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Smart spending for IP technologies

Publish Date: 4/3/2013

CRE, C.Diff, MRSA—these are just a few of the drug-resistant organisms that continue to lurk in perioperative care settings. In the fight to stay ahead of these deadly pathogens, new technologies continue to emerge.

As perioperative leaders work with infection preventionists and other colleagues to explore purchasing these technologies, they must take a comprehensive look at the cost/benefit analysis of these purchases and—most importantly—they must evaluate the infection prevention behaviors and practices of staff members.

That’s according to Linda Goss, MSN, APRN, CIC, COHN-S, an infection preventionist and infectious disease nurse practitioner with Norton Healthcare in Louisville, Ky. She also serves on the board of directors for the Association for Professionals in
Infection Control and Epidemiology (APIC).

“First, shore up your current state of affairs,” Goss recommends. “Equipment or products never take the place of good infection prevention processes.”

She advises this evaluation should include (but is not limited to) observation of compliance with safe infection prevention practices for:

  • surgical attire (including no fleece clothing in the OR, no caps brought from home) 
  • OR traffic (no unnecessary movement in and out of the OR, no entering the sterile core without a mask) 
  • correct sterilization and appropriate handling of implants 
  • safe staffing in the OR, so scrub techs are not pulled away from the back table 
  • realistic efficiency practices, so the race for turnover does not cut time for safe cleaning 

“Quality improvement projects can be a great way to refine infection prevention practices and increase awareness of simple behaviors that can expose surgical patients to deadly infections,” Goss stresses. “No one can afford to spend money on something that could be addressed with a refined process.”

When infection prevention processes and practices are looking good, here are Goss’ top picks for technologies that can enhance infection prevention in the perioperative setting:

  1. Automated Instrument Tracking
    An automated system that uses barcoding to track the life cycle of instrument use—from sterile processing to the OR—and back again—makes sense for many reasons, not only for sterility assurance, but also for tracking outbreaks, Goss explains. “A purchase like this is a large capital expenditure and requires cross-departmental coordination, but it’s an important technology to improve instrument management and ultimately infection prevention.”
  2. Hydrogen Peroxide Vapor
    Research has shown this environmental decontamination technology is beneficial for reduction of drug-resistant pathogens. It can be especially useful in closed or contained spaces where there is an abundance of advanced equipment, Goss says. She cautions that this technology is costly and requires several hours drying time after use to be effective. “Leasing this equipment may be a more affordable option to consider and it’s smart to talk to vendors about trialing this equipment.”
  3. Ultra Violet Light Disinfection
    This technology uses ultra violet light to reduce the colony count of viruses, bacteria and bacterial spores. “It’s portable and can be used remotely. Some argue that this technology can’t replace manual cleaning,” Goss notes. She cautions that this technology is also expensive. If cost is a concern, she suggests hospitals explore leasing and trialing options as alternatives to purchasing the equipment.
  4. ATP Cleanliness Testing
    For facilities looking to advance their ability to monitor cleaning practices in the OR, ATP (Adenosine triphosphate) testing is a technology that has been validated and is moderately priced (well below the typical $5,000 capital expenditure mark). Goss suggests collaborating with other hospital services where ATP monitoring may be beneficial or may already be in place, such as food services. “In addition to the upfront cost for purchasing the equipment, supplemental costs for purchasing swabs must be factored into the purchase,” Goss advises.

Additional Resources

Review the list of exhibitors displaying infection prevention technologies at the upcoming APIC Annual Conference.

Guidelines for Perioperative Practice


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