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1. Headline Goes Here Infection Prevention and Control: Cleaning and Disinfecting Mobile Workstations (WOWs) and Computer Equipment

2. CDC Guidelines • The 2008 Guidelines for Disinfection and Sterilization recommends methods for cleaning, disinfection and sterilization of patient-care medical devices • Preferred methods are based on evidence-based recommendations • Policies identify methods based on intended use • Workstations on Wheels (WOWs) are often not specifically addressed • Lack of compliance to guidelines can lead to infection outbreaks.

3. CDC Definitions Cleaning - the removal of visible soil from objects and surfaces by manually or mechanically using water with detergents or enzymatic products. Disinfection - the process that eliminates pathogenic microorganisms on inanimate objects by liquid chemicals or wet pasteurization. (Guideline for Disinfection and Sterilization in Healthcare Facilities. p. 8 – 9)

4. CDC Recommendations • Factors that affect the efficacy of cleaning, disinfection and sterilization include: • Prior cleaning of the object • Organic and inorganic load present • Type and level of microbial contamination • Physical nature of the object

5. CDC Classification Scheme • Instruments and items are categorized for appropriate disinfection and sterilization: • Critical: surgical instruments • Semi-critical: scopes • Non-critical: devices and patient items

6. Disinfection and Cleaning Policy • For WOWs, computer hardware and components: • Prevention and control is key • Staff is accountable for cleaning and disinfecting (define staff roles) • Contaminated environmental surfaces cause healthcare acquired infections • Effective hand hygiene stops the transmission of infection (HAI) • Cleaning and disinfection interrupts the spread of pathogenic organisms

7. The Evidence… • Over 2 million patients annually contract infection while hospitalized • Close to 100,000 of these patients die annually • HAI is a top 10 killer of Americans • MRSA , antibiotic resistant staph is a factor • Keyboards and computer mice harbor germs and are a source for: • Cross contamination • Transmission • Nosocomial infection

8. Mobile Workstation Essentials • Configuration recommendations • Sealed keyboards* • Optical mouse • Non-porous wrist support • Hand-held optical readers without cables • Solid non-porous surfaces • Baskets or solid drawers • Hospital-approved cleaning products

9. Sealed Keyboard Consideration • Transmission from contaminated keyboards can be eliminated with consistent hand-washing • Studies have demonstrated low compliance (approx. 40%) with hand hygiene guidelines • Keyboards are more safely and successfully decontaminated and disinfected when sealed • Disinfectants are less damaging to sealed keyboards

10. Best Practice Considerations • Infection Control Policies and Procedures should be writtenspecifically to address the care of the WOWs, hardware and components • Computers cleaned daily • WOW cleaned before entering and exiting the room • Use plastic covers when applicable • Increase smooth surfaces to reduce risk of contamination • High risk areas should include disinfecting and gloved hands • Include computer equipment in policies for hand hygiene

11. Best Practice Recommendations • Written policy/procedures regarding cleaning and disinfection are key to compliance • Be consistent with recognized authorities • CDC, SHEA, IDSA, APIC Text • Be flexible to facility • Patient population, risk level and physical location • Cleaning and disinfecting agents used/available • Manufacturers and types of devices • Clean to remove visible dirt and biologic debris

12. Best Practice Recommendations (cont’d) • Disinfect to eliminate pathogenic microbes • Provide cleaning and disinfecting that is safe for patients, health care workers and equipment • Appropriate hand hygiene needs to be followed • Clearly defined scope of authority and accountability

13. Summary • Specific, written mobile work station and hardware component cleaning and disinfection policies are a requirement • Education programs ensure continued compliance • Employee Orientation and Training • Visual Reminders • Annual training requirement

14. References • Neeley, AN, Weber, JM (2002). Basic Microbiologic and Infection Control Information to Reduce Potential Transmission of Pathogens to Patients via Computer Hardware. Journal of the American Medical Informatics Association, Vol. 9 (5), p. 500 – 508. • Neeley, AN, Weber, JM (2005). Computer equipment used in patient care within a multihospital system: Recommendations for cleaning and disinfection. American Journal of Infection Control, Vol. 33 (4), p. 233 – 237. • Rutala, WA, Weber, DJ, and the Healthcare Infection Control Practices Advisory Committee (2008). Guideline for Disinfection and Sterilization in Healthcare Facilities. Centers for Disease Control, Chapel Hill, NC. • Taurasi, R (2010). CS Solutions: Cleaning keyboards. Healthcare Purchasing News, June, p. 42.