The Case for Disposable Electrodes Caroline Finnegan The Walton Centre for Neurology and Neurosurgery, Department of Neurophysiology, Liverpool, UK Introduction Healthcare acquired infection (HCAI) is a major killer of patients worldwide. The World Health Organisation ( 2002), estimate that it affects 1.4 million worldwide. For the patient, it can result in functional disability, reduced quality of life and can prove fatal. The financial implications of HCAI is estimated to be approx £1 billion per annum. Whilst HCAI cannot be totally eradicated, the prevention and control of infection should be an integral part of the role of all healthcare professionals. The use of disposable electrodes reduces cross infection. However, the use of disposable EEG electrodes within Neurophysiology is still not fully embraced. To encourage a shift in culture for the routine use of disposable EEG electrodes there is a need to: 1. Gather and publicise evidence of a reduction in infection rates due to the use of disposable electrodes. 2. Outline a successful business case for disposable EEG electrodes Risks associated with reusable EEG electrodes If skin debri is left on the electrode cup it can lead to cross infection (i.e. MRSA and Varicella Zoster) 2. Using electrodes in both in and out patients increases the risk of cross infection between these groups 3. Decontamination of reuseable electrodes cannot eliminate CJD prions. 4. Decontamination of reuseable electrodes involves the use of COSHH substances, which should be avoided Varicella Zoster MRSA Example structure of business case for disposable electrodes: It must be concise to maximise its impact and yet must be informative. Headings 1. Purpose of request. Use these sections to give an outline of request together with overview of 2. Current Practice. Neurophysiology service and an explanation of purpose of electrodes 3. Supporting evidence- Use audit and: (a) DoH documents Standards for Better Health (2006), Saving Lives (2005), Towards Cleaner Hospitals(2004), Getting Ahead of the Curve (2002) (b) Opinion of professionals Clinical Physiologists in the department, Infection Control team Other Neurophysiology centres, Procurement team (c) Opinion of patients Essential for service development. Patient and Public Involvement (PPI) Forums have statutory powers to ensure that health service providers listen to their views. (d) Risk of not funding (a) Risk of reuseable electrodes (b) Clinical incidents where by the infection status of the patient was confirmed after the test was performed (e)Technical quality We concluded that disposable electrodes had excellent, comparable, recording characteristics to reuseable electrodes Audit of surgical site surveillance/ Infection rate in depth and grid EEG telemetry patients (The Walton Centre) 2005/6 0% After 12 months of using disposable electrodes 2004/5 18% Pre-use of disposable electrodes Summary Healthcare acquired infection is a worldwide problem and there needs to be effective infection control measures in all healthcare settings. Disposable EEG electrodes can contribute to reducing cross infection. At The Walton Centre, I now view disposable EEG electrodes as an essential requirement of the Neurophysiology service.