Issuu

healthcare

Environmental solutionsnews Covering infection prevention, medical waste management & sustainable practices

VOL. XII NO. 2

www.HealthcareEnvironmentalSolutions.com

Summer 2016

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Next-Generation Genetics Offer New Way to Combat Hospital Infections

By Andrew Porterfield, Genetic Literacy Project

ospital infections are a huge public health problem. For the United States in 2011, about 722,000 infections occurred that were brought on during a hospital stay, according to the Centers for Disease Control and Prevention (CDC). These infections are often severe, even fatal, and include pneumonia, surgery site infections, urinary tract infections, and gastrointestinal illness. But lately the situation has gotten worse, as more and more infections are caused by bacteria that have become very good at resisting antibiotics. The number of these “HAIs” (short for “hospital acquired infection”) has been decreasing, as more screening efforts detect more bacteria, and the use of antibiotics has become more controlled. But 722,000 infections is still a lot, and, it turns out, newer genetics techniques have shown how much more we have to learn about how these infections arise, what causes them, and what the best methods are to combat them. Usually, when such outbreaks occur and they get public notice, news coverage (and even health remedies) follows a pretty simple pattern: Somebody gets sick, somebody else gets sick, a sample is taken and a bacterium (assuming it’s

that) is isolated. Then, hospital staff tries to identify and decontaminate the possible source. Too often, though, the isolation procedure doesn’t cover all bacteria, and a single source isn’t the sole cause of the outbreak.

Headlines Declare an Epidemic

hen antibiotic-resistance and HAIs first started getting attention, early news headlines pointed to alleged shoddy hygiene practices behind the growth of one particular resistant microbe, the bacterium MRSA, or methicillin resistant Staphylococus aureus. In 2008, the Seattle Times crunched some numbers and found high rates of infection from MRSA. This and other stories introduced the idea of the “superbug” in hospitals to the public: Many people first learned about the germ last fall when the federal Centers for Disease Control and Prevention set off a media frenzy with its announcement that invasive MRSA infections claim at least 18,000 lives a year, more than AIDS. But MRSA has been quietly killing for decades. And all along, there has been a simple diagnostic test that could have saved countless lives. Continued on page 3

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HEALTHCARE ENVIRONMENTAL SOLUTIONS news

Summer 2016

Healthcare Environmental Solutions news

healthcare

Environmental solutionsnews Covering Infection prevention, medical waste management & sustainable practices

PUBLICATION STAFF Publisher / Editor Rick Downing Contributing Editors / Writers P.J. Heller Andrew Porterfield Sandy Woodthorpe Production & Layout Barb Fontanelle Christine Pavelka Advertising Sales Rick Downing Subscription / Circulation Donna Downing Editorial, Circulation & Advertising Office 6075 Hopkins Road Mentor, OH 44060 Ph: 440-257-6453 Fax: 440-257-6459 Email: downassoc2@oh.rr.com For subscription information, please call 440-257-6453. Healthcare Environmental Solutions news (ISSN #1557‑6388) is published quarterly by Downing & Associates. Reproductions or transmission of Medical Waste Management, in whole or in part, without written permission of the publisher is prohibited. Annual subscription rate U.S. is $19.95. Outside of the U.S. add $10.00 ($29.95). Contact our main office, or mail-in the subscription form with payment. Copyright 2016 by Downing & Associates Printed on Post-Consumer Recycled Paper

Next-Generation Genetics Offer New Way to Combat Hospital Infections

Continued from page 1

More recent coverage tends to follow a formula, similar to an Associated Press/Fox News story about a mold “outbreak” of four people at the University of Pittsburgh Medical Center (UPMC). The formula usually shows a number of similar infections, at least one death (or a lot of sickness), and the search for a single pathogen in a section of the hospital: Four organ transplant patients who developed a mold infection at UPMC likely got it from time spent in a “negative pressure” room normally reserved for those who already had infections…DuVall and his wife, Karen, had filed a lawsuit in Allegheny County last month against UPMC Presbyterian, alleging that the hospital recklessly housed him in a room that made him more susceptible to such an infection…UPMC…has maintained that the deaths cannot be directly attributed to mold because transplant patients with weakened immune systems are at risk of picking up infections that otherwise healthy people routinely fight off. But screening methods available then were mostly the same techniques that had been used for about a century. These involve taking a clinical sample from a patient, culturing that sample, and identifying bacterial strains. Traditionally, identifying bacteria was based on phenotypic characteristics, such as its appearance in culture, its ability to accept or reject a stain, and shape and size under a microscope. Since, pathology labs and hospitals have started to embrace next-generation genetic techniques, including the polymerase chain reaction and, most important, massively parallel sequencing. These newer techniques have been able to identify exact identities of bacteria (and any other microbe, including viruses), discover brand new types of infectious bugs, and may create a very different picture of how a hospital outbreak happens. While HAIs have been decreasing, new disease transmissions have been blamed on “breakdowns in infection prevention and control practices, unrecognized transmission in the community, and important new strains of antimicrobial-resistant pathogens,” wrote Canadian researchers Patrick Tang and Jennifer Gardy. However, Tang and Gardy also wrote, new genetics methods are becoming cheap enough to become part of a hospital pathology lab, and a “new” science of genomic epidemiology (using genetics to trace the progress of a disease in populations) “has been instrumental for resolving hospital outbreaks, Summer 2016

sometimes disproving previous assumptions regarding nosocomial pathogen transmission.” The authors point to a case in 2010 in Birmingham, England, which was the first to use whole-genome sequencing to study a hospital outbreak. In this case, a protracted outbreak of Acinetobacter baumannii that resists multiple antibiotics was reported and first analyzed using traditional culture and molecular biology techniques. After 40 weeks, the health care team started using WGS, which could more rapidly rule out certain isolates, winnowing the list down from 102 to 32 genotypes. Genomics epidemiology then showed that transmission occurred in patient wards, but also an operating and treatment room for burn victims. But the cases continued after 70 weeks, and genomic analysis led the team to a contaminated bed, and patients returning to the burn unit. Specific cleaning of the bed halted the outbreak, after 80 weeks. More recently, new genomics techniques have helped hone in on similar infectious outbreaks, helping determine new isolates and giving a more complete picture of what arises during the outbreaks. At the University of Washington, researchers spent a year using whole genome sequencing in intensive care units at the university’s hospital in Seattle. Looking at 1,229 bacterial genomes from 391 patients, the researchers found that 12 percent of the clinical isolates were distinct, novel species (even though conventional microbiology methods didn’t uncover this distinction). Often, patients had overlapping bacterial infections (that is, more than one bug), and different strains of infectious bacteria could arise during the course of the outbreak. These discoveries helped establish new targets for eliminating the bacteria behind the outbreak, and underscored the need to understand the identification and behavior of every infectious strain involved in an HAI. Modern next-generation sequencing techniques are becoming cheaper, just at a time when antibiotics are facing more dangerous resistance from bacterial pathogens. Newer techniques have the advantage of more granularity compared to traditional methods (including PCR), and could identify brand new pathogens that need to be identified, sooner rather than later. This article is reprinted from an article originally published by the Genetic Literacy Project, a nonprofit organization. For more information, please visit www.geneticliteracyproject.org.

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

Healthcare Environmental Solutions news

New Trade Association Formed for Medical Waste Industry

By P.J. Heller

embers of the medical waste industry, seeking a trade association similar to the National Association for Information Destruction (NAID) which serves the document destruction industry, will soon have their wish come true. The new nonprofit Medical Waste Management Association (MWMA), designed to serve medical waste transporters and processors, equipment vendors and healthcare professionals responsible for medical waste disposal, is scheduled to be up and running before the end of April. “MWMA is a catalyst and advocate for safe and ethical medical waste disposal practices, as well as a resource for relevant and emerging industry information,” the organization says. The new trade group was formed at the behest of NAID members, which include document destruction companies moving into the medical waste arena as well as medical waste haulers who have begun offering information destruction services. “We’ve definitely seen a lot of new NAID members who have entered the information destruction business who were only in the medical waste hauling business,” notes Bob Johnson, chief executive officer of NAID. “So not only do we have companies who are in the shredding industry getting into the medical waste business – the ones who brought this to NAID and said, ‘Will you help us?’ – but we also noticed at the same time that many medical waste management companies were getting into the information destruction industry.” NAID helped form the new trade group, which will operate as a completely separate and independent organization. In the early going, NAID staff will help manage it to get it off the ground and Johnson will serve as acting executive director. Six people, all in the medical waste hauling business and from states from California to Florida, will serve as an interim board of directors. “The interim board will be in place until such time as there are enough members and the time is right to have an election,” Johnson says, predicting that it will be eight to 12 months before a board is formally elected. He also expects a permanent executive director to be named once the organization is big enough. NAID members came to that organization’s board seeking help in launching a new trade group for medical waste companies, saying it would help their businesses. “A lot of NAID members are getting into that [medical waste] business as part of what they do,” Johnson says, “They already service the medical 4

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

Summer 2016

industry in their information destruction needs, so they’re adding this service, often in a separate company to their business model. They came to the board of directors and said, ‘There’s no trade association doing for our industry on the medical waste management side what NAID has done on the information destruction side, and we think it would be very valuable.’” That appeal for help was bolstered by concerns that medical waste haulers and processors could come under the same HIPAA (Health Insurance Portability and Accountability Act) regulations as the document destruction industry concerning protected health information. “We’re now quickly approaching a time in technology . . . where DNA is able to be analyzed to the point where it’s going to be considered protected health information,” Johnson says. “And it’s only a matter of time, not very much time, before DNA has to be protected like every other type of information has to be protected. It is very personal and confidential and shows a lot [of personal information]. “I don’t believe it’s going to be very long at all before you’ve got medical waste haulers who are actually considered under the regulations as business associates under HIPAA,” he says. “The overlap there is amazing between what a NAID member does and what a waste hauler company does. They’re transporting confidential information. They are literally business associates under HIPAA. They would be subject to all the same things as NAID members are as business associates. In one respect they’re disposing of information just like the NAID member disposes of other types of information.” Johnson says not many people see the connection yet but predicts it is only a matter of time before medical waste falls under HIPAA guidelines. “I don’t understand why it already isn’t considered as protected health information under HIPAA,” he says. “That is one more layer of justification why NAID got involved in forming this association.” Once the MWMA goes live, prospective members will be able to join online or by calling the Phoenix, Ariz., headquarters and requesting an application, which can be mailed, faxed or downloaded and then mailed in. Three categories of membership will be offered: medical waste transporters and processors, vendors to the industry such as manufacturers of autoclaves, shredders and vehicles, and medical waste practitioners who are responsible for the disposal needs of their organizations. Unlike NAID, there are no plans at present to offer a certification program. That voluntary program “verifies the qualifications of certified

Continued on next page

Healthcare Environmental Solutions news Continued from previous page information destruction providers through a comprehensive scheduled and unannounced audit program,” according to NAID’s website. Offering a certification program for waste haulers would be up to the MWMA board, Johnson says, adding that it is too early in the process to discuss such an option. Johnson says the MWMA will be a voice for the industry, provide education to members to improve their businesses and offer information to healthcare practitioners to help them make good decisions and better do their job when it comes to medical waste disposal. “Every industry worth its salt has a trade association that acts as its voice in either state or local regulations,” he adds. “There could be a regulatory component or a regulatory voice.” MWMA may also get involved in federal issues relating to medical waste. “If there’s potential legislation, either negative or positive, that is going to effect medical waste haulers, MWMA would either be responding or commenting or attempting to act as an advocate for the industry,” Johnson says. “It’s important to recognize when such legislation can be helpful to the industry and promote it. There’s also the need to watch when that legislation could be damaging to the industry and when you’ve got to push back on that legislation.” NAID currently has 30 percent of its membership outside North America and Johnson says it’s conceivable that the MWMA could also spread worldwide. “I don’t think it’s anything that will happen soon but eventually it could transcend the borders of North America and move into other countries,” he says. In the meantime, Johnson is hopeful that the new group will flourish. The MWMA will fill a void in medical waste transport services, as well as with the vendors that supply them and the professionals who are responsible for making disposal decisions “and that will translate into significant new membership,” he says. “We have hopes . . . “ Johnson adds. “We expect to be welcomed into the industry.”

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HEALTHCARE ENVIRONMENTAL SOLUTIONS news

News Briefs

2015 CMS Patient Safety Reviews Reveal Risks, Hospital Revenue Losses

ashington, D.C. – Combined reductions totaling $13 million in Medicare/Medicaid payments to 24 Michigan hospitals point to an array of issues, not just infection control, hospital administrators and industry experts note, according to a CrainsDetroit.com article. As required by the Affordable Care Act (ACA), the federal Centers for Medicare & Medicaid Services each year ranks healthcare facilities that accept Medicare and Medicaid payments according to “hospital-acquired condition” occurrence. The rankings were included as part of the Affordable Care Act in a push to improve patient safety and reduce health-care costs. Penalties are calculated using a formula that results in a one percent reduction for any facilities that score above 6.5 on a 10-point scale. Every January, the agency posts the rankings for the previous year in an easily searchable database online. The Michigan hospitals being penalized include three Detroit Medical Center facilities (Detroit Receiving, Sinai-Grace and Harper Hospital), St. Joseph Mercy Oakland, Hurley Medical Center and McLaren Health Care Corp. in Flint. According to CrainsDetroit.com, Akin Demehin, senior associate director of policy for the American Hospital Association, an industry group based in Washington, D.C., said that the difficulty is presenting the data in a way that fairly assesses the big picture impacting any one hospital. “What we’ve found with HACs specifically is that hospitals that care for complex patients – academic centers, teaching hospitals, large urban hospitals – tend to do quite a bit worse,” Demehin said. Those hospitals tend to have a higher percentage of sicker, poorer, more medically fragile patients in the first place, he explained. The U.S. Centers for Disease Control and Prevention estimates that in one recent year, 722,000 patients suffered infections related to hospitalization, and 75,000 of them died. The CMS survey counts MRSA (Methicillin-resistant Staphylococcus aureus), clostridium difficile, bloodstream and urinary-tract infections associated with catheters or central lines, as well as surgical sites on the body, and bedsores.

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HEALTHCARE ENVIRONMENTAL SOLUTIONS news

Summer 2016

Rigid Containers Used in Sterilization Harbor Bacteria

study published in the concluded that the rigid, reusable plastic containers used for holding surgical or other instruments used in healthcare settings, such as operating rooms, may harbor colonizing bacteria that can cause infections. The study was conducted under a United States Air Force program by a team of government researchers, along with scientists from the engineering and science firm, Applied Research Associates and Sterilization Consulting Services, Inc. and others. Plastic packaging and containers that are commonly used in operating rooms and dental offices have been presumed to maintain the sterility of surgical instruments and devices from the time of sterilization until use. The containers are reusable and come in various sizes and materials, many of which have a filter mechanism to allow sterilizing agents to enter and exit the container. Standard sterilization wrapping is typically three layers of meltblown polypropylene bonded on top and bottom surfaces with a layer of spunbonded polypropylene. The study evaluated the effectiveness of rigid plastic containers versus wrapped instrument trays, sterilized using North Operational Sustainability American sterilization protocols. The research team found that almost all — readiness 97 of 111 — rigid Fortify emergency built in containers had bacterial colonies. All 161 of the trays wrapped in plastic sterilization wrap maintained sterility. The experiment involved spraying both types of packaging with bacteria, then taking cultures. The testing was done using a custom aerosol chamber, 111 rigid containers of various durations of use (unused, used <5 years, used 5-9 years) and 161 wrapped trays using three grades of sterilization wrap. The aerosol challenge consisted of ∼102 colony-forming units per liter of air containing aerosolized Micrococcus luteus with a count median particle size of 1 μm, while simultaneously experiencing air volume exchanges due to vacuum cycles–two 1-psi cycles, three 0.7-psi cycles, and three 0.4-psi cycles–to simulate air exchange events occurring during the sterilization, transportation, and storage of sterilized instrument trays in health care facilities. The study findings challenge previouslyheld beliefs that the rigid containers are effective to maintain sterility of their contents. The study also showed the unused containers failed to maintain barrier performance under the study’s test conditions. The research was funded by Halyard Health (formerly Kimberly-Clark Healthcare). Target your products, equipment and services to more than 5,000 healthcare facilities and medical waste contractors throughout the U.S. ... Advertise in HES! call Today 440-257-6453

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ork, PA – Sorters employed by the waste and recycling company, Penn Waste, are reporting a dramatic increase in the number of hypodermic needles, lancets and other biohazard sharps in trash, according to a YDR.com article. Amanda Davidson, a spokeswoman for the company said workers are finding enough of the waste to fill a 3-by-4-foot box in one month. The growing volume of sharps has moved the company to launch a public education campaign, as it gains even more contracts with other waste haulers that do not have their own recycling centers. Employees wear gloves, but the hazardous work has resulted in two sorters being jabbed. Most the sharps are coming from home use by people who must regularly inject pharmaceuticals or use lancets to test blood glucose levels. Penn is asking people to collect needles in laundry detergent bottles and then toss the filled bottles in the garbage, not recycling bins. Sharps in the recycling stream can result in jammed equipment and worker injuries. The U.S. Food and Drug Administration suggests the following methods for disposal: 1. Used sharps should be immediately placed in a sharps disposal container. Pharmacies, medical supply companies and health care providers sell sharps containers, which are puncture and leak resistant and have been approved by the Food and Drug Administration. If an FDA-cleared container is not available, use a heavy-duty plastic household container, such as a laundry detergent container. 2. For home trash pick-up, sharps should be placed in the trash bin — not the recycling bin— as long as they are in a sealed, sturdy container. Never place loose needles and other sharps in household or public trash cans or recycling bins, and never flush them down the toilet.

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HEALTHCARE ENVIRONMENTAL SOLUTIONS news

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Nanotechnology May Hold Key to Fighting Antibiotic-Resistant Infections

ayetteville, AR – A research team at University of Arkansas has developed an alternative therapeutic approach to fighting antibiotic-resistant infections using cutting edge nanotechnology, reports News.UARK.edu. In lab experiments led by two professors, chemist, Jingyi Chen and microbiologist, Mark Smeltzer, the team tested a targeted, light-activated nanodrug, an antibiotic, which they “loaded” into a polydopamine coating. This process involved creating minute gold nanocages, or hollow, porous gold nanoparticles that range in size from 10 to over 150 nm (a nanometer measures one billionth of a meter). The researchers used the nanocages to convert laser irradiation to heat in order to release the drug from the coating. “We believe that this approach could facilitate the effective treatment of infections caused by antibioticresistant bacteria, including those associated with bacterial biofilms, which are involved in a wide variety of bacterial infections,” said Chen. Microbial resistance to antibiotics has become a growing public health concern in hospitals and the community at large, so much so that the Infectious Diseases Society of America has designated six bacterial species as “ESKAPE pathogens” –Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species. This designation reflects the limited availability of antibiotics that can be used to treat infections caused by these species. According to Smeltzer, an estimated 80 percent of all bacterial infections involve formation of a biofilm, and all of these infections share the common characteristic of intrinsic resistance to conventional antibiotic therapy. Intrinsic resistance refers to the fact that bacteria within a biofilm exhibit a therapeutically relevant level of resistance to essentially all antibiotics. The team used Staphylococcus aureus as the proof-of-principle pathogen to demonstrate the potency of their nanodrug. The combination of achieving a photothermal effect and controlled release of antibiotics directly at the site of infection was achieved by laser irradiation at levels within the current safety standard for use in humans. The in laboratory-based study validated the approach using planktonic bacterial cultures – bacterial cells that are free-floating rather than contained with a biofilm – of both methicillinsensitive and methicillin-resistant Staphylococcus aureus strains. The method was subsequently shown to be effective even in the context of an intrinsically resistant biofilm. “The even better news is that the technology we developed would be readily adaptable to other bacterial pathogens that cause such infections, including the other ESKAPE pathogens,” Smeltzer said.

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HEALTHCARE ENVIRONMENTAL SOLUTIONS news

Summer 2016

Scotland Study: WHO Hand Hygiene Technique Most Effective

lasgow, Scotland – Study findings published online in Infection Control & Hospital Epidemiology show that a six-step hand-hygiene technique recommended by the World Health Organization is the most effective procedure for reducing bacteria on healthcare workers’ hands. The study was conducted by a team of Glasgow Caledonian University researchers who observed hand hygiene techniques used by 42 physicians and 78 nurses at an urban, acute-care teaching hospital. Cultures obtained after handwashing revealed a median bacterial count of 3.28 to 2.58 for the lengthy (42.50 second) six-step method and 3.08 to 2.88 for a shorter (35-second) three-step method that is CDC standard. The study authors concluded that compliance issues, along with the sixstep method should be considered when public health organizations make official recommendations on best practices in hand hygiene.

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News Briefs

Stericycle Relocation Plan Moves Forward

alt Lake City, UT – According to an Associated Press report published on KSL.com, the regulatory approval process is underway regarding a controversial medical waste incinerator in Utah. After years of public opposition, Stericycle submitted a proposal to the State Department of Air Quality to move its incineration facility out of North Salt Lake City to the less populated Tooele County. If approved, the new facility will burn 18,000 tons of medical waste per year. The company had been authorized by the state to burn 7,000 tons per year at its current North Salt Lake City location. In 2014, Stericycle agreed to pay Utah a $2.3 million fine and move its facility after being cited for toxic emissions.

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urlington, VT – Sterilizing, repackaging and repurposing surgical instruments has become another way for the University of Vermont Medical Center to reduce its medical waste, according to a UVMHealth.org article. The hospital’s 53-person Center’s Sterile Reprocessing (CSR) department is responsible for reprocessing, checking, sterilizing, packaging and supplying the operating rooms, patient floors and off-site clinics with sterilized instrumentation and disinfected equipment. According to its website, certain instruments are kept at the hospital to be used in practicums for residents, while others are donated to veterinary clinics. The CSR department also receives 50 pounds of paper inserts from testing packets, which it recycles. Also, hundreds of tons of blue wrap used for packing sterilized instruments are sent for recycling where it is turned into plastic pellets. Overall the Medical Center has reduced its solid waste stream by seven percent and increased recycling by six percent over the past three years. The hospital has been accepting a greater range of plastics and introducing recycling in the operating rooms and patient rooms, and a new program is underway to use reusable “sharps” containers. UVM also is one of the few hospitals in the nation to establish a comprehensive drug waste program that has special collection receptacles placed in all high priority areas including pharmacies and locations that prepare and administer chemotherapy agents.

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Wristbands and Soap Dispensers Track Handwashing

Globes.com article reports that Internet of Things (IoT) technology is helping to improve hand hygiene compliance and reducing patient infection rates, thanks to two Israeli companies. The companies, Hyginex and Atomation, have partnered to provide a sensors and data tracking system to pilot programs in 10 hospitals this year. The combined technology captures the frequency and duration of hand cleaning by healthcare workers who wear wristbands and use specially designed soap dispensers. The data that has been generated so far has proven the value of the monitoring system: hand hygiene events doubled, and average hand cleaning duration increased from 7 seconds to 24 seconds. The technology is designed for easy adoption and is hoped to be effective against healthcare acquired infections (HAI). In the U.S., the number of HAIs has grown to one million per year, with such infections causing 100,000 deaths annually. The problem has a huge financial impact, too, costing U.S. hospitals $40 billion total. The Hyginex/Atomation system has another benefit – raising healthcare worker hand hygiene awareness, which is sometimes a challenge where healthcare is delivered under demanding conditions. At the same time, the system provides management with a useful training and intervention tool because bacteria counts can be quantified and tracked.

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News Briefs

Imperfect Cleaning Can Miss EBOV on Surfaces, Italian Researchers Say

espite no current evidence that the Ebola virus can be “caught” via solid surfaces, researchers urge healthcare facilities to make sure stringent cleaning procedures are followed, a Healio.com article reports. After Ebola RNA was recovered from cleaned surfaces in a high isolation unit where a patient infected with the disease had been treated and discharged, the effectiveness of final decontamination procedures came under sharp scrutiny. A study, led by Vincenzo Puro, MD, of the Lazzaro Spallanzani National Institute for Infectious Diseases in Rome, reviewed cleaning procedures and looked for any remaining virus genetic material where EBV patients had been treated. The researchers swabbed cleaned surfaces in a high isolation unit (HIU) at the National Institute where two patients with EBOV previously had been hospitalized. Despite daily cleaning of the floor, surfaces and all reusable equipment using bleach solution during and following the patients’ hospitalization, EBOV RNA was left on surfaces that had not been thoroughly disinfected. Puro and his colleagues used a genetic testing method to identify the virus. “According to our findings, the daily cleaning of patient rooms with 0.5% hypochlorite was sufficient to remove EBOV in most cases,” they wrote. “However, viral genetic material was found in areas where heavy contamination had occurred. Imperfect cleaning and intensive contamination by bloody vomit may have contributed to this finding.” The researchers concluded that more studies are needed to assess the efficacy of the cleaning procedures at other health care facilities. A 2014 APIC survey cites waste management, waste removal and personal protective equipment donning and doffing protocols as critical areas needing improved training and support. APIC conducted another survey the next year in which 92% of respondents indicated better preparation for highly lethal infectious disease. Nearly three-quarters reported adequate personal protective equipment was available, and 62.4% said they were continuing to train staff on Ebola patient management.

Handwashing Protocols Not Being Followed Closely Enough

ashington, DC – According to an Elsevier. com abstract of study findings published in the American Journal of Infection Control, caregivers are not being diligent enough in following established protocols for hand washing. In a 2014 study, medical students from the University of New Mexico and the New Mexico Health Department conducted interviews and observations at 15 different outpatient facilities to document the correlation between hand hygiene recommendations and actual practice. The students reviewed administrative policies, education and training, occupational health, environment cleaning, hand hygiene and injection safety policies. Then, they observed each observed 10 injections and 20 hand hygiene opportunities at their assigned outpatient practice for a total of 330 observations. Although 93 percent of the facilities have hand hygiene rules and all have the necessary supplies in place, the students observed that hand washing was not done 37 percent of the time in general patient contacts. For injection safety, no hand washing was done prior to 33 percent of the 163 injections observed. The study authors concluded that the findings “were critical because there have been outbreaks and infection transmission to patients reported in outpatient settings due to these types of infection prevention breaches, including transmission of hepatitis B and C.”

Multi-Tasking! Vecoplan’s Universal Shredders Pull Double Duty! IT’S A MEDICAL WASTE SHREDDER... • • • • •

Vecoplan has years of med-waste experience developing systems used in hospitals world wide for red bag processing Use as the first or last step in your med-waste treatment system Shreds sharps and other tough materials Shreds to an unrecognizable consistency Turnkey medical waste sterilization systems

...AND A SECURE DESTRUCTION SHREDDER... • • • •

The same Vecoplan med-waste shredders have also been used for years for confidential data destruction. Gain control of HIPAA compliance and costs by “in house” destruction of records, disks, drives and other media Vecoplan shredders are AAA NAID compliant Vecoplan shredders are currently being used in hundreds of secure destruction operations

Large Hopper Hydraulic Ram l Auto-Feeds Materia or to the Cutting Rot

...ALL IN ONE!

ic Controls Mind Reader Log d, Ram Adjust Material Fee d Speeds Direction and Fee

Low Speed, High Torque or Single Cutting Rot d,

Consistently Size Unrecognizeable Particles

Phone: (336) 447-3565

vecoplanllc.com www.vecoplanllc.com 10

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

Summer 2016

www.healthcarewasteconf.com

Summer 2016

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

Formerly Medical Waste Management

healthcare

Environmental solutionsnews

6075 Hopkins Road • Mentor, OH 44060

PRSRT STD

Ph: 440-257-6453 • Fax: 440-257-6459 Email: downassoc2@oh.rr.com

Mentor, OH Permit No. 2

Covering infection prevention, medical waste management & sustainable practices

VOL. XII NO. 2

SUMMER 2016