The good: improving clinical care

Clinically, mobile devices have been hugely beneficial, revolutionising the way in which healthcare is structured and delivered. From increasing medical staff’s ability to communicate, to the myriad available medical apps, they allow access to all sorts of information at the point of patient contact.  However, with opportunities come challenges.

The bad: encouraging addictive behaviour

Anyone who owns a smartphone will know that they can be addictive. Encouraging staff to bring their phones to work carries the risk of 'Distracted Doctoring'. Our recent study¹ found that 92% of hospital staff used their phone at work. If staff are using their phone for personal rather than clinical reasons, then this can divert their attention away from their duties – in the same way that it does if used when driving. This may have a negative impact on patient care.

The ugly: infection control

Are you carrying around a petri dish in your pocket? Warm, moist, and full of sweat and nutrients from the owner’s hands, our mobile devices provide an optimal habitat for bacteria to survive and potentially even grow.  We were able to grow bacterial contaminants from 98% of the 250 phones belonging to hospital staff we tested.  These contaminants included not just environmental and commensal organisms from the skin, but also potentially pathogenic bacteria known to cause healthcare-associated infections (HCAIs), such as Staphylococcus aureus. While these are not usually a concern for the healthy owners of the mobile phones, they could potentially be a threat to patients with compromised immune systems.

Some of the hospital staff phones harboured Enterococcus species – an organism whose natural habitat is our gut. How have they ended up on phones? Well, 75% of people admit to using their phones on the toilet….

So are mobile phones reducing the effectiveness of hand hygiene protocols? However careful you are to wash your hands after using the toilet or between seeing patients, if your phone is contaminated then every time you touch your phone, you are recontaminating your hands.  Unlike many other devices in a hospital environment, your phone will travel with you – patient to patient, ward to ward, into the cafeteria, home at the end of the shift.

What’s more, our study found that the bacteria we isolated from hospital staff phones were more resistant to antibiotics than those isolated from the control group.  For example, 11% of hospital staff phones carried the superbug MRSA, compared to none from our control group.

We know that the hospital environment can play a role in infection outbreaks, and we know the importance of hand hygiene. The way we use our mobile phones gives them a unique but ubiquitous role in our environment, and warrants consideration of their impact on infection control.

Around 90% of staff never clean their phones, yet our study shows that daily cleaning significantly reduces contamination load. While we don’t yet know the absolute best method to clean your phones, or their exact role (if any) in HCAIs, it seems sensible to suggest that you regularly give them a quick wipe, and that you think twice before using them next time you’re on the loo…

Rebecca Simmonds and Emma Hayhurst

References 

1. Simmonds R, Lee D and Hayhurst E. Mobile phones as fomites for potential pathogens in hospitals: microbiome analysis reveals hidden contaminants. Journal or Hospital Infection (2019). https://doi.org/10.1016/j.jhin.2019.09.010