Dr Peter Wilson, University College London Hospital
Do you ever eat at your desk at work? It may worry you that your computer keyboard is a hotbed of bacteria, but even more worrying is the fact that keyboards in hospital wards also house bacteria. Dr Peter Wilson is from University College London Hospital, and heís taken steps to ensure that the keyboards in his hospital will be much cleaner...
Chris - Peter, hello. Thank you for joining us.
Peter - Hi.
Chris - So, why are computer keyboards a threat in hospitals? Whatís the evidence that they are?
Peter - Weíve known for a while that all sorts of bugs can grow on computer keyboards. We did a study and others have done a study where we find up to 25% of them have superbugs like MRSA. They got there because a nurse will do observations on the patient and then go and put the observations in to the computer. She wonít wash her hands between touching the computer and touching the patient. A doctor will then come along, touch the keyboard Ė not necessarily touching the patient so he wonít wash his hands either. Then heíll go on to the next keyboard. Any bugs that have been brought from patient to keyboard will then go the next keyboard and then to the next patient. In fact, we could see when we did our study that certain strains of MRSA were, in effect, going around the ward.
Chris - What proportion of keyboards were infected with bugs?
Peter - Well, up to 25% have MRSA. Itís not just that. Thereís 3 or 4 other superbugs which small numbers of these organisms sit on the keyboards. The problem is nobody ever cleans the keyboard. Or if they do itís very rare.
Chris - What proportion of keyboards do actually get cleaned?
Peter - Well, when we audited it we found only 6% got cleaned. These are ones that already had plastic covers on them to try and make it easier to clean. If you have an ordinary keyboard, as youíll know yourself itís very difficult to get between the keys and clean yourself and get all the debris out from in between. Itís a real problem.
Chris - What have you done to overcome the problem?
Peter - We knew we were going to have electronic patient records so it was supposed to be a paperless hospital. We were moving into a new hospital in 2005 in Euston Road. What we did was we had a look at what was on the market. There were a few washable keyboards around but they required you to wash them under a tap and blow dry with a hairdryer. Nobody was going to do that. We then went to four companies, gave them a very detailed specification of what we wanted and an American one came back with one that was pretty close.
What it is, really is the keyboard is completely flat. Itís absolutely flat. Thereís an optical illusion printed on it which makes it look as if itís got ordinary keys. The reason itís flat is that you can take an alcohol wipe or a detergent wipe, just go across it once in literally about 4 seconds and completely clean it and sterilise it. In addition to that what we put in was an alarm so that if you havenít cleaned it for 12 hours it starts flashing irritatingly at you. You can only turn the flashing light off if you take an alcohol wipe and go across the whole surface.
Chris - But in some places where computers are getting very heavy use then 12 hours might still be too infrequent, wouldnít it?
Peter - Oh yes, and you can reduce the interval to 3 hours. We have it set at three hours in our intensive care unit. If you do that you reduce the bug counts on the surface of these keyboards by 70% compared to ordinary keyboards.
Chris - Extrapolating that, what sort of impact do you see that having in terms of hospital-acquired infections?
Peter - Thatís very difficult to say. We know that most hospital acquired infections are spread on peopleís hands. We know that a lot of it is direct from patient-to-patient. Probably around about a third is from patient Ėto-somewhere in the local environment then picked up by somebody else, back to a patient. It might have an effect on about a third of the transmission of hospital infection. Very difficult to prove, though. As you make an investment in these keyboards and they last for four years it would only have to have a four or five percent effect on the overall level of infection to pay for itself.