Intensive Care Unit Equipment Research Articles

Bacterial Contamination on Electronic Surfaces in ICU

Bacteria, especially MDR isolates, can infect inanimate surfaces and equipment in ICUs (such as bedrails, stethoscopes, medical charts, and ultrasound machines). Transmission of microbes from inanimate surfaces may play a major role in the colonization and infection of patients in intensive care units. Healthcare worker hands and patient discharge both have the potential to spread germs, which can live for months on dry surfaces. It has been reported that the rate of environmental contamination is higher near infected individuals than it is near colonized patients, and that within the latter group, there is a link between the frequency of environmental contamination and culture-positive body locations. In addition to acquiring germs from direct patient contact, healthcare personnel can pick them up through inanimate surfaces and equipment in the patient zone. Patient colonization or infection can occur if healthcare workers don't properly clean their hands before and after handling patients. Several pieces of equipment and frequently used objects in the intensive care unit (ICU) include bacteria with antibiotic susceptibility profiles that are quite similar to those of germs isolated from patients. In light of the patient-zone concept and the potential consequences for bacterial pathogen cross-transmission to critically ill patients, this review aims to present up-to-date knowledge concerning the contamination of inanimate surfaces and equipment in ICUs.

Determinants of Pneumothorax Among Mechanically Ventilated COVID-19 Intensive Care Unit Patients, a Single Centre Study.

Millions of deaths and co-morbidities have been brought on by the COVID-19 epidemic worldwide. Acute respiratory distress syndrome (ARDS), multiple organ failure, and death can result from the condition in some people. The disease's course can range from a moderate upper respiratory tract infection to severe pneumonia. Numerous reports have been made on the occurrence of pneumothorax in COVID-19 ICU patients, particularly in those who are receiving invasive ventilation. This study assesses factors associated with pneumothorax among mechanically ventilated COVID-19 ICU patients in Addis Ababa, Ethiopia. A case-control study design was employed from August 1, 2022, to August 31, 2022, GC, with a sample size of 281, where cases are 94 and controls are 187. A pre-tested structured quantitative tool was used to collect data on ODK and export it to SPSS version 26 for analysis. Descriptive statistics were presented using text and tables. The association between variables was analyzed with binary logistic regression. A statistical significance was declared at a p-value of 0.05 with a 95% confidence interval. Assumptions like model fitness and multicollinearity were checked to be satisfied. A total of 281 (94 cases and 187 controls) patient charts were carefully reviewed. After adjustment for possible confounders in multivariate analysis, ARDS (AOR = 0.214, 95% CI (0.088, 0.519), P value =0.001) and invasive ventilation (AOR = 0.311, 95% CI (0.121, 0.796), P value =0.015) had a significant association with pneumothorax. Despite the introduction of preventive breathing methods, pneumothorax is still a frequent and deadly consequence in COVID-19 patients with ARDS. ARDS and invasive mechanical ventilation were found to be significantly associated with the development of pneumothorax. Health facilities should be well equipped with recent medical equipment in intensive care units and with well-trained and organized manpower.

Comparative Assessment of Detecting Bacterial Populations on the Surface of Medical Equipment in ICU by Standard Microbial Culture and Nanosensor

Background: A healthy, clean, and secure environment is necessary for the hospital, one of the fundamental foundations of the nation’s healthcare system, to function well and sustain the general well-being of society. Timely detection of contaminated surfaces and efficient and timely disinfection will be helpful in hospital infection control.
 Objectives: The level of surface contamination of medical equipment in intensive care units was to be determined and compared as part of this research.
 Methods: Using standard microbial culture and nanosensors, the current study was conducted descriptively over one month, with a sample size of 400 cases on ten different types of medical equipment.
 Results: The findings showed that 66% of samples acquired using the nanosensor and 54.5% obtained using the culture medium were clean, and the rest were contaminated. The most prevalent microbes were also identified as E. coli, Staphylococcus aureus, and salmonella, with 55.68%, 28.9%, and 23.86%, respectively.
 Conclusions: Both methods have the necessary precision to identify contamination reservoirs, and the contamination reported in both methods is similar to what was expected. So nanosensors can be utilized as a quick, precise, and affordable method when the aim is to identify the overall contamination rather than to differentiate between different types of bacteria.

Nurses Knowledge Regarding Personal Protective Equipment in Intensive Care Units at a Public Tertiary Care Public Hospital, Peshawar

PPE is designed to protect Health Care Workers (HCWs) from workplace infections and injuries and the most commonly used equipment including goggles, masks, medical gloves, and respirators. Objective: To determine nurses’ knowledge regarding PPE in intensive care units at a Public Tertiary Care Hospital, in Peshawar, Pakistan. Methods: A cross-sectional study was directed using convenient sampling. A structured questionnaire from the literature was used to collect the data. Responses of the participants as good/Average/Poor were recorded. The data were collected from the Nurses who have five or more than five years of experience in the intensive care units of Hayatabad Medical Complex, a Public sector tertiary care Hospital. Results: The mean age of the participant was evaluated which was 30.09 years with a standard deviation of 7.04 years. The professional experience of the participants was 6.78 years with a standard deviation of 5.85 years. Our study shows that 65.4% had good knowledge or an acceptable knowledge level, 30.9% had average knowledge, and 3.7% of the participants had poor knowledge. Conclusions: The study concluded that most of the participants have good knowledge of Personal Protective equipment but a significant number of participants had average knowledge and some have poor knowledge as well. Therefore, regular sessions should be given to enhance the knowledge level

Developing and Evaluating a Novel Educational Intensive Care Unit Wall Map

Developing and Evaluating a Novel Educational Intensive Care Unit Wall Map

Changes that Intensive Care Unit Should Make in the Post-Epidemic Era

The novel coronavirus (covid-19) pandemic of 2019 poses significant challenges to the healthcare system, some of which will lead to transformative changes. With the fact that covid-19 is currently under control, the post-pandemic era will require appropriate changes in the intensive care unit (ICU) to adapt to the changes in the post-pandemic era, including the need for ICUs to be prepared to accommodate patient surge, prevent shortages of personal protective equipment, ICU equipment, consumables, and medications, and more rational and safe ward planning. Pre-existing training and stockpiling of critical care professionals and training of existing medical and nursing staff in basic operations. Pre-existing ICU triage and remote control have been emphasized and implemented. covid-19 pandemic reminds us that we are committed to improvement beyond the core responsibilities that already exist. By addressing these challenges in advance, we will be able to provide better care for future patients.

Assessment of magnetic flux density properties of electromagnetic noninvasive phrenic nerve stimulations for environmental safety in an ICU environment

Diaphragm weakness affects up to 60% of ventilated patients leading to muscle atrophy, reduction of muscle fiber force via muscle fiber injuries and prolonged weaning from mechanical ventilation. Electromagnetic stimulation of the phrenic nerve can induce contractions of the diaphragm and potentially prevent and treat loss of muscular function. Recommended safety distance of electromagnetic coils is 1 m. The aim of this study was to investigate the magnetic flux density in a typical intensive care unit (ICU) setting. Simulation of magnetic flux density generated by a butterfly coil was performed in a Berlin ICU training center with testing of potential disturbance and heating of medical equipment. Approximate safety distances to surrounding medical ICU equipment were additionally measured in an ICU training center in Bern. Magnetic flux density declined exponentially with advancing distance from the stimulation coil. Above a coil distance of 300 mm with stimulation of 100% power the signal could not be distinguished from the surrounding magnetic background noise. Electromagnetic stimulation of the phrenic nerve for diaphragm contraction in an intensive care unit setting seems to be safe and feasible from a technical point of view with a distance above 300 mm to ICU equipment from the stimulation coil.

Telerobotic Operation of Intensive Care Unit Ventilators.

Since the first reports of a novel coronavirus (SARS-CoV-2) in December 2019, over 33 million people have been infected worldwide and approximately 1 million people worldwide have died from the disease caused by this virus, COVID-19. In the United States alone, there have been approximately 7 million cases and over 200,000 deaths. This outbreak has placed an enormous strain on healthcare systems and workers. Severe cases require hospital care, and 8.5% of patients require mechanical ventilation in an intensive care unit (ICU). One major challenge is the necessity for clinical care personnel to don and doff cumbersome personal protective equipment (PPE) in order to enter an ICU unit to make simple adjustments to ventilator settings. Although future ventilators and other ICU equipment may be controllable remotely through computer networks, the enormous installed base of existing ventilators do not have this capability. This paper reports the development of a simple, low cost telerobotic system that permits adjustment of ventilator settings from outside the ICU. The system consists of a small Cartesian robot capable of operating a ventilator touch screen with camera vision control via a wirelessly connected tablet master device located outside the room. Engineering system tests demonstrated that the open-loop mechanical repeatability of the device was 7.5 mm, and that the average positioning error of the robotic finger under visual servoing control was 5.94 mm. Successful usability tests in a simulated ICU environment were carried out and are reported. In addition to enabling a significant reduction in PPE consumption, the prototype system has been shown in a preliminary evaluation to significantly reduce the total time required for a respiratory therapist to perform typical setting adjustments on a commercial ventilator, including donning and doffing PPE, from 271 to 109 s.

Effectiveness of application of a manual for improvement of alarms management by nurses in Intensive Care Units.

Objective.To evaluate the effects of application of a manual on the improvement of alarms management in Intensive Care Units (ICU).Methods.This quasi-experimental study evaluated the effectiveness of the introduction into of a manual for alarm management and control in the ICU of a hospital in southeastern Iran. The intervention was a 4-hour workshop was on topics related to the adverse effects of alarms, standardization of ECG, oxygen saturation and blood pressure monitoring systems, and the use of ventilators and infusion pumps. Data were collected thorough 200 hours of observation of 60 ICU nurses (100 hours’ pre-intervention and 100 hours’ post-intervention). Response time, type of response, customization of alarm settings for each patient, the person responding to an alarm, and the cause of the alarm were analyzed. Alarms were classified into three types: false, true and technical.Results.The results showed a statistically significant difference between the pre- and post-intervention frequency of alarm types, frequency of monitoring parameters, customized monitoring settings for patients, and individuals who responded to alarms. The percentage of effective interventions was significantly higher for all parameters after the intervention (46.9%) than before the intervention (38.9%).Conclusion.The employment of a manual for management of alarms from electronic equipment in ICUs can increase the frequency of appropriate responses to alarms in these units.

Developing the COVID-19 intensive care medical equipment distribution platform: outcomes and lessons learned

During the first wave of the coronavirus pandemic, the UK government took the decision to centralise the procurement, allocation and distribution of mission-critical intensive care unit (ICU) medical equipment. Establishing...

Anesthesiology and Critical Care Response to COVID-19 in Resource-Limited Settings: Experiences from Nepal.

It is difficult to predict the future course and length of the ongoing COVID-19 pandemic, which has devastated health care systems in low- and middle-income countries. Anesthesiology and critical care services are hard hit because many hospitals have stopped performing elective surgeries, staff and scarce hospital resources have been diverted to manage COVID-19 patients, and several makeshift COVID-19 units had to be set up. Intensive care units are overwhelmed with critically ill patients. In these difficult times, low- and middle-income countries need to improvise, perform indigenous research, adapt international guidelines to suit local needs, and target attainable clinical goals.

Geographic access to COVID-19 healthcare in Brazil using a balanced float catchment area approach.

The rapid spread of COVID-19 across the world has raised concerns about the responsiveness of cities and healthcare systems during pandemics. Recent studies try to model how the number of COVID-19 infections will likely grow and impact the demand for hospitalization services at national and regional levels. However, less attention has been paid to the geographic access to COVID-19 healthcare services and to hospitals’ response capacity at the local level, particularly in urban areas in the Global South. This paper shows how transport accessibility analysis can provide actionable information to help improve healthcare coverage and responsiveness. It analyzes accessibility to COVID-19 healthcare at high spatial resolution in the 20 largest cities of Brazil. Using network-distance metrics, we estimate the vulnerable population living in areas with poor access to healthcare facilities that could either screen or hospitalize COVID-19 patients. We then use a new balanced floating catchment area (BFCA) indicator to estimate spatial, income, and racial inequalities in access to hospitals with intensive care unit (ICU) beds and mechanical ventilators while taking into account congestion effects. Based on this analysis, we identify substantial social and spatial inequalities in access to health services during the pandemic. The availability of ICU equipment varies considerably between cities, and it is substantially lower among black and poor communities. The study maps territorial inequalities in healthcare access and reflects on different policy lessons that can be learned for other countries based on the Brazilian case.

Critical care for severe coronavirus disease 2019: a population-based study from a province with low case-fatality rate in China.

Critical care for severe coronavirus disease 2019: a population-based study from a province with low case-fatality rate in China.

Study on present status of ICU in county-level general hospitals of Henan Province

To investigate the present status of intensive care unit (ICU) in the county-level general hospitals of Henan Province and provide basis for improving the construction level and rational allocation of medical resources of ICU. According to The guidelines for the construction and management of critical care medicine (trial implementation) issued by National Health Commission (NHC) (hereinafter referred as the guidelines), a cross-sectional survey was conducted on the present status of ICU in 93 county-level general hospitals in Henan Province in 2018 by using a self-designed questionnaire concerning this topic. The survey included the basic information of ICU (establishment time, organization and management mode, development of special departments in ICU, construction of key disciplines), scale and staffing allocation and training, and the equipment and technology development situation in ICU. The basic aspects of ICU situation were as follows: firstly, the establishment time: the ICU of county-level general hospitals in Henan Province started relatively late. The survey showed that all the 93 hospitals had set up ICU, of which the earliest was the ICU of Xunxian People's Hospital in 1989, only 4 county-level general hospitals established their ICUs before 2000, and 34 before 2009. Secondly, the management mode: the proportion of ICU closely managed was accounting for 68.82% (64/93), while semi-open management was 18.28% (17/93), and 12.90% (12/93) hospitals still adopted the open management mode. Thirdly, development of specialized ICU and construction of key disciplines: comprehensive ICUs were founded in 86 hospitals, and the proportions of specialized ICUs such as neonatal ICU, emergency ICU and coronary heart disease care unit (CCU) were higher than other kinds of special department; the ICUs of 8 hospitals were the key discipline of Henan Provincial Health Commission, and the ICUs of 9 hospitals were the discipline of Municipal Health Commission. Scale and staffing of ICU: a total of 2 189 ICU beds were opened in 93 county-level general hospitals. The utilization rate reaching the targets of ICU beds and the compliance rate of ICU bed area per bed were relatively high, 76.34% and 80.64%, while the compliance rates of ICU doctors/ICU beds, ICU nurses/ICU beds were low, which were 8.60% and 7.52% respectively, indicating that the clinicians and nursing facilities were insufficient. There were 1 tertiary hospital, 76 secondary-A hospitals and 16 secondary-B hospitals in this survey. Compared with secondary-B hospitals in the total number of beds (sheets: 922.22±285.99 vs. 636.75±258.84) and ICU beds (sheets: 25.28±21.15 vs. 14.63±6.89), the secondary-A hospitals were significantly higher (all P < 0.01), and the rate of bed use compliance of secondary-A hospitals was significantly higher than that in secondary-B hospitals [81.6% (62/76) vs. 50.0% (8/16), P < 0.01]. In terms of staffing, the proportion of clinicians and nurses with elementary titles was the highest, the proportion of full-time senior professional titles was relatively low, the proportion of doctors with bachelor's degree was the highest, and that of nurses with junior college degree was the highest. In personnel training, the hospitals surveyed had sent the doctors and nurses mostly to participate in the continuing education and training of critical care medicine at or above the provincial level for 745 person-times and 1 156 person-times, and there were in the mean for 8 and 12 person-times in each hospital, respectively. In terms of equipment configuration and technology development of ICU, mostly the equipment in ICU of county-level general hospitals consisted of microinjection pump, monitor, infusion pump, invasive ventilator, expectorant machine, etc. but the overall equipment was insufficient. Although an extracorporeal membrane oxygenation (ECMO) equipment was introduced in one hospital, it had not been carried out clinically. All county-level general hospitals in Henan Province had set up ICUs, but there were gaps between the compliance rates of many indicators and the requirements of the guidelines, and the medical personnel and equipment were relatively insufficient. The ICUs of county-level general hospitals in Henan Province have developed rapidly in recent years, but there is still much room for improvement.

Availability of Emergency Drugs and Essential Equipment in Intensive Care Units in Hospitals of Ethiopia: A Multicenter Cross-Sectional Study.

PurposeEmergency drugs and essential equipment are important to successfully manage patients in the intensive care unit (ICUs). The absence of these emergency drugs and essential equipment might result in mortality and morbidity which is more compounded in resource-limited settings. This study aims to assess the availability of emergency drugs and essential equipment in ICUs in hospitals in Ethiopia.Materials and MethodsA cross-sectional descriptive study design was employed in the intensive care unit of nine Amhara regional state hospitals in Ethiopia. This study was done from August 01, 2020, to September 01, 2020. The data were collected using a structured questionnaire, which were adopted from the Emergency Medicine Society of South Africa (EMSSA) guidelines. Tables and narration were used to describe results.ResultsThere were deficiencies of essential emergency items particularly in the pediatrics domain, devices to confirm tracheal intubation and equipment for managing difficult intubation. Emergency drugs like adrenaline, salbutamol puff, atropine, aspirin, furosemide, hydrocortisone, insulin, lidocaine, and medical oxygen were available in all ICUs, whereas amiodarone, sodium bicarbonate, glucagon, ipratropium nebulization, thiamine were not available in all ICUs.Conclusions and RecommendationsThere were considerable deficiencies in emergency drugs and essential equipment. Based on our findings, we recommend to develop standardized checklists, regular audits, and healthcare personnel awareness program to improve checking, maintaining, restocking, and repairing the equipment in the emergency trolley.

Investigation and analysis of the development status of critical care medicine in Xinjiang Uygur Autonomous Region in 2019

To comprehensively understand the basic construction of intensive care unit (ICU) in the secondary and tertiary hospitals in Xinjiang Uygur Autonomous Region, and to provide a theoretical basis for the development direction of critical care medicine and the rational allocation of medical resources in our region. On the March 14th, 2020, a cross-sectional survey of 147 ICU in 122 hospitals in Xinjiang Uygur Autonomous Region was conducted using an online questionnaire. The survey included 6 modules: the basic conditions of the hospital, ICU profile, ICU human resources status, equipment allocation, technology development, and ICU quality control. Among the 147 ICUs, there were 69 ICUs in tertiary hospital and 78 ICUs in secondary hospital. 75.51% (111/147) were comprehensive ICU and 24.49% (36/147) were specialized ICU. The total number of ICU beds was 1 818, accounted about 2.43% (1 818/74 912) of the total number of hospital beds. In ICU terms of human resourse, physicians/beds ratio was 0.54:1, and nurses/beds ratio was 1.55:1. Physicians/beds ratio in the secondary hospitals was 0.52:1, and nurses/beds was 1.45:1; physicians/beds ratio in the tertiary hospital was 0.56:1, and nurses/beds ratio was 1.79:1. The ICU management model was mainly closed management (82.99%, 122/147), and the proportion of closed management in tertiary hospitals was 88.41% (61/69), which was higher than that in secondary hospitals (78.21%, 61/78). In aspect of ICU equipment, the invasive ventilator/bed ratio, enteral nutrition infusion pump/bed ratio, and blood purifier/bed ratio in the tertiary hospitals were significantly higher than those in the secondary hospitals [0.70 (0.46, 1.00) vs. 0.45 (0.33, 0.67), 0.18 (0.00, 0.56) vs. 0.00 (0.00, 0.13), 0.08 (0.00, 0.13) vs. 0.00 (0.00, 0.10), respectively, all P < 0.01]. In the tertiary hospital, the chest sputum excretion device, blood gas analyzer, blood purification instrument, transport ventilator, fiber bronchoscope, enteral nutrition infusion pump, bedside ultrasound machine, continuous hemodynamics and oxygen metabolism monitor, electroencephalogram bispectral index monitor, bedside electroencephalography machine and extracorporeal membrane oxygenation (ECMO) were also superior to the secondary hospitals. ICU technologies, such as deep venipuncture, jejunal nutrition tube placement, percutaneous tracheotomy, invasive blood pressure monitoring, invasive hemodynamic monitoring, bedside ultrasound examination, continuous blood purification, fiber bronchoscopy, high frequency ventilation, intra-aortic balloon counterpulsation (IABP), and ECMO had also performed better than secondary hospitals. In the management of ICU medical quality control, in tertiary hospitals, the proportions of single or isolated room for patients with drug-resistant bacteria, 1-hour bundle and hemodynamic monitoring for patients with septic shock, routine prone position ventilation and lung recruitment for patients with acute respiratory distress syndrome (ARDS), common analgesic, and use of personal digital assistant (PDA) for pre-operation scan code by nurses and electronic medical record for routine rounds were significantly higher than those in secondary hospitals (91.30% vs. 85.90%, 68.12% vs. 48.72%, 85.51% vs. 70.51%, 28.99% vs. 12.82%, 85.51% vs. 61.54%, 76.81% vs. 61.54%, 71.01% vs. 29.49, 49.28% vs. 28.21%, respectively), and the differences were statistically significant (all P < 0.05). 89.74% (70/78) ICU in secondary hospitals and 89.86% (62/69) of tertiary hospitals used acute physiology and chronic health evaluation II (APACHE II) to evaluate the severity of critically ill patients; in terms of sequential organ failure assessment (SOFA), the difference between the secondary hospitals and the tertiary hospitals was not statistically significant (51.28% vs. 62.32%, χ2 = 1.814, P = 0.178). Although the ICU construction of the tertiary hospitals in Xinjiang Uygur Autonomous Region is more complete than secondary hospitals, there is a big gap between the requirements of the national guidelines and the developed regions in the east. The ICU's investment in human resource, equipment and supporting facilities allocation, promotion of suitable technology, and medical quality control management should be increased to promote the development of critical care medicine in Xinjiang Uygur Autonomous Region.

Nurses' perception on technology advancement in intensive care

BACKGROUND: Fast changing technology applications in intensive care units (ICUs) are believed to enhance the result of nursing care. We expect the nurses to work with constantly updated technology and presume that they are receptive to any revised version of medical devices. The nurse's perception on technology is infrequently discussed in hospitals or among medical device manufacturers.AIMS: The aim of this study was to assess the nurses' perception about the advancement of technology in ICUs.SETTINGS: The study was conducted among the nurses working in different ICUs in a selected tertiary care hospital in Bengaluru, India.MATERIALS AND METHODS: An exploratory study was done using a hybrid method of qualitative and quantitative techniques. Semi-structured interviews were conducted with nurses having ≥5 years of experience in ICUs, and thematic analysis was applied. Quantitative data were collected from the population of nurses with 1 year or more experience using survey questionnaire.STATISTIACAL ANALYSIS USED: ANOVA test and sample t-test were conducted on the applicable parameter.RESULTS: Most of the nurses found that high-tech equipment in ICUs is easy to operate, reduce their effort, prevent errors, and increase the comfort of the patient. The study found that nurses' perception about the advancement of technology does not vary according to age, experience, qualification, and whether they have attended any continued nursing education on technology applications. Statistically significant relationship was found between total perception and the nature of ICU in which the nurses work.CONCLUSIONS: The study found that nurses perceive advanced technology in ICU as beneficial. Nurses expressed their satisfaction about the advancement of technology, and they perceive it as a good learning opportunity for them. The participants expressed their need for more training when equipment with advanced technology or a revised version is brought in.

The Management of Electro-Medical Equipment in Intensive Care Units: Assurance of Traceability and Metrological Reliability

Physiological measurements in the health sector have been supported by the rapid evolution of medical equipment technologies. The health sector increasingly requires the development of mechanisms and applications that assure the metrological reliability of the results obtained using the equipment for the diagnosis, treatment, and monitoring of the clinical evolution of patients. This study demonstrates the weaknesses in the control of metrological parameters related to electro-medical equipment (EMS) in Brazil, specifically those used in Intensive Care Units (ICU), where reliability is critical in terms of survival, sequelae or death. We discuss essential determinants to ensure physiological measurements, such as the limitations of legislation/standards, laboratory infrastructure, voluntary accreditations, including a brief history and indicators of patient safety in Brazil and the United States of America, as well as data from research at Hospital Units (HUs) located in Salvador, Bahia, Brazil.

Microbial contamination of keyboards and electronic equipment of ICU (Intensive Care Units) in Kashan University of medical sciences and health service hospitals

Microbial contamination of computer keyboards and inanimate surfaces of electronic equipment in ICU (Intensive Care Units) can have a significant role for ICU-acquired colonization and a spectrum of nosocomial infections. The aim of this study was to survey the incidence of bacterial contamination and the distribution of species of computer keyboards and inanimate surfaces of bed side equipment in ICUs in Kashan University of medical sciences and health service hospitals. This descriptive, cross-sectional study was done on 75 computer keyboards and inanimate surfaces electronic equipment in 5 ICUs during 2016–2017. Samples were collected from computer keyboards and electronic equipment with normal saline rinsed swabs. Samples were Cultivated on Blood Agar (BA), and MacConkey Agar (MAC) and growing bacteria were identified based on their morphology and biochemical properties. Seventy six (76%) out of 75 computer Keyboards and electronic equipment were contaminated with bacteria and fungi. The most contamination pertained to gram positive bacteria (70.7%) and the most isolated bacteria were coagulase-negative staphylococci. The highest contamination rates were found on computer keyboards and electronic equipment of which were nurses.•This study demonstrates that monitoring inanimate surfaces and considering these surfaces as source of nosocomial infections is necessary.•In total, Seventy six (76%) out of 75 computer keyboards and electronic equipment in ICUs had positive culture.•It can be concluded that it is necessary for ICUs of Kashan university of medical sciences and Health service hospitals to have practical and regular program to reduce nosocomial infections.

Early mobilisation practices of patients in intensive care units in Zimbabwean government hospitals – a crosssectional study

Background. Recent evidence shows that early mobilisation of patients in an intensive care unit (ICU) is feasible, safe and associated with improvement in patients’ clinical outcomes. However, its successful implementation is dependent on several factors, which include ICU structure and organisational practices. Objectives. To evaluate the structure and organisational practices of Zimbabwean government hospital ICUs and to describe early mobilisation practices of adult patients in these units. Methods. A cross-sectional survey was conducted in all government hospitals in Zimbabwe. Data collected included hospital and ICU structure, adult patient demographic data and mobilisation activities performed in the ICU during the 24 hours prior to the day of the survey. Results. A total of five quaternary level hospitals were surveyed, with each hospital having one adult ICU. Four of the units were open-type ICUs. The majority of the units ( n =3; 60%) reported that they had a permanent physiotherapist who covered their unit, but none of the physiotherapists worked solely in the ICU. The nurse-to-patient ratio across all units was 1:1. None of the units utilised a standardised sedation scoring system or a standardised outcome measure to assess patient mobility status. Only one ICU (20%) had a patient eligibility guideline for early mobilisation in place. Across the ICUs, 40 patients were surveyed. The median (interquartile range) age was 33 (23.3 - 38) years and 24 (60%) were mechanically ventilated. Indications for admission into the ICU included acute respiratory failure ( n =12; 30%) and postoperative care ( n =10; 25%). Mobilisation activities performed in the previous 24 hours included turning the patient in bed ( n =39; 97.5%), sitting over the edge of the bed ( n =10; 25%) and walking away from the bedside ( n =2; 5%). The main reason listed for treatment performed in bed was patients being sedated and unresponsive ( n =13; 32.5%). Conclusion. Out-of-bed mobilisation activities were low and influenced by patient unresponsiveness and sedation, staffing levels and lack of rehabilitation equipment in ICU.