The use of portable mobile devices has facilitated timely communication among healthcare team members. It\u27s now a common practice for hospital-owned mobile phones to be shared among healthcare employees from shift to shift. Despite the benefit of increased, timely communication between caregivers, sharing mobile devices can lead to the spread of healthcare-associated infections (HAIs). This article looks at the efficacy of two types of cleaning products on shared mobile phones carried by RNs at a 489-bed, Magnet-designated, Midwestern regional medical center. The cleaning methods evaluated were 70% isopropyl alcohol wipes and ethyl alcohol wipes

Basol, Roberta

Beckel, Jean

Gildsdorf-Gracie, Judy

Hilleren-Listerud, Amy

McCaffrey, Terri

Reischl, Sherri

Rickbeil, Pamela

Schimnich, Mary

Skillings, Kirsten

Struffert, Mary A.

English

CentraCare Health

CentraCare HealthDigitalCommons@CentraCare HealthArticles Posters and Scholarly Works7-2013You Missed a Spot! Disinfecting Shared MobilePhonesRoberta BasolSt. Cloud Hospital, CentraCare HealthJean BeckelSt. Cloud Hospital, CentraCare HealthJudy Gildsdorf-GracieSt. Cloud Hospital, CentraCare HealthAmy Hilleren-ListerudSt. Cloud Hospital, CentraCare Health, hilleren-listeruda@centracare.comTerri McCaffreySt. Cloud Hospital, CentraCare HealthSee next page for additional authorsFollow this and additional works at: https://digitalcommons.centracare.com/articlesPart of the Perioperative, Operating Room and Surgical Nursing CommonsThis Article is brought to you for free and open access by the Posters and Scholarly Works at DigitalCommons@CentraCare Health. It has beenaccepted for inclusion in Articles by an authorized administrator of DigitalCommons@CentraCare Health. For more information, please contactschlepers@centracare.com.Recommended CitationBasol, Roberta; Beckel, Jean; Gildsdorf-Gracie, Judy; Hilleren-Listerud, Amy; McCaffrey, Terri; Reischl, Sherri; Rickbeil, Pamela;Schimnich, Mary; Skillings, Kirsten; and Struffert, Mary A., "You Missed a Spot! Disinfecting Shared Mobile Phones" (2013). Articles.7.https://digitalcommons.centracare.com/articles/7AuthorsRoberta Basol, Jean Beckel, Judy Gildsdorf-Gracie, Amy Hilleren-Listerud, Terri McCaffrey, Sherri Reischl,Pamela Rickbeil, Mary Schimnich, Kirsten Skillings, and Mary A. StruffertThis article is available at DigitalCommons@CentraCare Health: https://digitalcommons.centracare.com/articles/7www.nursingmanagement.com16  July 2013 •  Nursing Management Risk managementYou missed a spot! Disinfecting shared mobile phonesBy Roberta Basol, MA, RN, NE-BC; Jean Beckel, DNP, MPH, RN, CNML; Judy Gilsdorf-Gracie, MBA, MS, RN, CNOR; Amy Hilleren-Listerud, MA, RN, ACNS-BC, CBN, PCCN; Terri D. McCaffrey, MA, APRN, CNS; Sherri Reischl, RN, CEN; Pamela Rickbeil, MSN, RN, ACNS-BC, RN-BC; Mary Schimnich, RN; Kirsten Skillings, MA, RN, CCNS, CCRN; and Mary A. Struffert, MSN, RN, NE-BCT he use of portable mobile devices has facili-tated timely communication among health-care team members. It’s now a common practice for hospital-owned mobile phones to be shared among healthcare employees from shift to shift. Despite the benefit of increased, timely communication between caregivers,  sharing mobile devices can lead to the spread of healthcare-associated infections (HAIs) if they aren’t properly disinfected. The Guidelines for Disinfection and Sterilization in Healthcare Facili-ties  describe “non-critical environmental surfaces” as items that are frequently touched by the hand and may pose a risk of secondary infection  transmission.1 Mobile phones are recognized as noncritical environmental surfaces, and research demonstrates the presence of contaminates on these devices.2-4 The CDC recommends a cleaning regimen that’s effective, fast-acting, easy to follow, and economical.1 Currently, there are no pub-lished studies with standards for cleaning mobile phones.We studied the efficacy of two types of cleaning products on shared mobile phones carried by RNs at a 489-bed, Magnet®-designated, Midwestern  regional medical center. The cleaning methods evaluated were 70% isopropyl alcohol wipes and ethyl alcohol wipes.Background checkThe issue of HAIs has presented an ongoing chal-lenge to healthcare facilities. Healthcare workers are a potential source of HAIs because many pathogens are transmitted by hand and contami-nated medical devices. There’s extensive litera-ture on the survival of organisms on inanimate objects, and studies suggest that commonly used patient-care items may serve as reservoirs and vectors for HAIs.5,6 For example, vancomycin- resistant enterococci (VRE) are capable of  prolonged survival on hands, gloves, and  environmental surfaces.7Mobile communication devices can act as res-ervoirs for bacteria associated with HAIs and are routinely transported into the operating environ-ment by medical staff.8 Data indicate that health-care employee mobile phones have evidence of significant bacterial contamination, including  bacteria known to cause HAIs.9-19 Additional studies have shown cross-contamination  between healthcare workers’ hands, mobile phones, and patients, including transmission of multidrug- resistant strains of bacteria.20 Contami-nated mobile phones are hazardous to patients and may also pose a threat of spreading infec-tions into the community.21 In one study, it was found that 88% to 89.5% of study participants Copyright © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.www.nursingmanagement.com  Nursing Management •  July 2013  17Risk managementnever cleaned their mobile com-munication  devices and that pag-ers were often touched during or after the examination of patients without hand washing. Microbial contamination is a risk associated with the infrequent cleaning of phones.22The good news is that studies have shown a significant reduc-tion in contaminated pagers with the use of several prepackaged disinfecting agents; alcohol wipes with 0.5% chlorhexidine/70%  isopropyl were significantly more efficacious in eliminating all bacte-rial growth than the other agents.23In a unique study on the use of  alcohol-based hand foam, results showed that the foam simultane-ously sterilized the hands and a stethoscope head, which signifi-cantly reduced the number of bac-terial colonies, including methicil-lin-resistant Staphylococcus aureus (MRSA).24 These studies suggest that cleaning  mobile phones may significantly  decrease bacterial  colonies and the threat of de-vice related bacterial cross- contamination.Collecting the culturesA random sample of 66 shared  mobile phones routinely used by direct care RNs was taken. The  collection occurred in 11 acute care units and CCUs, with six samples taken from each unit. Two phone cleaning products were tested: 70% isopropyl alcohol wipes  (product a) and ethyl alcohol wipes (product b).A cleaning method sampler con-tainer holding an equal number of products a (33) and b (33) was used to determine which cleaning method was tested. Paper lab req-uisition forms and adhesive labels for cultures were premade to match the total number of samples, with two requisitions per sample and a unique identifier number. The researcher selected a patient care unit as well as cleaning  product a or b. The researcher approached a direct care RN on the selected unit and informed the RN of the study to culture his or her phone. No consent was obtained. RNs were  allowed to refuse to participate; however, none refused.To culture the devices, an RN held the phone while the re-searcher swabbed the keypad, mouthpiece, earpiece, and back of the phone using three long strokes per side, constantly rotating the swab and not touching the RN’s fingers. This method was used to obtain the  culture before and after cleaning. The RN was asked to perform hand hygiene with alco-hol-based foam following the first culture and before cleaning the phone. He or she was then in-structed to clean the phone thor-oughly using product a or b. The researcher waited 2  minutes while the RN continued to hold the phone, which wasn’t  allowed to be set down, placed in a pocket, air blown, or waved dry. Then, the second culture was obtained. The culturettes were sent to the hospi-tal lab for analysis. A data collec-tion log was used to track the  samples and results.Now that’s clean!Culture results from 66 paired samples taken before and after cleaning shared mobile phones were analyzed for the presence and identification of bacteria. There were no pathogenic bacteria detected on the mobile phones be-fore or after cleaning with either 70% isopropyl alcohol wipes or ethyl alcohol wipes. Of the 66 sam-ples obtained, 64% had the pres-ence of normal skin flora. Normal skin flora was reduced from 64% to 12% with  isopropyl alcohol wipes and from 64% to 15% with ethyl  alcohol wipes.Researchers in our study deter-mined that the shared mobile phones tested weren’t contami-nated with pathogenic bacteria and weren’t a source of HAIs. Because there was no MRSA or VRE cul-tured, resistance testing wasn’t necessary. Disinfection of normal skin flora did occur with both 70% isopropyl alcohol wipes and ethyl alcohol wipes, but no conclusion may be drawn as to which product is more effective for disinfection of pathogenic bacteria. However, it was determined that the cleaning of mobile phones by healthcare workers is an effective way to  eliminate bacteria.Continued infection preventionInanimate objects may harbor pathogenic bacteria, which may  result in cross-contamination from healthcare workers to patients, leading to HAIs. Previous studies have demonstrated that pens, stethoscopes, pagers, computer keyboards, and mobile phones test positive for pathogenic and Balance efficient communication with hands-on patient contact to minimize the transfer of bacteria within the hospital environment.Copyright © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.18  July 2013 •  Nursing Management www.nursingmanagement.comRisk managementnonpathogenic bacteria, including multidrug-resistant organisms. Healthcare workers are responsible for maintaining clean shared mo-bile phones by following the clean-ing process. In this particular study, culture results didn’t reveal the presence of pathogenic bacte-ria, however, normal skin flora was found. Healthcare facilities should consider disinfecting shared mobile devices with 70% isopropyl alcohol wipes or ethyl alcohol wipes to help prevent the spread of bacteria.Mobile phones go everywhere with staff members on duty and are handled during the course of pa-tient care, staff breaks, and in other venues within the hospital. Nurses need to balance efficient communi-cation with hands-on patient con-tact to minimize the transfer of  bacteria within the hospital envi-ronment. Identifying efficient and effective disinfection methods  related to mobile phone bacterial transmission may reduce the spread of HAIs and their related impact on patient length of stay, cost, and mortality. NMREFERENCES 1.  CDC. Healthcare-associated infections. http://www.cdc.gov/ncidod/dhqp/ healthDis.html. 2.  Ulger F, Esen S, Dilek A, Yanik K, Gunaydin M, Leblebicioglu H. Are we aware how con-taminated our mobile phones with noso-comial pathogens? Ann Clin Microbiol  Antimicrob. 2009;8:7. 3.  Akinyemi KO, Atapu AD, Adetona OO, Coker AO. The potential role of mobile phones in the spread of bacterial infections. J Infect Dev Ctries. 2009;3(8):628-632. 4.  Jeske HC, Tiefenthaler W, Hohlrieder M, Hinterberger G, Benzer A. Bacterial con-tamination of anaesthetists’ hands by  personal mobile phone and fixed phone use in the operating theatre. Anaesthesia. 2007;62(9):904-906. 5.  Williams C, Davis D. Methicillin-resistant Staphylococcus aureus fomite survival. Clin Lab Sci. 2009;22(1):34-38. 6.  Singh D, Kaur H, Gardner WG, Treen LB. Bacterial contamination of hospital  pagers. Infect Control Hosp Epidemiol. 2002;23(5):274-276. 7.  Noskin GA, Stosor V, Cooper I, Peterson LR. Recovery of vancomycin-resistant en-terococci on fingertips and environmental surfaces. Infect Control Hosp Epidemiol. 1995;16(10):577-581. 8.  Brady RR, Fraser SF, Dunlop MG, Paterson-Brown S, Gibb AP. Bacterial contamination of mobile communication devices in the operative environment. J Hosp Infect. 2007;66(4):397-398. 9.  Al-Abdalall AH. Isolation and identifica-tion of microbes associated with mobile phones in Dammam in eastern Saudi Arabia. J Family Community Med. 2010;17(1):11-14.10.  Jayalakshmi J, Appalaraju B, Usha S.  Cellphones as reservoirs of nosocomial pathogens. J Assoc Physicians India. 2008;56:388-389.11.  Kilic IH, Ozaslan M, Karagoz ID, Zer Y,  Davutoglu V. The microbial colonisation of mobile phone used by healthcare staffs. Pak J Biol Sci. 2009;12(11):882-884.12.  Tambekar DH, Gulhane PB, Dahikar SG, Dudhane MN. Nosocomial hazards of  doctor’s mobile phones in hospitals. J Med Science. 2008;8(1):73-76.13.  Brady RR, Wasson A, Stirling I, McAllister C, Damani NN. Is your phone bugged? The incidence of bacteria known to cause nosocomial infection on healthcare  workers’ mobile phones. J Hosp Infect. 2006;62(1):123-125.14.  Braddy CM, Blair JE. Colonization of per-sonal digital assistants used in a health care setting. Am J Infect Control. 2005;33(4):230-232.15.  Hassoun A, Vellozzi EM, Smith MA. Coloni-zation of personal digital assistants car-ried by healthcare professionals. Infect Control Hosp Epidemiol. 2004;25(11):1000-1001.16.  Karabay O, Kocoglue E, Tahtaci M. The role of mobile phones in the spread of bacte-ria associated with nosocomial infections. J Infect Dev Ctries. 2007;1(1):72-73.17.  Morioka I, Tabuchi Y, Takahashi Y, et al. Bacterial contamination of mobile phones shared in hospital wards and the con-sciousness and behavior of nurses about biological cleanliness. Nihon Eiseigaku Zasshi. 2011;66(1):115-121.18.  Saxena S, Singh T, Agarwal H, Mehta G, Dutta R. Bacterial colonization of rings and cell phones carried by health-care providers: are these mobile bacterial zoos in the hospital? Trop Doct. 2011;41(2):116-118.19.  Namias N, Widrich J, Martinez OV, Cohn SM. Pathogenic bacteria on personal  pagers. Am J Infect Control. 2000;28(5):387-388.20.  Borer A, Gilad J, Smolyakov R, et al. Cell phones and Acinetobacter transmission. Emerg Infect Dis. 2005;11(7):1160-1161.21.  Khivsara A. Sushma TV, Dahashree B. T yping of Staphylococcus aureus from  mobile phones and clinical samples. Curr Sci. 2006;90(7):910-912.22.  Ramesh J, Carter AO, Campbell MH, et al. Use of mobile phones by medical staff at Queen Elizabeth Hospital, Barbados: evidence for both benefit and harm. J Hosp Infect. 2008;70(2):160-165.23.  Beer D, Vandermeer B, Brosnikoff C,  Shokoples S, Rennie R, Forgie S. Bacterial contamination of health care workers’ pagers and the efficacy of various disin-fecting agents. Pediatr Infect Dis J. 2006;25(11):1074-1075.24.  Schroeder A, Schroeder MA, D’Amico F. What’s growing on your stethoscope? (And what you can do about it). J Fam Pract. 2009;58(8):404-409.At St. Cloud Hospital in St. Cloud, Minn.,  Roberta Basol is the Care Center director for the ICU, Surgical Care, and Clinical Practice; Jean Beckel is a performance improvement analyst and Magnet® Program director; Judy Gilsdorf-Gracie is a clinical resource nurse; Amy Hilleren-Listerud is a clinical nurse spe-cialist; Terri D. McCaffrey is a clinical nurse specialist; Sherri Reischl is an ICU RN and ED interim director; Pamela Rickbeil is a clinical nurse specialist; Mary Schimnich is a heart failure specialist; Kirsten Skillings is a clinical nurse specialist; and Mary A. Struffert is an administrative nursing supervisor.The authors have disclosed that they have no financial relationships related to this article.DOI-10.1097/01.NUMA.0000431426.16206.75Healthcare workers are responsible for maintaining clean shared mobile phones.Copyright © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

You Missed a Spot! Disinfecting Shared Mobile Phones

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You Missed a Spot! Disinfecting Shared Mobile Phones

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