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Contamination of medical charts: an important source of potential infection in hospitals.

Chen KH, Chen LR, Wang YK - PLoS ONE (2014)

Bottom Line: Except for obstetric-gynecologic charts, the incidence was significantly higher in each and in all ICUs than in corresponding wards.Special units had a significantly higher incidence of bacterial contamination due to Staphylococcus aureus (17.8%), Methicillin-resistant Staphylococcus aureus (9.3%), Streptococcus viridans (9.4%), Escherichia coli (11.2%), Klebsiella pneumoniae (7.5%), and Acinetobacter baumannii (7.5%).These findings highlight the importance of effective hand-washing before and after handling medical charts.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Taipei Tzu-Chi Hospital, The Buddhist Tzu-Chi Medical Foundation, Taipei, Taiwan ; School of Medicine, Tzu-Chi University, Hualien, Taiwan.

ABSTRACT

Objective: This prospective study aims to identify and compare the incidence of bacterial contamination of hospital charts and the distribution of species responsible for chart contamination in different units of a tertiary hospital.

Methods: All beds in medical, surgical, pediatric, and obstetric-gynecologic general wards (556) and those in corresponding special units (125) including medical, surgical, pediatric intensive care units (ICUs), the obstetric tocolytic unit and delivery room were surveyed for possible chart contamination. The outer surfaces of included charts were sampled by one experienced investigator with sterile cotton swabs rinsed with normal saline.

Results: For general wards and special units, the overall sampling rates were 81.8% (455/556) and 85.6% (107/125) (p = 0.316); the incidence of chart contamination was 63.5% and 83.2%, respectively (p<0.001). Except for obstetric-gynecologic charts, the incidence was significantly higher in each and in all ICUs than in corresponding wards. Coagulase-negative staphylococci was the most common contaminant in general wards (40.0%) and special units (34.6%) (p>0.05). Special units had a significantly higher incidence of bacterial contamination due to Staphylococcus aureus (17.8%), Methicillin-resistant Staphylococcus aureus (9.3%), Streptococcus viridans (9.4%), Escherichia coli (11.2%), Klebsiella pneumoniae (7.5%), and Acinetobacter baumannii (7.5%). Logistic regression analysis revealed the incidence of chart contamination was 2- to 4-fold higher in special units than in general wards [odds ratios: 1.97-4.00].

Conclusions: Noting that most hospital charts are contaminated, our study confirms that a hospital chart is not only a medical record but also an important source of potential infection. The plastic cover of the medical chart can harbor potential pathogens, thus acting as a vector of bacteria. Additionally, chart contamination is more common in ICUs. These findings highlight the importance of effective hand-washing before and after handling medical charts. However, managers and clinical staff should pay more attention to the issue and may consider some interventions.

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A comparison of the incidence of bacterial contamination on sampled medical charts between general wards and special units.
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pone-0078512-g003: A comparison of the incidence of bacterial contamination on sampled medical charts between general wards and special units.

Mentions: The contamination rates of medical charts selected for sampling were 63.5% in all general wards and 83.2% in all ICUs (p<0.001); 66.0% in medical wards and 86.3% in the MICU (p = 0.004); 63.4% in surgical wards and 84.6% in the SICU (p = 0.042); 52.4% in pediatric wards and 90.0% in the PICU (p = 0.015); 51.5% in Obs-Gyn wards and 50.0% in the Obs-Gyn special units (p = 0.933) (Table 1). With the exception of charts in Obs-Gyn- associated wards and special units, the incidence rates of chart contamination were significantly higher in each ICU than in the corresponding general ward. On the whole, the incidence of chart contamination was significantly higher in all ICUs than in all general wards (Figure 3).


Contamination of medical charts: an important source of potential infection in hospitals.

Chen KH, Chen LR, Wang YK - PLoS ONE (2014)

A comparison of the incidence of bacterial contamination on sampled medical charts between general wards and special units.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3928153&req=5

pone-0078512-g003: A comparison of the incidence of bacterial contamination on sampled medical charts between general wards and special units.
Mentions: The contamination rates of medical charts selected for sampling were 63.5% in all general wards and 83.2% in all ICUs (p<0.001); 66.0% in medical wards and 86.3% in the MICU (p = 0.004); 63.4% in surgical wards and 84.6% in the SICU (p = 0.042); 52.4% in pediatric wards and 90.0% in the PICU (p = 0.015); 51.5% in Obs-Gyn wards and 50.0% in the Obs-Gyn special units (p = 0.933) (Table 1). With the exception of charts in Obs-Gyn- associated wards and special units, the incidence rates of chart contamination were significantly higher in each ICU than in the corresponding general ward. On the whole, the incidence of chart contamination was significantly higher in all ICUs than in all general wards (Figure 3).

Bottom Line: Except for obstetric-gynecologic charts, the incidence was significantly higher in each and in all ICUs than in corresponding wards.Special units had a significantly higher incidence of bacterial contamination due to Staphylococcus aureus (17.8%), Methicillin-resistant Staphylococcus aureus (9.3%), Streptococcus viridans (9.4%), Escherichia coli (11.2%), Klebsiella pneumoniae (7.5%), and Acinetobacter baumannii (7.5%).These findings highlight the importance of effective hand-washing before and after handling medical charts.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Taipei Tzu-Chi Hospital, The Buddhist Tzu-Chi Medical Foundation, Taipei, Taiwan ; School of Medicine, Tzu-Chi University, Hualien, Taiwan.

ABSTRACT

Objective: This prospective study aims to identify and compare the incidence of bacterial contamination of hospital charts and the distribution of species responsible for chart contamination in different units of a tertiary hospital.

Methods: All beds in medical, surgical, pediatric, and obstetric-gynecologic general wards (556) and those in corresponding special units (125) including medical, surgical, pediatric intensive care units (ICUs), the obstetric tocolytic unit and delivery room were surveyed for possible chart contamination. The outer surfaces of included charts were sampled by one experienced investigator with sterile cotton swabs rinsed with normal saline.

Results: For general wards and special units, the overall sampling rates were 81.8% (455/556) and 85.6% (107/125) (p = 0.316); the incidence of chart contamination was 63.5% and 83.2%, respectively (p<0.001). Except for obstetric-gynecologic charts, the incidence was significantly higher in each and in all ICUs than in corresponding wards. Coagulase-negative staphylococci was the most common contaminant in general wards (40.0%) and special units (34.6%) (p>0.05). Special units had a significantly higher incidence of bacterial contamination due to Staphylococcus aureus (17.8%), Methicillin-resistant Staphylococcus aureus (9.3%), Streptococcus viridans (9.4%), Escherichia coli (11.2%), Klebsiella pneumoniae (7.5%), and Acinetobacter baumannii (7.5%). Logistic regression analysis revealed the incidence of chart contamination was 2- to 4-fold higher in special units than in general wards [odds ratios: 1.97-4.00].

Conclusions: Noting that most hospital charts are contaminated, our study confirms that a hospital chart is not only a medical record but also an important source of potential infection. The plastic cover of the medical chart can harbor potential pathogens, thus acting as a vector of bacteria. Additionally, chart contamination is more common in ICUs. These findings highlight the importance of effective hand-washing before and after handling medical charts. However, managers and clinical staff should pay more attention to the issue and may consider some interventions.

Show MeSH
Related in: MedlinePlus