Bacterial Cross-Contamination and Patient\'s Charts Is There

Bacterial Cross-Contamination and Patient's Charts

IS THERE ANY CONNECTION BETWEEN BACTERIAL CROSS-CONTAMINATION AND PATIENTS' CHARTS?

Is there any connection between bacterial cross-contamination and patients' charts?

With recent interventions in nursing standards, there is an increasing emphasis on care which requires to be taken by the nursing and surgical staff while handling patient's charts an also other equipments which are prone to bacterial cross contamination. Failure to adhere to such standards can have fatal effects not only on the health of nursing staff but may also endanger other patients as well. Where more emphasis has been levied on bacterial cross-contamination present and evidenced on surgical instruments, there does lies a need to study similar impacts on patient's charts as well which are widely handled in normal treatment as well surgical procedures as well where the chances of cross-contamination are largely extensive.

Where there are various studies to support the very idea of bacterial cross-contaminations on surgical instruments, the importance of handling patient's charts has been greatly undermined, which gives rise to the need of performing extensive research or perhaps a literature review in order to establish an understanding as to how and what percentage of people can get affected through this cross-contamination caused via patient's charts.

Problem Statement:

The problem being evaluated is the presence of little information and lack of research which may support the connection between patient's charts and bacterial cross-connections.

Research Question

Is there a connection between bacterial cross-contamination and patient's charts?

Hypothesis

I hypothesize that there is a clear connection between bacterial cross-connection and patients' charts.

Literature Review

There are various studies to support the hypothesis that hospital surfaces and medical instruments used during clinical and surgical procedures become contaminated by various pathogenic and unpathogenic organisms. Some of the most commonly occurring organisms are methicillin-resistant, Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), Clostridium difficile, Acinetobacter species, and noroviruses which have an ability to survive on the hospital surfaces and objects often used in this particular environments. Such types of surfaces may include medical devices and other items as well which includes hospital charts too. However, the criticality level of patients' charts is rather low as compared to other equipments and hospital surfaces due to lack of contact between patients and their respective charts. Nursing staff and surgical residents can become the main source of bacterial transmission resulting in cross-contamination of patient's charts.

It is important to note that the items which come under non-critical category are those which only have contact with patient's skin or may have tendency to become contaminated by the negligence of healthcare staff/. Here arises a need for promotion of hand hygiene which is integral in hospital environment especially before and after patient's contact. Where surgical and clinical tools undergo frequent cleaning and sterilization, patients' charts are the most neglected objects which are more prone to contamination (Panhotra et al. 2005 & Harrison et al. 2003)

For the purpose of showing connection between bacterial cross-contamination and patient's charts, a study was conducted in 2009 by Wang Fang hospital in Taiwan by local surgical residents (Teng SO et al. 2009) For the purpose of this study, a random sample of 180 medical charts was taken with 50% representation from surgical ICU and surgical wards. Moistened sterile swabs were used for the sample taking of these charts by using sterile normal saline as solution medium. These samples were made to transfer to trypticase soy broth and were kept in aerobic incubation for the time period of 48 hours. The sample was later on sub-cultured into separated sheep blood and eosin-methylene blue agars. Standards methods were used for the identification of microorganisms present in these subcultures using normal microbiological laboratory.

After the careful deliberation, it was found that samples taken from surgical ICU as well as surgical wards showed contamination respective of their place of origin. The presence of pathogenic and potentially pathogenic bacterium was found on 90% of surgical ICU samples and 72% of surgical wards samples respectively. Coagulase-negative staphylococci (CoNS) were the most commonly isolated bacteria, both in the surgical ICU (n = 40, 44.44%) and in the surgical ward (n = 48, 53.33%). Several bacteria isolated from the charts, including multidrug-resistant Acinetobacter baumannii, Stenotrophomonas maltophilia, and Klebsiella pneumoniae, had the same antibiogram as the same bacteria isolated from patients.

This study clearly helped in establishment of the evidence that patients' charts are susceptible to contamination with pathogenic and potentiall pathogenic bacteria leading to nonsocomial infection.

Similar study was conducted by Nils-Olaf Hubner, Claudia Hubner, Axel Kramer, and Ojan Assadian in 2011. The basic objective was to evaluate the chances of survival of bacterial pathogens on paper and bacterial retrieval from paper to hands. The study was