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Can Pulsed Xenon Ultraviolet Disinfect Aerobic Bacteria in the Presence of Organic Material and the Absence of Manual Disinfection?
Poster Abstracts / American Journal of Infection Control 42 (2014) S29-S166
Publication Number 2-133 Effectively Reducing Flash Sterilization in a Rural Community Hospital Surgical Suite Christine A. Bingman RN, BSN, CCRN, CIC, Infection Prevention Coordinator, University of Pittsburgh Medical Center-Northwest ISSUE: Patients are the main stakeholders in surgical equipment reprocessing, and critical item sterilization is paramount in the reduction of surgical site infections. Flashing is a modification of conventional sterilization which is not recommended. A retrospective analysis of flash sterilization records for calendar year 2011 identified a flash rate of forty-five percent. A joint Infection Prevention (IP) and Sterile Processing Department (SPD) initiative was launched to reduce the total Number of flashed items. PROJECT: A PDSA design was implemented to evaluate the sterilization process. Daily flashed item documentation listed reasons for immediate release reprocessing and were entered into a database monthly. The IP and SPD analyzed for themes. Analysis of pre-established quality indicators identified three areas of concern; timing of vendor-provided loaner trays, low volumes of frequently used one-of-a-kind instruments and contamination. Safe reprocessing education and potential risks were provided to perioperative personnel. A policy for loaner instruments was revised to include delivery of instruments twenty-four hours prior to scheduled cases. Innovative scheduling practices were implemented. RESULTS: Based on data, leadership provided the means to purchase additional instruments and rigid containers to decrease flash sterilization frequency and to prevent surgical time delays. Flash sterilization usage decreased dramatically with the implementation of these practice alterations. Annual data were compared using a Fisher’s Exact Test. The 2012 rate for flashed items was (544/ 5394*100) 10.1. The rate of flashed items for the first eleven months of 2013 (393/4422*100) is 8.9. The two-tailed p ¼ 0.000872. The association is considered extremely statistically significant. LESSON LEARNED: With teamwork and leadership support, SPD and IP made a significant impact on the volume of flashed items for immediate release. This impacts patient safety and complies with the Joint Commission’s National Patient Safety Goals for Infection Prevention.
Publication Number 2-134 Can Pulsed Xenon Ultraviolet Disinfect Aerobic Bacteria in the Presence of Organic Material and the Absence of Manual Disinfection? Chetan Jinadatha MD, MPH, Chief, Infectious Diseases Division, Central Texas Veterans Health Care System - Texas A&M University Health; Robin Keene PhD, ACOS, Central Texas Veterans Healthcare System; Deana Hamson LVN, Fall Prevention Coordinator, Central Texas Veterans Healthcare System; John Zeber PhD, Investigator, Central Texas Veterans Healthcare System; Laurel Copeland PhD, MPH, Research Scientist, Central Texas Veterans Health Care System; Nagaraja Ganachari-Mallappa PhD, Research Associate, Central Texas Veterans Healthcare System; Donna Brown RN, Clinical Research Coordinator, Central Texas Veterans Healthcare System; Thomas Huber PhD, Director, Microbiology Lab, Central Texas Veterans Healthcare System
S45
BACKGROUND/OBJECTIVES: Pulsed xenon-based Ultraviolet (PXUV) no-touch disinfection systems are being widely used for room disinfection after patient discharge. Typically a hospital room is cleaned manually to remove gross soiling while achieving disinfection using an Environmental Protection Agency (EPA) approved product. Then a pulsed xenon disinfection system is deployed to attain more thorough disinfection. Effectiveness of pulsed xenon in the presence of organic material and the absence of manual disinfection have not been evaluated. METHODS: Patient rooms that were occupied for a minimum of 48 hours were identified. Aerobic colony count samples were collected from five high-touch surfaces (bedrail, toilet seat, bathroom handrail, call button and tray table) before and after usage of pulsed xenon disinfection device. The samples were collected using Rodac plates (Hardy Diagnostics, Santa Maria, CA) that contained Tryptic Soy Agar (TSA) supplemented with Lecithin and Tween 80. The plates were incubated for 484 hours at 302 C. RESULTS: A total of 15 rooms were included in the study. Individual colonies were counted immediately after incubation. For plates with >200 colonies, the colony counts were recorded as 200 (>200 colonies is too many to enumerate). The pre-cleaning and postpulsed xenon colony counts were totaled, and a percent decline in the colony counts was calculated. There was an average decline of 75% in colony counts (range 23%-97%) after pulsed xenon disinfection. The decline was consistently observed across surfaces/ rooms. CONCLUSIONS: Our study indicates that pulsed xenon effectively reduces aerobic bacteria in the absence of manual disinfection and in the presence of organic material. A properly truncated aesthetic cleaning protocol supplemented by pulsed xenon no-touch disinfection might be effective in disinfecting vacated hospital rooms. This study also provides an insight into what happens if a surface is missed during manual disinfection while pulsed xenon is deployed.
Publication Number 2-135 Clostridium Difficile Identification from Environmental Samples: A Study Comparing Three Different Identification Methodologies Chetan Jinadatha MD, MPH, Chief, Infectious Diseases Division, Central Texas Veterans Health Care System - Texas A&M University Health; John Zeber PhD, Investigator, Central Texas Veterans Healthcare System; Laurel Copeland PhD, MPH, Research Scientist, Central Texas Veterans Health Care System; Nagaraja Ganachari-Mallappa PhD, Research Associate, Central Texas Veterans Healthcare System; Donna Brown RN, Clinical Research Coordinator, Central Texas Veterans Healthcare System; Thomas Huber PhD, Director, Microbiology Lab, Central Texas Veterans Healthcare System BACKGROUND/OBJECTIVES: Isolation and identification of Clostridium difficile (C.diff) spores from environmental samples is difficult. C.diff chromogenic agar (bioMérieux Inc., Durham, NC) has been previously described for the identification of clinical but not environmental specimens. Similarly, C.diff latex agglutination tests (Microgen Bioproducts Ltd, Surrey, UK) have been used for identification of environmental specimens, but these tests have not been compared to Matrix-Assisted Laser Desorption/Ionization-Time of Flight mass spectrometry (MALDI-TOF MS, bioMérieux Inc.) or to C.diff chromogenic agar.
APIC 41st Annual Educational Conference & International Meeting j Anaheim, CA j June 7-9, 2014
Publication Number 2-133 Effectively Reducing Flash Sterilization in a Rural Community Hospital Surgical Suite Christine A. Bingman RN, BSN, CCRN, CIC, Infection Prevention Coordinator, University of Pittsburgh Medical Center-Northwest ISSUE: Patients are the main stakeholders in surgical equipment reprocessing, and critical item sterilization is paramount in the reduction of surgical site infections. Flashing is a modification of conventional sterilization which is not recommended. A retrospective analysis of flash sterilization records for calendar year 2011 identified a flash rate of forty-five percent. A joint Infection Prevention (IP) and Sterile Processing Department (SPD) initiative was launched to reduce the total Number of flashed items. PROJECT: A PDSA design was implemented to evaluate the sterilization process. Daily flashed item documentation listed reasons for immediate release reprocessing and were entered into a database monthly. The IP and SPD analyzed for themes. Analysis of pre-established quality indicators identified three areas of concern; timing of vendor-provided loaner trays, low volumes of frequently used one-of-a-kind instruments and contamination. Safe reprocessing education and potential risks were provided to perioperative personnel. A policy for loaner instruments was revised to include delivery of instruments twenty-four hours prior to scheduled cases. Innovative scheduling practices were implemented. RESULTS: Based on data, leadership provided the means to purchase additional instruments and rigid containers to decrease flash sterilization frequency and to prevent surgical time delays. Flash sterilization usage decreased dramatically with the implementation of these practice alterations. Annual data were compared using a Fisher’s Exact Test. The 2012 rate for flashed items was (544/ 5394*100) 10.1. The rate of flashed items for the first eleven months of 2013 (393/4422*100) is 8.9. The two-tailed p ¼ 0.000872. The association is considered extremely statistically significant. LESSON LEARNED: With teamwork and leadership support, SPD and IP made a significant impact on the volume of flashed items for immediate release. This impacts patient safety and complies with the Joint Commission’s National Patient Safety Goals for Infection Prevention.
Publication Number 2-134 Can Pulsed Xenon Ultraviolet Disinfect Aerobic Bacteria in the Presence of Organic Material and the Absence of Manual Disinfection? Chetan Jinadatha MD, MPH, Chief, Infectious Diseases Division, Central Texas Veterans Health Care System - Texas A&M University Health; Robin Keene PhD, ACOS, Central Texas Veterans Healthcare System; Deana Hamson LVN, Fall Prevention Coordinator, Central Texas Veterans Healthcare System; John Zeber PhD, Investigator, Central Texas Veterans Healthcare System; Laurel Copeland PhD, MPH, Research Scientist, Central Texas Veterans Health Care System; Nagaraja Ganachari-Mallappa PhD, Research Associate, Central Texas Veterans Healthcare System; Donna Brown RN, Clinical Research Coordinator, Central Texas Veterans Healthcare System; Thomas Huber PhD, Director, Microbiology Lab, Central Texas Veterans Healthcare System
S45
BACKGROUND/OBJECTIVES: Pulsed xenon-based Ultraviolet (PXUV) no-touch disinfection systems are being widely used for room disinfection after patient discharge. Typically a hospital room is cleaned manually to remove gross soiling while achieving disinfection using an Environmental Protection Agency (EPA) approved product. Then a pulsed xenon disinfection system is deployed to attain more thorough disinfection. Effectiveness of pulsed xenon in the presence of organic material and the absence of manual disinfection have not been evaluated. METHODS: Patient rooms that were occupied for a minimum of 48 hours were identified. Aerobic colony count samples were collected from five high-touch surfaces (bedrail, toilet seat, bathroom handrail, call button and tray table) before and after usage of pulsed xenon disinfection device. The samples were collected using Rodac plates (Hardy Diagnostics, Santa Maria, CA) that contained Tryptic Soy Agar (TSA) supplemented with Lecithin and Tween 80. The plates were incubated for 484 hours at 302 C. RESULTS: A total of 15 rooms were included in the study. Individual colonies were counted immediately after incubation. For plates with >200 colonies, the colony counts were recorded as 200 (>200 colonies is too many to enumerate). The pre-cleaning and postpulsed xenon colony counts were totaled, and a percent decline in the colony counts was calculated. There was an average decline of 75% in colony counts (range 23%-97%) after pulsed xenon disinfection. The decline was consistently observed across surfaces/ rooms. CONCLUSIONS: Our study indicates that pulsed xenon effectively reduces aerobic bacteria in the absence of manual disinfection and in the presence of organic material. A properly truncated aesthetic cleaning protocol supplemented by pulsed xenon no-touch disinfection might be effective in disinfecting vacated hospital rooms. This study also provides an insight into what happens if a surface is missed during manual disinfection while pulsed xenon is deployed.
Publication Number 2-135 Clostridium Difficile Identification from Environmental Samples: A Study Comparing Three Different Identification Methodologies Chetan Jinadatha MD, MPH, Chief, Infectious Diseases Division, Central Texas Veterans Health Care System - Texas A&M University Health; John Zeber PhD, Investigator, Central Texas Veterans Healthcare System; Laurel Copeland PhD, MPH, Research Scientist, Central Texas Veterans Health Care System; Nagaraja Ganachari-Mallappa PhD, Research Associate, Central Texas Veterans Healthcare System; Donna Brown RN, Clinical Research Coordinator, Central Texas Veterans Healthcare System; Thomas Huber PhD, Director, Microbiology Lab, Central Texas Veterans Healthcare System BACKGROUND/OBJECTIVES: Isolation and identification of Clostridium difficile (C.diff) spores from environmental samples is difficult. C.diff chromogenic agar (bioMérieux Inc., Durham, NC) has been previously described for the identification of clinical but not environmental specimens. Similarly, C.diff latex agglutination tests (Microgen Bioproducts Ltd, Surrey, UK) have been used for identification of environmental specimens, but these tests have not been compared to Matrix-Assisted Laser Desorption/Ionization-Time of Flight mass spectrometry (MALDI-TOF MS, bioMérieux Inc.) or to C.diff chromogenic agar.
APIC 41st Annual Educational Conference & International Meeting j Anaheim, CA j June 7-9, 2014