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Infection Prevention and Control Germ Warfare: An Innovative and Novel Approach to Assess a Non-manual Room Disinfection Technology Heather Gagnon, Jenine Leal April 23, 2019 Infection Prevention and Control Disclosure Neither of the

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Germ Warfare:

An Innovative and Novel Approach to Assess a Non-manual Room Disinfection Technology

Infection Prevention and Control

April 23, 2019

Heather Gagnon, Jenine Leal

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Infection Prevention and Control

April 23, 2019

  • Neither of the authors has an actual or potential conflict of interest

in relation to this topic or presentation.

Disclosure

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Infection Prevention and Control

April 23, 2019

Alberta Health Services

  • Vision

– Healthy Albertans. Healthy Communities. Together.

  • Mission

– To provide a patient-focused, quality health system that is accessible and sustainable for all Albertans. Infection Prevention and Control

  • IPC Strategy

– Develop progressive partnerships with key stakeholders to support their success in improving IPC practices across the province.

Background

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Infection Prevention and Control

April 23, 2019

  • Surface contamination as a source of transmission of pathogens and

healthcare-associated infections (CADTH, 2015)

  • Subsequent occupancy of a room previously occupied by a patient

colonized or infected increases the risk of acquiring pathogens by a factor

  • f two or more (CADTH, 2015).
  • A measure to minimize this risk is perform enhanced isolation cleaning and

disinfection following the discharge of colonized or infected patients (CADTH, 2015).

Introduction

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Infection Prevention and Control

April 23, 2019

  • Contract Procurement & Supply Management
  • Facilities Maintenance & Engineering
  • Health Technology Assessment & Innovation
  • Infection Prevention & Control
  • Linen & Environmental Services
  • Site - Foothills Medical Centre – Unit-37 and Unit-57
  • Site - Royal Alexandra Hospital – Unit-41 and Unit-43
  • Site - University of Alberta Hospital – Unit-3C2 and Unit-3D4
  • Workplace Health & Safety

Teams

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Infection Prevention and Control

April 23, 2019

Evidence-informed Public Health Process

DEFINE SEARCH APPRAISE SYNTHESIZE ADAPT IMPLEMENT EVALUATE

Adapted from National Collaborating Centre for Methods and Tools (2019) Evidence-informed Public Health

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Infection Prevention and Control

April 23, 2019

Methodology

2014 - Jan 2015 - Jan 2016 - Jan 2017 - Jan 2018 - Jan 2014 - Jun 2015 - Jun 2016 – Jun 2017 – Jun 2018 - Jun 2019 - Jun

Pre-Intervention Intervention Post-Intervention Project Plan Developed Working Group Established Technologies selected for proof of concept testing Technology selected Review

Proof of Concept Testing

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Infection Prevention and Control

April 23, 2019

  • Used as an enhancement to current cleaning practices and

protocols.

  • Application, when feasible,

– Isolation discharge or transfer out of private patient rooms. – Semi-private or ward rooms. – Identified medical equipment could be included in rooms. – Washrooms in semi-private or ward rooms at least once per week.

Intervention

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Infection Prevention and Control

April 23, 2019

Primary outcome

  • Hospital-acquired Clostridioides difficile infection rates

Secondary outcomes

  • Hospital-acquired Methicillin resistant Staphylococcus aureus rates
  • Hospital-acquired gram negative organism rates
  • Hospital-acquired bloodstream infection rates
  • Hand hygiene compliance
  • Antibiotic utilization

Clinical effectiveness

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Infection Prevention and Control

April 23, 2019

Primary outcomes

  • Cleaning turnaround time
  • Time to operate technology
  • Document interruptions in the use of technology
  • Qualitative evaluation of the use of technology

Operational feasibility

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DESIGN

  • Identify

research question ENGAGEMENT

  • Identify

partners for research and invite to collaborate DATA COLLECTION

  • Choose and

implement the research and data collection methodology DATA ANALYSIS

  • Analyze the

results REPORTING

  • Report the

results

Infection Prevention and Control

April 23, 2019

Participatory Research Framework

COMMUNICATION, DOCUMENTATION, AND EVALUATION THROUGHOUT PROCESS

Adapted from Advancement Project – Healthy City (2011) A Short Guide to Community Based Participatory Action Research

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April 23, 2019

  • Enhancing communication, training frontline staff, and improving

patient flow and workflow processes.

  • Applicability and buy-in.
  • Importance of ongoing meetings.
  • Importance of defined outcomes and processes and the use of

existing data .

  • Understanding the benefits and challenges of implementing the

technology.

Results

Infection Prevention and Control

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Infection Prevention and Control

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  • The use of a collaborative, systematic approach was essential in

exploring the use of a technology for implementation within a complex healthcare system.

Conclusion

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Infection Prevention and Control

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  • Complete a final analysis on the clinical effectiveness and operational

feasibility of the technology after the completion of the post-intervention period.

  • Continue to share the results with the teams.
  • Submit a manuscript for publication.

Next steps

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Infection Prevention and Control

April 23, 2019

  • Contract Procurement & Supply Management

– Inna Mackay

  • Facilities Maintenance & Engineering

– John Chalupa, Trevor Fourmeaux, and Calvin Smith

  • Health Technology Assessment & Innovation

– Tanya Ewashko

  • Infection Prevention & Control

– Nancy Alfieri, Kathyrn Bush, Melody Cordoviz, Leanne Dekker, Karin Fluet, Karen Hope, Dr. Mark Joffe, Roberta McCombie, Gwyneth Meyers, Jennifer Parsonage, Craig Pearce, Arun Pokhrel, Dr. Geoffrey Taylor, Winnie Winters, and Samantha Woolsey.

  • Linen & Environmental Services

– Julian Stampp Anderson, Treena Antkow, Ken Campbell, Brandi Dul, Frank Galetta, Emine Muminhodzic, Charles Power, Fadila Selma, Heather Truber, Hailey Smitten, Ivelina Vanguelova, and Paul Zork

  • Site - Foothills Medical Centre – Unit-37 and Unit-57

– Lorraine Harrison and Debbie Meilleur

  • Site - Royal Alexandra Hospital– Unit-41 and Unit-43

– Monica Cook, Danielle Eidelman,Teri Harris, and Carmela Zumbo

  • Site - University of Alberta Hospital – Unit-3C2 and Unit-3D4

– Catherine Castle, Monica Cookson, Chidi Nwofor, and Dallas Schroeder

  • Workplace Health & Safety

– Savonna Dombrosky

  • Others

– All of the staff that participated in the implementation of the technology and in particular those that participated in the structured, one-on-one interviews – All of the people that provided data including Marlene Brandt, Bruce Dalton, and Camryn Knoll

Acknowledgments

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Infection Prevention and Control

April 23, 2019

  • Heather Gagnon

Heather.Gagnon@ahs.ca

  • Jenine Leal

Jenine.Leal@ahs.ca

Question?

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Infection Prevention and Control

April 23, 2019

  • Advancement Project – Healthy City. (2011). A Short Guide to

Community Based Participatory Action Research.

  • Canadian Agency for Drugs and Technologies in Health (CADTH).

(2015). Non-Manual Room Disinfection Techniques for Infection Prevention and Control in Healthcare Facilities: A Review of the Clinical Effectiveness, Cost-Effectiveness, and Guidelines.

  • National Collaborating Centre for Methods and Tools. (2019).

Evidence-informed Public Health. Obtained on April 10, 2019 from https://www.nccmt.ca/about/eiph/define.

References