In 2010 Xavier University researcher
Dr. Edmond Hooker began research delving into a possible link between hospital beds and healthcare acquired infections (HAIs).
It immediately became apparent that hospital mattresses have been frequently linked to outbreaks of HAI;s. Hospital mattresses are soft porous surfaces.
They are designed to allow moisture to move away from the patient to prevent skin breakdown and bedsores. However, this design makes it impossible for the mattress surface to be thoroughly cleaned and disinfected using currently available cleaning products.
Dr. Hooker’s first line of scientific inquiry was to culture the surfaces of mattresses that had been “terminally” cleaned and were ready for the next patient. In 2011, the Xavier team showed that these mattresses were still contaminated with pathogenic bacteria despite having been cleaned.
Again in 2012, while investigating the use of a launderable mattress barrier cover,
Dr. Hooker showed that mattresses cleaned using traditional hospital methods were still contaminated with pathogenic bacteria.
Prior research demonstrated that patients who are placed in a bed where the previous patient had Clostridium difficile (C. diff) and/or other bacterial infections are at an increased risk of acquiring those infections.
In 2015, researchers from Xavier University published the results of a landmark study. It demonstrated that, by using the launderable mattress barrier cover in two long-term acute care hospitals (treating extremely ill patients), they could decrease the number of patients who became infected with C. diff by 50%, even when the beds of C. diff patients had been cleaned using bleach.
Another recent study, just published in JAMA, demonstrated that hospital beds are the vector for transmission of C. diff even from asymptomatic patients who had occupied the same bed and received antibiotics during their hospital stay.
It is clear that the hospital environment, especially the hospital bed, is a major vector in the transmission of C. diff and many other bacteria that cause HAIs.
Healthcare providers must find ways to ensure that hospital mattresses are cleaned and disinfected properly between patients, and that additional non-chemical measures are taken, if available, to protect patients.
Enjoy the following Video Clips For Additional Trinity Guardion News
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Join us as guest, and co-founder of Xenex, Dr. Mark Stibich Epidemiologist and Chief Scientific Officer, discusses UV Disinfection with Xenex UV Disinfecting Systems and Germ Zapping Robots making a clean sweep across the globe zapping C.diff. and all harmful germs that can cause pain, suffering, and double digits in the already stressed healthcare industry.
MORE ABOUT OUR GUEST:
Dr Mark Stibich, a co-founder of Xenex, Mark oversees scientific research, new technology development, and protocol design. An epidemiologist who has published many scientific papers about Pulsed Xenon technology, Mark is also an inventor on multiple patents. Originally from Dayton, OH, Mark graduated from Yale and the Johns Hopkins University School of Public Health, where he earned a Masters in Health Science and PhD. Mark’s interest in public health has taken him to many distant countries. He served as a Peace Corps health volunteer and then trained Peace Corps health volunteers in Ulaanbaatar, Mongolia. He has conducted research in Russia, Tajikistan, Afghanistan, South Africa, Kenya, the U. S., and Brazil. In addition, he has received grants for and directed HIV/AIDS research and intervention projects throughout Russia and has been a consultant with the USAID project.
“C. diff. Spores and More ™“ Global Broadcasting Network spotlights world renowned topic experts, research scientists, healthcare professionals, organization representatives,C. diff. survivors, board members, and their volunteers who are all creating positive changes in the
C. diff. community and more.
Through their interviews, the C Diff Foundation mission will connect, educate, and empower many worldwide.
Questions received through the show page portal will be reviewed and addressed by the show’s Medical Correspondent, Dr. Fred Zar, MD, FACP, Dr. Fred Zar is a Professor of Clinical Medicine, Vice Head for Education in the Department of Medicine, and Program Director of the Internal Medicine Residency at the University of Illinois at Chicago. Over the last two decades he has been a pioneer in the study of the treatment of Clostridium difficile disease and the need to stratify patients by disease severity.
Infection rates decreased significantly at Orlando Health South Seminole Hospital after the hospital began using Xenex’s xenon light Germ-Zapping Robots™ for room disinfection, according to a new peer-reviewed study published in the American Journal of Infection Control (AJIC). This is the eighth peer-reviewed study that demonstrates how a hospital successfully reduced its infection rates after utilizing Xenex Disinfection Services’ unique Xenon Full-Spectrum Disinfection™ technology to disinfect its rooms. Xenex Germ-Zapping Robots™ havebeen credited for helping healthcare facilities in the U.S. decrease their Methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C.diff) and Surgical Site infection rates by more than 50, 70 and 100 percent respectively.
Xenex’s xenon light disinfection system is the only disinfection system that uses pulsed xenon to create light that covers the entire germicidal spectrum. The Xenex system is the only ultraviolet light disinfection technology shown, in multiple peer-reviewed published studies, to help hospitals reduce infection rates.
According to the new AJIC study, South Seminole Hospital reported a 61 percent reduction in combined Vancomycin-resistant enterococci (VRE), MRSA and C.diff infection rates in its Intensive Care Unit (ICU), an 87 percent reduction in its ICU VRE infection rate, and a 29 percent reduction facility-wide in combined VRE, MRSA and C.diff infection rates after it began using Xenex’s xenon light technology. The hospital estimates that it saved $730,000 based on the number of C.diff and VRE infections that were avoided.
The study titled “Impact of pulsed xenon ultraviolet light on hospital-acquired infection (HAI) rates in a community hospital” analyzed the efficacy of pulsed xenon light in two different deployment strategies.
The difference in infection rate reduction was associated with the two different utilization strategies, which indicates best practices for pulsed xenon disinfection. ICU discharges and transfers were disinfected with Xenex Germ-Zapping Robots with a goal of all terminal cleans.
As a result, the combined VRE, MRSA and C.diff infection rates decreased 61 percent. Non-ICU discharges and transfers were disinfected with Xenex robots for C.diff cases only, resulting in a 29 percent decrease in VRE, MRSA and C.diff infection rates facility wide.
“This is an exciting study because it demonstrates best practices for pulsed xenon automated disinfection,” said Dr. Mark Stibich, Chief Scientific Officer at Xenex. “Previous studies have shown that the number of rooms disinfected with the Xenex robot correlates to the infection rate reduction the hospital will experience. This study shows that it’s more effective to use the Xenex robot to disinfect as many rooms as possible versus only disinfecting rooms where patients are known to have an infection. Our pulsed xenon robot works in a five-minute disinfection cycle, so they are able to quickly disinfect multiple rooms per day in a facility – leading to dramatic reductions in infection rates.”
Designed for speed, effectiveness and ease of use, hospital cleaning staff operate the Xenex robot without disrupting hospital operations. The robot pulses intense UV light covering the entire UV spectrum, destroying viruses, bacteria and bacterial spores in a five-minute disinfection cycle. Without contact or chemicals, the robot eliminates harmful microorganisms safely and effectively. According to Xenex customers, the robot can disinfect 30-62 hospital rooms per day, including: patient rooms, operating rooms, equipment rooms, emergency rooms, intensive care units and public areas.
Proven to Reduce HAI Rates
MD Anderson Cancer Center, the Central Texas Veterans Health Care System, Cooley Dickinson Health Care, Trinity Medical Center and other hospitals have published 14 studies providing evidence of the robot’s efficacy in highly regarded scientific journals that include the American Journal of Infection Control (AJIC), Journal of Infection Prevention, Infection Control & Hospital Epidemiology (ICHE) and BMC Infectious Diseases.
About Xenex Disinfection Services
Xenex’s patented Full Spectrum™ pulsed xenon UV room disinfection system is used for the advanced disinfection of healthcare facilities. Due to its speed and ease of use, the Xenex system has proven to integrate smoothly into hospital cleaning operations. The Xenex mission is to save lives and reduce suffering by eliminating the deadly microorganisms that cause HAIs. The company is backed by well-known investors that include Brandon Point, Battery Ventures, Targeted Technology Fund II and RK Ventures. For more information, visit www.xenex.com.
Each hospital had been trying to combat C. difficile on its own, but they were often outwitted by the hardy spore, which is fueled by overuse of antibiotics, spread by hands and able to survive on bed rails, call buttons and doorknobs for as long as five months if not longer and cleaned off.
Plus, it was traveling: Patients in one hospital or nursing home were often discharged and then admitted to another. Dealing with the mess was costing the hospitals an estimated $4 million to $5 million a year.
So they did something rare for competing health-care systems. Four hospitals joined forces to beat back the debilitating bug, forming a C. difficile prevention collaborative. Six nursing homes that share patients with the hospitals and had a huge C. difficile problem of their own then formed a separate alliance.
It paid off: In the 12 months ended in September 2015, rates of C. difficile infections fell 36% from 2011 levels across the hospitals, which initially were in three but are now in two health-care systems: the University of Rochester Medical Center and Rochester Regional Health System.
“It’s not very simple—you have to have a multidisciplinary approach to prevent this infection,” says Ghinwa Dumyati, who leads both the hospital and nursing-home collaboratives as an infectious-disease physician with the Center for Community Health at the University of Rochester Medical Center. “We needed to work together.”
A good cleaning
Hospitals compete intensely for patients, doctors and insurance dollars, but when it comes to safety, they are increasingly collaborating to solve common problems, according to Arjun Srinivasan, an expert at the Centers for Disease Control and Prevention in the prevention of health-care-associated infections. The CDC says working together allows hospitals to more effectively fight infections caused by drug-resistant bacteria and C. difficile because the bugs are intractable and the difficulties each facility faces are similar. Plus, Dr. Srinivasan says, “hospitals share those patients.”
New federal requirements to improve health-care quality, such as public reporting of health-care-associated infections and penalties for readmissions, also are prodding hospitals to collaborate more on safety issues, Dr. Srinivasan and hospital executives say.
C. difficileis the most common pathogen causing health-care-associated infections in U.S. hospitals, according to the CDC. It led to approximately 453,000 infections and 29,000 deaths in the U.S. in 2011, according to a study last year in the New England Journal of Medicine.
Infections occur when someone ingests C. difficile and takes antibiotics that wipe out the good bacteria in their gut. That leaves the C. difficile to flourish in the colon, producing diarrhea that can last for weeks or months. The elderly are particularly at risk of infection because their immune systems may be weak, and they are frequent users of hospitals and nursing homes.
Rochester’s C. difficile-prevention collaborative began in 2011, funded by the health-care
systems involved and a large regional insurer, Excellus BlueCross BlueShield. It grew out of an earlier initiative that Dr. Dumyati had led that sharply reduced bloodstream infections from central lines, or catheters, inserted in the body. This time, the collaborative—Dr. Dumyati, along with doctors, infection preventionists and others from the hospitals—
chose to target C. difficile. “We knew we had a lot of cases,” she says.
First, the collaborative focused on cleaning procedures. The hospitals taught staff to scrub long and hard with bleach wipes to get rid of super-resilient C. difficile in hospital rooms. “Just like if you’re washing a plate, you have to apply pressure to get food off,” says Jeanna Hibbert, who cleans rooms at Strong Memorial Hospital, one of the four participating hospitals.
They also introduced inspections of cleaned rooms, using a tool that checks for even small amounts of contamination. “That was new and extraordinarily helpful,” says Robert Panzer, chief quality officer and associate vice president at Strong Memorial.
Each hospital made changes in its own way, and borrowed ideas from the others. Strong Memorial dedicated a crew to clean the rooms of discharged C. difficile patients after determining that it takes an hour and half—twice as long as normal—to properly clean them, adopting a practice from its sister, Highland Hospital.
After the collaborative laid out a policy for treating less severe forms of pneumonia, Strong Memorial pharmacists changed an electronic order form for antibiotics to prevent physicians treating those infections from prescribing a class of drugs linked to C. difficile infection without special approval, says Dr. Dumyati.
Across town at Rochester General Hospital, staff promoted the new pneumonia policy in a newsletter for doctors. Use of the desired antibiotic, doxycycline, for pneumonia more than tripled in a year; use of the one it replaced fell 48%, the hospital says.
The team at Rochester General also created a poster with new guidelines for diagnosing and treating urinary-tract infections after the collaborative determined that five out of six of its hospital patients treated for them don’t actually have them. Dr. Dumyati adopted it for use in the nursing homes she had started to work with, with a grant from the state.
The new policies have helped Rochester General strengthen an antibiotic stewardshipprogram it adopted a few years ago, in which a team of experts reviews antibiotic prescriptions, says Maryrose Laguio-Vila, the program’s director. “We gain insight into whether what we’re doing is along the right track or can be tweaked in a certain way.”
The collaborative has helped all of the hospitals improve their practices and patient care, says Nayef El-Daher, chief of infectious disease at Unity Hospital. “When we started the project, every one of us had [our] own ideas and protocols,” he says.
The next front
Dr. Dumyati feeds data on C. difficile infection rates and other measures every quarter to each of the hospitals, so that they can see how they’re doing. “The data really drive where we go next,” she says.
Next, she hopes to take the new policies to doctors’ and dentists’ offices. About 35% of all C. difficile infections aren’t linked to stays in hospitals or long-term-care facilities, according to the NEJM study.
“It’s fairly clear that you have to work with the nursing homes and you have to work across the community to make progress,” says Mark Shelly, chief of infectious disease at Highland Hospital. “Otherwise we’ll be pointing across the fence for a long time.”
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The C. difficile infection is a preventable infection, and more than 14,000 individuals die each year from or with the involvement of a C. difficile infection.
In eight hours time – it claims 13 individuals in America. 13 people will have died from a preventable infection.
While attending a “Raising C Diff Awareness” Conference you will listen to various presentations from world renown topic experts presenting on the many topics pertaining to C. difficile prevention, treatments, and environmental safety. During the conference you will learn something important. Then the day after the conference we will all return to work and on that day we will remember those 13 individuals – we will remember the 14,000 + people nationwide.
Your skills, your passion is instrumental in saving their lives.
Remember: None of us can do this alone…..all of us can do this TOGETHER!
Thank you and we look forward to meeting you at the
upcoming “Raising C Diff Awareness” conferences.
Nancy C Caralla
Executive Director of the C Diff Foundation