Microbial (Staphylococcus aureus & Methicillin resistant Staphylococcus aureus) contamination of tourniquets and infection control practice among phlebotomists

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Microbial (Staphylococcus aureus & Methicillin resistant Staphylococcus aureus) contamination of tourniquets and infection control practice among phlebotomists

 

Author: Li, Yee-man
Title: Microbial (Staphylococcus aureus & Methicillin resistant Staphylococcus aureus) contamination of tourniquets and infection control practice among phlebotomists
Degree: M.Sc.
Year: 2010
Subject: Hong Kong Polytechnic University -- Dissertations
Phlebotomy -- Practice
Tourniquets
Infection -- Prevention
Department: Faculty of Health and Social Sciences
Pages: xiv, 112 leaves : ill. ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2356829
URI: http://theses.lib.polyu.edu.hk/handle/200/5697
Abstract: Phlebotomists are the main professional responsible for blood taking. Tourniquet is the frequently used tool by phlebotomist. Apart from blood taking, trained phlebotomists would also help to set the intravenous catheters. They have received general infection control measure in order to perform their job duties in a proper procedure. Phlebotomists need to have adequate knowledge in infection control practice during venepuntures. Thus, it is important to evaluate phlebotomists' infection control practice in using tourniquet when they perform their duties. Bacterial transmission in hospital may occur by contact with contaminated fomites such as stethoscopes, laboratory coats, and computer keyboards. Health professionals may act as vectors of disease which microorganisms may colonize on them. Unlike keyboards, tourniquets will be used from patient to patient, therefore, contaminated tourniquets may be a source of cross-infection among patients of unknown infectious disease. This study was designed to investigate the bacterial count on tourniquets by microbiological study and a self-administered questionnaire survey was used to collect information on infection control practice of the phlebotomists. For the microbiological study, microorganisms were isolated from all the ten tourniquets used in Department of Medicine. Bacterial counts were ranged from 30-3120 cfu/cm² among the 140 cultured samples. Staphylococcus aureus (S. aureus) was isolated from 36% of 140 culture samples (75-1575 cfu/cm² ). Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from 9% of 140 culture samples (75-150 cfu/cm² ). There was potential risk of cross-infection in using reusable tourniquets. Result showed that there was linear trend between bacterial count and day of study. Eighteen phlebotomists were recruited from the Department of Medicine in a large regional hospital in Hong Kong. Eighteen completed questionnaires were returned and results were presented. All of the phlebotomists had less than one day basic infection control training. The majority of them thought that their infection control knowledge and training in using tourniquets were adequate. All of the phlebotomists claimed that they would perform hand hygiene before and after venipuncture but they may not perform it each time. There were several reasons for the phlebotomists not to perform hand hygiene in each time. Fifty-six percent of the phlebotomists claimed that there was absence of visible dirt on their hands. Thirty-three percent of them thought that their hands were clean and 44 % of them did not have enough time to perform hand hygiene. Only 33% of phlebotomists would use designated tourniquets on contact precaution cases, and they only used it usually. Forty-four percent of the phlebotomists would use designated tourniquets occasionally. Twenty-two percent of phlebotomists would never use designated tourniquets for contact precaution cases. The results showed that although the phlebotomists claimed they had adequate infection control knowledge and training in using tourniquets, further education and training would help to reinforce their infection control practice in using tourniquets. Based on the results of this study, implications, strategies and recommendations towards improving tourniquet usage among phlebotomists are discussed.

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