The Health Roundtable Meeting the Granny Test at a Microbiological Level Presenter: Counties Manukau Health Poster Session HRT1306 – Best Practice Health Service Cleaning 18 th and 19 th April 2013 Sydney

The Health Roundtable 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

The Health Roundtable 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

The Health Roundtable BASELINE DATA -

The Health Roundtable 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

The Health Roundtable OUTCOMES

The Health Roundtable Over all Incidence ESBL Not presented as primary study result

The Health Roundtable 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)

The Health Roundtable 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