Mobile phone usage in the clinical setting: Evidence-based guidelines for all users is urgently required

Abstract

We commend the recent article1Tekerekoglu M.S. Duman Y. Serindag A. Cuglan S.S. Kaysadu H. Tunc E. et al.Do mobile phones of patients, companions and visitors carry multidrug-resistant hospital pathogens?.Am J Infect Control. 2011; 39: 379-381Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar that adds to the compelling body of evidence that suggests mobile phones as communication devices in the clinical environment are popular and regularly utilized by patients and health care workers.It is concerning that these devices have been found to harbor such a variety of multidrug-resistant pathogens.1Tekerekoglu M.S. Duman Y. Serindag A. Cuglan S.S. Kaysadu H. Tunc E. et al.Do mobile phones of patients, companions and visitors carry multidrug-resistant hospital pathogens?.Am J Infect Control. 2011; 39: 379-381Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar, 2Brady R.R. Hunt A.C. Visvanathan A. Rodrigues M.A. Graham C. Rae C. et al.Mobile phone technology and hospitalized patients: a cross-sectional surveillance study of bacterial colonization, and patient opinions and behaviours.Clin Microbiol Infect. 2011; 17: 830-835Crossref PubMed Scopus (67) Google Scholar In particular, there are associations between patient nasal colonization and patient mobile phone contamination by multidrug-resistant bacteria2Brady R.R. Hunt A.C. Visvanathan A. Rodrigues M.A. Graham C. Rae C. et al.Mobile phone technology and hospitalized patients: a cross-sectional surveillance study of bacterial colonization, and patient opinions and behaviours.Clin Microbiol Infect. 2011; 17: 830-835Crossref PubMed Scopus (67) Google Scholar and between mobile phone contamination and hand contamination, suggesting cross contamination.3Khivsara A. Sushma T.V. Dahashree B. Typing of Staphylococcus aureus from mobile phones and clinical samples.Curr Sci. 2006; 90: 910-912Google ScholarMobile phone decontamination to reduce the risk of cross contamination has been widely advocated.4Brady R.R. Verran J. Damani N.N. Gibb A.P. Review of mobile communication devices as potential reservoirs of nosocomial pathogens.J Hosp Infect. 2009; 71: 295-300Abstract Full Text Full Text PDF PubMed Scopus (167) Google Scholar However, the authors’ recommendation of ultraviolet irradiation in this context currently has an insufficient evidence base.4Brady R.R. Verran J. Damani N.N. Gibb A.P. Review of mobile communication devices as potential reservoirs of nosocomial pathogens.J Hosp Infect. 2009; 71: 295-300Abstract Full Text Full Text PDF PubMed Scopus (167) Google Scholar In contrast, decolonization with 70% isopropyl alcohol is simple, cheap, and induces a proven significant reduction of bioburden in most reported studies.4Brady R.R. Verran J. Damani N.N. Gibb A.P. Review of mobile communication devices as potential reservoirs of nosocomial pathogens.J Hosp Infect. 2009; 71: 295-300Abstract Full Text Full Text PDF PubMed Scopus (167) Google ScholarThe higher rate of pathogens on patients’ mobile phones1Tekerekoglu M.S. Duman Y. Serindag A. Cuglan S.S. Kaysadu H. Tunc E. et al.Do mobile phones of patients, companions and visitors carry multidrug-resistant hospital pathogens?.Am J Infect Control. 2011; 39: 379-381Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar perhaps indicates inadequate patient education regarding disinfection. Indeed, whereas over 70% of patients questioned were aware of the potential colonization of their phones with pathogenic bacteria, only 50.9% had ever cleaned their phones.2Brady R.R. Hunt A.C. Visvanathan A. Rodrigues M.A. Graham C. Rae C. et al.Mobile phone technology and hospitalized patients: a cross-sectional surveillance study of bacterial colonization, and patient opinions and behaviours.Clin Microbiol Infect. 2011; 17: 830-835Crossref PubMed Scopus (67) Google Scholar The efficacy of such decontamination is also questionable. The importance of immediate and adequate staff and patient education on hand hygiene and device cleaning should not be underestimated in its potential to reduce the risk of transmission of bacteria from such devices.2Brady R.R. Hunt A.C. Visvanathan A. Rodrigues M.A. Graham C. Rae C. et al.Mobile phone technology and hospitalized patients: a cross-sectional surveillance study of bacterial colonization, and patient opinions and behaviours.Clin Microbiol Infect. 2011; 17: 830-835Crossref PubMed Scopus (67) Google ScholarRestriction on the use of mobile phones in the clinical environment is unlikely to be practical. Over 90% of patients support the use of mobile phones, and, indeed, 24.5% of patients have stated that the ability to use mobile phones in hospital was vital.2Brady R.R. Hunt A.C. Visvanathan A. Rodrigues M.A. Graham C. Rae C. et al.Mobile phone technology and hospitalized patients: a cross-sectional surveillance study of bacterial colonization, and patient opinions and behaviours.Clin Microbiol Infect. 2011; 17: 830-835Crossref PubMed Scopus (67) Google Scholar A major reason for such popularity is the role mobile phone technology plays in the prevention of patient isolation,5Ammenwerth E. Buchauer A. Bludau B. Haux R. Mobile information and communication tools in the hospital.Int J Med Inform. 2000; 57: 21-40Abstract Full Text Full Text PDF PubMed Scopus (153) Google Scholar among their other diverse potential applications such as improving communication, facilitating information transfer, and impacting on almost all areas of clinical care delivery.4Brady R.R. Verran J. Damani N.N. Gibb A.P. Review of mobile communication devices as potential reservoirs of nosocomial pathogens.J Hosp Infect. 2009; 71: 295-300Abstract Full Text Full Text PDF PubMed Scopus (167) Google Scholar Therefore, we think that, whereas mobile phones are an efficient, common, and popular means of communication, all users in the clinical environment urgently require clear evidence-based guidelines to avoid potential pitfalls. We commend the recent article1Tekerekoglu M.S. Duman Y. Serindag A. Cuglan S.S. Kaysadu H. Tunc E. et al.Do mobile phones of patients, companions and visitors carry multidrug-resistant hospital pathogens?.Am J Infect Control. 2011; 39: 379-381Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar that adds to the compelling body of evidence that suggests mobile phones as communication devices in the clinical environment are popular and regularly utilized by patients and health care workers. It is concerning that these devices have been found to harbor such a variety of multidrug-resistant pathogens.1Tekerekoglu M.S. Duman Y. Serindag A. Cuglan S.S. Kaysadu H. Tunc E. et al.Do mobile phones of patients, companions and visitors carry multidrug-resistant hospital pathogens?.Am J Infect Control. 2011; 39: 379-381Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar, 2Brady R.R. Hunt A.C. Visvanathan A. Rodrigues M.A. Graham C. Rae C. et al.Mobile phone technology and hospitalized patients: a cross-sectional surveillance study of bacterial colonization, and patient opinions and behaviours.Clin Microbiol Infect. 2011; 17: 830-835Crossref PubMed Scopus (67) Google Scholar In particular, there are associations between patient nasal colonization and patient mobile phone contamination by multidrug-resistant bacteria2Brady R.R. Hunt A.C. Visvanathan A. Rodrigues M.A. Graham C. Rae C. et al.Mobile phone technology and hospitalized patients: a cross-sectional surveillance study of bacterial colonization, and patient opinions and behaviours.Clin Microbiol Infect. 2011; 17: 830-835Crossref PubMed Scopus (67) Google Scholar and between mobile phone contamination and hand contamination, suggesting cross contamination.3Khivsara A. Sushma T.V. Dahashree B. Typing of Staphylococcus aureus from mobile phones and clinical samples.Curr Sci. 2006; 90: 910-912Google Scholar Mobile phone decontamination to reduce the risk of cross contamination has been widely advocated.4Brady R.R. Verran J. Damani N.N. Gibb A.P. Review of mobile communication devices as potential reservoirs of nosocomial pathogens.J Hosp Infect. 2009; 71: 295-300Abstract Full Text Full Text PDF PubMed Scopus (167) Google Scholar However, the authors’ recommendation of ultraviolet irradiation in this context currently has an insufficient evidence base.4Brady R.R. Verran J. Damani N.N. Gibb A.P. Review of mobile communication devices as potential reservoirs of nosocomial pathogens.J Hosp Infect. 2009; 71: 295-300Abstract Full Text Full Text PDF PubMed Scopus (167) Google Scholar In contrast, decolonization with 70% isopropyl alcohol is simple, cheap, and induces a proven significant reduction of bioburden in most reported studies.4Brady R.R. Verran J. Damani N.N. Gibb A.P. Review of mobile communication devices as potential reservoirs of nosocomial pathogens.J Hosp Infect. 2009; 71: 295-300Abstract Full Text Full Text PDF PubMed Scopus (167) Google Scholar The higher rate of pathogens on patients’ mobile phones1Tekerekoglu M.S. Duman Y. Serindag A. Cuglan S.S. Kaysadu H. Tunc E. et al.Do mobile phones of patients, companions and visitors carry multidrug-resistant hospital pathogens?.Am J Infect Control. 2011; 39: 379-381Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar perhaps indicates inadequate patient education regarding disinfection. Indeed, whereas over 70% of patients questioned were aware of the potential colonization of their phones with pathogenic bacteria, only 50.9% had ever cleaned their phones.2Brady R.R. Hunt A.C. Visvanathan A. Rodrigues M.A. Graham C. Rae C. et al.Mobile phone technology and hospitalized patients: a cross-sectional surveillance study of bacterial colonization, and patient opinions and behaviours.Clin Microbiol Infect. 2011; 17: 830-835Crossref PubMed Scopus (67) Google Scholar The efficacy of such decontamination is also questionable. The importance of immediate and adequate staff and patient education on hand hygiene and device cleaning should not be underestimated in its potential to reduce the risk of transmission of bacteria from such devices.2Brady R.R. Hunt A.C. Visvanathan A. Rodrigues M.A. Graham C. Rae C. et al.Mobile phone technology and hospitalized patients: a cross-sectional surveillance study of bacterial colonization, and patient opinions and behaviours.Clin Microbiol Infect. 2011; 17: 830-835Crossref PubMed Scopus (67) Google Scholar Restriction on the use of mobile phones in the clinical environment is unlikely to be practical. Over 90% of patients support the use of mobile phones, and, indeed, 24.5% of patients have stated that the ability to use mobile phones in hospital was vital.2Brady R.R. Hunt A.C. Visvanathan A. Rodrigues M.A. Graham C. Rae C. et al.Mobile phone technology and hospitalized patients: a cross-sectional surveillance study of bacterial colonization, and patient opinions and behaviours.Clin Microbiol Infect. 2011; 17: 830-835Crossref PubMed Scopus (67) Google Scholar A major reason for such popularity is the role mobile phone technology plays in the prevention of patient isolation,5Ammenwerth E. Buchauer A. Bludau B. Haux R. Mobile information and communication tools in the hospital.Int J Med Inform. 2000; 57: 21-40Abstract Full Text Full Text PDF PubMed Scopus (153) Google Scholar among their other diverse potential applications such as improving communication, facilitating information transfer, and impacting on almost all areas of clinical care delivery.4Brady R.R. Verran J. Damani N.N. Gibb A.P. Review of mobile communication devices as potential reservoirs of nosocomial pathogens.J Hosp Infect. 2009; 71: 295-300Abstract Full Text Full Text PDF PubMed Scopus (167) Google Scholar Therefore, we think that, whereas mobile phones are an efficient, common, and popular means of communication, all users in the clinical environment urgently require clear evidence-based guidelines to avoid potential pitfalls. Do mobile phones of patients, companions and visitors carry multidrug-resistant hospital pathogens?American Journal of Infection ControlVol. 39Issue 5PreviewA cross-sectional study was conducted to determine bacterial colonization on the mobile phones (MPs) used by patients, patients' companions, visitors, and health care workers (HCWs). Significantly higher rates of pathogens (39.6% vs 20.6%, respectively; P = .02) were found in MPs of patients' (n = 48) versus the HCWs' (n = 12). There were also more multidrug pathogens in the patents' MPs including methicillin-resistant Staphylococcus aureus, extended-spectrum β-lactamase-producing Escherichia coli, and Klebsiella spp, high-level aminoglycoside-resistant Enterococcus spp, and carabepenem-resistant Acinetobacter baumanii. Full-Text PDF