The effectiveness of the current guidelines for disinfection of mobile clinical solution (MCS) devices in a private hospital

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The effectiveness of the current guidelines for disinfection of mobile clinical solution (MCS) devices in a private hospital

 

Author: Tsang, Miu Fan
Title: The effectiveness of the current guidelines for disinfection of mobile clinical solution (MCS) devices in a private hospital
Degree: M.Sc.
Year: 2014
Subject: Telecommunication in medicine.
Infection -- Prevention.
Hong Kong Polytechnic University -- Dissertations
Department: School of Nursing
Pages: xii, 80 leaves : col. ill. ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2646772
URI: http://theses.lib.polyu.edu.hk/handle/200/7320
Abstract: Background: The use of Mobile Clinical Solution (MCS) devices for patient identification has recently been introduced in a private hospital. The MCS device is used to scan a patient's wristband before certain nursing procedures. The purposes of the MCS devices are to ensure the identity of the patient and maintain accurate medical records. Although the MCS devices do not come into direct contact with patients, any pathogens on the devices could be transmitted to patients via the nurses' and clinical assistants' hands leading to cross infection. Medical equipment has been suggested to be a possible vehicle for person-to-person transmission of pathogens. A MCS device may be used up to hundred times per day by different nurses and clinical assistants. It is not practical to swab or wash hands each time after using the MCS device to scan a patient's wristband or after data entry. Therefore, effective disinfection of the MCS devices is important. Aim and objectives: The aim of the study was to evaluate the effectiveness of disinfecting the MCS devices according to current hospital guidelines. The objectives were to evaluate the total bacterial load, and levels of contamination with Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) on the screens and keypads of MCS devices, and to examine the effectiveness of disinfection of the screens of MCS devices by 70% isopropyl alcohol prep pad. Methods: A pretest-posttest study design was used. The MCS devices which were located in a mixed ward of a private hospital were selected as the study targets. There were 35 MCS devices involved in this study. The sample swabs of screens and keypads were taken at defined time slots. The disinfection effectiveness of 70% isopropyl alcohol prep pad to the screens of MCS devices was evaluated by wilcoxon signed ranks test. Results: The total bacterial load of the screens of MCS devices before disinfection ranged from 10 to 3,040 cfu/ml. S. aureus was isolated from 7/35 (20%) samples of the screens of the MCS devices. One isolate (2.86%) from the screen was confirmed as MRSA. The mean bacterial load of screens reduced significantly by 99% from 342 cfu/ml to 3.43 cfu/ml, before and after disinfection using a 70% isopropyl alcohol prep pad (p-value < 0.001) (Z = -5.167). Rates of S. aureus contamination was also decreased significantly (p-value = 0.008) (Z = -2.646). Bacteria were isolated from keypads of all 35 MCS devices. The total bacterial load of keypads ranged from 10 to 10,460 cfu/ml, (mean = 508.57 cfu/ml, SD = 1959.55). Only one sample from the keypad isolated S. aureus. Conclusion: 70% isopropyl alcohol prep pad was effective to disinfect the screens of MCS devices. According to current hospital guidelines, the screens of MCS devices are routinely disinfected once daily but the keypads would not be disinfected. High levels of bacterial contamination of both screens and keypads were found. It is worth to introduce the disinfection guidelines of the keypads and increase the frequency to disinfect the whole MCS devices more than once daily.

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