Hospital bedrails and the pockets and sleeves of healthcare workers' scrubs are the most likely sites for contamination in the ICU, research finds.
Nurses and other hospital direct care workers need to be aware of the "transmission triangle"—patients, the environment, and the provider, according to a new study from Duke University Hospital.
The study was presented at IDWeek, a joint meeting of the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the HIV Medicine Association, and the Pediatric Infectious Diseases Society in New Orleans.
Any type of activity in patient care, including walking into a patient room where care is provided, "truly should be considered a chance for interacting with organisms that can cause disease," Deverick Anderson, MD, the study's lead author, said in a statement.
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The researchers took cultures from the sleeves, pockets, and midriff area of surgical scrubs of 40 ICU nurses at Duke University Hospital in Durham, NC. The scrubs were new and the samples were collected at the start and end of each shift.
The researchers also sampled the nurses' patients and the patients' beds, bedrails, and supply carts. Samples were collected from 167 patients during 120 shifts of 12 hours each. The study collected 2,185 cultures from the nurses' clothing, 455 from patients, and 2,919 from patients' rooms.
Molecular analysis revealed organisms on the nurses' clothing at the end of shifts that were not present at the start. Reseachers looked for the same organisms in the rooms and on the patients, specifically pathogens that were known to cause difficult-to-treat infections including MRSA.
Pockets and sleeves of the scrubs and bed rails were the most likely sites for contamination, according to the research.
In 12 cases, at least one of the five pathogens were transmitted from the patient or the room to the scrubs. The study also identified six cases of transmission from patient-to-nurse and room-to-nurse, and 10 transmissions from the patient to the room.
However, researchers did not find any nurse-to-patient or nurse-to-room transmission.
In 2011, there were an estimated 722,000 healthcare-acquired infections in U.S. acute care hospitals, and about 75,000 patients with HAIs died during their hospitalizations. More than half of all HAIs occurred outside of the intensive care unit, the CDC stated.