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Safe Zone: Taking the Red Box to the Next Step
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Poster Abstracts / American Journal of Infection Control 42 (2014) S29-S166
catalog of IRS 3200m UV treatments. A total of 2886 completed UV treatments, 2224 vegetative and 662 spore treatments, performed from October 2012 to April 2013 are included in the summary. RESULTS: The surgical unit, consisting of eight operating rooms averaging to 3388.07 ft 3 per space, had a mean treatment of 13.42 minutes and 30.30 minutes for vegetative and spore treatments, respectively. Three inpatient room configurations ranging from an average volume of 1867.10 ft 3 to 2424.54.10 ft 3, had a mean treatment time range from 8.92-11.07 minutes and 19.81-23.66 minutes for vegetative and spore treatments, respectively. Two bathroom configurations with an average volume of 267.60 ft 3 and 506.42 ft 3, had a mean treatment time of 3.17 minutes and 3.71 minutes and 6.44 minutes and 8.64 minutes for vegetative and spore treatments, respectively. LESSONS LEARNED: Aside from treatment type and room size, both technical and operational factors contribute to treatment time. While infrequent, activation of safety mechanisms and other treatment interruptions are also included in treatment time. As device treatment time affects the frequency, ability, and cost of implementing ultraviolet technology within a facility, robust device evaluation data assists healthcare providers assess the impact of a UV disinfection program on hospital operations. Further, careful and proactive analysis of treatment data may contribute to the creation of a quality control program to detect device deterioration and operational error.
under the device during daily changes found that 99.5% of device 1 pads remained uncontaminated versus 38.1% of pads placed under device 2 (p<0.001). LESSON LEARNED: Findings from this in vitro study demonstrate that stool management systems can limit or prevent environmental contamination from CD. Results also reveal significant differences in the 2 systems that we hypothesize are attributable to the area immediately adjacent to the tubing/collection bag interface, the point where these systems are most often disconnected as collection bags become filled with fecal material.
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Publication Number 6-199 Can a Stool Management System Prevent Environmental Spread of Clostridium Difficile: A Comparative Trial Mikel Gray PhD, PNP, FNP, CUNP CCCN, FAANP, FAAN, Professor and Nurse Practitioner, Department of Urology, University of Virginia; Amin Omar PhD, Technical Services Supervisor, Innovotech, Inc; Brenton Buziak BSc, Developmental Research, Innovotec, Inc
Publication Number 6-200 Safe Zone: Taking the Red Box to the Next Step Doug Blomberg RN CIC, Infection Prevention & Control Coordinator, St. Mary’s Health Care System ISSUE: Before we heard about Janet Fraunks "Red Box" concept for Isolation precautions our PPE complience was 84% and our isolation patients constantly complained about feeling like they were being neglected. Our hospital staff sought to derive their own “Safe Zone.” Since that time we have worked toward using her concept and adapting it to our hospital. We believed this time and cost saving measure would increase Staff PPE use and increase our patients satisfaction. PROJECT: We are a 199 bed Acute care community Hospital where, on average, 15-25% of all patients are on isolation. Due to the unique design of rooms at our Hospital, the Infection Control Department along with our front line nurses decided to add an extra step to the space enclosed by the red tape to make sure they could have eye contact with their patients. Health care workers still could not get closer than three feet to the patient or move to the opposite side of the room without having to put on PPE.
ISSUE: Clostridium difficile (CD) is a prevalent cause of hospital acquired diarrhea and acute fecal incontinence. Multiple interventions are used to prevent environmental contamination in patients with CD associated diarrhea including selective use of stool management systems. However, evidence concerning the efficacy of these devices is lacking. The purpose of this study was to compare the efficacy of 2 stool management systems for preventing contamination of the immediate environment in a simulated clinical setting. PROJECT: We compared 2 stool management systems, DigniShield (Bard, Inc., Atlanta GA) [device 1] and Flexi-Seal (ConvaTec, Princeton, NJ) [device 2], over a 30 day period in a controlled laboratory setting. Sixteen systems were filled with sterile loose stool inoculated with 106 CFU/ml CD (ATCC 42355). Specially prepared culture media were used to detect CD contamination on various surfaces of the device and immediate environment including the containment bag, hub/tubing interface and an absorbent pad placed underneath the device. Containment bags were changed daily and the devices refilled with inoculated stool to more closely mimic use in the clinical setting. RESULTS: Analysis revealed that 79.2% of the anterior surface of the collection bags of the device 1 group remained free from contamination versus 16.1% of device 2 bags (p<0.001). Comparison of the tubing/hub interface revealed that 79.2% of the device 1 group remained free from contamination versus 13.7% of interfaces in the device 2 group (p<0.001). Analysis of an absorbent pad placed APIC 41st Annual Educational Conference & International Meeting j Anaheim, CA j June 7-9, 2014
Poster Abstracts / American Journal of Infection Control 42 (2014) S29-S166
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assess and communicate with patients more easily. Patients also liked the “Safe Zone” at our hospital, and patients gave “Safe Zone” a 90% positive rating. Patients said that “Safe Zone” lessened the feelings of being isolated. LESSON LEARNED: The involvement of Front line staff is crucial when developing a new concept in patient care and helped them understand why these Issues are important. This use of common sence thinking lessening the barriers when communicating with isolation patients saves cost and time. We recognized that not only did this increase staff compliance but Patients said that “Safe Zone” lessened the feelings of being isolated and made them feel like they saw the staff more often.
Publication Number 6-201 The Effect of Universal Intranasal Povidone Iodine Antisepsis on Total Joint Replacement Surgical Site Infections Lynne Brown RN, MBA, CIC, Infection Preventionist, Highland Hospital; Mark Shelly MD, Epidemiologist, Highland Hospital; Linda R. Greene RN, MPS, CIC, Manager Infection Prevention, Highland Hospital; Ann Marie Pettis RN, BSN, CIC, Director Infection Prevention, University of Rochester Medical Center; Sherry Romig RN, Infection Preventionist, Highland Hospital
RESULTS: By the end of the study, compliance was at 98% Over all Thirty-eight percent of patient interaction utilized the “Safe Zone.” Some units were almost 50% due to the needs of the patients. The health care workers agreed with the healthcare workers of Franck’s study in that “Safe Zone,” lessened barriers when communicating with patients, saved time, and allowed health care workers to APIC 41st Annual Educational Conference & International Meeting j Anaheim, CA j June 7-9, 2014
Poster Abstracts / American Journal of Infection Control 42 (2014) S29-S166
catalog of IRS 3200m UV treatments. A total of 2886 completed UV treatments, 2224 vegetative and 662 spore treatments, performed from October 2012 to April 2013 are included in the summary. RESULTS: The surgical unit, consisting of eight operating rooms averaging to 3388.07 ft 3 per space, had a mean treatment of 13.42 minutes and 30.30 minutes for vegetative and spore treatments, respectively. Three inpatient room configurations ranging from an average volume of 1867.10 ft 3 to 2424.54.10 ft 3, had a mean treatment time range from 8.92-11.07 minutes and 19.81-23.66 minutes for vegetative and spore treatments, respectively. Two bathroom configurations with an average volume of 267.60 ft 3 and 506.42 ft 3, had a mean treatment time of 3.17 minutes and 3.71 minutes and 6.44 minutes and 8.64 minutes for vegetative and spore treatments, respectively. LESSONS LEARNED: Aside from treatment type and room size, both technical and operational factors contribute to treatment time. While infrequent, activation of safety mechanisms and other treatment interruptions are also included in treatment time. As device treatment time affects the frequency, ability, and cost of implementing ultraviolet technology within a facility, robust device evaluation data assists healthcare providers assess the impact of a UV disinfection program on hospital operations. Further, careful and proactive analysis of treatment data may contribute to the creation of a quality control program to detect device deterioration and operational error.
under the device during daily changes found that 99.5% of device 1 pads remained uncontaminated versus 38.1% of pads placed under device 2 (p<0.001). LESSON LEARNED: Findings from this in vitro study demonstrate that stool management systems can limit or prevent environmental contamination from CD. Results also reveal significant differences in the 2 systems that we hypothesize are attributable to the area immediately adjacent to the tubing/collection bag interface, the point where these systems are most often disconnected as collection bags become filled with fecal material.
ˇ
ˇ
ˇ
ˇ
ˇ
Publication Number 6-199 Can a Stool Management System Prevent Environmental Spread of Clostridium Difficile: A Comparative Trial Mikel Gray PhD, PNP, FNP, CUNP CCCN, FAANP, FAAN, Professor and Nurse Practitioner, Department of Urology, University of Virginia; Amin Omar PhD, Technical Services Supervisor, Innovotech, Inc; Brenton Buziak BSc, Developmental Research, Innovotec, Inc
Publication Number 6-200 Safe Zone: Taking the Red Box to the Next Step Doug Blomberg RN CIC, Infection Prevention & Control Coordinator, St. Mary’s Health Care System ISSUE: Before we heard about Janet Fraunks "Red Box" concept for Isolation precautions our PPE complience was 84% and our isolation patients constantly complained about feeling like they were being neglected. Our hospital staff sought to derive their own “Safe Zone.” Since that time we have worked toward using her concept and adapting it to our hospital. We believed this time and cost saving measure would increase Staff PPE use and increase our patients satisfaction. PROJECT: We are a 199 bed Acute care community Hospital where, on average, 15-25% of all patients are on isolation. Due to the unique design of rooms at our Hospital, the Infection Control Department along with our front line nurses decided to add an extra step to the space enclosed by the red tape to make sure they could have eye contact with their patients. Health care workers still could not get closer than three feet to the patient or move to the opposite side of the room without having to put on PPE.
ISSUE: Clostridium difficile (CD) is a prevalent cause of hospital acquired diarrhea and acute fecal incontinence. Multiple interventions are used to prevent environmental contamination in patients with CD associated diarrhea including selective use of stool management systems. However, evidence concerning the efficacy of these devices is lacking. The purpose of this study was to compare the efficacy of 2 stool management systems for preventing contamination of the immediate environment in a simulated clinical setting. PROJECT: We compared 2 stool management systems, DigniShield (Bard, Inc., Atlanta GA) [device 1] and Flexi-Seal (ConvaTec, Princeton, NJ) [device 2], over a 30 day period in a controlled laboratory setting. Sixteen systems were filled with sterile loose stool inoculated with 106 CFU/ml CD (ATCC 42355). Specially prepared culture media were used to detect CD contamination on various surfaces of the device and immediate environment including the containment bag, hub/tubing interface and an absorbent pad placed underneath the device. Containment bags were changed daily and the devices refilled with inoculated stool to more closely mimic use in the clinical setting. RESULTS: Analysis revealed that 79.2% of the anterior surface of the collection bags of the device 1 group remained free from contamination versus 16.1% of device 2 bags (p<0.001). Comparison of the tubing/hub interface revealed that 79.2% of the device 1 group remained free from contamination versus 13.7% of interfaces in the device 2 group (p<0.001). Analysis of an absorbent pad placed APIC 41st Annual Educational Conference & International Meeting j Anaheim, CA j June 7-9, 2014
Poster Abstracts / American Journal of Infection Control 42 (2014) S29-S166
S81
assess and communicate with patients more easily. Patients also liked the “Safe Zone” at our hospital, and patients gave “Safe Zone” a 90% positive rating. Patients said that “Safe Zone” lessened the feelings of being isolated. LESSON LEARNED: The involvement of Front line staff is crucial when developing a new concept in patient care and helped them understand why these Issues are important. This use of common sence thinking lessening the barriers when communicating with isolation patients saves cost and time. We recognized that not only did this increase staff compliance but Patients said that “Safe Zone” lessened the feelings of being isolated and made them feel like they saw the staff more often.
Publication Number 6-201 The Effect of Universal Intranasal Povidone Iodine Antisepsis on Total Joint Replacement Surgical Site Infections Lynne Brown RN, MBA, CIC, Infection Preventionist, Highland Hospital; Mark Shelly MD, Epidemiologist, Highland Hospital; Linda R. Greene RN, MPS, CIC, Manager Infection Prevention, Highland Hospital; Ann Marie Pettis RN, BSN, CIC, Director Infection Prevention, University of Rochester Medical Center; Sherry Romig RN, Infection Preventionist, Highland Hospital
RESULTS: By the end of the study, compliance was at 98% Over all Thirty-eight percent of patient interaction utilized the “Safe Zone.” Some units were almost 50% due to the needs of the patients. The health care workers agreed with the healthcare workers of Franck’s study in that “Safe Zone,” lessened barriers when communicating with patients, saved time, and allowed health care workers to APIC 41st Annual Educational Conference & International Meeting j Anaheim, CA j June 7-9, 2014