the health roundtable meeting the granny test at a microbiological level presenter: counties manukau...
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The Health Roundtable
Meeting the Granny Test at a Microbiological Level
Presenter: Counties Manukau Health
Poster SessionHRT1306 – Best Practice Health Service Cleaning 18th and 19th April 2013 Sydney
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KEY PROBLEM
Cleaning services not achieving good microbial population reduction in high risk rooms
Cleaning services designed to achieve
Victorian Standards cleaning success, little
correlation to microbial flora Cleaning Services achieving present goals
which are not related to microbial safety for the patient environment
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AIM OF THIS INNOVATION To meet the Granny Test at a
microbiological level Cleaning services not achieving good
microbial population reduction in high risk rooms
Cleaning services designed to achieve Victorian Standards cleaning success, little correlation to microbial flora
Goal therefore to achieve high level reduction in environmental flora
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BASELINE DATA -
Manual Cleaning
0
100
200
300
400
500
600
Bed F
ram
e Pre
Mat
ress
Pre
Nighte
ngale
Pre
Call bell P
re
Toilet
seat
Pre
Hand ra
il Pre
Toilet
Tap
Pre
Flush b
utton
Pre
Bed F
ram
e Pos
t
Mat
ress
Pos
t
Nighte
ngale
Pos
t
Call bell P
ost
Toilet
seat
Post
Hand ra
il Post
Toilet
Tap
Post
Flush b
utton
Pos
t
Mea
n B
acte
rial
Co
lon
y fo
rmin
g U
nit
s/10
0cm
2
Pre Post
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KEY CHANGES IMPLEMENTED
Trial of automated area decontamination technology
Well implemented in critical industries (e.g. CSL) System chosen post research: vaporized
Hydrogen Peroxide (vHP) Trialed on an active ward for both operational
acceptability and antimicrobial efficacy Unit purchased for National Burns Centre
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OUTCOMES
Bioquell
0
100
200
300
400
500
600
Bed F
ram
e Pre
Mat
tress
Pre
Nighte
ngale
Pre
Call bell P
re
Toilet
seat
Pre
Hand ra
il Pre
Toilet
Tap
Pre
Flush b
utton
Pre
Bed F
ram
e Pos
t
Mat
tress
Pos
t
Nighte
ngale
Pos
t
Call bell P
ost
Toilet
seat
Post
Hand ra
il Post
Toilet
Tap
Post
Flush b
utton
Pos
t
Mea
n B
acte
rial
Co
lon
y fo
rmin
g U
nit
s/10
0cm
2
Pre clean
Post
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Over all Incidence ESBL
ESBL incidence/1000 Bed Days Ward
0
2
4
6
8
10
Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12
Inci
den
c/10
00 B
ed d
ays
Trial Period
Not presented as primary study result
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LESSONS LEARNT
Prior to 2005 little focus on environmental decontamination
Now research has demonstrated a clear role for the environment in healthcare associated infection
Good data difficult to obtain due to multimodal transmission
Obligation to mitigate the risk for patients
Manual systems inherently faulty as no good measure available of process efficacy (as against process performance)
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Lessons
Area decontamination effective at eliminating prior contamination in patient environment
Reduced disposal of unused consumerables in isolation rooms. In high acuity areas such as burns can amount to thousands of dollars
To stop new organism establishment must get decontamination right first time