Microbial Magnets: Mobile Handheld Devices (and other popular items!) in the Operating Room

Author: Holly Montejano, MS, CIC, CPHQ

Operating Room Blog Photo
Categories: General Infection Prevention March 23, 2020

While patients are vulnerable to healthcare-associated infections (HAI) across the healthcare setting, patients preparing for and undergoing invasive procedures in the operating rooms (OR) – and other procedural areas – are at risk for developing a surgical site infection (SSI). In 2015, the Centers for Disease Control and Prevention (CDC) reported that ~110,800 SSIs were associated with inpatient procedures1.  Multiple factors contribute to the risk of a patient developing an SSI.  The cleaning and disinfection of mobile handheld devices (MHD), among some other items that frequent the OR space are highlighted in recently released Association for periOperative Nursing (AORN) Guideline for Surgical Attire2.

Despite the lack of data directly linking HAIs (and SSIs, in particular) to mobile handheld devices, there is no shortage of compelling literature supporting the sanitization of mobile devices across various healthcare settings.  Manning, et al reported that 50-65% of healthcare professionals (HCP) use their MHD during patient care3. Additionally, it has been found   that 73.7% of MHDs tested were colonized with bacteria4 and 100% of the bacteria found on MHDs was also on the HCP hands5.

The AORN Guideline for Surgical Attire addresses the importance of cleaning
(and/or performing low level disinfection) of items carried on the healthcare worker and routinely enter the OR. According to the literature, these items have been consistently associated with significant microbial loads2.  In addition to MHD, these other items are also listed within the guideline recommendations:

  • Clean identification badges and lanyards with a low-level disinfectant when the badge/lanyard becomes soiled with blood, bodily fluids, or other potentially infectious materials.
  • Clean stethoscopes before each patient use according to manufacturer’s instructions for use (IFU).
  • Clean cell phones, tablets, and other personal communication or hand-held electronic equipment according to the device manufacturer’s IFU before these items are brought into the OR and perform hand hygiene.

Apple products recently released cleaning guidelines which provide guidance for the use of 70% isopropyl alcohol (IPA): “…you may gently wipe the hard, nonporous surfaces of your Apple product, such as the display, keyboard, or other exterior surfaces.”6

It is important to note, in the CDC’s Guideline for Disinfection and Sterilization in Healthcare Facilities (2008), definitions are outlined to provide a distinction between cleaning and disinfection.  By definition, cleaning provides the removal of visible soil (e.g., organic and inorganic material) and low-level disinfection provides the destruction of vegetative bacteria, some fungi, and lipid viruses7.

These recommendations hold true outside of the OR and should be applied across the various healthcare settings.  Any items that stands to come in close contact with patients or their environment, including those listed above should be routinely cleaned and/or disinfected (remember to look at manufacturer IFU and your own facility policy) to keep our patients safe from these microbial magnets!

PDI offers products to address the cleaning, disinfection and hand hygiene recommendations set forth in this guidance, including Easy Screen® Cleaning wipes, Sani-Cloth® Germicidal Disinfectant products, and Sani-Hands® Instant Hand wipes

holly Holly Montejano, MS, CIC, CPHQ

Holly Montejano earned her Master of Science from Colorado State University in Epidemiology and Infectious Disease. While working in a post-graduate fellowship as a public health EIS (Epidemic Intelligence Service) Officer, and then later as an epidemiologist and hospital infection prevention practitioner, she completed a Graduate Certification in Infection Control from University of South Florida and achieved the CIC and CPHQ credentialing. Her main professional interests are infection prevention, epidemiology, education and research. She is thrilled to be a new member of the PDI Clinical Affairs team!

1. NHSN 2020 SSI Protocol: https://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf
2. AORN Guideline for Surgical Attire, 2019. Association for Peri-Operative Registered Nurses
3. Manning, Mary Lou PhD, CRNP, CIC, James Davis MSN, CCRN, CIC, Erin Sparnon MEng, Raylene M. Ballard MS, MT (ACSP) “iPads, droids, and bugs: Infection prevention for mobile handheld devices at the point of care”. AJIC 41 (2013) 1073-6.
4. Heyba M, Ismaiel M, Alotaibi A, et al. Microbiological contaminationof mobile phones of clinicians in intensive care units and neonatalcare units in public hospitals in Kuwait. BMC Infect Dis. 2015;15:434.
5. Pal S, Juyal D, Adekhandi S, et al. Mobile phones: Reservoirs for thetransmission of nosocomial pathogens. Adv Biomed Res. 2015;4:144.
6. https://support.apple.com/en-us/HT204172?mod=article_inline
7. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 https://www.cdc.gov/infectioncontrol/pdf/guidelines/disinfection-guidelines-H.pdf