Most medical groups likely underestimate the cleanliness of their portable medical equipment (PME), thanks to overly lax policies and/or policies not being followed.
Chetan Jinadatha, MD, MPH, chief of infectious diseases at the Central Texas Veterans Health Care System in Temple, Texas and clinical associate professor at the Texas A&M Health Science Center College of Medicine, researched the relationship between PME and infection control. His findings led to “a significant reality check,” as he told Infection Control Today: “Sometimes you are aware of the problem but sometimes you are not aware of the magnitude of the problem.”
Jinadatha singled out computers on wheels as an area of special concern: “I know the computer on wheels goes in and out of patient rooms at our hospital but I didn’t realize how integral they are to providers’ workflow, as well as how integral they are in potentially transmitting infectious pathogens.”
He and his co-authors found the sanitation of this equipment was highly inconsistent, and most groups cleaned it “three times a day at most.” The CDC recommends cleaning “as soon as practical after use (e.g., at the point of use).”
Jinadatha’s team aren’t the only ones sounding the alarm. A study published in The American Journal of Infection Control recommends: “While equipment should be wiped down with disinfectant between each use, such cleaning has not been reliably incorporated into hospital practices.”
This unreliability can be the inadvertent result of either policy or the sheer logistics of cleaning. Keyboards are a prime example. As the main interface between users and their computers on wheels, medical keyboards get touched most frequently, but they’re often a nightmare to effectively clean and disinfect. Even covered keyboards have far too many nooks and crannies and they’re often not fully sealed, which means cleaning agents risk damaging the delicate electronics within. The materials used for medical keyboards and covers are often porous, not able to withstand frequent cleaning with commonly used disinfectants. To prevent unintended inputs, keyboards may need to be manually disconnected from the computer for cleaning – adding more time and labor to the process.
So, what should hospitals and medical groups do?
Ease-of-cleaning should be a major criterion when evaluating medical equipment – especially high-touch objects like keyboards – for use in a healthcare delivery setting. It’s human nature: if it’s hard to do, people won’t do it.
Further, equipment needs to be able to accommodate even harsh cleaning agents like alcohol, bleach, iodine, and other chemical agents, and it should be possible to wipe the equipment down in a minute without worrying about digging into those nooks and crannies. Finally, the keyboard should be fully sealed (and IP-rated ideally) to make it easily washable. Only medical equipment that meets these standards can be relied upon to help reduce risk of infection.
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