Date of Publication
Stuart Whitney, EdD, RN, CNL, Amanda Young, BSN, RN
Purpose Electrocardiograms (EKGs) are a frequently performed test in the emergency department (ED). Despite an increased awareness of infection prevention, there is currently no standard policy on the routine cleaning of EKG machines at The University of Vermont Medical Center (UVMMC). The purpose of this project was to: 1) establish baseline data on type and amount of bacterial presence on EKG machines, and compliance with cleaning of machines between use, 2) Determine if feedback to staff on their compliance of cleaning EKGs after each use alters practice, 3) Establish an Emergency Medicine policy for the cleaning of medical equipment, and 4) Implement a sustainable change to the daily practice in the Emergency Department that will improve the quality of care patients receive.
Methods EKG machines in the emergency department were swabbed to determine presence of bacteria. A cleaning campaign was initiated within the emergency department to promote and encourage the cleaning of EKG machines after each patient use. The photographs of the plates were laminated and placed in a central location in the ED, where they could be reviewed by clinical staff. An e-mail was sent to all ED staff reminding them that the machines should be cleaned after each use, with a copy of the agar plate images attached. The same content was brought up in each of the daily huddles across a two-week period, as well as included in the ED newsletter. In addition to this, brightly colored signs were placed on each of the machines to serve as a reminder.
Results The initial swabs from the EKG machines showed high levels of bacteria, with an overall decrease in bacterial presence after the cleaning campaign was initiated.
Conclusions Findings indicate that bacterial presence decreased following the cleaning campaign, however there are limitations to these findings. The bacterial type was not able to be determined, making the environmental swabs of the EKG machines indeterminate. Future work is needed to determine bacterial type in order to establish more reliable results. A measure of baseline compliance with cleaning EKG machines after each use would be helpful to allow for a comparison with post intervention results in order to determine causation versus simply correlation.
Keywords. EKG Machines, Infection Prevention, Emergency Department, Cleaning Protocol
Bidad, Roz N., "Reduction of Risk from Bacterial Transmission in the Emergency Department through Implementation of Standardized EKG machine cleaning protocols: An Evidence-Based Approach." (2019). College of Nursing and Health Sciences Clinical Nurse Leader (CNL) Project Publications. 1.