Ideas That Work: Infection Control

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How Clean Are Your Medical Charts?


At my former hospital, a patient expressed concern about sticker residue on the outside of the plastic binder that held their paper chart and wondered aloud about the overall cleanliness of the facility. A nurse quickly attempted to remove the residue, only to discover the wipe she used turned black from the grime on the binder’s surface. The incident served as a wake-up call. Medical charts are circulated throughout the facility and travel with patients from pre-op into sterile ORs. We clean handheld personal devices before taking them into surgery, so why aren’t we wiping down medical charts with a low-level disinfectant? To determine the scope of the problem, we used adenosine triphosphate (ATP) tests on the surfaces of 25 random medical charts and found most were above the threshold for the presence of high levels of organic residues, including microorganisms. In response to the findings, we eliminated the use of stickers on charts and wipe down each binder before they enter the OR and the PACU, and again after patient discharge. The new cleaning process significantly reduced the amount of bioburden on the binders.

Romel Jimera, MSN, RN, CNOR
Keck Medicine of USC
Los Angeles, Calif.
[email protected]

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