2021 Annual Conference

CNS Improving Outcomes
CNS as Researcher
CNS as Project Manager
Capture Value of the CNS

Significance and Background: Healthcare-associated infections result in over $20,000 in non-reimbursable healthcare costs per infection. Keyboards harbor bacteria associated with these infections and require frequent cleaning and meticulous hand hygiene to prevent the spread of bacteria. However, this behavior is inconsistent with regards to nursing staff and keyboard usage. Ultraviolet light decreases bacteria on surfaces. Automating the cleaning of keyboards with ultraviolet light can reduce cross contamination between these surfaces and patients. The purpose of this evidence-based practice project was to evaluate the effectiveness of ultraviolet disinfection of hospital keyboards compared to current practice within medical surgical inpatient environments. Evaluation Methods: To allow for paired sampling, both desktop computer and workstations on wheels keyboards were labeled by unit and number. Using standard microbiology techniques, the keyboards were sampled and the swab was streaked onto a 5% blood agar plate. After 24 hours of incubation, each plate was manually counted and the total number of bacterial colonies annotated. Additionally, a clinical microbiologist visually reviewed each plate and completed identification of bacteria suspected of being associated with healthcare-associated infections. After baseline sampling was completed, ultraviolet devices were installed on 31 keyboards. Post-intervention swabbing, counting and identification mirrored the baseline methods. Outcomes: Baseline sampling was conducted on 35 keyboards. A two-tailed paired t-test was conducted on the intervention and control keyboards. There was a significant difference in the colony forming unit counts from baseline (M=74.81, SD=57.96) and after ultraviolet light installation (M=28.25, SD=30.40) conditions; t(15)=2.81, p = 0.013.  Initial bacteria identification found Staphylococcus aureus on 40% of the keyboards (14/35) and Micrococcus on 60% of the keyboards (21/35).  This decreased post intervention with Staphylococcus aureus identified on 6% of the keyboards (2/32) and Micrococcus on 6% (2/32) of the keyboards. We found no difference in our control results. Implications: This project highlights the fact that computer keyboards are a high touch surface that can harbor bacteria consistently associated with healthcare-associated infections. It also builds on prior research demonstrating the effectiveness of ultraviolet devices on keyboards that are difficult and burdensome to clean with traditional chemicals and wipes. Ultraviolet devices for keyboards are a relatively low cost investment. The prevention of one infection with these devices would offset the cost of more than 60 of these devices. Beyond the financial benefits, technology like this has the potential to improve patient outcomes and reduce the occurrence of healthcare-associated infection.