INFECTION PREVENTION
onto bleach disinfectant wipes, provides a temporarily visible bright blue trace to depict wiping surface coverage before fading away to clear in minutes. The IP team docu- mented their work, which was published in the November 2021 edition of the American Journal of Infection Control (AJIC).4 “Environmental disinfection is founda- tional for an effective Infection Prevention pro- gram to help minimize the risk of transmission of cer- tain pathogens (e.g., C dif- ficile, MRSA, Multidrug resistant gram negative bacteria),” said Jerry M. Zuckerman, MD, Vice
Jerry M. Zuckerman
President of Infection Prevention & Control, Hackensack Meridian Health, who helped lead the research. “To assess the effectiveness of room cleaning, ATP bioluminescence assays or fluorescent markers may be used. This approach has several limitations includ- ing limited sampling and they only provide feedback after the cleaning process is complete.”
“The advantage of adding a color additive to the bleach wipes is that it allows the person to see, in real-time, the areas that they have, or have not, cleaned,” Dr. Zuckerman added. “Making the invisible, visible will enable more efficienteffective cleaning at the time it is being performed and contribute to our overall infection prevention improvement efforts.”
Dr. Zuckerman and his team performed a prospective study from July 2021 to August 2021. During the control phase, routine terminal cleaning of isolation rooms was performed by EVS staff using standard bleach disinfectant wipes (Sani- Cloth Bleach Germicidal Disposable Wipe, PDI Healthcare). During the intervention phases, EVS staff were provided with the color additive (Kinnos Highlight) to combine with their standard bleach wipes. Disinfection quality was quantified through both fluorescent marking removal (Diversey VeriClean Fluorescent Marking Spray) and ATP bioluminescence assay (3M Clean-Trace Luminometer). The results showed that use of the color additive on the bleach wipes improved fluorescent marking cleaning scores by 7 and ATP scores by 3 in just a few weeks. While the facility’s cleaning assessment scores varied significantly before addi- tion of the colorant, after its addition they achieved 1 passing scores. “The pilot performed was a result of a shared decision-making process between environmental services and infection pre- vention,” said Dr. Zuckerman. “The recent COVID surge and staffing shortages has put further roll out of the product on temporary
hold. In the short term, we hope to see an impact on EVS job satisfaction as they learn and recognize how their efforts contribute to patient safety.”
Scope storage initiative drives greater compliance and safety Effective scope management and storage have been hot topics in infection control, with several highly publicized infection outbreaks tied back to contaminated scopes. The U.S. Food and Drug Administration (FDA) and industry associations continue to publish new guidance on scope handling and reprocessing in light of these events. As an organization dedicated to patient safety, infection prevention, and quality improvement, the safe and effective repro- cessing and storage of endoscopes has been a high priority at The Queen’s Health Systems in Honolulu, Hawaii. “The drying of endoscopes is important to decrease the risk of microbial growth while they are stored and before the next use,” said Julian Martinez, CRCST, CIS, CHL, Coordinator, Sterilization & Disinfection, Infection Prevention & Control, The Queen’s Health Systems. “Drying at the right temperature and humidity promotes optimal scope readiness. Proper storage of scopes is important to protect them from damage, decrease the potential for microbial growth, and ensure monitoring of its use is managed.”
The Queen’s Health Vice President of Surgical Services was the first to acknowl- edge that the health system’s scope manage- ment processes and equipment at the time did not meet industry standards: AAMI ST91:2015 and SGNA:2018. In particular, the old scope cabinets in place were insufficient and could not support the organization’s growing demands.
“With the old cabinets being conventional and outdated, the issue of compliance was not having the endoscopes stored properly in a secured cabinet, and not allowing ade- quate space around the scope for optimal drying capabilities,” Martinez explained. The VP engaged the Infection Prevention (IP) department, and they collaborated on a solution. Because new scope storage cabinets would be a capital expenditure, the VP and IP team built a case for why their request should be at the top of the health system’s priority list. They also developed a list of required cabinet features to meet compliance standards which included dry- ing capability, humidity control, and ability to store longer scopes.
“Our organization was committed to making a move to comply with society guidelines for temperature, humidity, and the drying of the inner channels,” said Martinez. “The purchase of these cabinets
36 March 2022 • HEALTHCARE PURCHASING NEWS •
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was going to help us improve on compli- ance, and leadership at The Queen’s Health Systems was very supportive during the process.” Leadership acknowledged the impor- tance of scope drying and storage for the safety of the health system’s patients and approved the cabinet purchase (Clinical Choice ScopeVault cabinets). According to Martinez, the cabinets have helped The Queen’s Health Systems improve compli- ance in several ways:
“ScopeVault cabinets helped us achieve appropriate storage standards by not having the scopes touch the bottom of the cabinet and by circulating HEPA filtered air within the cabinet space and through the scope channels to ensure the scopes remain dry. These improvements have provided greater patient safety by providing endo- scopes that have gone through the proper disinfection process and are appropriately dried. We can easily store endoscopes that previously would not fit in the older cabi- nets with the space-saving design.” Martinez added, “by utilizing an endo-
scope cabinet that can provide security and proper drying of the channels, it ensures that we are providing the best possible care to our patients.”
Supporting those who protect caregivers and patients Like physicians, nurses and other healthcare workers, IPs have been working nights, weekends and holidays under intense pres- sure throughout the pandemic. But unlike those on the front lines, it is not generally known what IPs are doing behind the scenes to protect patients and their caregivers from harm. Their efforts are monumental and APIC has been doing what it can to help its members take care of themselves while they fight the fight. “It’s hard to find time to unplug when you are working long hours, buried in email and your phone is ringing off the hook, but we have to. If we don’t, we will burn out,” said Dickey.
Despite the unprecedented challenges IPs
have faced over the past two years, APIC members continue to plan for the future of the profession. “We are in the same boat as all of the other
healthcare fields with the need to fill the pipeline with new talent to replace those who are retiring,” said Dickey. “We’ve had volunteers continue to do good work to figure out what APIC’s future will look like. I want to honor those people who have carved out time to continue to help move us forward as a profession.” HPN
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