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The Control of Infectious Disease in Orthotics and Prosthetics

Muller, Ashley, MS; Fiedler, Goeran, PhD

JPO: Journal of Prosthetics and Orthotics: July 2018 - Volume 30 - Issue 3 - p 124–129
doi: 10.1097/JPO.0000000000000202
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Introduction It is generally expected that medical professionals use methods in their practice to prevent the spread of infectious disease. Although these methods are typically observed in patient examination rooms, practitioners and other professionals in the industry of orthotics and prosthetics (O&P) face the unique challenge that patient care continues without the patient in other locations where disease may spread: the laboratory and the storage room. Orthotics and prosthetics laboratories use tools throughout the day to fabricate and/or modify multiple devices for different patients. Commonly, little to nothing is done to prevent cross-contamination from one device to another. Items kept in storage rooms have potential for use by more than one patient, primarily for sizing or casting purposes, but may not be cleaned in any way before being restocked. Despite the inherent risk of infection spreading as a result of cross-contamination from the laboratory or restocked items, no standard protocol for this issue has been set in place by the Occupational Safety and Health Administration (OSHA) or by any O&P facility accreditation bodies.

Materials and Methods A survey emailed to subscribers of OANDP-L, an online email discussion list consisting of members of the O&P community, inquired about current O&P infection control methods used outside of patient examination rooms, general knowledge of terms regarding infection control, and perception of risk of infection in the O&P industry. The survey results were used to assess the current climate of infection control in O&P so that future research can lead to a standard protocol designed to protect patients and professionals from infectious disease.

Results A total of 123 O&P professionals completed the survey. Roughly two-thirds of respondents agreed that cross-contamination from devices poses infection risks. Only about half of the sample reported washing hands for the recommended 15 seconds or longer. A total of 44% and 76c of respondents, respectively, reported mostly not cleaning patient devices and tools.

Discussion Findings show a deficit in awareness by a substantial number of respondents. Infection control in O&P work environments has potential for improvement. A key aspect in fostering those improvements is, next to educational efforts, a change in reimbursement policies that account for the staff time required to follow recommended procedures.

ASHLEY MULLER, MS, and GOERAN FIEDLER, PhD, are affiliated with the University of Pittsburgh, School of Health and Rehabilitation Sciences, Pittsburgh, PA.

Disclosure: The authors declare no conflict of interest.

Correspondence to: Goeran Fiedler, PhD, Department of Rehabilitation Science and Technology, University of Pittsburgh, Suite 403, Bakery Square, Pittsburgh, PA 15206; email:

© 2018 by the American Academy of Orthotists and Prosthetists.