A MICROBIOLOGICAL ASSAY OF COMMON OPERATING ROOM TAPES: DEVELOPING A CULTURE FOR PATIENT SAFETY

Document Type

Conference Proceeding

Publication Date

5-1-2019

Publication Title

Anesthesia and Analgesi

Abstract

BACKGROUND: A medical adhesive tape is a ubiquitous and essential piece of equipment that is used in almost all of the patients admitted to the hospital. As a medical equipment, adhesive tapes are unique as it is almost never washed or sterilized after the initial opening of the package.While we would hope and expect that grossly contaminated rolls of tape would be discarded, but there are no existing practices or methods to ensure cleanliness, sterility, or prevent cross-contamination. The authors hypothesized that a roll of tape may become colonized by organisms, increasing the risk of METHODS: Research Design: Prospective Observational study Research Setting: Urban Tertiary Care center Study Population - Research was conducted on OR Tapes Primary Objective: Investigate the rates of contamination for common adhesive tapes used in OR and other locations of the adhesive tape obtained in a large hospital. Study Groups: Group I - Culture of 50 tapes collected from OR, various locations outside OR, Anesthesia carts, ETC.. (ACTIVE TEST SPECIMEN) Group II - Culture of 20 random tapes collected from unopened boxes in the storage unit for OR tapes (negative control) The tape handling and all rolls were meticulously handled through the central hole using sterile gloves and placed in a sterile, unopened biohazard bag. Two investigators collected and labelled the specimen while the third investigator closely observed and made sure that all sterile precautions were followed. Upon specimen collection the bags were immediately transported to the microbiology lab to be processed. After the initial exercise of sample collection and reporting the investigators initiated the quality improvement initiative. Quality Improvement Intervention: Goal was to investigate if the tapes handled in sterile fashion from storage unit, to be used on the patient, and then discarded after each case (single use tape), will continue to report high contamination rates. To achieve this objective, the tapes were collected from unopened boxes in storage unit, in sterile fashion, and placed in a biohazard bag. The bag was sealed and placed in the OR, to be used by an anesthesia provider to secure ET tubes, IV lines and nasogastric tubes using sterile gloves. The sample was taken from the tape securing the endotracheal tube, using sterile precautions, and were transported to the microbiology lab to be processed. The tapes were single use and discarded after the case finished. We again cultured 18 tapes using this exercise. RESULTS: The negative control group in which the tapes were removed from unopened boxes in the Anesthesia stock room reported no growth in all 20 specimens (10 Durapore and 10 Transpore specimens). As compared to the negative control the OR tapes had significant growth of microbes (p value < 0.0001).There was poly-microbial growth on almost all of the active tape specimens. The most cultures positive, from tapes collected from OR, were for Streptococcus Mitis. The cultures from off-site locations which are situated outside the main OR complex reported Streptococcus Mitis, Staphylococcus epidermidis, Staphylococcus Aureus in interventional radiology suites. The tapes collected from all the procedure suites of Gastroenterology endoscopy floor were contaminated with cultures reporting Staphylococcus epidermidis, Staphylococcus Warnerii and Streptococcus Mitis. The tapes collected as a part of quality initiative failed to report any growth. CONCLUSIONS: The authors conclude that the current practices of handling the OR tapes, leads to a significant contamination of these tapes. The OR tapes servers vector of transmission and contamination among various OR and have the potential to promote healthcare associated infections. Future implications: The authors advocate for ET tubes, nasogastric tubes to be packaged with a sterile, single use tape, which can be used to secure the device.

Volume

128

Issue

5

First Page

590

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