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Cleanliness of disposable vs nondisposable electrocardiography lead wires in children
Nancy Addison1, Beth Quatrara2, Lisa Letzkus2
1Nancy Addison is a research nurse clinician in the pediatric intensive care unit, Beth Quatrara is director and Lisa Letzkus is assistant director of nursing research for the medical center, David Strider is a nurse practitioner at the medical center, Virginia Rovnyak is a statistician at the school of nursing, and Virginia Syptak and Lisa Fuzy are nurse clinicians in the pediatric intensive care unit. All are employed at the University of Virginia Health System in Charlottesville. nkg2x@hscmail.mcc.virginia.edu.
Insights
Disposable electrocardiography (ECG) lead wires show lower adenosine triphosphate (ATP) levels in pediatric cardiac surgery patients compared to nondisposable wires. This suggests disposable ECG leads can improve hospital cleanliness and reduce infection risks.
Area of Science:
- Medical Device Cleanliness
- Hospital Infection Control
- Pediatric Cardiac Surgery
Background:
- Mediastinitis poses significant financial and clinical burdens on hospitals.
- Limited data exists on adenosine triphosphate (ATP) levels on electrocardiography (ECG) lead wires in pediatric patients.
- ATP measurement is a standard for assessing hospital equipment cleanliness and microbial contamination.
Purpose of the Study:
- To compare the cleanliness of disposable versus nondisposable ECG lead wires.
- To quantify adenosine triphosphate (ATP) levels on lead wires in pediatric cardiac surgery patients.
- To evaluate ATP as a marker for microbial contamination on medical devices.
Main Methods:
- Prospective, randomized trial design.
- ATP swab testing on ECG lead wires (disposable and nondisposable).
- Testing conducted on postoperative days 1, 2, and 3 in 51 pediatric patients.
Main Results:
- Disposable ECG lead wires demonstrated significantly lower ATP counts on postoperative day 1 (median 157 RLUs vs. 610 RLUs).
- Lower ATP levels were observed for disposable wires on postoperative day 2 (median 200 RLUs vs. 453 RLUs).
- Results indicate a statistically significant difference in cleanliness between the two types of lead wires.
Conclusions:
- Disposable ECG lead wires are a cleaner option for pediatric cardiac surgery patients.
- Utilizing disposable ECG lead wires can reduce ATP contamination for at least 48 hours post-surgery.
- This strategy may contribute to improved patient safety and reduced hospital-acquired infections.
Background:
Mediastinitis costs hospitals thousands of dollars a year and increases the incidence of patient morbidity and mortality. No studies have been done to evaluate adenosine triphosphate (ATP) counts on disposable and nondisposable electrocardiography (ECG) lead wires in pediatric patients.
Objective:
To compare the cleanliness of disposable and nondisposable ECG lead wires in postoperative pediatric cardiac surgery patients by measuring the quantity of ATP (in relative luminescence units [RLUs]). ATP levels correlate with microbial cell counts and are used by institutions to assess hospital equipment and cleanliness.
Methods:
A prospective, randomized trial was initiated with approval from the institutional review board. Verbal consent was obtained from the parents/guardians for each patient. Trained nurses performed ATP swabs on the right and left upper ECG cables on postoperative days 1, 2, and 3.
Results:
This study enrolled 51 patients. The disposable ECG lead wire ATP count on postoperative day 1 (median, 157 RLUs) was significantly lower (P < .001) than the count for nondisposable ATP lead wires (median, 610 RLUs). On postoperative day 2, the ATP count for the disposable ECG lead wires (median, 200 RLUs) was also lower (P = .06) than the count for the nondisposable ECG lead wires (median, 453 RLUs).
Conclusion:
Results of this study support the use of disposable ECG lead wires in postoperative pediatric cardiac surgery patients for at least the first 48 hours as a direct strategy to reduce the ATP counts on ECG lead wires.
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