A qualitative study of health care professionals’ attitudes and practices of mobile equipment cleaning

BACKGROUND: Skilled nursing facilities report a high prevalence of multidrug-resistant organisms (MDROs) among their vulnerable patient population. While research has identified fomite-mediated transmission such as surfaces and health care professional (HCP) hands and clothing, emerging work on outbreaks has focused on the role of mobile medical equipment and associated cleaning procedures. This study sought to better characterize HCP attitudes toward cleaning and MDRO transmission, as well as describe cleaning practices for mobile equipment. METHODS: Fifteen focus groups were conducted at 3 skilled nursing facilities (n ≥ 4 focus groups per site) with HCP likely to be tasked with cleaning mobile equipment (ie, nurses, certified nursing assistants, and environmental service workers). Focus groups were recorded and transcribed, reviewed for accuracy, and analyzed by 2 independent reviewers using thematic analysis. RESULTS: Participants at all 3 sites described suboptimal cleaning practices of mobile equipment. Barriers to MDRO infection prevention and control practices included time pressure, knowledge gaps, and cost (material and staff). CONCLUSIONS: Many of these challenges can be addressed through role-specific education campaigns, substituting dedicated equipment (eg, vital signs carts) for mobile equipment where possible, and human factors-based interventions to support cleaning efforts within existing clinical workflow.