Efficacy and Impact of a Cleaning and Disinfection Protocol for Musical Instruments Used in Music Therapy Services in ICUs: A Prospective Cohort Study

IF 2.3 Q2 HEALTH CARE SCIENCES & SERVICES

Joint Commission journal on quality and patient safety Pub Date : 2024-07-26 DOI:10.1016/j.jcjq.2024.07.007

Mark Ettenberger PhD, MA, MT (is Coordinator, Music Therapy Service, Department of Social Management, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia, and Director, SONO – Centro de Musicoterapia, Bogotá, Colombia.), Andrés Salgado MMT, MT (is Clinical Musical Therapist, Department of Social Management, University Hospital Fundación Santa Fe de Bogotá, and Clinical Musical Therapist, SONO – Centro de Musicoterapia.), Rafael Maya MNMT, NMT, MT (is Clinical Musical Therapist, Department of Social Management, University Hospital Fundación Santa Fe de Bogotá, and Clinical Musical Therapist, SONO – Centro de Musicoterapia.), Adriana Merchán-Restrepo MSc (is Coordinator, Epidemiological Surveillance, University Hospital Fundación Santa Fe de Bogotá.), Pedro Barrera-López MD (is Pediatric Intensivist and Consultant Epidemiologist, Office of Clinical Studies and Epidemiology, University Hospital Fundación Santa Fe de Bogotá. Please address correspondence to Mark Ettenberger)

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引用次数: 0

Abstract

Background

Health care–associated infections (HAIs) can affect patient safety and recovery. Musical instruments used by music therapy services may carry pathogens, particularly in ICUs. The aim of this study was to determine the efficacy of the cleaning and disinfection protocol by the music therapy service of the University Hospital Fundación Santa Fe de Bogotá.

Methods

This prospective cohort study included all ICU music therapy patients from July to August 2023. Adenosine triphosphate (ATP) bioluminescence tests and microbiological cultures were taken before and after cleaning the musical instruments for nine patients in the adult and pediatric ICUs. ATPs were taken before starting music therapy, after finishing music therapy, and after cleaning the instruments. Cultures were taken if an ATP test was above the established cutoff of ≤ 200 relative light units (RLUs). If no ATP value was above the cutoff, cultures were taken randomly.

Results

A total of 63 ATPs and 10 random microbiological cultures were taken. After applying the cleaning and disinfection protocol, all ATP values were ≤ 200 RLUs. Of the 10 microbiological cultures, 1 screened positive for Streptococcus sp., yeast, and Micrococcus. One hundred ICU music therapy patients were followed up, and positive associations with HAIs were found for age (p = 0.01), type of unit (p = 0.001), tracheostomy (p < 0.001), arterial line (p = 0.005), hemodialysis catheter (p = 0.05), bladder catheter (p = 0.02), number of invasive devices (p = 0.02), duration use of invasive devices (p = 0.01), and days of hospitalization (p = 0.01). Number of music therapy sessions/patient was not associated with HAIs (p = 0.86).

Conclusion

The results indicate that the current cleaning and disinfection protocol can be considered safe and effective. To the authors’ knowledge, this is one of the first studies investigating biosafety of musical instruments in a hospital-based music therapy service. Patient safety is of the utmost importance in hospital settings, and awareness about proper cleaning of their work tools among music therapists is paramount.

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重症监护病房（ICU）音乐治疗服务中使用的乐器清洁和消毒规程的功效和影响 - 一项前瞻性队列研究

背景医疗相关感染（HAIs）会影响患者的安全和康复。音乐治疗服务使用的乐器可能携带病原体，尤其是在重症监护病房。本研究的目的是确定波哥大圣菲基金大学医院音乐治疗服务机构的清洁和消毒方案的有效性。方法这项前瞻性队列研究纳入了 2023 年 7 月至 8 月期间所有接受音乐治疗的重症监护病房患者。在成人和儿童重症监护病房的九名患者清洗乐器前后，对其进行了三磷酸腺苷（ATP）生物发光测试和微生物培养。分别在开始音乐治疗前、结束音乐治疗后和清洁乐器后进行 ATP 检测。如果 ATP 检测值高于设定的≤ 200 相对光单位 (RLU) 临界值，则进行培养。如果 ATP 值未超过临界值，则随机进行培养。采用清洁和消毒方案后，所有 ATP 值均小于 200 RLUs。在 10 个微生物培养物中，1 个筛查出链球菌、酵母菌和微球菌阳性。对 100 名重症监护室音乐治疗患者进行了随访，发现年龄（p = 0.01）、病房类型（p = 0.001）、气管切开术（p < 0.001）、动脉导管（p = 0.005）、血液透析导管（p = 0.05）、膀胱导管（p = 0.02）、有创设备数量（p = 0.02）、有创设备使用时间（p = 0.01）和住院天数（p = 0.01）。结果表明，目前的清洁和消毒方案是安全有效的。据作者所知，这是首批调查医院音乐治疗服务中乐器生物安全性的研究之一。在医院环境中，患者的安全至关重要，而音乐治疗师对正确清洁工作工具的认识也至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Joint Commission journal on quality and patient safety HEALTH CARE SCIENCES & SERVICES-

CiteScore

3.80

自引率

4.30%

发文量

116

审稿时长

49 days