118. Owning Orphan Objects – Tracking and Cleaning
Session: Symposium: The Environment—A New Frontier
Thursday, October 3, 2013: 11:00 AM
Room: The Moscone Center: 134 (Hall E)
Philip C. Carling, MD, FSHEA, Division of Infectious Disease, Carney Hospital, Dorchester, MA

Dr. Carling is the Director of Infectious Diseases and Hospital Epidemiology at Carney Hospital in the Dorchester area of Boston. He teaches and is involved in clinical research at Boston University School of Medicine where he is a Professor of Clinical Medicine. In the past his clinical research was related to the development of standardized epidemiologic tools to rapidly and accurately monitor antibiotic use in hospitals. These tools were then used to study patterns of antibiotic use in multiple hospitals to better understand prescribing practices. Subsequently, the same format was used to identify opportunities for improving antibiotic use and stewardship including the ways in which the clinical and economic impact of antibiotic management programs can be quantified to enhance patient care and decrease the incidence of resistant bacterial infections. While Dr. Carling has continued his involvement in antibiotic management issues, the ongoing escalation of hospital associated infections despite advances of hand hygiene and new isolation interventions led to his considering the need for new approaches to optimize hygienic cleaning of hospitals. During the past decade Dr. Carling’s research activities have primarily related to developing processes to evaluate and improve patient area surface disinfection cleaning. A substantial portion of his work has evolved around the use of a simple surrogate marking system to bypass the need for doing quantitative bacterial cultures to evaluate environmental hygiene. Using a targeting system specifically developed for this purpose, preliminary studies disclosed opportunities to improve disinfection cleaning in several pilot hospitals. When education and procedural interventions as well as standardized performance feedback using the surrogate testing system resulted in sustained improvements in hygienic cleaning, evaluation of the system was expanded to more than 100 hospitals In the U.S., as well as hospitals in Canada, Ireland Norway and Australia. Based on the success in improving hygienic practice and the evidence that this form of programmatic approach can decrease transmission of pathogens, further studies have been implemented in the hospitality industry and cruise ships both in the US and the United Kingdom.

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