Cell phone use in the OR

AORN Journal, March, 2008 by Mary Ogg

QUESTION: At our hospital, more and more staff members and physicians are carrying and using their personal cell phones in the OR. I am worried about where the cell phones have been before they are brought into the OR. They are either in someone's pocket or on a belt holder or at the bottom of a purse. I have never seen anyone wipe a cell phone off before bringing it into the OR. In tight of the increase in health care-associated infections and recent news reports about methicillin-resistant Staphylococcus aureus (MRSA), what is appropriate in regard to using personal cell phones in the OR?

ANSWER: Cell phone usage in the perioperative environment should be restricted. There is a possibility of cross contamination of the practitioners' hands from a bacterial-laden cell phone.

A study conducted at a health care organization in Ireland investigated the use of cell phones and their potential for carrying bacteria that cause health care-associated infections (HAIs). (1) The sample was composed equally of physicians and nurses; 98% owned a cell phone and 70% had their cell phones available for bacterial sampling. Ninety-six percent of the cell phones were contaminated with bacteria, and 15% grew bacteria known to cause HAIs. One bacterial species was found on 38% of the telephones, two different species were found on 38% of the telephones, and three or more species grew on 20.9% of the telephones. Bacterial types isolated were coagulase-negative Staphylococcus (93%), Micrococcus species (39%), Bacillus species (20%), diptheroids (6.6%), methicillin-sensitive Staphylococcus aureus (5.7%), Streptococcus viridians (5.7%), coliforms (4.7%), MRSA (1.9%), Enterococci faecalis (0.95%), and Clostridium perfringens (0.95%). There was no significant difference in bacterial contamination between the physicians' and nurses' telephones. (1)

Investigators at a tertiary care hospital in Israel studied cross contamination between cell phones, hands, and patients. (2) Cell phones and hands were swabbed and cultured for Acinetobacter baumannii. A significant percentage of the cell phones (ie, 41.8%) and hands (ie, 81%) were contaminated with Acinetobacter species, and cross contamination between cell phones, hands, and patients occurred.

Cell phones also are a cause of distraction and may interfere electromagnetically with monitoring equipment. (3,4) Although no clinical studies have documented distractibility from talking on a cell phone during a surgical procedure, studies have shown the distractibility of individuals using cell phones, both handheld and hands free, while driving. One study found that attention was diverted from driving to the telephone conversation. (3) The ECRI advocates restricted use of cell phones in highly instrumented area, such as operating and procedural rooms. Critical medical devices are susceptible to electromagnetic interference from wireless communication devices. (4)

Cell phone usage should be restricted in the OR to prevent cross contamination between hands touched by bacterial-laden cell phones to patients and items in the perioperative environment. Cell phones may play a part in health care-associated transmission of microbes to surgical patients. (2) Distractibility and electromagnetic interference with monitoring equipment are additional reasons to restrict cell phone use in the OR. (4)

REFERENCES

(1.) Brady RR, Wasson A, Stirling I, McAllister C, Damani NN. Is your phone bugged? The incidence of bacteria known to cause nosocomial infection on healthcare workers' mobile phones. J Hosp Infect. 2006;62(1):123-125.

(2.) Borer A, Gilad J, Smolyakov R, et al. Cell phones and Acinetobacter transmission. Emerg Infect Dis. 2005;11(7):1160-1161. http://www.cdc.gov/ncidod /EID/vol11no07/05-0221.htm. Accessed December 28, 2007.

(3.) Strayer DL, Johnston WA. Driven to distraction: dual-task studies of simulated driving and conversing on a cellular telephone. Psych Science. 2001;12(6): 462-466.

(4.) Cell phones and electromagnetic interference revisited. Health Devices. 2006;35(12):449-456.

MARY OGG

RN, MSN, CNOR

PERIOPERATIVE NURSING SPECIALIST

AORN CENTER FOR NURSING PRACTICE