4 Cornerstones Environmental Report PICNET 2014 Linda Dempster - - PowerPoint PPT Presentation

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4 Cornerstones Environmental Report PICNET 2014 Linda Dempster Dr. Elizabeth Bryce Sydney Scharf March 3, 2014 The 4 Cornerstones Prevents ARO spread Hand Hygiene Prevents infection Prevents ARO spread Environmental Provides

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4 Cornerstones Environmental Report PICNET 2014

Linda Dempster

  • Dr. Elizabeth Bryce

Sydney Scharf March 3, 2014

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The 4 Cornerstones

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SLIDE 3
  • Prevents ARO spread
  • Prevents infection

Hand Hygiene

  • Prevents ARO spread
  • Provides clean equipment
  • Prevents infection

Environmental Program

  • Improves quality
  • Reduces mistakes or omissions
  • Decreases adverse events
  • Alters microbial ecology

Antimicrobial Stewardship

  • Improves quality
  • Reduces mistakes or omissions
  • Prevents infection
  • Improves patient perception/experience

Standard Protocols

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4

Key Elements of the 4 Cornerstones Program

  • A VCH antimicrobial stewardship program to ensure

appropriate, cost effective use of antibiotics on the clinical units within our hospitals

  • An environmental management program to improve

clinical equipment surface cleanliness as well as clinical equipment management on each clinical unit

  • Implementation of a risk-managed approach to the

isolation of VRE clients in an effort to support patient flow and reduce unit supply costs

  • An equipment cleaning program
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Partners

  • Aramark
  • Biomedical Engineering
  • BISS
  • CDI Working Group at VGH, Goldie Luong
  • Clinical Services
  • FMO
  • HSSBC
  • IMIS
  • Infection Control
  • Leslie Forrester & Epidemiology Team
  • Medical Microbiology
  • Pharmacy
  • Professional Practice
  • Simon Tse

5

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□ Wall mounted gloves

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Decluttering

Before After

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Decluttering Cost Template

Supplies Quantity (per patient room) Cost per unit Waste

22G x 1" Protectant IV 3060

$ 0.26

$

  • 3M Brown Compressor Dressing - System 2

$ 5.02

$

  • 3M Medipore Dressing Roll

$ 6.81

$

  • 3M Tape

$ 0.62

$

  • 3M Tegaderm Film 4" by 4 3/4" (1626W)

$ 0.89

$

  • 3M Tegaderm Film 6cm by 7cm

$ 2.38

$

  • Suction Toothbrush

$ 2.56

$

  • Tegaderm Transparent Film Dressing with Border 3" x 4"

$ 1.77

$

  • Triumph Sterile Latex Gloves, Powder Free (6)

$ 0.70

$

  • Yankauer Suction Tube

$ 0.60

$

  • Time spent decluttering (in hours)

People involved Number of patient rooms

Total $ - Total per Unit

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Milestones:

Clean stretcher protocol VGH June 27th

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RH

  • MECD- July 2nd

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RH

  • EQD opening - August

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LGH

  • MECD Program - July 9th
  • EQD opening - August 20th

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Wheelchair Amnesty

LGH August 30 to September 20

  • 15 returned
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Green Means Clean VGH September

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Clean bed protocol VGH, LGH

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Equipment cleaning manual

  • Inspired by VIHA
  • Available online

October 2013

  • Shared with SPH and

Saskatchewan HA

  • Accreditation at RH
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Environmental Cleaning Outcomes

  • De-cluttering
  • Introduction of PPE carts
  • Introduction of color coded microfiber cleaning

cloths and color coded buckets

  • Equipment management includes cleaning,

preventative maintenance, establishing par levels, and ensuring that the right piece of equipment is available and is clean at all times.

  • Labeling/tagging
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Color coded housekeeping cart

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  • Regional inventory, 5 surplus beds

and 2 walkers moved - transferred from UBC to VGH.

  • Savings of approximately $ 5,200
  • 8 commodes to LGH $8,000

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Equipment Management Benefits

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Yellow Gowns

BEFORE

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Yellow Gowns

AFTER

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Personal size hygiene trial

2 units at VGH, ongoing. Now at 6 months.

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Benefits:

  • 1. Decreased cross contamination
  • 2. Less waste
  • 3. Savings, neutral at 6 months
  • 4. Patient satisfaction
  • 5. Staff satisfaction
  • 6. Non-quantifiable data but qualitatively

in favour of proceeding.

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Decrease VRE patients isolated daily at VGH

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Before After 32 beds 7 beds

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Savings:

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To Date Year Projected Soap-Swap Out $46,435.04 $65,490.00 Lab Savings $64,830.00 Yellow Gowns $154,170.00 Decreased FTE Equipment Program $480,000.00 Decreased Stock Clerk $40,000.00 Linezolid Savings $202,237.00

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What is antimicrobial stewardship?

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ASPIRES

Antimicrobial Stewardship Program – Innovation, Research and Education for Safety

Clinical Care Education Research Collaboration Excellence

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VGH Data

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Four Cornerstones VGH:

Pre and Post Implementation

375 263 50 100 150 200 250 300 350 400 Pre Post Total Number of Cases

Total CDI Acquired at VGH (Pre & Post Implementation)

Sep 2012 - Dec 2013 Jun 2011 - Aug 2012

↓ 30%

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Next Steps

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  • Sustain program
  • Patient rooms, begin cycle again
  • SOP – dock to dock regional inventory
  • Audits of MECD Program
  • Individual Hygiene Packs, regional
  • Safe/clean hospital – new way of doing

business

  • Green Means Clean
  • Focus, continued decrease of CDI
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 Dollars saved  Bed Days saved  Patients protected from CDI

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Target

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CDI

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Questions

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