- Email: [email protected]
Impact of No-touch Ultraviolet-C Light Room Disinfection System on Hospital Acquired Infection Rates
S64
Poster Abstracts / American Journal of Infection Control 44 (2016) S28-S82
use, placement of hand rub dispensers, “gel in” and “gel out” exercises and monthly HH dashboards to all U/D.
9-198 How a Pro-Active Response to National Duodenoscope Outbreaks Led to Improved System-Wide Processes Renee L. Smith, MT(ASCP), CIC, Coordinator, Infection Control, PinnacleHealth System; Kimberly Rivera, MT(ASCP), CIC, Manager Infection Control, PinnacleHealth System BACKGROUND: The 2015 “superbug” outbreaks associated with duodenoscopes alerted the nation and made the public aware of the importance of proper cleaning and disinfection of these complex devices. In response, The Centers for Disease Control and Prevention (CDC) published an Interim Duodenoscope Surveillance Protocol for healthcare facilities. METHODS: In April 2015, a multi-disciplinary team examined all procedures and processes related to duodenoscopes at the three campuses of the health system. Utilizing the CDC protocol, all endoscopes were sampled to determine baseline results. Duodenoscope testing continued monthly, thereafter. Additionally, duodenoscopes used on patients with a multi-drug resistant gram negative bacilli (MDRGNB) were processed and then sampled, cultured, and quarantined until results were final. Infection Control, in collaboration with Endoscopy management, performed the sampling; the microbiology department performed the testing. RESULTS: Following an initial concern related to contamination of broth in the microbiology lab, baseline results of the 32 endoscopes sampled were negative for high-concern bacteria. Subsequent monthly sampling of all duodenoscopes, and scopes used on MDRGNB patients was negative for high-concern bacteria. CONCLUSIONS: Procedural inconsistencies were discovered; consequently system-wide changes were implemented. A recommendation was made that all scopes go to Endoscopy for processing in the automated endoscope reprocessor (AER). Gloves are used when handling clean scopes from the cabinet and the AER. Staff competencies are now conducted every six months. Manual flushes are performed prior to the scope being placed in the AER. Adenosine Triphosphate (ATP) testing is performed on duodenoscopes used on MDR-GNB patients (prior to placing in AER). A patient education sheet was created with the most frequently asked questions regarding duodenoscopes, and explains the cleaning process. Endoscopy has assumed the role of monthly sampling of the duodenoscopes. The recently reported outbreaks of duodenoscope related infections led to several pro-active process improvements as well as implementation of a comprehensive scope culturing program.
9-199 Impact of No-touch Ultraviolet-C Light Room Disinfection System on Hospital Acquired Infection Rates Kathleen McMullen, MPH, CIC, Manager, Infection Prevention and Occupational Health, Christian Hospital; Gaylene Dunn, RN, CIC, Infection Preventionist, Christian Hospital; Rebecca Wade, RN, BSN, CIC, Infection Preventionist, Christian Hospital; Adnan Siddiqui, MD, Medical Director for Infection Prevention, ID Physician, Christian Hospital
BACKGROUND: Intensive environmental cleaning may lead to decreased hospital acquired infections. The objective of this study is to determine the effect of a no-touch ultraviolet-C light disinfection system (UVC) on the incidence of Clostridium difficile infection (CDI) and multi-drug resistant organisms (MDRO). METHODS: A before-after study design was used at a 472 bed acute-care facility. In June 2014, UVC was instituted for disinfection (after the normal manual cleaning process by environmental services [EVS] was completed) of patient care rooms, at time of discharge or transfer of a patient known to have diarrhea, CDI or a carbapenem-resistant Enterobacteriaceae (CRE). Utilization of the UVC device was measured as a percent, calculated as the number of rooms with documented UVC use divided by the number of rooms that met criteria for UVC. CDI cases were measured using the National Healthcare Safety Network LabID Event definition. MDRO cases included patients with positive specimens for an organism with increased antibiotic resistance more than 2 days after hospital admission. Hospital-acquired CDI and MDRO incidence density (cases per 1000 patient-days) were compared for 12 months before and after use of UVC was instituted, using chisquare analysis (EpiInfo 7, CDC). RESULTS: 1331 rooms were eligible for UVC (average 3.6 rooms per day), of which 1159 (87%) were treated with UVC. There was no statistical difference in hospital-wide CDI or MDRO rates after UVC was instituted (Table 1). CONCLUSIONS: Despite high rates of utilization of the UVC device, decreases in CDI or MDRO infection rates were not seen.
9-200 Implementation of a Housewide Chlorhexidine Gluconate Bathing Program Josephine A. Fox, MPH, BSN RN, Infection Prevention Specialist, Barnes-Jewish Hospital; Kathleen McMullen, MPH, CIC, Manager Infection Prevention and Occupational Health, Christian Hospital; Patricia Potter, RN, PhD, FAAN, Director of Research, Patient Care Services, Barnes-Jewish Hospital; Elizabeth Pratt, DNP, RN, ACNS-BC, Research Scientist, Barnes-Jewish Hospital; Anthony Russo, MPH, Data Analyst, Barnes Jewish Hospital; David K. Warren, MPH, MD, Associate Professor of Medicine, Hospital Epidemiologist, Barnes-Jewish Hospital; Marilyn Schallom, Ph.D, RN, Clinical Nurse Specialist, BarnesJewish Hospital; Rachael Snyders, MPH, BSN, RN, CIC, Infection Prevention Consultant, BJC HealthCare BACKGROUND: Chlorhexidine gluconate (CHG) bathing has been shown to prevent hospital-acquired infections (HAIs) in high risk patients, including intensive care units (ICU) and peri-operative patients. All ICUs in our institution have been using CHG for daily bathing since 2009, which correlated with decreased HAI rates. The objective of this study was to determine the effect of daily CHG bathing in non-ICU inpatient units. METHODS: CHG bathing was instituted on non-ICU inpatient units at a 1315-bed tertiary care, academic hospital in January 2014. In-person education and educational materials were used to demonstrate the advantages of CHG bathing and incompatibilities of CHG with other skin care products. Clostridium difficile infection (CDI) cases were measured using the National Healthcare Safety Network LabID Event definition. Multi-drug resistant gram negative organisms, methicillin resistant Staphylococcus aureus (MRSA), and vancomycin resistant Enterococcus (VRE) included patients
APIC 43rd Annual Educational Conference & International Meeting | Charlotte, NC | June 11-13, 2016
Poster Abstracts / American Journal of Infection Control 44 (2016) S28-S82
use, placement of hand rub dispensers, “gel in” and “gel out” exercises and monthly HH dashboards to all U/D.
9-198 How a Pro-Active Response to National Duodenoscope Outbreaks Led to Improved System-Wide Processes Renee L. Smith, MT(ASCP), CIC, Coordinator, Infection Control, PinnacleHealth System; Kimberly Rivera, MT(ASCP), CIC, Manager Infection Control, PinnacleHealth System BACKGROUND: The 2015 “superbug” outbreaks associated with duodenoscopes alerted the nation and made the public aware of the importance of proper cleaning and disinfection of these complex devices. In response, The Centers for Disease Control and Prevention (CDC) published an Interim Duodenoscope Surveillance Protocol for healthcare facilities. METHODS: In April 2015, a multi-disciplinary team examined all procedures and processes related to duodenoscopes at the three campuses of the health system. Utilizing the CDC protocol, all endoscopes were sampled to determine baseline results. Duodenoscope testing continued monthly, thereafter. Additionally, duodenoscopes used on patients with a multi-drug resistant gram negative bacilli (MDRGNB) were processed and then sampled, cultured, and quarantined until results were final. Infection Control, in collaboration with Endoscopy management, performed the sampling; the microbiology department performed the testing. RESULTS: Following an initial concern related to contamination of broth in the microbiology lab, baseline results of the 32 endoscopes sampled were negative for high-concern bacteria. Subsequent monthly sampling of all duodenoscopes, and scopes used on MDRGNB patients was negative for high-concern bacteria. CONCLUSIONS: Procedural inconsistencies were discovered; consequently system-wide changes were implemented. A recommendation was made that all scopes go to Endoscopy for processing in the automated endoscope reprocessor (AER). Gloves are used when handling clean scopes from the cabinet and the AER. Staff competencies are now conducted every six months. Manual flushes are performed prior to the scope being placed in the AER. Adenosine Triphosphate (ATP) testing is performed on duodenoscopes used on MDR-GNB patients (prior to placing in AER). A patient education sheet was created with the most frequently asked questions regarding duodenoscopes, and explains the cleaning process. Endoscopy has assumed the role of monthly sampling of the duodenoscopes. The recently reported outbreaks of duodenoscope related infections led to several pro-active process improvements as well as implementation of a comprehensive scope culturing program.
9-199 Impact of No-touch Ultraviolet-C Light Room Disinfection System on Hospital Acquired Infection Rates Kathleen McMullen, MPH, CIC, Manager, Infection Prevention and Occupational Health, Christian Hospital; Gaylene Dunn, RN, CIC, Infection Preventionist, Christian Hospital; Rebecca Wade, RN, BSN, CIC, Infection Preventionist, Christian Hospital; Adnan Siddiqui, MD, Medical Director for Infection Prevention, ID Physician, Christian Hospital
BACKGROUND: Intensive environmental cleaning may lead to decreased hospital acquired infections. The objective of this study is to determine the effect of a no-touch ultraviolet-C light disinfection system (UVC) on the incidence of Clostridium difficile infection (CDI) and multi-drug resistant organisms (MDRO). METHODS: A before-after study design was used at a 472 bed acute-care facility. In June 2014, UVC was instituted for disinfection (after the normal manual cleaning process by environmental services [EVS] was completed) of patient care rooms, at time of discharge or transfer of a patient known to have diarrhea, CDI or a carbapenem-resistant Enterobacteriaceae (CRE). Utilization of the UVC device was measured as a percent, calculated as the number of rooms with documented UVC use divided by the number of rooms that met criteria for UVC. CDI cases were measured using the National Healthcare Safety Network LabID Event definition. MDRO cases included patients with positive specimens for an organism with increased antibiotic resistance more than 2 days after hospital admission. Hospital-acquired CDI and MDRO incidence density (cases per 1000 patient-days) were compared for 12 months before and after use of UVC was instituted, using chisquare analysis (EpiInfo 7, CDC). RESULTS: 1331 rooms were eligible for UVC (average 3.6 rooms per day), of which 1159 (87%) were treated with UVC. There was no statistical difference in hospital-wide CDI or MDRO rates after UVC was instituted (Table 1). CONCLUSIONS: Despite high rates of utilization of the UVC device, decreases in CDI or MDRO infection rates were not seen.
9-200 Implementation of a Housewide Chlorhexidine Gluconate Bathing Program Josephine A. Fox, MPH, BSN RN, Infection Prevention Specialist, Barnes-Jewish Hospital; Kathleen McMullen, MPH, CIC, Manager Infection Prevention and Occupational Health, Christian Hospital; Patricia Potter, RN, PhD, FAAN, Director of Research, Patient Care Services, Barnes-Jewish Hospital; Elizabeth Pratt, DNP, RN, ACNS-BC, Research Scientist, Barnes-Jewish Hospital; Anthony Russo, MPH, Data Analyst, Barnes Jewish Hospital; David K. Warren, MPH, MD, Associate Professor of Medicine, Hospital Epidemiologist, Barnes-Jewish Hospital; Marilyn Schallom, Ph.D, RN, Clinical Nurse Specialist, BarnesJewish Hospital; Rachael Snyders, MPH, BSN, RN, CIC, Infection Prevention Consultant, BJC HealthCare BACKGROUND: Chlorhexidine gluconate (CHG) bathing has been shown to prevent hospital-acquired infections (HAIs) in high risk patients, including intensive care units (ICU) and peri-operative patients. All ICUs in our institution have been using CHG for daily bathing since 2009, which correlated with decreased HAI rates. The objective of this study was to determine the effect of daily CHG bathing in non-ICU inpatient units. METHODS: CHG bathing was instituted on non-ICU inpatient units at a 1315-bed tertiary care, academic hospital in January 2014. In-person education and educational materials were used to demonstrate the advantages of CHG bathing and incompatibilities of CHG with other skin care products. Clostridium difficile infection (CDI) cases were measured using the National Healthcare Safety Network LabID Event definition. Multi-drug resistant gram negative organisms, methicillin resistant Staphylococcus aureus (MRSA), and vancomycin resistant Enterococcus (VRE) included patients
APIC 43rd Annual Educational Conference & International Meeting | Charlotte, NC | June 11-13, 2016