Program Schedule

1371
Ambulatory Dialysis Unit Surface Decontamination: Roles for Enhanced Environmental Service Resources and Antimicrobial Surfaces

Session: Poster Abstract Session: Cleaning and Disinfection in Healthcare Settings
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: Hospitalization for infection in hemodialysis patients increased 43 percent between 1993 and 2011. Reducing the burden of healthcare-acquired infection pathogens on healthcare surfaces is a major infection control strategy. We developed an intervention bundle designed to reduce surface contamination on key areas within a large, urban ambulatory dialysis unit. 

Methods: The intervention bundle included enhanced environmental service (ES) resources (increased staffing and implementation of a cleaning checklist for the entire unit) as well as installation of antimicrobial copper components (sinks, light switch plates and glove box holders) in one section of the unit. Pre- and post-intervention implementation, we measured contamination of dialysis stations, sinks, light switch plates, and glove box holders. All surfaces were sampled with a tryptic soy agar contact plate. Plates were incubated overnight at 37ºC and colonies were counted. Contamination was reported either as colony forming units (CFU) per surface or the percentage of plates positive for contamination (% Positive). All data was reported as mean CFU or % Positive ± standard error of the mean.

Results: ES interventions significantly reduced the % Positive rate of dialysis stations relative to pre-intervention measurements (78.5 ± 2.2 and 89.3 ± 5.7, respectively; p < 0.0236). For copper surfaces, when compared to pre-intervention measurements, ES interventions significantly reduced surface mean CFUs on glove box holders (19.59 ± 17.04 and 3.57 ± 0.69, respectively; p = 0.048). Installation of copper sinks significantly reduced mean CFUs relative to pre-intervention and non-copper, ES intervention sinks (5.91 ± 1.94, 74.94 ± 24.64, 60.12 ± 14.16, respectively; p < 0.0001). The % Positive rate was also significantly lower on copper sinks relative to pre-intervention and ES intervention sinks (55, 100, 100, respectively; p < 0.0001).

Conclusion: Enhancement of ES resources lead to a reduction in the % Positive rate of dialysis stations and the total contamination on glove box holders. Installation of copper sinks lead to a dramatic reduction in both the frequency and total surface contamination.   

Matthew Hardwick, PhD1, Lindsey Clark, MS2, Natalie Benda2 and Vicki Lewis, PhD2, (1)Laboratory of Clinical Investigations, Medstar Health Research Institute, Washington, DC, (2)National Center for Human Factors Engineering in Healthcare, Washington, DC

Disclosures:

M. Hardwick, None

L. Clark, None

N. Benda, None

V. Lewis, None

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