Just recently my husband and I had a really bad encounter with the flu. I took him to an Urgent Care
to receive a confirmation nose swab on a Friday afternoon at 4:30 PM. This urgent request was from our primary care physician via phone. As we were escorted into the treatment room, we were presented with an iPad to complete multiple screens of medical history, demographics, insurance information, and current symptomology. The nurse then collected the iPad and completed his portion of the information. The nurse did “glove up” but the next patient was exposed to whatever nasty germs (never defined by medical sources) we had at the time.
It is a given and recorded fact that many items we touch every day, from cell phones to our shoes, have far more germs than our toilets. Most of the germs that cause disease come from items we touch and these items get less cleaning than our toilets. There are multiple studies that document the frequent contamination of mobile hand held devices with healthcare-associated pathogens. It seems we seldom clean and disinfect because we are unsure of the type of products or methods that would be effective and safe for the devices. Even cleaning and disinfecting will not decontaminate a mobile device completely. One new device for decontamination was seen on the TV show Shark Tank recently. Using UV light, Phone Soap, advertises compatibility with various cell phone vendors. The device is pricey ranging from $50-$70 online.
Documented studies in ICU, surgery and NICU show the mobile hand held device the culprit of unwanted bacteria. The most common isolated microorganisms are coagulase-negative staphylococci and Staphylococcus aureus. But we also know that norovirus, MRSA and c. difficile can live and accumulate on the mobile device. They travel into secure areas with the hospital staff, cleaning staff, medical sales persons and family. Cleaning methods vary widely from alcohol wipes to cleaning cloths. Many studies evaluated the frequency of cleaning and found varying results. Frequency did not indicate levels of bacteria reduction, but one study identified that surgeons and surgical personnel carried more bacteria than other physicians.
It’s the sharing of devices that provide the cross-contamination. A cell phone used by one person carries a single set of germs that should not make the owner sick. But, items such as an iPad or a touchscreen computer share their germs, even if staff are gloved. Even sign in screens at patient registration require a finger or a shared stylus to confirm patient information.
Mobile devices are not the only fomites bringing bacteria to our workplace. It only takes a couple of weeks for a pair of shoes to collect high counts of bacteria. A study by Gerba found that nearly one third of shoes (27%) carry E.coli, indicating frequent contact with fecal material, likely originating from floors in public restrooms or contact with animal material outdoors. Be careful where you put your shoes.
Recommendations to reduce contamination risks include staff education, strict hand hygiene, guidelines on device cleaning and restrictions where the use of mobile technology is allowed. One rule does not fit all as high risk areas such as operating rooms, ICU and the burn units should have stricter guidelines. New technology will always be a part of the healthcare environment. But, we MUST NOT (yes, I am shouting) introduce new technology without considering the ramifications inherent with the device.