| Abstract. |
Computers are on many GP consulting room desks, and used to enter anything from the whole notes to a brief coded summary of each consultation. Could they be a hazard for transmitting infection between patients. This preliminary study suggests they are not.
|
| Aim |
To determine whether GP computer keyboards are colonised by pathogens. |
|
Discussion. |
AMs practice make all clinical notes directly onto the computer, ensuring legibility. There is potential for instance to touch a child with conjunctivitis and, while making a note to this effect and printing a prescription, to contaminate the keyboard and then periodically recontaminate one's hands thus infecting other patients. |
Method. | The practice contains three Olivetti PCs used
to run the Micro Solutions Surgery Manager program. Their keyboards
are neatly styled and dirt resistant but are basically the standard
PC keyboard. Two machines are in clinical areas, one in the consulting
room and one in the Nurse's/treatment room, and one is in the
reception area and was included as a control.
The keytops and surround, and mice were swabbed at the end of a Friday surgery, when they could be assumed to have the maximum chance of having accumulated contaminants, and then again on the Sunday evening after they had been unused for 36 hours. No attempt was made to isolate viruses. The swabs were pre-moistened in saline and after sampling added to a vial of Ringers and returned to the laboratory. Using a standard Miles Misra technique a series of dilutions were made in "Maximum Recovery Diluent" and plated onto Sabourauds agar and blood agar. Plates were incubated aerobically at 30 degrees Celsius for 72 hours. After incubation the average number of colonies per drop of the dilution and the viable count of organisms present in the original samples were calculated as usual. Organisms were identified using standard microbiological techniques. |
| Findings |
|
| Conclusions | Finding low counts only of organisms of low virulence
suggests that infection via the keyboard is a potential rather
than actual hazard. The risks of cross-infection are obviated
by attention to the basic principle of infection control, thorough
hand-washing. The same potential applies to pens. Since all of
us lapse occasionally the results are reassuring. Why the reception
computer changed flora over the weekend is uncertain.
The slick surface of computer keys is not friendly to bacteria(1). Systems which have such a non- standard user interface that users need to stick paper legends onto the keytops may be more likely to harbour bacteria. For this and other reasons they should be supplied with appropriately labelled keytops. In practice this applies only to the Exeter System. The findings in the reception area are not surprising, and would probably match those obtained in an office elsewhere. Computers will be used more and more in clinical areas, and this will extend within hospitals. The troubled HCI hospital in Glasgow boasts a complete electronic record system. Hospital clinical keyboards should be examined to ensure the situation is the same. When designing a consulting room, after siting the monitor so the doctor can see it while looking at the patient, and show to or conceal it from the patient and anyone accompanying them, the wash basin should be sited so that it is convenient to wash hands between patient and typing. |
| With thanks to Dr Marina
Morgan MRCPATH DMS Senior Registrar in Microbiology Royal Devon
and Exeter Hospital Trust for advice and assistance.
04/03/95 |
| References | 1 Attachment of Staphylococci to different
plastic tubes in vitro. Esperson F. et al Journal of Medical Microbiology
40(1): 37-42, Jan 1994
2 Overend A, Hall W, Godwin G Does earwax lose its pathogens on your auriscope overnight? BMJ 1992;305:1571-3 3 Stethoscopes as possible vectors of infection by staphylococci. Breathnach A, Jenkins D, Pedler S. BMJ 1992;305:1573-4 |
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