COVID-19 and Infection Control When Using Mobiles, Ward Phones and Tablets in Healthcare Settings
The COVID-19 pandemic has forced healthcare organisations to place increased emphasis on infection control. This includes personal protection equipment (PPE) such as face shields and head-to-toe disposable gowns, disposable gloves and disposable masks. There has also been an emphasis on healthy habits and frequent hand-washing to protect individuals from spreading and contracting coronavirus. The shift in social and workplace behaviours has been a world-wide phenomenon. However, it is likely that healthcare professionals and organisations have overlooked highly-touched objects as a breeding ground for microorganisms: smartphones, shared ward phones and tablets.
Doctors, Nurse Unit Managers, and other healthcare professionals often use their work-supplied or personal mobile device for work-related communication. 95% of doctors use personal smartphones and messaging applications in the course of their daily workflow. On hospital wards, ward phones are often shared by multiple staff members. Although hand-washing inhibits the transmission of communicable diseases, mobile surfaces are ‘high-risk’ as it comes in close contact with a user’s face or mouth, even despite frequent hand-washing.. Hence, the question is, how often are these devices being thoroughly disinfected?
The World Health Organisation (WHO) conducted a study to assess the knowledge, attitude and infection prevention practices of healthcare workers’ hands and personal belongings as a mode of transmission for hospital-acquired infections. The survey revealed that only 13.6% of respondents disinfected their mobile phones. The reasons for poor compliance included inadequate awareness on standard disinfection practices and fear of damaging electronic equipment from disinfectants.
In one study, 94.5% of mobile phones owned by healthcare workers contained bacterial growth, some of which are known to cause hospital-acquired infections. In another study on the prevalence of microbial infections on smartphone devices, 32.1% of touchscreens and 46.4% of posterior surfaces were contaminated. In addition, the bacillus species and coagulase-negative staphylococci were isolated from each surface.
According to the Centers for Disease Control and Prevention (CDC), survival rates of SARS-CoV-2 can be detected on non-porous surfaces from days to weeks. The combination of days-to-weeks long infection periods and the lack of device hygiene practices could potentially lead to disastrous outcomes for vulnerable, elderly or immuno-compromised patients.
Hospitals should create a device hygiene policy similar to the five moments of hand hygiene map. Devices should be disinfected at the following key moments:
Before charging a device
Before using a device for the first time
Before handing a device to a colleague or patient
After using a device, especially on COVID wards or in areas where infectious patients are located
After a device is exposed to any body fluids or other risk
Device hygiene policy should contain information on how to clean, when to clean, the type of disinfectants to use, and other occupational, health and safety precautions. Cleaning guidelines should include both the touchscreen and posterior surfaces and provide guidance based on recommendations from common manufacturers such as Apple, Android providers and DECT phone providers. Hospital organisations need to create evidence-based infection control policies, awareness posters, training and compliance monitoring on device hygiene.
Hospitals should also create guidelines for patients, visitors and contractors entering hospital settings. One study revealed that 40% of patient and visitor phones were contaminated with disease-causing bacteria. This may be concerning for hospital organisations especially if devices are placed on reception countertops, bedside tables, cafes, bathrooms and other public areas. Establishing a device hygiene policy for staff and guidelines for patients, visitors and contractors will not only minimise the risk of hospital-acquired infections but improve workplace safety.
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