Making Headway in the Fight Against Clostridium difficile

Making Headway in the Fight Against Clostridium difficile

Read this article originally published as an advertorial in the American Journal of Infection Control. All findings are from Dr. Helene Paxton, Infection Prevetion Director at St. Francis Healthcare in Wilmington, Delaware.

At an acute care inner-city hospital, SteraMist™ powered by Binary Ionization Technology® (BIT™) is making the difference in the battle to prevent the spread of persistent and deadly pathogens such as Clostridium difficile spores, including those that are drug resistant. In 2013, the hospital responded to a rise in community rates of Clostridium difficile infection (CDI) and a hospital measured incidence of CDI at 6.439/10,000 patient days by establishing a more stringent nurse-driven protocol for enteric contact precautions and CDI testing. In addition to this protocol, terminal cleaning of the rooms that housed CDI contact precaution discharges was implemented. The terminal clean utilized bleach wipes and a phenolic product wiped manually with a micro-fiber rag. However, even after these measures, positive cultures for CDI were still present. In January 2015, the facility’s Infection Prevention Committee agreed to add the use of the SteraMist BIT to their terminal clean protocol. Activated Ionized Hydrogen Peroxide (AIHP) mist is utilized after terminal cleaning, according to Helene Paxton, MS, MT(ASCP), PhD, CIC, the hospital’s director of infection prevention. Later in 2015, SteraMist™ BIT™ was also used in carpeted areas where mold spores were present, in the pharmacy to disinfect biological hoods, for OR terminal cleaning, and in all ICU rooms and long-term care rooms. “We found that once the SteraMist™ step was added, the hospital’s infection rates for C. diff took a dramatic fall,” Paxton said. “In a six-month trial that included the added SteraMist™ step, we tracked a dramatic drop in C.diff rates from 6.4 to 2.2/10,000 patient days.” Through continued use of SteraMist™ BIT™, the hospital has been able to stabilize their CDI events from 1.1 to 0.41 Standardized Infection Ratio (SIR), even with using increasingly sensitive detection methods and with increasing CDI community onset prevalence.

Why it Works
SteraMist™ BIT™ is a patented two-step process that activates and ionizes a 7.8% hydrogen peroxide solution into Activated Ionized Hydrogen Peroxide (AIHP), which contains a high concentration of reactive oxygen species (ROS), consisting mostly of hydroxyl radicals that damage pathogenic organisms through oxidation of proteins, carbohydrates, and lipids.

This leads to cellular disruption and/or dysfunction and allows for disinfection in targeted areas and large spaces. This technology is EPA registered for use as a hospital-health care disinfectant as a combination solution and application technology (EPA # 90150-2). It was first developed in conjunction with the Defense Advanced Research Projects Agency (DARPA) and a large US defense contractor in response to Amerithrax (anthrax attacks) post 9/11/2001.

On boarding Made Easy
Paxton said SteraMist™ BIT™ has been an easy technology for her facility’s environmental services professionals to train on and use in various settings. “We find clinicians calling environmental services and asking them to ‘SteraMist’ an area—that tells me that our clinicians are confident it works and our environmental services professionals are proficient in quickly responding and using SteraMist™.” Through TOMI’s SteraMist’s C. diff Terminal Clean Partnership Program, the company supports a hospital’s SteraMist™ on boarding process from beginning to end. This includes training environmental services staff, integrating SteraMist™ seamlessly into a terminal clean protocol, providing marketing collateral to enhance patient awareness and satisfaction, and assisting in the development of marketing and media strategies about new disinfection protocols and outcomes. The TOMI™ Service Network (TSN) is also available to help hospitals with disinfection from the top down, including regular maintenance, post-renovation/repairs, and after remediation or disaster cleanup.

Making the Financial Case
To reinforce their current disinfection protocol, the hospital initially chose a spray disinfectant product that was wiped away manually by environmental services staff. After the Ebola outbreak in the US last year, the hospital’s emergency preparedness director made the quick decision to purchase SteraMist™ BIT™ for use in cleaning ambulances used to transport potential Ebola infected patients and to disinfect the PPE of staff caring for Ebola patients before the PPE was doffed. “Seeing was believing once SteraMist™ was in use in our facility,” Paxton said. “Now that we see it’s optimal efficacy in disaster preparedness and keeping our rates down for CDI and other health care-acquired infections, our return on investment with the technology is a no-brainer.” Based on current CDI cost data, an estimated average $7,285 per patient is spent in hospital costs, costs for acute-care length of stay, and readmission. Paxton said labor cost for using SteraMist™ BIT™ has remained constant as no extra labor is used for the application of SteraMist™ BIT™, and it has resulted in significant cost savings to the hospital in lower readmission and Medicare penalties such as insurance reimbursement incentives.

DOWNLOAD WHITE PAPER: C.diff, an Ever Increasing Problem for a Healthcare Facility

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