References

Albert NM, Hancock K, Murray T Cleaned, ready-to-use, reusable electrocardiographic lead wires as a source of pathogenic microorganisms. Am J Crit Care. 2010; 19:(6)e73-e80 https://doi.org/10.4037/ajcc2010304

Brandt D, Blüher M, Lankiewicz J, Mallow PJ, Saunders R. Sternal-wound infections following coronary artery bypass graft: could implementing value-based purchasing be beneficial. JHEOR. 2020; 7:(2)130-138 https://doi.org/10.36469/jheor.2020.13687

Brown DQ. Disposable vs reusable electrocardiography leads in development of and cross-contamination by resistant bacteria. Crit Care Nurs. 2011; 31:(3)62-68 https://doi.org/10.4037/ccn2011874

Falk PS, Winnike J, Woodmansee C, Desai M, Mayhall CG. Outbreak of vancomycin-resistant enterococci in a burn unit. Infect Control Hosp Epidemiol. 2000; 21:(9)575-582 https://doi.org/10.1086/501806

Hollenbeak CS, Murphy DM, Koenig S, Woodward RS, Dunagan WC, Fraser VJ. The clinical and economic impact of deep chest surgical site infections following coronary artery bypass graft surgery. Chest. 2000; 118:397-402 https://doi.org/10.1378/chest.118.2.397

Keller JP. Clinical alarm hazards: a ‘top ten’ health technology safety concern. J Electrocardiol. 2012; 45:588-591 https://doi.org/10.1016/j.jelectrocard.2012.08.050

Kligfield P, Gettes LS, Bailey JJ Recommendations for the standardization and interpretation of the electrocardiogram: part I: the electrocardiogram and its technology: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: endorsed by the International Society for Computerized Electrocardiology. Circulation. 2007; 115:(10)1306-1324 https://doi.org/10.1161/CIRCULATIONAHA.106.180200

Lankiewicz J, Wong T, Moucharite M. The relationship between a single-patient-use electrocardiograph cable and lead system and coronary artery bypass graft surgical site infection within a Medicare population. Am J Infect Control. 2018; 46:(8)949-951 https://doi.org/10.1016/j.ajic.2018.01.023

Lestari T, Ryll S, Kramer A. Microbial contamination of manually reprocessed, ready to use ECG lead wire in intensive care units. GMS Hyg Infect Control. 2013; 8:(1)1-7 https://doi.org/10.3205/dgkh000207

National adult cardiac surgery audit. 2020 Summary Report.London: NICOR; 2020

National Institute of Health and Care Excellence. Prevention and control of healthcare-associated infections in primary and community care. Clinical guideline [CG139]. 2017. http://www.nice.org.uk/guidance/cg139 (accessed 22 March 2021)

National Institute of Health and Care Excellence. Infection prevention and control. Quality standard [QS61]. https://www.nice.org.uk/guidance/qs61/chapter/introduction#:~:text=It%20is%20estimated%20that%20300%2C000,of%20care%20within%20the%20NHS (accessed 1 April 2021)

Office for National Statistics. Updated estimates of coronavirus (COVID-19) related deaths by disability status, England: 24 January to 20 November 2020. 2021. https://tinyurl.com/3cz7f4eb (accessed 1 April 2021)

Royal College of Nursing. Records broken in new nurse vacancy data for England 2019a. https://www.rcn.org.uk/news-and-events/press-releases/vacancy (accessed 22 March 2021)

Royal College of Nursing. Nursing staff stretched to breaking point over workloads, report reveals. 2019b. https://www.rcn.org.uk/news-and-events/press-releases/staff-survey (accessed 22 March 2021)

Society for Cardiological Science and Technology. Clinical guidelines by consensus. Recording a standard 12-lead electrocardiogram. 2017. https://tinyurl.com/8wvaxt8v (accessed 22 March 2021)

World Health Organization. WHO Patient Safety Healthcare Associated Infection Factsheet. 2011. https://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf (accessed 1 April 2021)

World Health Organization. WHO Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020. 2020. https://www.who.int/director-general/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020 (accessed 22 March 2021)

The role of single-use ECG leads in reducing healthcare-associated infections

10 June 2021
9 min read
Volume 30 · Issue 11
Figure 3. Twelve-lead ECG, with four limb and six chest electrodes
Figure 3. Twelve-lead ECG, with four limb and six chest electrodes

Abstract

An electrocardiogram (ECG), the recording of the electrical activity in the heart, is the most commonly performed cardiac test. It is carried out in a variety of clinical settings in hospitals and primary care, and its use is standard practice among high-risk, critically ill patients, and those who have undergone cardiac surgery. ECG recording is classified into two main categories: monitoring and diagnostic. 12-lead ECGs, which require electrodes to be placed on the chest and each limb, are used for diagnostic purposes, whereas 3- or 5-lead ECGs are used for rhythm monitoring. Cross-infection can arise from reusing ECG cables, even if they have been cleaned. Surgical site infection is a particular risk in patients who have undergone coronary artery bypass grafting, because ECG wires are placed on the chest close to the incision site. Single-use ECG leads, such as the Kendall DL™ ECG cable and lead wire system, reduce the risk of cross-contamination between patients and free nursing time for patient care because they are discarded after use and do not have to be cleaned and disinfected for use with another patient.

An electrocardiogram (ECG) is a recording of the electrical activity within the heart muscle and is the most commonly performed cardiac test (Kligfield et al, 2007). ECG monitoring is used in a variety of clinical settings in hospitals and in primary care, and the test is standard practice with the highest risk, critically ill patients.

ECG monitoring essentially falls in to two categories: 12-lead ECG recording and ECG rhythm monitoring. As the terms imply, the latter is used to monitor the heart's rhythm and identify any deviations from normal sinus rhythm, while the former is used primarily to ‘visualise’ anatomical surfaces of the heart to aid diagnosis of conditions such as myocardial infarction.

It is possible to record ECG rhythm without having to apply monitoring electrodes and cables, for example when using the AliveCor Kardia Mobile device, but they are required for continuous ECG monitoring in clinical settings.

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