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.
Materials and 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).
Conclusion: The use of printed electronic PN prescriptions can reduce microbial loads for contamination of surfaces that compromises aseptic techniques.
Keywords: administration; outcomes research/quality; parenteral nutrition; sepsis.