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

Author: Holly Montejano, MS, CIC, CPHQ, VA-BC

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

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

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

Author

Holly Montejano MS, CIC, CPHQ, VA-BC
holly Clinical Science Liaison, PDI Gulf Coast

Profile

Holly’s passion for infectious disease epidemiology developed during her undergraduate studies at University of Connecticut, where she studied biology and anthropology – and the profound impact of disease on people, public health and within healthcare systems. This passion led to a graduate program focused in infectious disease epidemiology and a post-graduate epidemic intelligence service (EIS) fellowship in public health, and a graduate certification in infection control at the University of South Florida.

After several years as a public health epidemiologist, Holly transitioned into infection prevention and healthcare epidemiology where she currently is part of a dynamic clinical affairs team, supporting the Gulf Coast region as a Clinical Science Liaison (CSL).

Contact

Phone: 321.439.7923

Company Website: Pdihc.com

Email: Holly.Montejano@pdihc.com

Hobbies

Interior design
Beach staycations
Little League baseball and softball

Education

University of Connecticut, Storrs, CT
Bachelor of Science in Biology and Anthropology

Colorado State University, Fort Collins, CO
Master of Science in Environmental and Radiological Health Sciences (Epidemiology and Infectious Disease)

Certification
Certification Board of Infection Control (CBIC)- CIC
Certified Professional in Healthcare Quality (NAHQ)- CPHQ
Vascular Access- Board Certified (VA-BC)
Lean Six Sigma Yellow Belt Certification
Prosci Change Management Certification

Why I love what I do

Infectious disease epidemiology – from both a biological and anthropological standpoint – have always been a passion of mine. Studying the effects of disease on populations (from a public health standpoint and from that of an Infection Preventionist) has fueled my interest in patient safety and quality outcomes initiatives. My work of providing clinical expertise and evidence-based guidance on infection prevention products (which are used in communities and healthcare systems daily) bolsters the satisfaction I experience in this role.

Areas of Expertise

Microbiology and infectious disease transmission
Infection Prevention
Patient Safety and healthcare quality
Safety culture
Public Health
Vascular access
Environmental disinfection
Performance Improvement
Education

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