Infection Control Concerns

From Clinfowiki
Revision as of 14:32, 23 November 2009 by Ndgoldstein (Talk | contribs)

Jump to: navigation, search

Although already considered in this section (1), special consideration should be paid to infection control measures during implementation of an Electronic Health Record, particularly if that implementation includes CPOE and/or physician documentation. There is considerable evidence and discussion of the keyboard as a source of pathogens; particularly Methcillin Resistant Staph Aureus (MRSA) and Vancomycin Resistant Enterococcus (VRE).(2) These antibiotic resistant organisms are of particular concern within the hospital environment. Dr. Peter Wilson has reported that the keyboard within a non medical office harbors more than five times the bacteria of a toilet seat.(3) Other authors have noted that MRSA may reside on medical surfaces for days to weeks.(4) Thus, with the increased use of computer keyboards that accompany EHR implementation pose a significant risk for increasing incidence of hospital acquired MRSA and VRE. To prevent this risk a multi-pronged approach should be utilized. During training, physicians and nurses should be educated to the risks posed by the keyboard.(5) Housekeeping staff should have keyboard cleaning techniques added to the list of task for “turning over a room” or daily cleaning rounds. Standard housekeeping operating procedure should include cleaning keyboard surfaces every shift (every 8 hours) or at least every 12 hours. The use of keyboard barriers which cover the keyboard recesses. Medigenic keyboards have been shown to have lower colonization rates and may reduce cross contamination.(6) Finally, Infection Control Staff should carefully monitor MRSA and VRE rates. Any unit with unexpected spikes post go live should be carefully studies. One needs only look at the poor rates of adequate hand washing in the hospital to see that a single measure of prevention will be effective.

(1) http://www.informatics-review.com/wiki/index.php/Mobile_Computers
(2) Hartmann, et al. Computer Keyboard and Mouse as a Reservoir of Pathogens in an Intensive Care Unit, Journal of Clinical  Monitoring and Computing; Vol 18, 1, Feb. 2004; 
(3) http://news.bbc.co.uk/2/hi/7377002.stm
(4) Boyce, JM.  Environmental Contamination Makes an Important Contribution to Hospital Infection.  J Hosp Infect, 2007 Jun; 65 Suppl 2:50-4
(5) Bascom, Erin.  Community-Acquired MRSA Infections Pose Threat to Health Care Workers, Infection Control and Hospital Epidemiology 206;27:113-1136
(6) http://www.advancedinput.com/medigenic.html


Submitted by Howard Bradley