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Title: The impact of a 'milking the COW' campaign in a regional hospital in Singapore
Authors: Pada, Surinder Kaur MS 
Lishi, Poh
Ng, Kim Sim
Rethenam, Sarathamani
Alenton, Lilibeth Silagan
Chee, Poh Ling
Guo, Wilma
Hsann, Yin Maw 
Cheng, Carmen Wan Rong
Ong, Chiou Horng
Lasantha, Ratnayake
Chan, Douglas
Tambyah, Paul Anantharajah 
Keywords: Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Infectious Diseases
Pharmacology & Pharmacy
Issue Date: 22-May-2021
Publisher: BMC
Citation: Pada, Surinder Kaur MS, Lishi, Poh, Ng, Kim Sim, Rethenam, Sarathamani, Alenton, Lilibeth Silagan, Chee, Poh Ling, Guo, Wilma, Hsann, Yin Maw, Cheng, Carmen Wan Rong, Ong, Chiou Horng, Lasantha, Ratnayake, Chan, Douglas, Tambyah, Paul Anantharajah (2021-05-22). The impact of a 'milking the COW' campaign in a regional hospital in Singapore. ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL 10 (1). ScholarBank@NUS Repository.
Abstract: Background: Computerisation of various processes in hospitals and reliance on electronic devices raises the concern of contamination of these devices from the patient environment. We undertook this study to determine if an attached hand hygiene device that unlocks the screen of a computer on wheels (COW) on usage can be effective in decreasing the microbiological burden on computer keyboards. Methods: An electronic hand sanitizer was integrated onto the COW. A prospective cohort study with a crossover design involving 2 control and 2 intervention wards was used. The study end point was the number of colony forming units found on the keyboards. Bacteria were classified into 4 main groups; pathogenic, skin flora, from the environment or those thought to be commensals in healthy individuals. We then used a mixed effects model for the statistical analysis to determine if there were any differences before and after the intervention. Results: Thirty-nine keyboards were swabbed at baseline, day 7 and 14, with 234 keyboards cultured, colony forming units (CFUs) counted and organisms isolated. By mixed model analysis, the difference of mean bacteria count between intervention and control for week 1 was 32.74 (− 32.74, CI − 94.29 to 28.75, p = 0.29), for week 2 by 155.86 (− 155.86, CI − 227.45 to − 83.53, p < 0.0001), and after the 2-week period by 157.04 (− 157.04, CI − 231.53 to − 82.67, p < 0.0001). In the sub-analysis, there were significant differences of pathogenic bacteria counts for the Intervention as compared to the Control in contrast with commensal counts. Conclusion: A hand hygiene device attached to a COW may be effective in decreasing the microbiological burden on computer keyboards.
ISSN: 20472994
DOI: 10.1186/s13756-021-00948-1
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