Mark Ettenberger PhD, MA, MT (is Coordinator, Music Therapy Service, Department of Social Management, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia, and Director, SONO – Centro de Musicoterapia, Bogotá, Colombia.), Andrés Salgado MMT, MT (is Clinical Musical Therapist, Department of Social Management, University Hospital Fundación Santa Fe de Bogotá, and Clinical Musical Therapist, SONO – Centro de Musicoterapia.), Rafael Maya MNMT, NMT, MT (is Clinical Musical Therapist, Department of Social Management, University Hospital Fundación Santa Fe de Bogotá, and Clinical Musical Therapist, SONO – Centro de Musicoterapia.), Adriana Merchán-Restrepo MSc (is Coordinator, Epidemiological Surveillance, University Hospital Fundación Santa Fe de Bogotá.), Pedro Barrera-López MD (is Pediatric Intensivist and Consultant Epidemiologist, Office of Clinical Studies and Epidemiology, University Hospital Fundación Santa Fe de Bogotá. Please address correspondence to Mark Ettenberger)
{"title":"Efficacy and Impact of a Cleaning and Disinfection Protocol for Musical Instruments Used in Music Therapy Services in ICUs: A Prospective Cohort Study","authors":"Mark Ettenberger PhD, MA, MT (is Coordinator, Music Therapy Service, Department of Social Management, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia, and Director, SONO – Centro de Musicoterapia, Bogotá, Colombia.), Andrés Salgado MMT, MT (is Clinical Musical Therapist, Department of Social Management, University Hospital Fundación Santa Fe de Bogotá, and Clinical Musical Therapist, SONO – Centro de Musicoterapia.), Rafael Maya MNMT, NMT, MT (is Clinical Musical Therapist, Department of Social Management, University Hospital Fundación Santa Fe de Bogotá, and Clinical Musical Therapist, SONO – Centro de Musicoterapia.), Adriana Merchán-Restrepo MSc (is Coordinator, Epidemiological Surveillance, University Hospital Fundación Santa Fe de Bogotá.), Pedro Barrera-López MD (is Pediatric Intensivist and Consultant Epidemiologist, Office of Clinical Studies and Epidemiology, University Hospital Fundación Santa Fe de Bogotá. Please address correspondence to Mark Ettenberger)","doi":"10.1016/j.jcjq.2024.07.007","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Health care–associated infections (HAIs) can affect patient safety and recovery. Musical instruments used by music therapy services may carry pathogens, particularly in ICUs. The aim of this study was to determine the efficacy of the cleaning and disinfection protocol by the music therapy service of the University Hospital Fundación Santa Fe de Bogotá.</div></div><div><h3>Methods</h3><div>This prospective cohort study included all ICU music therapy patients from July to August 2023. Adenosine triphosphate (ATP) bioluminescence tests and microbiological cultures were taken before and after cleaning the musical instruments for nine patients in the adult and pediatric ICUs. ATPs were taken before starting music therapy, after finishing music therapy, and after cleaning the instruments. Cultures were taken if an ATP test was above the established cutoff of ≤ 200 relative light units (RLUs). If no ATP value was above the cutoff, cultures were taken randomly.</div></div><div><h3>Results</h3><div>A total of 63 ATPs and 10 random microbiological cultures were taken. After applying the cleaning and disinfection protocol, all ATP values were ≤ 200 RLUs. Of the 10 microbiological cultures, 1 screened positive for <em>Streptococcus</em> sp., yeast, and <em>Micrococcus.</em> One hundred ICU music therapy patients were followed up, and positive associations with HAIs were found for age (<em>p</em> = 0.01), type of unit (<em>p</em> = 0.001), tracheostomy (<em>p</em> < 0.001), arterial line (<em>p</em> = 0.005), hemodialysis catheter (<em>p</em> = 0.05), bladder catheter (<em>p</em> = 0.02), number of invasive devices (<em>p</em> = 0.02), duration use of invasive devices (<em>p</em> = 0.01), and days of hospitalization (<em>p</em> = 0.01). Number of music therapy sessions/patient was not associated with HAIs (<em>p</em> = 0.86).</div></div><div><h3>Conclusion</h3><div>The results indicate that the current cleaning and disinfection protocol can be considered safe and effective. To the authors’ knowledge, this is one of the first studies investigating biosafety of musical instruments in a hospital-based music therapy service. Patient safety is of the utmost importance in hospital settings, and awareness about proper cleaning of their work tools among music therapists is paramount.</div></div>","PeriodicalId":14835,"journal":{"name":"Joint Commission journal on quality and patient safety","volume":"50 11","pages":"Pages 755-763"},"PeriodicalIF":2.3000,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Joint Commission journal on quality and patient safety","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1553725024002277","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
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Abstract
Background
Health care–associated infections (HAIs) can affect patient safety and recovery. Musical instruments used by music therapy services may carry pathogens, particularly in ICUs. The aim of this study was to determine the efficacy of the cleaning and disinfection protocol by the music therapy service of the University Hospital Fundación Santa Fe de Bogotá.
Methods
This prospective cohort study included all ICU music therapy patients from July to August 2023. Adenosine triphosphate (ATP) bioluminescence tests and microbiological cultures were taken before and after cleaning the musical instruments for nine patients in the adult and pediatric ICUs. ATPs were taken before starting music therapy, after finishing music therapy, and after cleaning the instruments. Cultures were taken if an ATP test was above the established cutoff of ≤ 200 relative light units (RLUs). If no ATP value was above the cutoff, cultures were taken randomly.
Results
A total of 63 ATPs and 10 random microbiological cultures were taken. After applying the cleaning and disinfection protocol, all ATP values were ≤ 200 RLUs. Of the 10 microbiological cultures, 1 screened positive for Streptococcus sp., yeast, and Micrococcus. One hundred ICU music therapy patients were followed up, and positive associations with HAIs were found for age (p = 0.01), type of unit (p = 0.001), tracheostomy (p < 0.001), arterial line (p = 0.005), hemodialysis catheter (p = 0.05), bladder catheter (p = 0.02), number of invasive devices (p = 0.02), duration use of invasive devices (p = 0.01), and days of hospitalization (p = 0.01). Number of music therapy sessions/patient was not associated with HAIs (p = 0.86).
Conclusion
The results indicate that the current cleaning and disinfection protocol can be considered safe and effective. To the authors’ knowledge, this is one of the first studies investigating biosafety of musical instruments in a hospital-based music therapy service. Patient safety is of the utmost importance in hospital settings, and awareness about proper cleaning of their work tools among music therapists is paramount.
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