exam room watching), she might have felt confident about her level of care given at this institution, as well as in the professionalism of the staff.
Out of a horrible situation for the Dr. Rothschilds, came something good.
Dr. Peter A. Rothschild created a recommendation, an 11 step cleaning in 2008 for MRI suites:
11 Steps for infection control in MRI:
1) Have a written infection control policy to include MRI cleaning procedures and the cleaning schedule, and post it throughout the center.
2) Implement a mandatory procedure for hand washing/hand sanitizing between patient exams for technologists and any others who come into contact with patients.
3) Clean the MRI tables, inside the magnet bore, and any other items that come into contact with patients. Infection control experts recommend that this be done after each patient.
4) Clean all pads and positioners with an approved disinfectant. Infection control experts recommend cleaning after each patient.
5) Periodically inspect the pads with a magnifying glass, particularly at the seams, to identify fraying or tearing. If present, the pads should be replaced.
6) Regularly check all padding material with an ultraviolet (black) light, and ensure that any biological material detected on the pads can be removed.
7) Replace damaged or contaminated pads with new pads incorporating permanent antimicrobial agents.
8) Use pillows with a waterproof covering that is designed to be wiped clean. Replace pillows when their barrier is compromised.
9) Promptly remove body fluids; then disinfect all contaminated areas and surfaces.
10) All furniture should be periodically cleaned. Ideal surfaces are those that are waterproof and can be wiped clean. Infection control experts recommend this be done after each patient.
11) If a patient has an open wound or any history of MRSA or other infection:
a) Gloves and gowns should be worn by all staff coming in contact with the patient. These barriers must be removed before touching other areas not in contact with the patient, such as doorknobs, scanner consoles, and computer terminals.
b) The table and all the pads should be completely cleaned with disinfectant before the next patient is scanned, if it is not already being performed after every patient. For patients with any known infectious process, add 10 to 15 minutes to the scheduled scan time to ensure enough time to thoroughly clean the room and all the pads.
Post the cleaning schedule in the MRI suite for all staff to abide by, and if you’re a site that advocates transparency to patients, place it in an area for patients and managers to see.
Some popular restaurants often post a cleaning schedule in their restrooms, and while some are not always sanitary, many people use McDonalds restrooms while traveling, because they know they will be cleaner solution than many other alternatives.
Having an MRI Cleaning Schedule, and holding the staff accountable for carrying out the objectives are important in keeping a well run operation safe, and infection free for patients and staff.
Cleaning the MRI exam room is an essential task for MRI centers to administer a cleaning schedule that will reduce infection, increase site reputation, and conduct MRI business ethically. Accountability is key and your patients are trusting you with their health and safety.