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         Clinical intelligence for supply chain leadership

 
 
 

INSIDE THE CURRENT ISSUE

December 2008

People & Opinions


 

Worth Repeating

"Advanced automation has been one of the greatest advances we’ve seen with washers and sterilizers. Automation can take the guesswork out of the process, while also helping to drive more consistent, reliable results."

Natalie Lind, CRCST, educational director, International Association for Healthcare Central Service Materiel Management

"Supply-chain managers are in a position to balance the SC function with their hospital’s goals regarding safety, infection prevention, and patient outcomes. Hospitals are looking across their entire operations to control infection, including the supplies they use on patients. While cost is important, it is crucial that SC managers are involved in the preventive process."

Cindi Crosby, vice president, clinical operations management
Cardinal Health

"From a supply chain perspective, we used to be just focused on key elements, such as item number, manufacturer and vendor number, and unit of measure. Now, hospitals have much greater access to information beyond just what is needed for purchasing, such as product attributes."

Pete Nelson, vice president,
supply chain services, GHX

"One of the largest issues is that clinicians are only warming select patients, those that they identify as ‘at risk’ – this includes the young, the elderly or the frail. They don’t necessarily think that a 25-year-old man in good health who is undergoing a 50-minute procedure needs to be warmed. The fact is, the induction of anesthesia results in the redistribution of body heat and affects every surgical patient under anesthesia and every patient needs to be warmed. They are all at risk."

Troy Bergstrom,
marketing communications manager Arizant

Microfiber’s role in infection prevention

by Mark Hoyle & Bill Slezak

The risks and challenges associated with hospital acquired infections are well known, and emerging as a high-profile, high-priority public health issue. From the publication of the landmark study by the Institute of Medicine (IOM), entitled, "To Err is Human: Building a Safer Healthcare System", to the CDC’s 2002 data estimating 90,000 deaths from bacterial infection per year in U.S. hospitals, to the August 11, 2008 issue of The New Yorker, reporting the mechanism of antimicrobial resistance, professionals have been continually unraveling the complexities of ensuring that our healthcare system offers truly safe and clean environments. And while drug-resistant bacteria continue to evolve, or arrive from around the globe, the basics of preventing cross-transmission remain constant.

Patient care challenges

One of the more challenging aspects of patient care is keeping important areas of a healthcare facility clean. No mission is more important than ensuring that a patient is not exposed to needless health dangers while in the care of the facility. While preventable infection rates continue to be high, there have been dramatic developments in cleaning technologies that are proving to reduce and eliminate harmful bacteria from patient areas and other high-touch surfaces.

Microfiber has emerged as one of the most important technological developments for environmental services in this quest to prevent infections. It is extremely important, however, to understand that there are many different types and qualities of microfiber on the market with vastly different capabilities for removing viruses, bacteria and spores from an environmental surface.

Microfiber, by definition, is any type of fiber with a diameter of less than 10 micrometers. Every item labeled "microfiber" does not constitute a superior cleaning product. Optimal bacterial, virus and spore removal is achieved through a type of material called, "split microfiber." This fiber is a blend of nylon (polyamide) and polyester that is extruded (like spaghetti). In the manufacturing process, the bonds between these two materials are chemically and mechanically split so that the fiber actually splits, or explodes, creating a web of ultra-fine filaments and microscopic pores. Split microfiber has a net positive charge and the ability to absorb up to 8 times its weight in liquids.

In independent studies such as, "Using Microfiber Mops in Hospitals" published by the EPA1 and "Disinfection, Sterilization and Antisepsis" by Dr. William Rutala2, extremely fine (.37 micrometer diameter) microfiber was both laboratory and clinically tested and proven to remove up to 98 percent of bacteria and 93 percent of viruses from a surface using only water (no chemicals). In comparison, traditional cotton fibers have been shown to only remove 30 percent of the bacteria and 23 percent of the viruses from a contaminated environmental surface.

When most environmental services professionals speak of microfiber, they are usually referring to a flat mop floor cleaning system. These products are highly visible, are one-quarter the weight of traditional mops, and allow the housekeeper to effectively clean a room 40 percent faster than they could with an old-fashioned string mop system. There is no doubt that the use of these systems results in a much cleaner floor. And they permit a one-pad-per-room practice, to minimize cross-transmission risk.

Patients do get sick from surfaces

Microfiber cloths are sometimes overlooked as a major tool for infection prevention in healthcare facilities. Consider the risk of hand and glove contamination after contact with a VRE (+) patient environment; there are many touch surfaces (monitors, cabinet drawers, sink spouts and patient charts) in that patient’s room that can facilitate transmission. It is essential that environmental services not only institute the use of (data-supported) split microfiber cloths in their cleaning process for proven cleaning efficacy, but also follow a clearly defined process to properly clean surfaces in the room.

Using a color-code system for microfiber cloths enables a housekeeper to use the appropriate cloth to clean each area of the room: yellow for bathrooms, green for general purpose cleaning, red for beds and blue for glass and other reflective surfaces. As part of that process, it should be noted that only one set of cloths per room should be used to avoid cross-transmission into a second room. Some facilities have started using disposable disinfectant wipes in an effort to reduce infections. This strategy may backfire as British researchers have found that, "disinfectant wipes routinely used in hospitals may actually spread drug-resistant bacteria rather than kill the dangerous infections."3

While most of the focus in preventing infections is on patient rooms, effectively cleaning all areas of a facility provides opportunities for safeguarding patients and caregivers. Waiting rooms and the emergency room are high traffic areas where patients, visitors and employees can be exposed to a wide range of infections; from the common rhinovirus to life-threatening C. difficile. Following proper cleaning procedures in the dietary areas of the facility can help reduce exposure to E. coli and norovirus infections.

Microfiber equals cost-savings

Overall, the benefits of using green products such as premium microfiber, can be summed up using "The Three P’s: People, Profit, and Planet."

1. People - Products that promote worker well-being, improved health and ease-of-use are a benefit to all people—staff, patients and visitors.

2. Profit - By using environmentally beneficial products such as microfiber, those within the healthcare industry can save time and money in a variety of ways including: reducing the need for additional products and chemicals, reducing worker compensation claims, offering the potential for enhanced labor productivity and enabling savings on energy and water bills.

3. Planet - Products that require little or no chemicals help reduce the release of pollutants into the environment. Products that require less water and energy help to conserve natural resources.

All things considered

Microfiber cleaning systems, when supported by comprehensive training and proper implementation, can play a major role in infection prevention throughout healthcare facilities.

To realize the full benefits of microfiber, it is essential for environmental services professionals to fully evaluate all of the product and supplier options, insisting on the following:

• Independently tested microbiological data that validates superior product performance claims

• A complete system that consists of everything needed to clean the facility from carts to cloths

• A comprehensive training program to assist in both pre-sale education and post-sale support.

Mark Hoyle is a senior product manager for Rubbermaid Commercial Products, LLC.

Bill Slezak is a national healthcare segment manager for Rubbermaid Commercial Products, LLC., and a member of the board of trustees for ASHES. For more information about RCP, visit www.rcpworksmarter.com.

References

1. Environmental Best Practices for Health Care Facilities, "Using Microfiber Mops in Hospitals," United States Environmental Protection Agency, November 2002

2. "Disinfection, Sterilization and Antisepsis," June 2006, Edited by Dr. William Rutala

3. http://www.reuters.com/article/newsOne/idUSL0383329520080603, "Antibacterial Wipes Can Spread Superbugs: Study," June 3, 2008, Michael Kahn

 


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