APPROXIMATELY ONE-FOURTH OF THE ESTIMATED 2 MILLION patients who suffer healthcare-acquired infections each year contract them perioperatively, according to the most recent statistics from the CDC. There's no denying that 500,000 patients infected is a huge number, nor that 90,000 patients dead from HAIs every year is unacceptable. While federal agencies and regulatory bodies try to devise the preventative protocols, manufacturers are developing the products you'll work with on the front lines. Increasingly, their target isn't just the microbial growth on you and patients, but growth around the facility as well.
When it comes to healthcare providers, experts seem to be most worried about hand hygiene. Major studies still report lagging compliance rates averaging 50 percent, in spite of the CDC's four-year-old hand hygiene guidelines aimed at stemming the spread of bacteria on contaminated hands and improving access to alcohol-based hand rub dispensers in healthcare facilities, says the Institute for Healthcare Improvement. The Institute recently released what it describes as a program that prescribes an active approach to hand hygiene. To help you improve compliance rates, there are new waterless surgical scrubs from Healthpoint and Medline; foaming handwash from Steris Corp.; and personal alcohol-based-gel dispensers from Medonyx. All the products include ingredients meant to improve skin integrity, so users will not be deterred from using them by dried, irritated or cracked skin.
In addition, all boast mechanisms for preventing cross-contamination - which is the idea behind the new disinfectable computer keyboards from Medigenic and Unotron. A study published in the Journal of Clinical Monitoring and Computing shows the colonization rate for a keyboard and mouse with potentially pathogenic microorganisms is greater than that of other user interfaces in surgical units. As a result, the oft-used devices become reservoirs for the transmission of organisms, resulting in cross-contamination of users' hands. A presentation at the 15th annual Scientific Session of the Society for Healthcare Epidemiology of America highlighted the results of another study that shows bacteria such as vancomycin-resistant enterococcus and methicillin-resistant staph are capable of living on keyboards for more than a day after colonization.
Finally, when you consider that many of the organisms responsible for infections are already colonized on your patients' skin, the need for efficacious prepping becomes clear, as it serves as arguably the most front-line defense against surgical site infections. The newest offerings aren't just meeting guidelines for bacterial kill and persistence, they're also more concentrated (Professional Disposables International), administered via a new delivery system (Sage Products, Inc.), or quick, one-step applications (3M, Cardinal and Mediflex, whose product also offers a teal tint for better visibility).
Some More Must-sees for Use in Infection Control
- Health Mark. According to AAMI Standard ST46, using paper/poly pouches to separate small items in a wrapped or filtered instrument tray is forbidden because the poly laminate is a barrier to sterilization and its water repellancy may contribute to wet pack. New paper bags from Health Mark (www.healthmark.com) made of 100 percent medical grade paper - which is porous to sterilant and moisture-absorbent to help dissipate condensate - are an alternative. Price ranges from $37 to $98.80, depending on the quantity (the largest bags come in lots of 250, the smallest in lots of 1,000) and the size of bags you order.
- Metrex. Disposable CaviWipes Disinfecting Towelettes, which let you decontaminate and disinfect surfaces in one step, are now available in a size three times larger. CaviWipesXL are still made of the same durable, non-woven, non-abrasive material and pre-saturated with CaviCide Surface Disinfectant Cleaner. The company claims that CaviWipes are proven to kill Hepatitis B virus in three minutes and TB in five minutes. You can request free samples at www.metrex.com.
- Raven Labs. The company's ProPact peracetic acid culture test kit for use in the Steris System 1 sterilization process now sports an improved, more distinctive color change from purple to yellow and provides results in only 24 hours - instead of seven days. ProPACT offers room temperature storage and also a free training CD that outlines its usage and benefits. You can also download free recording sheets for ProPACT at www.ravenlabs.com/propact.html. Twenty-five spore strips and test tubes, plus two plastic clips to hold strips in place during the cycle, list for $54.00.
- SPS Medical. The SporView PA Culture Set also boasts a 24-hour incubation time. You can store the SporView at room temperature instead of refrigerating it, and it fits existing incubators, says SPS Medical (www.spsmedical.com). Each SporView box contains 25 tests and lists for $52.50; a record notebook is available to store results. Incubation time savings is significant when failures are detected and the sterilizer needs servicing, says the company.
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 Advanced Sterilization Products
Sterrad NX System
(888) 783-7723
www.sterrad.com
List Price: Not provided
Flexible and fast sterilization. The Sterrad System is a fast low-temperature hydrogen peroxide gas plasma sterilizer with the ability to sterilize a wide range of instruments, says Advanced Sterilization Products (ASP). The company says the system's flexibility, quick reprocessing times and gentle sterilization method let you handle more case loads while keeping the OR schedule on track. Based on its compact design, says ASP, the Sterrad NX System can be cart-mounted or placed in tight clinical areas.
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3M
One-Step Patient Prep
(800) 228-3957
www.3m.com/us/healthcare
List Price: $77 per case of 20 applicators
Povidone iodine meets FDA efficacy. This iodine-based, one-step prep boasts two-minute application and is said to keep bacteria below baseline for up to 24 hours post-prep. Further, says 3M, One-Step Patient Prep provides the efficacy of a five-minute iodophor scrub followed by a paint, meeting FDA requirements on both the abdomen (persistence through 24 hours) and groin (six hours). Unlike aqueous povidone iodine scrub-and-paint preps, One-Step Prep dries to form a microbial film that resists wash-off by blood and saline and that enhances drape adhesion. The prep can be used on skin or mucous membranes, but not in the eye or with patients who have an iodine sensitivity.
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Cardinal Health
Prevail-STX
(800) 964-5227
www.cardinal.com/prep
List Price: varies according to GPO contract
A one-step prep that sticks. Excellent water-insolubility and drape adhesion that help ensure a sterile surface throughout surgery let the new Prevail-STX one-step prep form a film on the skin around the surgical site, says Cardinal Health. Its isopropyl alcohol is said to provide fast-acting activity, while iodophor enhances the persistence. Prevail-STX solution meets the requirements of the FDA's Tentative Final Monograph in vivo guidelines for patient pre-operative skin prep, says the company. The prep's 40ml applicator lets you cover large areas, and the plastic and foil design with no glass ampoule means it doesn't require special sharps disposal.
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Certol International
ProEZ AW Quad
(800) 843-3343
www.certol.com
List Price: $152 per case of four 1-gallon bottles
More enzymes, more concentrated cleaning. This versatile multi-use lubricant has four enzymes: cellulase, lipase, protease and amylase. The concentrated formula dispenses in 0.5oz. to 1oz. increments, so you use only what you need. The cellulase and lipase attack tough-to-remove fatty soil and bio-film fibers. Odor suppressor, rust inhibitor and instrument brightener have also been added to extend the life of surgical instruments. Available in 1, 5, 15, 30 and 55 gallon quantities.
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Certol International
ProLube Concentrate
(800) 843-3343
www.certol.com
List Price: $9.95 for a 32oz. spray bottle
Extend instrument life, save time and backs. Labels on instrument milk, a key component in maintaining surgical instruments, have long stated "shake before use" because the ingredients have settled and separated within the container. But asking central sterile employees to shake a 15- 30- or 55-gallon drum could result in an injury, and shaking is time-consuming. ProLube's proprietary formula prevents this separation from occurring and is available in 32oz. ready-to-use spray bottles as well as in 1, 5, 15, 30 and 55 gallon quantities.
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Health Care Logistics
Daschner Bin Liners
(800) 848-1633
www.healthcarelogistics.com
List Price: From $3.90 to $31.90 per package of 25
Line your bins to reduce infection risks. Daschner Bin Liners from Health Care Logistics fit neatly inside storage bins to reduce the risk of passing along nosocomial infections. While cleaning out the bins may remove some of the offending debris, the practice often fails to reduce the risk for disease and improve infection control, says the company. Nine types of liners are available in a wide range of sizes.
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Healthmark
Laparoscopic ProTech Tray
(800) 521-6224
www.hmark.com
List Price: $875
Protect laparoscopic instruments during sterilization. Healthmark's Laparoscopic ProTech Tray is designed to secure and protect delicate and expensive laparoscopic instruments of many dimensions during sterilization, storage and transportation. The two-level design of the Double Decker model (pictured) lets the tray hold twice the number of instruments in the same amount of space, says the company. And because they are made of anodized aluminum, the trays are lightweight and strong. Also available are extra Secur-Its and cushion mats for the base level of the tray.
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Healthpoint
Surgicept Waterless
Surgical Hand Antiseptic
(800) 441-8227
www.healthpoint.com
List Price: Not provided
A waterless surgical scrub that feels and works great. Introduced at the annual AORN Congress, Healthpoint's Surgicept Waterless Surgical Hand Antiseptic is designed to reduce the build-up on hands and slipping in gloves - which can result in a loss of tactile sensation - associated with other waterless products while moisturizing skin and improving skin quality. According to data on file with the company, the scrub achieves a greater level of persistence than Avagard and Endure 450. That's because Surgicept protects with a patented antimicrobial-enhancing formulation: 70% ethyl alcohol provides rapid, broad-spectrum antiseptic action, while CHG and BZK prolong antimicrobial effect. It's user-friendly, too: Surgicept dries quickly so users don't give into the temptation to towel-dry, which decreases efficacy, and three quick-drying 2ml applications take just two minutes, says Healthpoint. Finally, the touch-free, infrared-activated, metered-dose delivery system means less waste and decreased potential for cross-contamination.
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MedDetect
OR Rapid Heat Transfer Sterilizer
(217) 498-9482
www.meddetect.com
List Price: $4,995
Rapid reprocessing. This device is a dry-heat sterilizer designed to provide quick and efficient reprocessing of instruments at the point of delivery, MedDetect says. Using rapid laminar dry airflow to transfer heat (375'F) to instruments, the Rapid Heat sterilizer achieves FDA-approved sterilized processing (12 log kill) in six minutes for unwrapped instruments and 12 minutes for wrapped instruments. During operation, the sterilizer remains cool to the touch and is highly insulated to keep heat inside the sterilizer; you need only turn it on at the beginning of the day and leave it on for immediate use if needed, says MedDetect. It plugs into a 110-volt outlet and takes 12 minutes to achieve operating temperature from a cold start. Because the device doesn't use water, the potential for rust and corrosion associated with traditional steam sterilization is eliminated, the company says. Among the accessories available for the compact (17 inches by 17 inches by 15 inches) stainless steel sterilizer is a cart to facilitate transport and use of the Rapid Heat sterilizer.
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Mediflex
ChloraPrep 26ml
(800) 523-0502
www.chloraprep.com
List Price: Based on distributor pricing
Bigger, stronger, more visible prep. With its new ChloraPrep 26ml, Mediflex has introduced the only 2% chlorhexidine gluconate and 70% isopropyl alcohol surgical prep that is FDA-approved and meets CDC guidelines for the preferred amount of CHG. Designed specifically for use within the surgical suite, it combines the CDC-recommended percentage of CHG with IPA for immediate and long-lasting bactericidal properties, says the company. The new ChloraPrep's dual action is the key to reducing infection-causing bacteria on the skin. In addition, Mediflex says it has enhanced the effectiveness of delivery. The applicator keeps the hands away from the prep site and provides a friction scrub. The new, larger size means you won't have to open two in the operating room for cases that need larger areas of the body prepped. And the patented Scrub Teal tinting translates to better visualization of the prepped area.
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Esterline
Medigenic
Medical Keyboard
(800) 444-5923
www.advanced-input.com/medigenic
List Price: $249 for keyboard and mouse
Flat keyboard is easy to disinfect. Keyboards throughout your facility require attention to maintain disinfection. The Medigenic Advanced Input Systems Medical Keyboard is flat, letting you use your own antibacterial wipes and sprays to clean it without damaging its functioning. The abrasion-resistant silicon-based overcoat doesn't provide any nooks and crannies between keys where bacteria can hide. A flashing light reminds you to clean the keyboard regularly at timed intervals; cleaning turns off the indicator. It interfaces with either the USB or PS/2 adaptor with auto-sense control electronics, which results in a simple, plug-and-play connection.
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Medline
Silvasorb Site Dressing
(800) MEDLINE
www.medline.com
List Price: Not provided
Silver antimicrobial technology protects surgical site. Silver, which is said to speed healing and protect against infection, is a component in a new line of dressings developed by AcryMed and distributed by Medline. SilvaSorb Site is said to provide an effective barrier to a broad spectrum of microorganisms and to inhibit the growth of dangerous bacteria including MRSA, Pseudomonas aeruginosa, Escherichia coli, Candida albicans, and VRE. The dressings are available in two sizes, depending on the diameter of the percutaneous device, and wrap snugly around catheters, CV lines, feeding tubes and other medical devices inserted into the skin, says Medline. The sustained release antimicrobial silver lets the SilvaSorb Site stay in place for up to seven days; it can absorb more than five times its weight and is non-toxic, non-irritating and non-sensitizing.
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Medline
Sterillium Surgical Hand Rub
(800) MEDLINE
www.medline.com
List Price: Not provided
Top European hand antisepsis comes stateside. Bode Chemie's Sterillium has been Europe's leading waterless pre-operative surgical hand prep for decades, thanks to its six-hour persistence and hydrating emollients. It's now been introduced to the U.S. market by Medline. The scrub meets international efficacy specifications and exceeds FDA guidelines for immediate kill, persistence and cumulative effect. The emollient blend is said to prevent contact dermatitis without leaving a residue, making gloves easier to don. And the automatic, touchless LX10 dispensing system prevents cross contamination, says Medline.
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Medonyx
GelFast
(866) MEDONYX
www.medonyx.com
List Price: Not provided
Wear and gel. A personal hand-gel dispenser that attaches to your waistband may help increase compliance with hand hygiene protocols. GelFast dispenses an unscented gel that contains 70% ethyl alcohol and emollients to keep skin from drying out. Grasp and flip the container open, press down to squirt gel into your hand, flip it closed and rub the gel into your hands. The nozzle dispenses the recommended amount of gel - 2cc with one squirt - and contains between 25 and 30 washes per cartridge (a little more than two shifts), says Medonyx. The unit is recyclable.
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Precision Air Products
Life-Island Systems
(800) 404-0931
www.precisionairproducts.com
List Price: Starting at $5,000
Breathe better in the OR. For your immunocompromised patients, Precision Air Products offers the Life-Island Systems, an integrated isolation room ventilation system. Providing HEPA-filtered laminar airflow, the system protects patients, visitors and healthcare workers from airborne microorganisms. The filter is 99.9 percent efficient at removing bacteria-carrying particles 0.3 microns or larger, says the company. The air flows over the patient, partially pressurizing the area immediately surrounding the bed. The system then draws this air away from the patient, either returning it to be re-filtered or exhausting it out of the room and building. It's available for horizontal or vertical airflow and between corridor, end or low return. The self-contained system doesn't require increasing the size of the air handler serving the isolation room.
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Professional Disposables International
Chlorascrub
(888) 437-6704
[email protected]
List Price: Not provided
A more concentrated prep. Chlorascrub features 3.15% chlorhexidine gluconate - the most on the market, the company says - and 70% isopropyl alcohol. Indicated for a variety of antiseptic skin preparation needs, including peripheral IVs, blood cultures and surgical procedures, Chlorascrub is available in both swab and swabstick delivery systems. The Chlorascrub CHG Swab is sold in quantities of 100 swabs per box; the Chlorascrub CHG Swabstick is sold in 50-count boxes; and the Chlorascrub CHG Maxi Swabstick is sold in boxes of 30.
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Sage Products, Inc.
2% Chlorhexidine
Gluconate Cloths
(800) 323-2220
www.sageproducts.com
List Price: Based on distributor pricing
No runs, drips or errors. The 2% Chlorhexidine Gluconate Cloths are the first FDA-approved applicator cloth, providing a rinse-free, quick-drying delivery of bactericidal action to surgical sites. The cloth's formula eliminates flammability concerns, loosens dirt and debris and softens skin with moisturizers, says Sage. Each cloth measures 7.5 inches square, contains 500mg of CHG and eliminates drips, runs and pooling associated with other prep products, according to the manufacturer. The cloths are available in packages of two cloths each and in multi-packs containing three individually wrapped packages of two cloths each.
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Sani-Dex
ALC Antimicrobial Gel Hand Wipes
(800) 999-6423
www.pdipdi.com
List Price: From $32 to $56 per case
Kill harmful bacteria. While Sani-Dex ALC Antimicrobial Gel Hand Wipes aren't a replacement for a thorough manual wash of soiled hands, they kill bacteria and can help remove soil, so they may replace or augment your alcohol-based hand gel routine in pre- and post-op areas. The hand wipes, which are composed of non-woven cloth saturated with an ethyl alcohol gel solution, effectively kill 99.99 percent of harmful bacteria, according to Sani-Dex. In addition to being fragrance and dye-free, Sani-Dex ALC contains emollients such as aloe, glycerin and Vitamin E to help minimize the drying effects of alcohol. The wipes are available in pocket packets or quick-pull canisters.
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Steris Corp.
Kindest Kare Antimicrobial Foaming Handwash
(800) 548-4873
www.steris.com
List Price: $96.24 per case of six 1 liter wall-mountable containers and $154.62 per case of 18 15oz. standing pump containers.
Foaming handwash for hand hygiene needs. Kindest Kare Antimicrobial Foaming Handwash was designed and clinically tested to meet the FDA's TFM and the CDC's guideline recommendation for the use of mild products, says the company. Kindest Kare is dermatologist-tested, dye-free, hypoallergenic and classified as a healthcare personnel handwash for use in high-risk areas.
The foaming solution incorporates highly effective emollients and skin conditioners to maintain skin integrity, says the company, and its fragrance further encourages hand hygiene compliance.
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Steris Corp.
Verify Integrators
(800) 548-4873
www.steris.com
List Price: $20 for a box of 100 indicators
Special monitoring for flash cycles. Steris has developed an integrator tailored to the needs of your flash sterilizer's cycles. Providing immediate assurance, Steris's line of flash integrators reach a "pass" condition when steam at 270'F has contacted the strip for the minimum exposure time required to achieve the sterilization conditions for the items being sterilized. The Verify Flash Integrator has two indicator spots: one for three-minute and one for 10-minute gravity flash sterilization cycles. The Verify 4-Flash Integrator is designed for use exclusively with single-wrapped four-minute cycles. Use of the proper integrator results in accurate confirmation of sterilization conditions, better monitoring and elimination of blind release, says the company.
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Unotron
SpillSeal Washable Keyboards
(800) 381-5817
www.unotron.com
List Price: $60 to $65
Reduce computer bacteria. Often overlooked, the keyboard can be a bacterial breeding ground. To improve infection control efforts in all areas of your facility, you you might want to consider Unotron's SpillSeal washable keyboards, which the company says are not only sealed and protected against liquid or airborne penetration, but also can be cleaned under running water or disinfected in antibacterial solutions, then rinsed under a tap. Liquids, including cleansers, can easily pass through keys and damage standard keyboards. Each of this keyboard's keys is individually sealed, meaning the keyboard can be entirely immersed; you are able to run it under a faucet or spray the keys with an antibacterial solution, letting you disinfect it after each use. Installation requires no additional software with Windows 95/98/2000/XP.
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