The purpose of an examination table cover is twofold: to provide a clean surface for the patient and to act as a physical barrier that protects the underlying table from contamination. Proper protocol for managing these covers is fundamental to maintaining a safe clinical environment and preventing the transmission of infectious agents. Adhering to strict hygiene standards, whether using a single-use paper roll or a reusable surface, is a foundational practice in all healthcare settings.
Standard Protocols for Disposable Paper Covers
Disposable paper covers must be changed immediately following every patient encounter, regardless of the duration of the visit or whether the patient disrobed. The paper serves as a physical shield against skin particles, minor spills, and potential contaminants transferred from the patient.
Examination paper comes in two common forms, smooth and crepe, but the type of material does not change the frequency of change. Crepe paper has a crinkled texture that offers greater absorbency and comfort, making it a good choice for general examinations. Smooth paper is typically more fluid-resistant and is often preferred in settings where minor fluid exposure is more likely.
When removing the used paper, the technique should be gentle to prevent spreading contaminants. The paper should be carefully gathered or folded inward to contain the exposed surface area before being placed in the appropriate waste receptacle. Unless the paper is saturated with visible blood or other potentially infectious material, it can typically be disposed of in a standard trash bin.
The Role of Immediate Change
The strict patient-to-patient protocol is directly related to minimizing the risk of cross-contamination. While the paper cover offers a sense of cleanliness, its most important function is to trap invisible microbes and bodily fluids. Even brief contact can transfer skin flora, viruses, or bacteria to the surface.
This immediate change prevents pathogens such as cold and flu viruses, or even more persistent organisms, from being transferred to the next patient. If a soiled cover is left in place, it creates a reservoir of contamination that could breach the paper and soil the table itself.
Changing the cover after every use ensures that the barrier is intact. The disposal of the used paper physically removes the potential source of infection from the room.
Handling Reusable and Non-Disposable Surfaces
When paper covers are not used, a different protocol is implemented for non-disposable surfaces. Some specialized examination tables, particularly in physical therapy or certain clinical areas, rely on a wipeable vinyl or padded surface designed to be cleaned directly. This surface must be thoroughly wiped down with a clinical-grade disinfectant between every patient.
If reusable linen sheets or blankets are used, they must be treated as contaminated and removed immediately after each use. These cloth items should be handled gently and placed into a designated, impermeable laundry bag or biohazard bin without shaking them. Clinical linens are then laundered using high-heat cycles, typically between 70°C and 80°C, with specialized detergents to ensure complete thermal disinfection.
Reusable cloth covers must be subjected to a validated laundering process, and fixed, wipeable surfaces must be disinfected to remove any trace of the previous patient’s contact.
Disinfecting the Examination Surface
Cleaning and disinfection are two separate steps required for maintaining the underlying examination table structure. Cleaning involves the mechanical removal of visible dirt and organic material using a detergent. Disinfection is the subsequent step that uses chemical agents to kill nearly all vegetative microorganisms on the surface.
Disinfectants must be EPA-registered and specifically approved for use on non-porous clinical surfaces. The most crucial factor for effective disinfection is the “dwell time,” also known as contact time. This is the specific period the disinfectant must remain visibly wet on the surface to achieve the required pathogen-killing efficacy.
Dwell times vary significantly between products, and the manufacturer’s label must be strictly followed. Wiping the surface dry before the required dwell time has passed renders the disinfection process ineffective. This final step of cleaning and disinfecting the underlying table is performed to manage spills or seepage that may have bypassed the cover.