Computer equipment used in patient care within a multihospital system: Recommendations for cleaning and disinfection

ISSUE: The introduction of computer equipment and devices (CE) into patient care settings has greatly increased in recent years. The potential for this equipment to serve as a reservoir for infectious organisms was identified by the infection control working group (ICWG) and the outcomes management department of our multihospital system. A computer disinfection taskforce (TF) was established to provide guidelines for cleaning and disinfection of this equipment for use by each hospital. PROJECT: The TF consisted of infection control professionals (ICPs) throughout the system, representatives of major service lines, and administrative and information technology professionals. Meetings were conducted via conference calls and supplemented by e-mail communications. A literature review was done of computer contamination in medical settings. In addition, all ICPs in the system were asked for any written policies related to cleaning/disinfection of CE. From this the TF determined that recognition of the problem was highly variable throughout the system. The taskforce also discussed criteria development, specifically that recommendations would need to be consistent with recognized authorities and flexible to fit the needs of the many hospitals in the system. Different types of CE likely to be in contact with patients were reviewed and equipment specifications were examined to determine what types of cleaning solutions might be used. RESULTS: Four recommendations were made related to CE and included: 1) When cleaning/disinfecting computer hardware, use the same type of cleaner/disinfectant and the same frequency of cleaning as would normally be used for other devices in that area. 2) The use of plastic keyboard covers or immersible keyboards should be considered for direct patient care areas. 3) When purchasing computer hardware, consider the design and purchase equipment with as many smooth surfaces as possible to reduce the risk of microbial contamination. 4) Ensure that use of CE is included in policies for handwashing. The final recommendations were reviewed by the ICWG and the director of medical affairs prior to distribution. LESSONS LEARNED: Development of a guideline for use in a multihospital system should have representation from all involved disciplines as well as a representative sample of hospitals within the system. This will ensure that the guidelines take into account the variety of clinical settings encountered within the system.