Contamination of pulse oximeter probes before and after decontamination in two intensive care units

Background. The internal surfaces of pulse oximeter probes may be overlooked as hot spots for pathogenic microorganisms in an intensive care unit (ICU), thereby contributing to the high incidence of hospital-acquired infections. Objectives. To determine the growth and identification of microorganisms on pulse oximeter probes in the multidisciplinary ICU (MICU) at Charlotte Maxeke Johannesburg Academic Hospital and the burns ICU (BICU) at Chris Hani Baragwanath Academic Hospital, before and after decontamination. Methods. This was a cross-sectional, comparative and contextual study, using purposive sampling. Data were collected from the internal surfaces of 34 pulse oximeter probes in a MICU and BICU. Each pulse oximeter probe was swabbed before and after decontamination. The endemic microorganism profile for the two ICUs was obtained from a laboratory database. Results. Internal surfaces of 31 (91%; 95% confidence interval (CI) 0.76 - 0.98) pulse oximeter probes were contaminated with 9 different pathogenic microorganisms pre decontamination. Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa were endemic to both ICUs, and were the most-frequently isolated microorganisms. Staphylococcus aureus was the most common microorganism endemic to both ICUs, isolated on the internal surfaces of only 2 pulse oximeter probes. Of the internal surfaces of pulse oximeter probes, 6 (18%; 95% CI 0.07 - 0.35) remained contaminated post decontamination, with a microorganism growth reduction of 80% (p=0.0001). Conclusion. The internal surfaces of pulse oximeter probes may serve as hot spots for an array of pathogens with the potential to cause infection and outbreaks in ICUs. Decontamination of the internal surfaces of pulse oximeter probes should be emphasised

Nurses' Accuracy in Estimating Backrest Elevation

Background. The Centers for Disease Control and Prevention (CDC) have recommended that the head of the bed of mechanically ventilated patients be elevated to between 30o and 45o to decrease the risk of ventilator associated pneumonia (VAP) Compliance with this recommendation may be affected by nurses' knowledge of the recommendation and their accuracy in estimating the backrest elevation. Objectives. To determine the difference between nurses' estimation of backrest angle and the actual measured angle; to determine the relationship between nurses' demographic characteristics and the accuracy of estimation; to determine nurses' knowledge of why this recommendation has been made. Methods. A convenience sample of 39 nurses working in the selected ICUs of the study hospital was used. The angles of elevation were preselected in each area. Estimated angles were correlated with measured angles and this was correlated with demographic characteristics. Results. Forty-two per cent of the nurses were accurate in their estimation of bedrest angle (correlation 0.6232). Demographic characteristics had little effect on accuracy. Conclusion. Nurses could benefit from assistance in accurately estimating backrest elevation angle; as well as from education regarding strategies to decrease the incidence of ventilator-associated pneumonia