title: A comparison of the surface contaminants of handwritten recycled and printed electronic parenteral nutrition prescriptions and their transfer to bag surfaces during delivery to hospital wards.
abstract: BACKGROUND
  Handwritten recycled paper prescription for parenteral nutrition (PN) may become a concentrated source of viable contaminants, including pathogens. This study examined the effect of using fresh printouts of electronic prescriptions on these contaminants.
  
  
  METHODS
  Cellulose sponge stick swabs with neutralizing buffer were used to sample the surfaces of PN prescriptions (n = 32 handwritten recycled; n = 32 printed electronic) on arrival to the pharmacy or following printing and PN prescriptions and bags packaged together during delivery (n = 38 handwritten recycled; n = 34 printed electronic) on arrival to hospital wards. Different media plates and standard microbiological procedures identified the type and number of contaminants.
  
  
  RESULTS
  Staphylococcus aureus, fungi, and mold were infrequent contaminants. nonspecific aerobes more frequently contaminated handwritten recycled than printed electronic prescriptions (into pharmacy, 94% vs 44%, fisher exact test P .001; onto wards, 76% vs 50%, p = .028), with greater numbers of colony-forming units (CFU) (into pharmacy, median 130 [interquartile range (IQR), 65260] VS 0 [075], Mann-Whitney U test, P .001; onto wards, median 120 [15320] vs 10 [040], P = .001). packaging with handwritten recycled prescriptions led to more frequent nonspecific aerobic bag surface contamination (63% vs 41%, fisher exact test P = .097), with greater numbers of CFU (median 40 [IQR, 080] VS 0 [040], Mann-Whitney U test, P = .036).
  
  
  CONCLUSIONS
  The use of printed electronic PN prescriptions can reduce microbial loads for contamination of surfaces that compromises aseptic techniques.
authors: Faculty of Medicine, University of Southampton, UK.
authors: Peter David
authors: PD
authors: Austin
authors: Kieran Sean
authors: KS
authors: Hand
authors: Marinos
authors: M
authors: Elia
mesh_terms: D015169:Colony Count, Microbial; D004349:Drug Packaging; D055695:Electronic Prescribing; D004866:Equipment Contamination; D005658:Fungi / Q000302:isolation & purification; D006761:Hospitals; D010288:Parenteral Nutrition; D055656:Prescriptions; D011897:Random Allocation; D013211:Staphylococcus aureus / Q000302:isolation & purification
keywords: administration; outcomes research/quality; parenteral nutrition; sepsis