Beginning in 2009, the World Health Organization (WHO) launched the annual SAVE LIVES: Clean Your Hands campaign, aiming to raise global awareness of the importance of hand hygiene in health care and to bring people together in support of improving hang hygiene globally. Read on to see the global challenges we face, and how you can do your part!
Antimicrobial Resistance and Hand Hygiene: A Global Challenge
Antimicrobial resistance (AMR) is one of today’s most complex and threatening global health challenges – The World Bank has warned that it could cause as much damage to the economy as the 2008 financial crisis. AMR threatens to reverse the progress made against infectious diseases since the second half of the 19th Century and is on the rise in every region of the world.
Antibiotics are losing effectiveness after decades of use (and overuse) in human medicine and food production, and few replacement products are on the horizon – our world is moving towards a post-antibiotic era, where common infections will once again turn deadly. Health interventions such as organ transplants, chemotherapy, and pre-term infant care will become increasingly difficult (or even too dangerous) to undertake if current trends continue.
Hand hygiene is the best way to combat antibiotic resistance, and serves as the cornerstone of any effective infection control and prevention plan.
Everyone at every level can help to influence safer, quality health care through infection prevention. One of the first steps through WHO’s campaign is to ensure that all health facilities sign up. You can also learn other ways to spread the word and get involved with the campaign here!
Did you know that 80% of all infections are spread by hands?
According to The Centers for Disease Control and Prevention, Hospital-acquired infections (HAIs) are a leading cause of death in the U.S. health care arena, with an overall estimated annual incidence of 1.7 million cases and 100,000 deaths. This results in an annual spend of excess health care costs for U.S. hospitals of $28.4 billion to $45 billion.
WHO estimates that 1 in 10 patients contract an infection while receiving care, and up to 32% of surgical patients get a post-op infection (of which up to 51% are antibiotic resistant). This is a huge number, when you consider that over 313 million people undergo surgery each year – that’s twice the number of babies born in the world!
In recognition that proper hand hygiene is the first line of defense for infection prevention, U.S. hospitals spend over $160 million each year to prevent unforeseen infections. Below is a breakdown of annual hand hygiene costs, based on a 450-bed U.S. hospital, according to the American Hospital Association (AHA) and the World Health Organization (WHO):
Even with all of the awareness and investments, however, statistics surrounding hand hygiene practices are still sobering. WHO found that 61% of health care workers don’t clean their hands at the right moment, and for surgical staff it’s 1 in 2.
What is the proper procedure for hand hygiene?
The World Health Organization (WHO) has many resources on proper hand hygiene procedures to help you:
Hand hygiene challenges in modern health care
Hand hygiene alone isn’t enough in modern health care – there is a multitude of evidence now supporting that the environment plays a role in disease transmission and how we pick up pathogens at the same level by touching the environment as we do by touching the patient.
William Rutala, PhD, MPH, CIC, of the University of North Carolina, Chapel Hill stated "There is increasing evidence to support the contribution of the environment to disease transmission, and that we pick up pathogens at the same level by touching the environment as we do by touching the patient. Unless we inactivate or remove these microbes, they are going to be present in a patient room for a long time. Just entering a room previously occupied by a MRSA, VRE or C. difficile patient significantly increases the risk of contracting that pathogen.”
But how many health care facilities are using mobile devices?
Becker’s Health care recently published a study citing that 59% of respondents reported that their hospitals have a “bring your own device” program. Smartphone usage in hospitals has increased steadily since 2012, with 77% of respondents reporting that their organizations support smartphone usage.
In the Fall of 2016, the American Academy of Pediatrics (AAP) published their Infectious Diseases, Volume 19, Issue 2 that examined the increase of mobile device usage in health care and the problems associated with it, reporting the 87% of physicians use a smartphone or tablet in the workplace, and 90% use mobile device apps to access drug information. Our current digital era has been largely integrated into modern health care, as it allows for streamlining communication and documentation regarding patient care, including the full spectrum of devices including cell phones, notebooks/tablets, laptops, pagers, handheld dictation devices, and computers/workstations on wheels (COW).
How do these devices infect health care workers?
According to AAP, an estimated 70-100% of health care workers’ (HCWs) mobile devices are contaminated with microbes, of which 9-25% sampled across different settings were contaminated with pathogens known to cause HAIs.
Approximately 50% of HCWs admitted to using mobile devices during physical contact with patients, a practice that is known to increase device contamination. Over 50% of HCWs are then carrying these devices in and out of patient rooms, therefore transporting pathogens across an entire facility at an alarming rate.
Knowing that these devices pose a threat – are they being cleaned?
The general answer here is no. A survey in a Michigan hospital (cited by AAP) revealed that 17% of physicians never cleaned their mobile devices, and 46% only cleaned them monthly or yearly. According to a similar study in the UK, only 8% of physicians cleaned their mobile phones.
Furthermore, practicing hand hygiene in association with mobile device usage is not currently common practice, as a study in Barbados showed that 97% of HCWs did not wash their hands before or after using their mobile device.
These devices must be considered an extension of the patient/health care environment, and proper handling and disinfection of such devices is imperative to facility’s infection control and infection prevention plans.
Further statistics and citations on the problem of mobile devices negating hand hygiene practices
- A study demonstrating how hospital staff members pick up pathogens from mobile phones after thoroughly washing their hands, concluding that mobile phones act as a reservoir for microorganisms. Before touching the mobile phones, the disinfected hands showed no appreciable pathogen levels. After touching mobile phones, bacterial contamination on hands increased to 93.7% (same rate as phones).
Annals of Clinical Microbiology and Antimicrobials; Are We Aware How Contaminated Our Mobile Phones Are with Nosocomial Pathogens, Ulger et al.
- Samples from the hands of 200 HCWs and 200 mobile phones were cultured. 94.5% of phones demonstrated evidence of bacterial contamination with different types of bacteria. The gram negative strains were isolated from mobile phones of 31.3% and the ceftazidime resistant strain from the hands were 39.5%. S. aureus strains isolated from mobile phones of 52% and those strains isolated from hands of 37.7% were methicillin resistant. Distributions of the isolated microorganisms from mobile phones were similar to hands isolates. Mobile phones used by HCWs in daily practice may be a source of nosocomial infections in hospitals.
American Journal of Infection Control (AJIC); Use of Portable Electronic Devices in a Hospital Setting and Their Potential for Bacterial Colonization, Khan et al.
- Sampling was conducted over a 3-day period on devices at 2 large medical centers. 53 out of 204 (25.9%) swabs yielded at least 1 pathogen; Gram-positive organisms were cultured from nearly all devices (93.4%; 99/106) and Gram-negative organisms were found on 21.7% (23/106). As with other fomites, these devices represent a potential reservoir for the transmission of pathogens.
American Journal of Infection Control (AJIC); Staphylococcus aureus surface contamination of mobile phones and presence of genetically identical strains on the hands of nursing personnel, Kanayama et. al
- Genetically identical isolates were detected from mobile phones and their user and multiple users, which is consistent with mobile phones serving as reservoirs of infection in the health care environment. These findings reinforce the need for hand hygiene prior to patient contact as the most effective intervention for preventing health care–associated infections.
- During the period from August-September 2010, 221 mobile phones and palms and fingers of nursing staff in 23 general wards of a university hospital were sampled for bacterial contamination.
- Of the 221 mobile phones used by nurses, 16 (7.2%) were contaminated with S aureus, of which 5 (2.3%) isolates were MRSA. Of the 5 mobile phones contaminated with MRSA, S aureus was isolated from 55 (24.9%) of the 221 nurses' palm or fingers, of which 13 (5.9%) nurses were positive for MRSA.
- Of the 23 wards in the hospital, MRSA was detected in the palms or fingers of nurses assigned to 8 wards.
- Surface contamination of mobile phones likely occurs when these devices are used with bare hands or gloved hands after contact with a patient.
- Although it is known that hand hygiene is the cornerstone of preventing health care–associated infection, data in this study suggests that contact with contaminated mobile phones after handwashing can recontaminate palms or fingers.
- Research showed that tens of thousands of microbes live on each square inch of mobile devices.
- Microbiologists say that the combination of constant handling with the heat generated by the phones creates a prime breeding ground for many microorganisms that are normally found on the skin. There is a close relationship between the emission of electromagnetic radiation and the microbial load on the mobile phones. Bacteria absorbing electro-magnetic energy from cell phones also emit these electromagnetic radiations which again form a conducive medium for their growth. Hence cell phones are rightly called as technological petridishes for thousands of worms. And the Micro-organisms can be transferred from person to person or from inanimate objects (such as stethoscopes, bronchoscopes, pagers, ballpoint pens, hospital charts, computer keyboards, mobile phones and fixed telephones) to hands and vice versa.
So what is the solution to the threat of mobile devices in undoing proper hand hygiene practices?
Luckily Seal Shield is dedicated to Preventing Infections and Saving Lives, and recognizes the issue of modern technology usage in health care. We’ve come up with the solution to help health care facilities support the implementation of mobile device plans, while effectively combating the pathogens they may carry in the process.
Meet the ElectroClave™, an all-encompassing solution to mobile device management and disinfection, with superior technology to also provide hospitals peace of mind over their investments.
- The LED UV-C disinfection process of the ElectroClave™ destroys bacteria and viruses in just minutes on the entire surface of the device, achieving a 99.99% pathogen kill on all sides of the device (360° disinfection). While disinfecting, the ElectroClave™ also charges the device and syncs to the management portal.
- RFID tracking system and cloud-based management portal allows for complete oversight of the facility’s mobile environment, from both an infection control and infection prevention perspective, as well as IT and asset management.
Learn more about the ElectroClave as the solution for mobile device disinfection and management:
Mobile devices aren’t the only source of modern technology in health care that can transmit infections and negate your best efforts at hand hygiene practices. Computer keyboards, mice, monitors, touch-screens, and other patient monitoring devices can all pose a threat, and Seal Shield has multiple product lines to help prevent devices from spreading pathogens and serving as a modern ‘trojan horse’ in health care facilities.
As our world advances – in both medicine and technology – the need for new technology and ways to combat the spread of infections is paramount, and Seal Shield has its finger on the pulse of this issue. Reach out to us today to see how we can help you do your part!