Ecolab Healthcare’s Quik-Care Moisturizing Gel Waterless Antimicrobial Hand Sanitizer is an emollient-enriched alcohol hand sanitizer that moisturizes and repairs skin with each use.

With the ever increasing proliferation of superbugs, comes not only a need for new products and protocols but also a look back at fundamental interventions. "Hand hygiene and environmental cleaning and disinfection are the two primary interventions that we can make and those are definitely back to basics," said Sue Barnes, national leader, infection prevention and control and patient safety, Kaiser Permanente Program Offices, and a member of the National APIC communications committee.

A study presented at the annual meeting of the Society for Healthcare Epidemiology of America (SHEA) in San Diego this March, showed that a rigorous environmental cleaning intervention can reduce the transmission of methicillin-resistant Staphylococcus aureus (MRSA) and other multidrug-resistant organisms in hospital intensive care units (ICUs).

KIMTECH PREP Wipers for the WETTASK Refillable Wet Wiping System in the smaller canister is easily portable, making it ideal for surface sanitation in patient rooms and other areas where the original bucket version may be too large.

Rupak Datta, MPH, an MD/PhD candidate at the University of California at Irvine and colleagues found that following an enhanced cleaning protocol reduced the spread of MRSA to patients exposed to rooms in which the prior occupant had been colonized or infected. The multi-modal cleaning intervention consists of three parts: a change from use of a pour bottle to bucket immersion for applying disinfectant to cleaning cloths; an educational campaign involving the environmental services staff at the hospital; and feedback method using removal of intentionally-applied marks visible only under UV light.

In the retrospective study of more than 13,000 hospital stays in 10 ICUs at a large academic medical center in Boston, researchers found that prior to the cleaning intevention 3.9% of the 1,454 patients exposed to a prior occupant with MRSA acquired the pathogen compared to just 1.5% of the 1,443 patients exposed during the intervention. Of the 1,291 patients exposed to vancomycin-resistant Enterococci (VRE) prior to the intervention, 4.5% acquired VRE compared to 3.5% of 1,446 patients during intervention.

Georgia-Pacific’s enMotion with Lotion towels, paired with the enMotion touchless dispensing system, can help improve hygiene by reducing the spread of infection caused by cross-contamination. The soft, moisture-activated enMotion with Lotion towels help protect hands from the signs of dryness, cracking and scaling that accompany frequent hand washing.

The study builds upon a body of research conducted by Datta and his co-authors, which found that patients admitted to an ICU room whose prior occupant had been infected with MRSA or VRE had as much as a 40% increased risk of acquiring either pathogen.

In another study at Case Western Reserve and the Cleveland VA Medical Center, researchers cultured commonly touched surfaces such as bed rails, telephones, call buttons, toilet seats, and bedside tables in the rooms of patients with Clostridium difficile. After routine cleaning, 78% of the surfaces were still contaminated with C. diff spores. But once researchers disinfected the rooms, including surfaces commonly overlooked by cleaners, with bleach, only 1% of surfaces were still contaminated.  

Dr. Carlene Muto and her colleagues at the University of Pittsburgh Medical Center–Presbyterian faced a 400% increase in C. diff infections in the year 2000. They responded with a comprehensive strategy that emphasized rigorous cleaning with bleach and rapid identification and isolation of C.diff positive patients to prevent the bacteria from spreading to other patients. (Additional interventions included reliance on soap and water rather than alcohol-based sanitizers to clean caregivers’ hands, and controlled use of antibiotics beginning in 2003). By 2006, C. diff rates were down 71%, and severe cases of C. diff associated diarrhea fell by 89%.

Barnes is helping to develop a National Kaiser Permanente EVS (environmental services) Program which will include:

1. Standard strategies for ensuring that EVS staff are recognized as part of the Infection Prevention and Control team at every medical center
    
2. Standard policies based on published guidelines such as ASHES (American Society for Healthcare Environmental Services)
    
3. Standard training content including ASHES video series and competency tools
    
4. Standard quality assessment tools such a fluorescing marker fluid and/or ATP
    
5. Standard products for environmental cleaning and disinfection
    
6. Standard contract language for those of our regions using contract EVS vendors (environmental services).
    

A novel approach to surface disinfection New research on thermal surface disinfection, in which moist heat is delivered directly to contaminated surfaces by a commercial steam vapor system, was published in the February 2009 issue of the American Journal of Infection Control. Photo courtesy Advanced Vapor Technologies An alternative to chemical disinfectants, the process incorporates a saturated steam vapor system with Thermal Accelerated Nano Crystal Sanitation (TANCS) technology from Advanced Vapor Technologies, harnessing the power of steam to eradicate antibiotic-resistant bacteria, viruses, and fungi on surfaces in less than 5 seconds. In the AJIC study, researchers treated a diverse assortment of pathogenic organisms, including VRE and MRSA with the TANCS system. Surface sanitation was observed within 2 seconds for most microorganisms, and all of the pathogens tested were completely inactivated within 5 seconds. Risks of infection from the contaminated surfaces clearly decreased with increasing periods of treatment.

Protection during flu outbreaks The CDC recommends frequent handwashing with soap and water as the primary method of prevention against H1N1 Influenza. When soap and water are not available, antiseptic hand sanitizers are suggested. Metrex offers an extensive line of VioNex and VioNexus hand soaps, antiseptic sprays and gels to meet various needs of healthcare facilities. In addition, the EPA released guidance stating that hospital-grade surface disinfectants with Influenza A virus claims are effective against H1N1 Influenza. Minimize cross-contamination by using products such as CaviWipes or CaviCide; hospital-grade, EPA-approved surface disinfectants that are effective against Influenza A viruses in as little as 2 minutes.

Green light for clean hands HyGreen hand hygiene recording and reminding system Xhale Inc.’s HyGreen patent-pending Intelligent Hand Hygiene Solution records all hand-washing events and patient-staff interactions in the hospital environment and reminds busy healthcare workers to wash their hands. Consisting of a handwash sensing device mounted next to each gel or soap dispenser; a bed monitor at every patient bed; and an electronic ID-badge holder worn by each healthcare worker, the system enables tracking and reporting of HAI vectors, and works with all major alcohol containing handwash products. When the employee applies gel or soap to their hands, they simply place their hands under the handwash sensing device which confirms that the hand has soap or gel on it and identifies the employee. A green LED light on the employee badge is illuminated verifying to the healthcare worker and the patient that a handwash event has occurred. Date, time and location of the handwash event is wirelessly transmitted to the central server. When the employee comes within 2-3 feet of a patient bed, a proximity sensing bed monitor wirelessly verifies that the healthcare worker badge is illuminated. If the badge is not illuminated when it comes into the proximity of the bed monitor, the badge vibrates a reminder to the healthcare worker to wash their hands.