Assessment of microbial bioburden on portable medical equipment in a hospital setting.

Objectives: Although routine disinfection of portable medical equipment is required in most hospitals, frontline staff may not be able to disinfect portable medical equipment at a rate that adequately maintains low bioburden on high-use equipment. This study quantified bioburden over an extended time period for two types of portable medical equipment, workstations on wheels and vitals machines, across three hospital wards. Methods: Bioburden was quantified via press plate samples taken from high touch surfaces on 10 workstations on wheels and 5 vitals machines on each of 3 medical surgical units. The samples were taken at three timepoints each day over a 4-week period, with random rotation of timepoints and portable medical equipment, such that frontline staff were not aware at which timepoint their portable medical equipment would be sampled. The mean bioburden from the different locations and portable medical equipment was estimated and compared with Bayesian multilevel negative binomial regression models. Results: Model estimated mean colony counts (95% credible interval) were 14.4 (7.7-26.7) for vitals machines and 29.2 (16.1-51.1) for workstations on wheels. For the workstations on wheel, colony counts were lower on the mouse, 0.22 (0.16-0.29), tray, 0.29 (0.22, 0.38), and keyboard, 0.43 (0.32-0.55), when compared to the arm, as assessed by incident rate ratios. Conclusions: Although routine disinfection is required, bioburden is still present across portable medical equipment on a variety of surfaces. The difference in bioburden levels among surfaces likely reflects differences in touch patterns for the different portable medical equipment and surfaces on the portable medical equipment. Although the association of portable medical equipment bioburden to healthcare-associated infection transmission was not assessed, this study provides evidence for the potential of portable medical equipment as a vector for healthcare-associated infection transmission despite hospital disinfection requirements.

Effect of a "feedback prompt" from a disinfection tracking system on portable medical equipment disinfection.

BACKGROUND: Portable medical equipment (PME) may contribute to transmission of multidrug-resistant organisms without proper disinfection. We studied whether a Disinfection Tracking System (DTS) with feedback prompt, attached to PME, can increase the frequency of PME disinfection. METHODS: DTS devices were placed on 10 workstations-on-wheels (WOWs) and 5 vitals machine (VM). After a 25 day "screen-off" period, the DTS device screens were turned on to display the number of hours since the last recorded disinfection event for a 42 day period. We used a Bayesian multilevel zero-inflated negative binomial model to compare the number of events in the display "screen-off" to the "screen-on" period. RESULTS: During the "screen-off" period, there were 1.26 and 0.49 mean disinfection events and during the "screen-on" period, there were 1.76 and 0.50 mean disinfection events for WOWs and VM, respectively, per day. The model estimated mean events per device per day in the the "screen-on" period for WOW's were 1.32 (1.10 - 1.57) times greater than those in the "screen-off" period and the "screen-on" period for VM devices was 1.37 (0.89 - 2.01) times greater than those in the "screen-off" period. CONCLUSIONS: The rate of disinfection events for WOWs increased following the implementation of the DTS feedback prompt.

Capturing portable medical equipment disinfection data via an automated novel disinfection tracking system.

BACKGROUND: Portable Medical Equipment (PME) such as workstations-on-wheels (WOWs) and vital signs machines (VMs) have been linked to healthcare-associated infections. Routine visual monitoring of PME disinfection is difficult. An automated Disinfection Tracking System (DTS) was used to record and report the number of disinfection events of PME in a hospital setting. METHODS: The study was conducted in 2 acute-care units for 25-days to determine the pattern of recorded events from DTS on PME. Devices record disinfection events as moisture events and automatically store on a central database. DTS devices with "screen-on" feedback and "screen-off" devices with no display were placed on 10 WOWs and 5 VMs on separate units. RESULTS: A total of 421 moisture events were recorded for the "screen-on" and 345 for the "screen-off", during the 25-day implementation period on the 2 different hospital units. The highest number of events occurred between 6:00am-7:00am, with 69 & 75 moisture events recorded for Units 1 and 2, respectively. CONCLUSIONS: The pattern of disinfection events for WOWs and VMs demonstrated that most events occurred regularly at the times corresponding with nursing shift change. The DTS has the potential to continuously record, and report data related to PME disinfection.

Effectiveness of Copper-Impregnated Solid Surfaces on Lowering Microbial Bio-Burden Levels in an Acute Care Hospital.

BACKGROUND: Microbial bio-burden on high-touch surfaces in patient rooms may lead to acquisition of health care-associated infections in acute care hospitals. This study examined the effect of a novel copper-impregnated solid material (16%-20% copper oxide in a polymer-based resin) on bacterial contamination on high-touch surfaces in patient rooms in an acute care hospital. METHODS: Five high-touch surfaces were sampled for aerobic bacterial colonies (ABCs) 3 times per day over a 3-day period in 16 rooms with copper installed and 16 rooms with standard noncopper laminate installed on high-touch surfaces. A Bayesian multilevel negative binomial regression model was used to compare ABC plate counts from copper-impregnated surfaces with standard hospital laminate surfaces. RESULTS: The mean and median (interquartile range [IQR]) ABC counts from copper-impregnated surfaces were 25.5 and 11 (4-27), and for standard hospital laminate surfaces they were 60.5 and 29 (10-74.3). The negative binomial regression model-estimated incidence rate for ABC counts on plates taken from copper-impregnated surfaces was 0.40 (0.21-0.70) times the incidence rate of ABC counts on plates taken from standard hospital laminate surfaces. CONCLUSIONS: Copper-impregnated solid surfaces may reduce the level of microbial contamination on high-touch surfaces in patient rooms in the acute care environment, as our study demonstrated a decline in microbial bio-burden on samples taken from copper-impregnated compared with standard hospital laminate high-touch surfaces.