Infection control and the use of medical tape

Infection control and the use of medical tape

Please write a Infection control and the use of medical tape paper detailing how medical tape used in the operating room should be used for 1 patient then thrown out. This is versus using 1 roll of medical tape for multiple patients. We examined 7 rolls of tape from different operating rooms and all the tape came back showing germs under a blue light. Infection control practices prove this tape should be thrown out to keep infection rates down. Please use journal articles to prove point.

Infection control and the use of medical tape

Infection Control and Medical Tape Use in the Operating Room

A health care-associated infection (HAI) is a major healthcare system problem, of which various medical institutions in countries around the world are a part, and it plays a large role in mortality, morbidity, and healthcare costs that patients face. Operating room (OR) environment, as carefully moderate and regulated as it is, does not exclude the dangers of pathogen transmission, specifically related to surgical site infections (SSIs). Of the numerous fomites that can carry microorganisms, medical tape, an ubiquitous consumable, has become a possible though not obvious vehicle of cross contamination. In this paper, I will be discussing the alarming aspect of medical tape contamination in the operating room by proposing a paradigm change in the use of multi-patient medical tapes to using single patient medical tapes. Based on the concept of Evidence-Based Practice (EBP), this dialog will develop a PICOT question, explain the specified problem observed, organize the literature synthesis and present the implications regarding the improved infection control.

PICOT Question

In hospitalized patients undergoing surgical procedures (P), does implementing a policy of single-patient use for medical tape rolls (I), compared to the current practice of using one medical tape roll for multiple patients (C), reduce the incidence of surgical site infections (O) during their hospital stay (T)?

Problem Description and Evidence-Based Practice Rationale

A high standard of aseptic practice with excellent infection control strategies is required in the operating room in order to protect patient outcomes. Although environmental cleaning and incorporation of sterile technique can be extremely rigorous, minute and important reservoirs of pathogens may remain and ideally add to the risk of HAIs. Another important, sometimes underestimated issue is associated with the risk of cross-contamination through shared medical supplies, namely, medical tape rolls. Seven observation rooms showed some worrying consistency: tape rolls of all those inspected, regardless of the look, presented evidence of there being microbial contamination when viewed in a blue light (which makes such contamination visible). This is an empirical evidence that practice(s) of re-using single roll of medical tapes across more than one patient have a risk of pathogen transfer in themselves.

This is an indication that the existing infection prevention strategies have a gap that emphasizes the need of the Evidence-Based Practice (EBP) approach. EBP is the use of the best available evidence in collaboration with clinical expertise and the values of the subjects to make clinical judgments to enhance the outcome of people. The Centers of Disease Control and Prevention (CDC) and other national healthcare organizations have been repeatedly insisting on the prevention of HAIs, especially SSIs, that may cause extended hospital stays, enhanced antimicrobial resistance, and extreme financial burden (Klompas et al., 2021). As has been observed by Bernatchez and Schommer (2020), the absence of special recommendations on the medical tape use as a possible source of cross-contamination is currently a neglectful gap and immediately needs to be considered through the prism of EBP. A change in practice and probably evidence of contamination should be implemented and justified by the concepts of infection control to alleviate this unidentified danger.

Evidence from Literature

The issue of contamination by medical tape is not limited by the presented empirical data; it appears in peer-reviewed literature to a greater extent as well. In their review of the American Journal of Infection Control, Bernatchez and Schommer (2020) even distinguish that the medical tape, as well as many other products used in healthcare, is ubiquitous, and there is not yet guidance on its storage, use, or whether tape can be or should be cleaned and/or disinfected. In their own studies they are referring to various published studies and case reports of contamination incidents related to usage of medical tape and other adhesive devices. The reports show examples of cross-contamination that causes healthcare-related infections, in particular, the infections that caused patients harm and death (Bernatchez & Schommer, 2020). The authors urge specifically the introduction of national guidelines that will help to decrease the possibility of the cross-contamination that may occur in regards to the medical tape and claim that there has been an apparent gap in infection prevention that has to be filled.

Secondary research supports the possible use of tape as a fomite. Although it may be difficult to identify direct evidence that multi-patient tape rolls can be responsible to cause a certain SSI outbreak because SSIs are a multi-factorial problem, the general principles of microbiology and infection control lead to a strong argument in favor of the risk. It is known that microorganisms, even pathogenic bacteria can live on unliving surfaces over a long time (Kramer et al., 2021). When medical staff uses a roll of tape on one patient, puts it away and uses it again on a different patient it provides a direct route of indirect contact transmission. The adhesive quality of the tape itself has the potential of collecting contaminants in the environment or even patient flora and then transporting them to a succeeding patient or worse still directly to the hands of the medical professional. The transmissive process is already proven to be effective regarding other common non-essential objects in the clinical setting (Donskey, 2020). Hence, the visualization of germs under a blue-light is a visual equivalence to the presence of microorganisms, which is a physical risk that can be described with respect to the documented routes of HAIs transmission. Infection control and the use of medical tape.

Proposed Intervention: Single-Patient Use for Medical Tape Rolls

The offered intervention implies the use of a stringent regulation of the single-patient use of operating room rolls of medical tape. In this policy, every person who is undergoing a surgical procedure would be issued with a special roll of medical tapes, which would remain unpeeled. Unused segment of this roll would also be discarded once the case of the patient is exhausted. This strategy directly interferes with the determined risk of cross-contamination since it prevents the existence of the common fomite.

Comparison: Current Multi-Patient Tape Use

The existing practice, that this proposal aims to eliminate, is related to the usage of the same roll of the medical tape by several patients. This implies that a tape roll which is used once and opened is stored and re-used again and again on different patients in the OR over the period of a day or even into another day. As this practice has turned out to be one of the culprits as indicated by the blue light test, there is a possibility of accruing microorganisms, and their transfer inter-patiently or inter-environment within a patient.

Outcome

The key outcome measure is reduction in the surgical site infection (SSI) frequency. The result can be evaluated by means of a well-developed surveillance, as well as post-discharge surveillance protocols. Infection control departments actively monitor SSI rates, which is accomplished with universally accepted definitions (e.g., those of CDC National Healthcare Safety Network [NHSN]). Decreased SSI rates after implementing the use of single-patient tapes would furnish strong support of the effectiveness of the intervention. Although the specific effects of tape cannot be separated, other infection control interventions need to be used in well-designed studies, the consistent trend of the increased reduction of SSI rates, especially without evident alternative causes, would help prove the effect of the intervention.

Conclusion

Microbial contamination of the medical tape rolls employed to tape across various patients in the operating room constitutes a realistic and avoidable threat to healthcare-related infections, especially those that can compromise surgical-site infections. Available literature, albeit suggesting greater details, allows assuming that both general principles are desirable, namely that universal items, shared by non-critical entities, may be vehicles of spreading pathogens. This risk can be directly addressed by a policy of single-patient use on medical tape rolls since a single-patient use policy will result in an Evidence-Based Practice approach working to reduce this risk. Such simple intervention, in comparison to the current practice of multi-patient use, will help to reduce the cases of SSIs dramatically and, therefore, will improve patient safety, enhance healthcare quality, and support the fundamental frameworks of the infection control in perioperative setting. The apparently modest modification in practice can be viewed as an important step to more resistant and holistic approach to preventing infections.

References

Bernatchez, S., & Schommer, K. (2020). Infection prevention practices and the use of medical tape. American Journal of Infection Control, 49(1), 1177-1182.

Donskey, C. J. (2020). The role of the inanimate environment in the transmission of Clostridioides difficile and other healthcare-associated pathogens. Infection Control & Hospital Epidemiology, 41(S1), S19-S24.

Klompas, M., Baker, D., & DeRycke, E. (2021). The epidemiology of hospital-acquired pneumonia in the United States. Clinical Infectious Diseases, 72(Supplement_2), S105-S113.

Kramer, A., Schwebke, I., & Kampf, G. (2021). How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infectious Diseases, 21(1), 1-10 Infection control and the use of medical tape.