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The computer key boards may act as routes for the transmission of potentially pathogenic bacteria. The use of patient data and management systems in intensive care units such as computer keyboard, may act as storage for the transmission of pathogenic microorganisms. Pathogenic microorganisms may be transmitted through the hands of medical attendant to the patient leading to infections that are nosocomial. The study aims at finding out the current status of fomite contamination of the more frequently used computer keyboards which are in use at least on a daily basis. Samples are to be collected from several places where computers are in use by various individuals which include; hospitals, internet cafes, homes, offices as well as supermarkets. Potential expected fomite pathogens are to include Gram negative bacilli. It is estimated that computer keyboards can very well lead to 90% contamination when compared with other objects. The study is aimed at examining the contamination resulting from microbial of computer user interfaces that have potential pathogenic microorganisms, in comparison with other fomites in a surgical intensive care unit belonging to a given hospital. Sterile swab samples are to be received from patients and computer keyboard.

Introduction

Fomite infections are rising all over the world. The most common way of transmission of fomite pathogen is hand carriage by nursing and medical personnel (Bates, 2005). Computer components items are fomites for pathogens. Recently, the computer in hospitals has increased greatly given multiple functions which include; instructing, laboratory check- up and re-recording patient. In order to put down information or record conditions of the patient, medical personnel use keyboards to input information into the computer putting on duty glove (Neely, 1999). Hands or gloves of the medical personnel could be contaminants after touching inanimate objects in patient rooms or after touching the surrounding near the patient or even due to frequent contact by a variety of individuals (Moini, 2008). The computer components used in hospitals may bring about significant transmission of pathogenic bacteria.  

Cross- transmission of pathogenic microorganisms by the contacts of medical personnel, from computer keyboards in various wards of health care unit might bring about an added risk for critically ill patients, having in mind the high number of contact with nursing and medical personnel during patient care with the computer keyboard fomites (Bures, 2000). Therefore, a fomite pathogenic microorganism surveillance of computer keys is to be carried out in various health care institutions and hospitals so as to study as well as, to establish the number and nature of microorganisms that exist on computer keyboard and assess their role as a source of nosocomial infection in health care institutions and hospitals (Bates, 2005). Nosocomial infections are a major cause of health care mortality as well as, the morbidity and hence that implies a rising health care and medical costs. A lot of intensive care unit patients are highly susceptible to infections and could even face death as a result of infections obtained in the hospital or a health care institution.

A very common way of transmission of nosocomial pathogens is through hand contact and carriage by the nursing and medical personnel (Owens and Ebbing, 2008).  However, the role of the hospital surrounding as a reservoir of fomite pathogens is controversial, the establishment of bedside computers gadgets into the rooms housing the patients in critical condition may contribute a lot to the transmission of fomite pathogenic organisms. Research has shown that hands play a great role as the main source in pathogenic transmission. Cross-transmission of pathogenic microorganisms by the hands of medical and health care personnel from computer components such as the computer key board at the patients’ bedside, might bring about an added risk for the already critically ill patients putting into consideration the frequency in the number of contact by the nursing and medical personnel during patient medical car care with these fomites. In this proposed study, the examination of the rate of contamination of computer key boards is to be carried out. This will include the ones used for both managing an individual patient as well as that for medical records at the physician’s work station. Rates of contamination of various fomites both inside and outside of patient’s room are for a test which is microbiological and also comparative.

 

Historiography Review 

In a historiography review of the literature computer keyboard fomites Computers continue to have a high presence in virtually all aspects of our lives in terms occupation, recreation, as well as residential surroundings (Danchin, 2009). In the healthcare surrounding or environment, it has been found out that a lot of nurses as well doctors have access to computers regularly. This is more so in attempts to accommodate the extensive and rapid growth and development in as far as computer technology is concerned.

Researchers have been able to explore the possibility of infectious pathogenic organisms to survive on inanimate surfaces such as the computer keyboard formites (Raoult & Michel, 2008). It has been found that a lot of gram-positive pathogenic bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), as well as Streptococcus pyogenes can survive for a period of several months’ surfaces that are dry (Hartmann, Matthias & Axel, 2003). Generally, there has not been an obvious difference when it comes to survival involving multi-resistant as well as susceptible strains of Enterococcus spp. However, there is a study in which such a discrepancy appeared to suggest, but due to the susceptibility of the strains it was revealed that there was a very brief survival of such (Neely, 1999). A lot of gram-negative species, like the Acinetobacter spp., Klebsiella spp., Pseudomonas aeruginosa, or Escherichia coli spp. can be able to survive well on surfaces that are inanimate for even close to months (Owens & Ebbing, 2008). The species that are found amongst the most occurring isolates from patients with nosocomial lead infections. Some others, like the Vibrio cholera, Bordetella pertussis, Proteus vulgaris as well as Haemophilus influenzae, are known to be persistent only for a few days (Danchin, 2009). However, Mycobacteria with an inclusion of Mycobacterium tuberculosis as well as spore-forming bacteria, also with an inclusion of Clostridium difficile have the ability to survive for a lot of months on dry surfaces.

Generally, according to the review it has been noted that bacteria of gran-negative kind have the ability to persist for very long periods of time in comparison to gram-positive bacteria. Factors of climate have a role to play in as far as persistence is concerned. Conditions of humidity are also found to increase the period of survival for pathogenic organisms on fomite (Moini, 2008). In a lot of studies with coupled and supported with experimental evidence, persistence has been studied on fomites with the use of artificial contamination belonging to a standardized kind of a surface in the laboratory.

The major advantage is that the conditions regarding the environment are consistent as far as air humidity as well as temperature is concerned. Additionally, the determination of the effect of relative humidity or temperature can be made only under conditions that are controlled, which a lot easier to carry out in a laboratory (Neely, 1999). Sampling would take place during two collection times in three months on seven nonconsecutive days. Computer Keyboards fomites are to be sampled for a microbial contamination and eventually tested for qualitative examination of nosocomial pathogens.

However,  as noted by Hartmann, Matthias & Axel (2003), this is not always the case when it comes to clinical situation, in which the fomites can be contaminated at the same time with various pathogenic organisms as well as different types of fluids and secretions from the body. In the health care or medical surrounding, fomites are many of the times contaminated with nosocomial pathogenic organisms, and they often serve as routes for cross-transmission (Johnston & Karen, 2009). If happens that there is an incidence of contact of the hand with a contaminated fomite, the results is that there is a variability in the degree of transfer of pathogens. Hands that are contaminated can be able to transfer pathogenic organisms to about five or more other subjects. The rate of compliance of healthcare personnel in as far as hand hygiene is concerned is said to be around 50 percent and therefore due to that overwhelming evidence of low compliance with hygiene of the hand, it is practically difficult to overlook the risk for contaminated fomites. Evidence that is observational has been able to show that the transmission of pathogenic organisms may be facilitated by the environment in its significant role played during out breaks. This has been description given too many microorganisms such as, Clostridium, as well as norovirus (Hernández & Antonio, 2009).

Theoretical Framework

The essential ideas on this subject of computer keyboard fomites carry pathogenic organisms is that, Computer equipment and components being the main culprit, an examination of the microbial computer contamination of the user interfaces harboring microorganisms (Isaacs & Andrew, 1998). They are potentially pathogenic as is compared to other fomites present in a health or medical care or even in intensive care unit of a surgical needs to be thoroughly investigated and sterile swab samples be acquired from a patient’s bedside computer keyboard fomite, as well as other sites around and inside of the patient’s room including surgical intensive care unit system.

In the literature review I wish to pursue the trend according to the, the quality of the evidence that examines contamination objects that are inanimate and also the proximal environment needs to be analyzed in according to whether a variety of factors have been taken into account or even measured. The extent in which contamination is made and the impact to the environment by pathogens that are specific also whether or not that is addressed temporality (Johnston & Karen, 2009). The confounders’ assessment, such as hygiene of the hand as well as the quality of fomites cleaning Whether or not when cleaning is improved, after the control of other interventions, will actually reduce the risk of infection to the patient.

The best studies involving cross-colonization of patients coming from the environments that are inanimate make use of molecular techniques to aid in identifying pathogens, also to aid in measuring the quality of cleaning of the environment as well as hygiene of the hand for a given period of time and link contaminated fomites as well as, events of cross colonization in temporal as well as geographic dimensions (Danchin, 2009). One important thing about environmental contamination is that, it is confounded by other interventions

Contamination of fomites  has been on many occasion  been found to be in the literature,  with an inclusion of gowns put on by patients and healthcare as well as medical care personnel, equipment used in the medical institution or environment, microsphere beds,  as well as surfaces of the fomites in the environment. The extent of l contamination of the environment has also been perceived to correlate with a variety of body sites (Moini, 2008). Transmission from surfaces to patients could also occur and contact involving surfaces that are contaminated alone is almost as likely to bring about the contamination of the hands of healthcare and medical care personnel as is contact with a patient who has been colonized. The other data which is in support of the transmission from the environment to the patient shows or indicates patients who are not colonized are admitted to rooms that are contaminated and are faced with highly increased chances of acquisition of infections.

The major criticism that can actually be leveled against the previous work would among others encompass the following; a discrepancy between the various types of fluids as well as secretions from the body yet there still arises the question of the evidence of clinical on the roles of computer keyboard fomites in pathogenic infections. The major advantage however is that the conditions regarding the environment are consistent as far as air humidity as well as temperature is concerned. Additionally, the determination of the effect of relative humidity or temperature can be made only under conditions that are controlled, which a lot easier to carry out in a laboratory. According to the review it has been noted that bacteria of gran-negative kind have the ability to persist for very long periods of time in comparison to gram-positive bacteria. Factors of climate have a role to play in as far as persistence is concerned (Hernández & Antonio, 2009). Conditions of humidity are also found to increase the period of survival for pathogenic organisms on fomite. In a lot of studies with coupled and supported with experimental evidence, persistence has been studied on fomites with the use of artificial contamination belonging to a standardized kind of a surface in the laboratory. Cross-transmission of pathogenic microorganisms by the hands of medical and health care personnel from computer components such as the computer key board at the patients’ bedside, might bring about an added risk for the already critically ill patients putting into consideration the frequency in the number of contact by the nursing and medical personnel during patient medical car care with these fomites  in case of an incidence of contact of the hand with a contaminated fomite, the results is that there is a variability in the degree of transfer of pathogens (Moini, 2008). Hands that are contaminated can be able to transfer pathogenic organisms to about five or more other subjects. Then also the compliance rate of medical as well as health care personnel in as far as hand hygiene is concerned is said to be around 50 percent which is due to the overwhelming evidence of little compliance with hygiene of the hand and the risk of contaminated fomites being overlooked

Methodology

The various hypothetical approaches towards the subject matter would include the following; are computer key boards used as vectors or routes in the transmission of pathogenic organisms that is if they are to be considered as potential fomites in the medical and or health care surrounding. Do the computer keyboard fomites really facilitate the rapid spread of pathogenic organisms? Is it really possible that the high incidences of negligence or laxity on the part of the medical as well as the health care personnel, is a major contributor in the use of computer key boards as fomites for pathogenic organisms transmission, and of course if there are possibilities that the negative impacts posed by computer key board fomites could be mitigated or even be completely done away with (Li & Perti, 2007). Samples from the keyboard and mouse of the Physician’s workstation computer key board samples need also to be obtained and followed by a thorough analysis as well as examination based on the scientific logic reasoning. Contaminated samples emanating from keyboards and other fomites within patients’ bed as well as, physicians’ workstation are to be clearly substantiated. 

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