For many, we’re closing in on the 2nd week of school. My son has so far avoided catching his first cold of the school season but I’m sure one will hit soon enough - and of course, flu season is only a few short weeks away. I just hope nothing too serious hits, so that we can avoid doctor’s visits or trips to the ER, especially after reading a recent article about cleaning mobile patient care equipment!
Like our personal devices, mobile patient equipment (MPE) like thermometers, blood pressure cuffs or bladder scanners can often be overlooked in terms of the frequency or thoroughness of cleaning. While the practice can be relatively simple and effective in removing potential pathogens, it can be more difficult to effectively implement and monitor MPE cleaning and disinfection programs. This is in part because MPEs tend to move from place to place, so unless you have a ‘tag and bag’-type process to clearly identify dirty from clean devices, it is harder to verify what ones have or have not been cleaned. This then leads to the issue of potential transmission of pathogens when healthcare workers either fail to clean or use MPEs that have not been cleaned immediately after use on a patient.
A study published in ICHE by Reese et al discussed the implementation of cleaning and evaluation of MPE cleaning. The study used ATP as their method for validating cleanliness. ATP can have its challenges and as the disinfectant or disinfectants used in the study were not disclosed, it is hard to determine if the results presented could have been skewed by quenching or enhancing of the ATP readings as a result from interactions by the disinfectant. Regardless, the researchers started with a one-month baseline period to gain an understanding of the level of cleanliness of the MPEs. Following the baseline period, there was a six-month implementation period with weekly ATP testing. The results were shared with nurse educators and management, and subsequently shared with nursing staff with the provision of ongoing education. They then entered a maintenance period for an additional six months where ATP results were collected bi-weekly.
Over all, the ATP results and therefore, the cleanliness of the MPEs did improve and was maintained with a 75% improvement in the levels of cleanliness. The study also highlighted the areas where no significant improvement was seen. The ultrasound probes tested in the ED consistently had higher than acceptable ATP readings, and this is consistent with similar studies looking at cleaning in the ED due to the large number of patients and high turnover of patients.
So what can we learn from this study? It highlights that with focus on MPEs in most areas of a healthcare facility, sustained improvements in the level of cleanliness can be achieved which in turn should minimize the risk of transmission of infectious pathogens and improve overall patient outcomes. It also highlights that the ED is an area of consistent issues in cleaning MPEs. Perhaps due to the nature of the ED with rapid patient turnover, high patient throughput and the fact that many patients can be critical and take more time, additional staff should be responsible for cleaning of MPEs (and perhaps even implementing a bag and tag program) to ensure that ED staff can immediately identify which MPEs are clean and safe to use and which MPEs are dirty and should not be touched.
If you happen to find yourself in an ED, feel free to do your own audit of cleaning. Unless you’re in critical condition you’re likely going to have time to waste! The only issue is that conducting your own audit may then make you wish you had just stayed home!