NEWS DICEMBRE 2016

New blog post!

December 2016

single-room

Single room, anyone?

There has been lots of debate over many years about the extent to which hospitals should provide single rooms for patients. Read more…

 
Clinell UV360 Significantly Reduces Clostridium difficile Incidence

October 2016

NEW YORK (October 6, 2016) – Ultraviolet C light disinfection to clean unoccupied patient rooms significantly reduced C. difficile infections (CDI) in high-risk patients who later occupied those rooms, according to a study published today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America. The no-touch device, used after patients with CDI were discharged from the hospital, also resulted in substantial healthcare savings, estimated between $350,000 and $1.5 million annually. 

“UV light disinfection is a fast, safe, and effective technology to reduce the risk of C. difficile infection associated with the hospital environment,” said David Pegues, MD, lead author of the study and a professor of Medicine in the Perelman School of Medicine at the University of Pennsylvania.
“The success of this technology is dependent on Environmental Services employees as a critical partner in our ongoing efforts to eliminate hospital-acquired infections such as C. difficile and
to improve patient safety.”

The study was conducted in three hematology-oncology units at the Hospital of the University of Pennsylvania during a one-year period (February 2014-January 2015). Results showed that adding UV disinfection to typical disinfection protocols reduced the incidence of CDI by 25 percent among new patients in these units, compared to the prior year. At the same time, CDI rates increased 16 percent in the non-study units during this period. The team found that using the ultraviolet robot after a room cleaning by members of the Environmental Services team not only reduced the number of infections, but did so without adversely impacting room turnaround time. According to this study, room cleaning took only five minutes longer on average compared to non-study units.

“These findings have real implications for both health systems and patients. The effectiveness and efficiency of UV-C robots make it a practical and cost effective technology that will benefit hospitals around the country and save people’s lives,” said Pegues.

The technique, known as ultraviolet wavelength C germicidal irradiation, uses short-wavelength ultraviolet light to kill microorganisms. CDI is one of the most common healthcare-acquired infections in the United States and is associated with serious complications. It is resistant to many surface disinfectants and can persist on surfaces, making it an ongoing risk for transmission to patients.

While the UV disinfection device proved to be effective at reducing CDI incidence, it showed no effect on other healthcare-associated infections, such as methicillin-resistant Staphylococcus aureus (MRSA).

David Pegues, Jennifer Han, Cheryl Gilmar, Brooke McDonnell, Steven Gaynes. “Impact of Ultraviolet Germicidal Irradiation for Terminal Room Disinfection on C. difficile Infection Incidence among Hematology Oncology Patients.” Web (October 6, 2016).

 
IPS 2016 Quiz Me winners

October 2016

This year we had a great turn out for the Quiz Me game, thanks for coming along! The winners from each day were Karen Hawker, Kirsty Louise Morgan and Jean Robinson. Congratulations, enjoy your tablet and Amazon vouchers!img_4155

 
IPS 2016 #clinellcandy Twitter wall winners

October 2016

This years Twitter winners for the #clinellcandy stand were Carley Baker, Kerry Ord and Gary! They each had the best photo throughout the show! Congratulations, enjoy the chocolate hamper prize!img_4101

 
Sporicidal Granules for high level disinfection

October 2016

granules

New evidence shows that flooring can be a reservoir for pathogens of significance in healthcare.

Uses Peracetic Acid (PAA) Technology
PAA generating products are now considered a suitable substitute in situations where 1,000 and 10,000 ppm of chlorine are recommended.
Unique granule formulation
Easily mixed within bespoke 1L and 2.5L jugs allowing quick and easy activation, avoiding dilution errors common with chlorine tablets.
ColourActive Technology
Once active the solution turns red in colour. After 24 hours it becomes colourless, indicating it is no longer active, allowing you to always know you are using an effective solution.
More effective than chlorine
PAA has been shown to be more effective than chlorine against C. difficile5,6 and unlike chlorine, PAA is not deactivated by organic matter.
Safer than Chlorine
Peracetic acid breaks down into the harmless, environmentally friendly by-products of water, carbon dioxide and oxygen.

NEWS NOVEMBRE 2016

Cost-effectiveness of C. difficile prevention

How much does it cost to prevent the transmission of C. difficile? And is switching to an automated room decontamination (ARD) system for the prevention to reduce environmental contamination with C. difficile spores cost effective? Whilst no formal cost-effectiveness evaluations have been published, there is enough evidence to suggest that switching to an automated room decontamination system will be cost-effective given the published scale of reduction in C. difficile transmission, and the per-case cost of C. difficle infection.
 
C. difficile infection can be an extremely expensive outcome for a patient. Leaving aside the important socioeconomic impact for the individual and obvious human cost, a recent review suggests that each case costs somewhere between £2000 and 19,500. A number of studies have shown that automated room decon systems reduce the incidence of CDI (see the summary table below). Whilst these studies are really non-comparable – performed in different settings, with a different baseline rate of CDI, and a different set of background interventions, a crude mean percentage reduction was 44%. (Incidentally, this suggests that 44% of CDI is related, directly or indirectly, to contaminated environmental surfaces, which is interesting in itself.)
jon-table-18-11-16 (Click on the table to enlarge)
 
So, let’s take a hospital with 50 cases of CDI each year. If an ARD system is introduced for the terminal disinfection of rooms following the stay of a patient with CDI, you would expect a 44% reduction in the number of cases, and only 28 cases of CDI – hence 22 cases averted. This would result in a cost saving in the range of £44,000 - £429,000. Taking a mid-point of this range (£240,000) leaves a pretty large envelope in which to fit an ARD service to ensure that all rooms occupied by patients with CDI are decontaminated. Furthermore, it is likely that a service could cover discharges with other pathogens and make an impact on them to – delivering further financial savings.


 jon-blog-18-11-16
One final thought: does an infection prevention initiative have to be cost-saving? Or is it acceptable for a prevention initiative to cost more than the associated financial savings? I guess this will depend on the circumstances and the costs involved on both sides of the equation, but it won’t always make sense to accept only cost saving prevention initiatives.
 

JOIN THE DISCUSSION

 
Does chlorhexidine resistance emerge in Staph aureus?

staph_aureus

It is prudent to be concerned that regular use of chlorhexidine will ultimately result in reduced chlorhexidine susceptibility and perhaps even resistance. However, a recent long term study performed over a decade in the north of England suggests that regular use of chlorhexidine as part of an MRSA decolonisation regieme does not result in widespread reduced susceptibility.

The regional study in the Yorkshire and Humber region collected a 'snapshot' of S. aureus isolates from 14 laboratories over two days. The isolates were tested for their in vitro susceptibility to chlorhexidine, and the carriage of the qacA gene, which has been associated with reduced chlorhexidine susceptibility. Overall, 1.7% of the 520 isolates carried the qacA gene, and 3.5% had a chlorhexidine minimum inhibitory concentration (MIC) of >2. Whilst there is no clinically defined breakpoint for chlorhexidine resistance, an MIC of >2 is generally considered to be reduced susceptibility. Similar findings were reported for mupiricin, with low levels of in vitro mupirocin resistance detected.

So, despite the widespread use of chlorhexidine for decolonisation of S. aureus carriage in the region, reduced susceptibility was not widespread. Does this mean that reduced susceptibility to chlorhexidine isn't a problem? No, we know from other studies that it can be. It's just that it seems to be a rather rare event, at least in the north of England!

JOIN THE DISCUSSION

News ottobre 2016

Clinell UV360 Significantly Reduces Clostridium difficile Incidence

October 2016

NEW YORK (October 6, 2016) – Ultraviolet C light disinfection to clean unoccupied patient rooms significantly reduced C. difficile infections (CDI) in high-risk patients who later occupied those rooms, according to a study published today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America. The no-touch device, used after patients with CDI were discharged from the hospital, also resulted in substantial healthcare savings, estimated between $350,000 and $1.5 million annually. 

“UV light disinfection is a fast, safe, and effective technology to reduce the risk of C. difficile infection associated with the hospital environment,” said David Pegues, MD, lead author of the study and a professor of Medicine in the Perelman School of Medicine at the University of Pennsylvania.
“The success of this technology is dependent on Environmental Services employees as a critical partner in our ongoing efforts to eliminate hospital-acquired infections such as C. difficile and
to improve patient safety.”

The study was conducted in three hematology-oncology units at the Hospital of the University of Pennsylvania during a one-year period (February 2014-January 2015). Results showed that adding UV disinfection to typical disinfection protocols reduced the incidence of CDI by 25 percent among new patients in these units, compared to the prior year. At the same time, CDI rates increased 16 percent in the non-study units during this period. The team found that using the ultraviolet robot after a room cleaning by members of the Environmental Services team not only reduced the number of infections, but did so without adversely impacting room turnaround time. According to this study, room cleaning took only five minutes longer on average compared to non-study units.

“These findings have real implications for both health systems and patients. The effectiveness and efficiency of UV-C robots make it a practical and cost effective technology that will benefit hospitals around the country and save people’s lives,” said Pegues.

The technique, known as ultraviolet wavelength C germicidal irradiation, uses short-wavelength ultraviolet light to kill microorganisms. CDI is one of the most common healthcare-acquired infections in the United States and is associated with serious complications. It is resistant to many surface disinfectants and can persist on surfaces, making it an ongoing risk for transmission to patients.

While the UV disinfection device proved to be effective at reducing CDI incidence, it showed no effect on other healthcare-associated infections, such as methicillin-resistant Staphylococcus aureus (MRSA).

David Pegues, Jennifer Han, Cheryl Gilmar, Brooke McDonnell, Steven Gaynes. “Impact of Ultraviolet Germicidal Irradiation for Terminal Room Disinfection on C. difficile Infection Incidence among Hematology Oncology Patients.” Web (October 6, 2016).

 
IPS 2016 Quiz Me winners

October 2016

This year we had a great turn out for the Quiz Me game, thanks for coming along! The winners from each day were Karen Hawker, Kirsty Louise Morgan and Jean Robinson. Congratulations, enjoy your tablet and Amazon vouchers!img_4155

clorexidina sol.acq.2%

Study demonstrates the value of Clinell 2% chlorhexidine wash cloths

CHG_pink

A new study shows that daily bathing using Clinell 2% chlorhexidine wash cloths dramatically reduces the transmission of carbapenem-resistant Acinetobacter baumannii where other measured failed. In the Korean intensive care unit where the study was performed, the proportion of patient who acquired this extremely antibiotic resistant pathogen was reduced by more than half, from 21% to 10%. Previous attempts to address this organism using enhanced screening, contact precautions and environmental disinfection had failed to bring the outbreak under control. Another important finding from the study is that there was no development of resistance to chlorhexidine, despite its daily use on the unit.

Carbapenem-resistant A. baumannii – sometimes known as 'CRAB' – is an emerging issue worldwide. It combines a very high level of resistance to antibiotics with a propensity for causing problems in the sickest patients, for example, in intensive care and burns units. The organism often colonizes the skin, so the use of daily bathing using a chlorhexidine wash cloth makes sense – and this study shows that this intervention works.

Further work is being performed in other hospitals to evaluate the effectiveness of Clinell 2% chlorhexidine wash cloths for reducing the transmission of CRAB and other pathogens.

ips 2015

IPS 2015

IPS2015

We would like to thank all those who attended Infection Prevention 2015 and took the time to visit our stand. It is so good to see so many familiar faces and to meet new ones. It was lovely to be back in Liverpool and the organising committee did an incredible job of making the event fun, educational and thoroughly enjoyable. We'll never be able to look at an Air Steward in the same way! It was rewarding to see the people and Trusts that we work with regularly receiving the credit their hard work and dedication deserves, in the IPS annual awards. We hope our industry leading aftercare support has helped them to achieve some of their goals. We are especially proud of our Clinical Director, Martin Kiernan, who won the Brendan Moore Award for his continued excellence in Infection Prevention and Control.

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The GAMA Healthcare stand was very busy throughout the exhibition. We gave away some very popular selfie sticks, bluetooth speakers, delicious sweets, phone stands and of course, the usual multi-coloured pens and bags. Our new EvaluClean audit system proved very popular and it was great to receive feedback from our users on the frontline. If your trust is interested in running a trial with our BETA app please don't hesitate to contact us.

hamper
The twitter wall produced some hilarious images and the well deserved winners of a delicious chocolate hamper are listed below:

Day 1: Merja Thomas and Carly Baker from UHCW
Day 2: IPC Team of Calderdale and Huddersfield
Day 3: Gary Thirkell and Donna Winter

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ips-2015
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This year  IPS annual conference and exhibition was based in our backyard at the ExCeL in London. The usual balance of informative talks, superb...
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