CONTAMINATED EQUIPMENT

For forty-four years, it has been known about the contamination of health care equipment.

It is estimated that up to three nursing hours a day are spent on hospital wards taking blood pressure readings.

Viable organisms have been recovered from blood pressure cuffs used between patients.

Not only is that a concern to you and your patients.

But consider this.

The organisms in over half the cuffs grew potential pathogens such as staphylococcus aureus and clostridium difficile.

So hands are not the only fomites to go from patient to patient – it is also the seemingly innocuous blood pressure cuff.

The most effective method used to decontaminate the equipment we use is 70% alcohol.

What, how and who does the cleaning is the responsibility of all nurses.

Inadequate hand hygiene can lead to cross transmission of pathogens but when should a nurse wash their hands.

The World Health Organisation (WHO) has defined “The five moments of hand hygiene”.

They are
1. before patient contact
2. before performing a clean/aseptic technique
3. after exposure to body fluids
4. after patient contact
5.  after touching a patient’s surroundings.

Patients do contaminate their immediate environments.

The chance of bacteria being acquired on hands and gloves is high from the patient’s surrounds.

So washing hands after patient contact is a given – but not everyone does that.

But the patient surroundings are easily forgotten and are perceived as low risk.

So it is just not the blood pressure cuff that are contaminated.

Case notes, computers, keyboards and door handles are also potential comtamination sites.

It is very likely that that case notes have never been cleaned.

And many keyboards would be the same.

Not only staff hand hygiene is important so is patient hand hygiene, especially between shower and toilet facilities and beds.

Patients need obvious cues to show and tell them to wash their hands as well.

Pathogen numbers on non-critical medical and hospital equipment can be reduced by using 70% alcohol.

Alcohol is more effective than detergents, antiseptic soap, and simple and double paper wipes.

Up to ten per cent of patients acquire an infection when they are in hospital and very awareness of how this happens is the beginning in prevention.

To learn more about contaminated equipment:

Bissett, L. (2010). Developing decontamination strategies and monitoring tools. British Journal of Nursing, 19(16). https://www.ncbi.nlm.nih.gov/pubmed/20852458

Davis, C. (2009). Blood pressure cuffs and pulse oximeter sensors: A potential source of cross-contamination. Australasian Emergency Nursing Journal, 12(3), 104–109. http://www.aenj.com.au/article/S1574-6267(09)00044-5/abstract

Eder, S. P. (2013). Standardizing the management of reusable medical equipment. AORN Journal, 97(2), 257–262. http://www.aornjournal.org/article/S0001-2092(12)01205-7/abstract

FitzGerald, G., Moore, G., & Wilson, A. P. R. (2013). Hand hygiene after touching a patient’s surroundings: the opportunities most commonly missed. Journal of Hospital Infection, 84(1), 27–31. http://www.journalofhospitalinfection.com/article/S0195-6701(13)00048-0/abstract

Montgomery, S. (2016). Disposable versus Reusable Blood Pressure Cuffs: A Nursing Led Initiative.  Journal of Perioperative and Critical Intensive Care Nursing, 2:108. https://www.omicsonline.org/open-access/disposable-versus-reusable-blood-pressure-cuffs-a-nursing-led-initiative-jpcic-1000108.php?aid=69324

Schabrun, S., & Chipchase, L. (2006). Healthcare equipment as a source of nosocomial infection: a systematic review. Journal of Hospital Infection, 63(3), 239–245. https://www.ncbi.nlm.nih.gov/pubmed/16516340

Walker, N., Gupta, R., & Cheesbrough, J. (2006). Blood pressure cuffs: friend or foe? Journal of Hospital Infection, 63(2), 167–169. http://www.journalofhospitalinfection.com/article/S0195-6701(06)00043-0/abstract