Article
Over the past 25 years, use of computers in healthcare faculties has increased dramatically. With the introduction of computers (keyboards, mice and touch screens) into increasing numbers of patient care areas have come reports of computer hardware serving as reservoirs of potentially infectious agents, such as staphylococci, Clostridium difficile, enterococci and coliforms.
There is concern that contact with contaminated computer keyboards might serve as a mechanism for contaminating the hands of healthcare workers with potential pathogens. The degree of contamination observed appears high enough potentially to allow transmission via contaminated hands. Up to 25% of keyboards in hospital wards have MRSA contamination independent of their design.
Reports linking healthcare-associated infections with use of contaminated computer equipment began in 1995. In several cases, identical contaminants were present on workplace keyboards, on the hands of a healthcare worker and on the keyboard at a worker's home. This places patients, workers and worker families at risk.
Clinicians often use computers without first washing their hands. After patient contact, and again not performing proper hand hygiene, they use the same computer another time and/or move on to use additional keyboards. Significant reductions in the risk of cross-transmission associated with contaminated keyboards and mice could occur if clinicians performed proper hand hygiene after contacting inanimate objects (fomites) in patient care areas. Unfortunately, numerous studies report traditionally low compliance (approximately 40–45%) by healthcare workers concerning hand hygiene.
There have been improvements in keyboard and mouse design. Today, there are waterproof keyboards and mice, easily washed with soap and water, or ones that can undergo disinfection. Some are dishwasher safe. Other products have antimicrobial agents incorporated into their surfaces. There is also a variety of surface covers, some single use, while others can undergo cleaning and disinfection. One new product is a silicon cover sheet, which can be removed, cleaned and autoclaved.
There have been studies performed using UV light to treat computer keyboards and mice. Most reports came from in vitro research. Use of UV light in clinical situations as a surface disinfectant is an emerging technology.
Currently, the most commonly used process to reduce contamination is surface disinfection. The goal is to be effective, yet not to affect function or damage surface lettering. Studies indicate that a variety of disinfectants meet this goal; however, cleaning and disinfection must be frequent activities, possibly even daily.
Improvement will likely require application of several factors – improved hand hygiene (eg before and after keyboard contact), effective cleaning and disinfection and employment of peripherals with special characteristics, such as being waterproof (washable), having continuous surfaces (fully sealed) or with antimicrobial surfaces.
The highest risk keyboards are those shared in clinical areas; however, improved hand hygiene and frequent surface disinfection in non-health settings, such as the home, is also needed.