Bacteria, viruses, fungi and parasites are the causes of Hospital Acquired Infections (HAIs), and a formidable challenge to healthcare facilities. Environmental sources of these infections are difficult to eliminate; their consequences are hard to treat, and sometimes lethal.
The five types of infections account for more than 85% of HAIs:
- Clostridium difficile infection
- Surgical site-related infections
- Urinary tract infections from catheterization
- Bloodstream infections associated with Central Line
According to CDC, about 722,000 HAIs occur in U.S. hospitals every year, with 75,000 patients dying as a result. 50% of HAIs occur outside intensive care units (ICUs). The European Centre for Disease Prevention and Control reports HAI rate as 7.1% in 2008, which translates to 4 million patients. The World Health Organization reports approximately 8.7% of patients worldwide develop an HAI. (Source)
Touch As The Means of HAIs Transmission
Hospitals abound in surfaces, which serve as a reservoir of pathogenic microbes, and play a key role in the transmission of HAIs. Pathogens persist for weeks, sometimes months, on common surfaces such as TV remotes, call buttons, medical device controls, computer touchscreens. Pathogens from these surfaces spread directly to patients by touch. Patients get infected indirectly when a healthcare worker transmits pathogens from contaminated surface onto the patient or medical equipment. In most cases, touch is the most common means of HAIs transmission.
Affordable Care Act Urges Healthcare Facilities To Combat HAIs
HAIs prolong hospital stays, result in patient readmissions, increase treatment costs, and are some of the major causes of mortality today. Under the Affordable Care Act, preventable readmissions can lead to financial penalties to hospitals. This has increased a motivation to develop new strategies to reduce HAIs.
Challenges for Disinfection of Equipment
The effective disinfection of equipment is an important element in preventing the HAIs. Memphis VA Medical Center (MVAMC) investigated the areas that present the greatest challenge for disinfection of noncritical equipment in hospitals such as patient-controlled analgesia pumps, blood pressure machines, patient beds, televisions, computers, monitors, etc. Several key concerns identified are:
- Equipment cleaning is technically challenging and time-consuming.
- Lack of training in cleaning complex equipment.
- Missed surfaces during routine cleaning.
- Insufficient contact time when applying disinfectants on surfaces.
- Inadequate cleaning of equipment in patient rooms and hallways.
Consumer grade computers, laptops and mobile devices used in hospitals can not be cleaned with disinfecting solutions that can get inside the casing and cause equipment failure. Yet, their screens, casing, and peripherals are infested with pathogens. Hence, they are difficult to clean and are often neglected. Hospitals might not have the policy for cleaning these devices, while the cleaning procedures might not be at par with the contamination danger presented by these surfaces.
Self-Disinfecting, Antimicrobial Surfaces
“Self-disinfecting” surfaces are becoming popular in healthcare, and the adoption rates of equipment and furniture with antimicrobial coating increases. Antimicrobial surfaces, as a rule, contain heavy metals such as silver or copper and other natural materials that have innate antimicrobial properties. Both copper and silver have been used for centuries for infection control practices.
Silver-impregnated privacy curtains have been shown to reduce or delay the infestation of curtains with pathogens.
Impregnating equipment surfaces with copper has been proven to reduce bacterial contamination of surfaces and reduced HAIs, according to a study “Copper surfaces reduce the rate of HAIs in the intensive care units.” According to the International Copper Association, antimicrobial copper continuously reduces bacterial contamination. Through the effective use of antimicrobial agents in surface coating, it is possible to achieve 99.9% reduction of gram-negative and gram-positive bacteria.
Copper continues to kill bacteria, viruses, and fungi even after repeated contamination and between routine cleaning during the entire product lifecycle.
Besides copper and silver, there is a number of other chemical compounds that are toxic to microorganisms. Some devices may be treated by attaching a polymer or polypeptide to their surface.
Healthcare Applications Call for Antimicrobial Surfaces
The antimicrobial coating, when implemented in medical grade panel PCs, tablets, computers and All-in-One PCs is quickly becoming the new norm for healthcare organizations. ICUs, surgery rooms, patient rooms and other near-patient areas call for equipment that is easy to disinfect, but also antimicrobial in its nature. Some devices now come with the antimicrobial coating in touchscreens, others come with full antimicrobial casing, as CyberMed RX.
Since mobile devices are widely used in U.S. hospitals, they easily travel from patient rooms to operating rooms, labs, and ICUs, thus becoming the common means of transmitting HAIs. A study in Annals of Clinical Microbiology and Antimicrobials showed bacterial growth on 94.5% of consumer-grade mobile phones used in 14 operating rooms and ICUs. 89.5% of participants never cleaned their mobile phones. Moreover, healthcare workers are not washing their hands often enough, and the compliance rate at many hospitals is as low as 30%. Hence, consumer devices aren’t fit for use in healthcare, especially in near-patient environments.
Disinfection vs Cleaning
Disinfection of touchscreens and casing is not identical to cleaning. A device has to be disinfected after it has been cleaned. CDC defines disinfection as “the use of chemical procedure” that kills all recognized pathogens. However, the frequency of cleaning of touchscreens and tablets used in healthcare is not consistent.
Therefore, a surface that is not antimicrobial can be even more contaminating due to the inconsistent or inadequate disinfection amplified by the failure of workers to adhere to the hand washing requirements.
Antimicrobial surfaces continue killing pathogens in between the disinfection procedures, thus effectively decreasing the contamination risk.
Another issue with consumer grade electronics used in healthcare is it can not withstand proper disinfection required in hospitals. Many chemicals in disinfecting solutions have a harsh impact on the casing and touchscreens of common computers and mobile devices. For a computer or mobile device to be apt for disinfection, it should have adequate ingress protection (IP) sealing to prevent the solutions from penetrating the device or damaging its casing. IP also dictates for the casing to be sturdy enough to prevent the material deterioration from the harsh chemicals in disinfecting solutions.
Choosing The Right Device
Hospital administrators need to take into account the risk of HAIs inherent in the use of consumer-grade equipment in hospitals and look towards the medical grade computers and tablets designed for use in healthcare. Even though CDC lists mobile devices as “noncritical equipment,” studies show how non-antimicrobial surfaces are quickly infested with pathogens increasing the HAIs rates. Incorporating computers and tablets with antimicrobial coating and casing allows hospitals to harness the benefits of hi-tech mobility and infotainment without compromising patient and doctor safety.