Association for the Healthcare Environment (AHE)
Meeting Convenes Sept. 25-28, 2011 in Florida

The annual meeting of the Association for the Healthcare Environment (AHE) will convene Sept. 25-28, 2011 at the Gaylord Palms Resort in Kissimmee, Fla. The AHE, part of the American Hospital Association, is the professional organization for directors and managers caring for the environment across all healthcare settings. Each year, AHE brings together members of the environmental services profession as well as those working in infection prevention for several days of professional education and networking – all with the purpose of addressing healthcare-associated infections through proper environmental cleaning. Infection Control Today magazine offers this special "What's Hot at AHE" section, providing pre-show and post-show highlights, interviews, articles and other information on healthcare environmental hygiene.

Top 10 Tidbits from the 2011 AHE Conference & Healthcare Marketplace

The annual meeting of the Association for the Healthcare Environment (AHE), held in late September, was a terrific opportunity for environmental services professionals to network and learn from each other, and come together to discuss strategies for infection prevention. Here are the top 10 observations and interesting tidbits from this meeting. Click here to read them.

    Clean Spaces, Healthy Patients
    AHE and the Association for Professionals in Infection Control and Epidemiology (APIC) have partnered to launch the "Clean Spaces, Healthy Patients" Initiative in order to strengthen the relationship between infection prevention and environmental services to reduce infections. A joint educational campaign, "Clean Spaces, Healthy Patients: Leaders in Infection Prevention and Environmental Services Working Together for Better Patient Outcomes," will incorporate educational resources, training materials, and other solutions to help infection preventionists and environmental services professionals combat the spread of healthcare-associated infections (HAIs). To determine the focus of the educational campaign, 2,000 members of APIC and AHE were surveyed to determine how they work together to protect patients. Survey results were presented at the AHE 2011 annual conference in Kissimmee, Fla. "These survey results indicate that we can make improvements to ensure that the environment in which care is rendered helps to combat infections," says Ruth Carrico, PhD, RN, CIC, clinical advisor to AHE and associate professor at the University of Louisville School of Public Health and Information Sciences. "Strengthening collaboration between infection prevention and environmental services staff will advance this goal and contribute to reducing infections and improving patient outcomes."

    The Heart of Healthcare
    The AHE has partnered with Kimberly-Clark Professional to launch "The Heart of Healthcare," a new educational campaign designed to recognize and elevate the critical role that healthcare environmental services departments play in supporting safety initiatives and furthering the goals of their institutions in reducing HAI rates. "The Heart of Healthcare" campaign will elevate these pivotal contributions to patient safety through print and online advertising with uplifting creative elements that spotlight the ways in which ES professionals help to improve patient outcomes. The campaign will encourage and support peer-to-peer learning, provide advice from experts in the field and offer support and tools for those new to the field. "We are proud to salute our members and all ES professionals with this well-deserved recognition. It honors the important contribution they make to enhance care safety and their commitment to patients and residents," says Patti Costello, executive director of the AHE. "We are appreciative that Kimberly-Clark Professional is partnering with us to recognize ES professionals with the "The Heart of Healthcare" award. This is an exciting time and we are pleased that the important role of ES professionals is being recognized."

    Survey for Successful Prevention of HAIs
    A survey of AHE and APIC members revealed that infection preventionists and environmental services professionals believe there is a need for additional education and resources to facilitate successful prevention of HAIs:

    • Half find it difficult to locate useful resources about proper cleaning and disinfection (51 percent).
    • 73 percent say their facility educates EVS front line staff well about their role in infection prevention; 54 percent believe other staff could be better educated about their role in cleaning.
    • About 6 in 10 respondents believe educational resources on cleaning, disinfection, and infection prevention and control should be directed to executives and also to physicians. Half believe patients and families of patients should be a target audience, while one-third state the general public should be an audience.
    • Nearly 9 in 10 respondents believe EVS team members are treated with respect (85 percent).
    • Almost 9 in 10 are interested in hearing how other facilities have created successful IP/EVS partnerships (88 percent).

    Improving Patient Outcomes: Building Bridges Between Infection Preventionists and Environmental Services Professionals
    In conjunction with the announcement of the "Clean Spaces, Healthy Patients," a panel discussion, "Improving Patient Outcomes: Building Bridges Between Infection Preventionists and Environmental Services Professionals," was held at the AHE annual conference. Panel members were William Rutala, PhD, MPH; Ruth Carrico, PhD, RN, CIC; Linda Dickey, RN, MPH, CIC; Marita Nash, MBA, CHESP; and Kathy Roye-Horn, RN, CIC. These experts in infection prevention and environmental hygiene discussed disinfection as a patient-safety issue, as well as explored the role of the healthcare environment in pathogen transmission. The panelists acknowledged that over the past decade, there has been growing appreciation of the role that the environment plays in disease transmission, especially the fact that colonized and infected patients contaminate their environment, especially the high-touch surfaces within their immediate reach. Drug-resistant pathogens persist in the environment unless they are removed and/or inactivated, and they are picked up on the hands of healthcare workers and passed along to other surfaces and objects, as well as other healthcare workers. Rutala emphasized that along with proper hand hygiene, improved disinfection and cleaning can reduce this risk of transmission.

    The Physiology of Superbugs
    Microbiologist Kirsten Thompson delivered an engaging presentation on "The Physiology of Superbugs," in which she explained the cellular structure of pathogens so that attendees could better understand how to control microbial growth. Thompson explored superbugs such as Clostridium difficile, MRSA. VRE and Acinetobacter and related the physiology of these microorganisms according to the descending order of resistance with regard to the use of germicidal chemicals. She touched upon the need for effective cleaning in the healthcare environment, especially given the persistence of pathogens on objects and devices in patient-care areas – for example, C. Diff has been found to survive up to five months on surfaces, with Staph bacteria surviving for up to seven months, VRE surviving for four months, and Acinetobacter persisting for up to five months. Thompson emphasized that the potential for the spread of infectious agents is everywhere in the healthcare setting and even a simple cough or sneeze can create trouble – droplets from a sneeze can travel as fast as 103 mph and can contaminate objects and surfaces as far as 30 feet!

    What Keeps You Up at Night: An Environmental Scan
    During a special exhibitor summit, "What Keeps You Up at Night: An Environmental Scan," participants provided an overview of the most critical factors impacting healthcare delivery today. Panelists R. Michael Bailey, Cindy Paget, Weston Thiss and Tina Cermignano represented environmental services, consulting and administration sectors, and were assisted by moderator John Penrod. Topics under discussion ranged from cost restructuring that is on the horizon for most hospitals, to the new emphasis on the reporting of outcomes, to value-based purchasing and ICD-10 challenges. One of the biggest issues panelists cited was that as margins tighten, capacity is squeezed and throughput is decreased unless healthcare institutions find innovative ways to balance patients’ needs, administrations’ expectations, and hospital employees’ challenges – all in a cost-cutting imperative. Panelists agreed that operational strategies must be examined closely to see how faster throughput can be achieved without sacrificing quality. Panelists also asked manufacturers and distributors to help their hospital clients streamline the product purchasing process to boost efficiencies and save money. Managers are also tasked with finding ways to get better results with fewer FTEs – a situation that can potentially jeopardize the very outcomes that healthcare is tasked to protect.

    AHE Conference & Healthcare Marketplace
    The exhibit hall of the AHE Conference & Healthcare Marketplace was bursting with energy, as vendors displayed their latest innovations designed to fight infections, boost institutional hygiene, and make the work of environmental services personnel easier. Prevalent throughout the exhibit hall were companies offering antimicrobial privacy curtains, area disinfection technologies, systems designed to monitor environmental cleaning, and microfiber cleaning systems.

    Practice Guidance for Healthcare Environmental Cleaning (PGHEC)
    The AHE will soon make available updated "Practice Guidance for Healthcare Environmental Cleaning (PGHEC)," the document that defines the best practices and processes relating to proper environmental hygiene in healthcare facilities. "This practice guidance contains recommendations that are evidence-based and operationally sound, says Sandra Rials, education manager for the AHE. "It provides some of the science behind environmental cleaning, including discussing infection prevention, microbiology, and the different levels of disinfection, etc. It offers a solid introduction to these issues for environmental services leaders so they can relay this important information to team members. It provides a good framework to begin discussions around the practice of effective and efficient environmental cleaning. We provide information in a step-by-step guide that covers the cleaning process in almost all areas of the hospital, including the isolation room, the morgue, outpatient treatment areas, the emergency department, and patient rooms. Practice Guidance also covers key processes such as terminal cleaning versus an occupied-room cleaning and what AHE recommends as the appropriate minimum time requirements for both." The practice guidance document also addresses a number of other critical issues such as precautions for infection control and prevention and guidelines for the use of personal protective equipment." "Practice Guidance for Healthcare Environmental Cleaning" will be available by year’s end. For ordering details, check the AHE website at www.ahe.org; send an email to ahe@aha.org or call (312) 422-3860.

    The 2012 AHE Annual Conference & Healthcare Marketplace
    The 2012 AHE Annual Conference & Healthcare Marketplace has been slated for September 16-19, 2012 at the Sheraton Phoenix Downtown Hotel, in Phoenix, Ariz. AHE is offering an early bird special that is available until Dec. 31, 2011. To register for next year’s conference, visit the 2012 registration site to submit your information.

    Presenters for the 2012 Annual Conference & Healthcare Marketplace
    AHE is calling for presenters for the 2012 Annual Conference & Healthcare Marketplace. Presenters are asked to provide relevant and cutting-edge information, foundational best practices, and essential tools to environmental services professionals caring for the healthcare environment. Presentations will be evaluated based on overall quality, relevance to the environmental services industry, well-defined focus within the program structure, practical applications of material, timeliness of the topic, and speaker qualifications. In addition, your presentation must be educational in nature. Sales presentations will not be accepted. Materials submitted must be original, with all external sources to be referenced. The call for presentations ends on Nov. 30, 2011, and the notification of approval is slated for Jan. 6, 2012. To submit your application visit the web.


Exhibitor Q&A: Insight from the Executives

Advanced Sterilization Products
Utpal Khambholja, MD, CCRP
Medical Officer at ASP

Why is proper environmental cleaning so critical?

The implementation of cGMP for all manufacturers (large and small) of dietary supplements and Nutraceutical products means that all manufacturers must test their products for microbiology quality assurance and generate a Certificate of Analysis for each batch. The products need to be tested in accordance with the methods described in USP 2021 and 2022. Products need to be tested for Total Aerobic Microbial Count, Total Combined Mold and Yeast, Bile-Tolerant-Gram-Negative bacteria, and objectionable organisms (absent in 10 grams of organisms such as Salmonella, E. coli, and sometimes S. aureus). To do these tests companies either send product samples to contract laboratories for microbiological testing or test them internally. Many outside laboratories utilize BAM and AOAC methods that were never validated against the USP methodology for Dietary supplement products.

What do you perceive to be the biggest barriers to effective environmental cleaning?

Time is one of the biggest barriers to effective environmental cleaning, because environmental services staff are under pressure to turn over rooms quickly, and studies have shown that high-touch surfaces may be missed. Another barrier to effective environmental cleaning is thoroughness, as manual processes are inherently variable. Therefore, education is critical so that environmental services staff understand the importance of cleaning and disinfection and its relationship to infection prevention.

What are the key elements of an effective hospital environmental hygiene program?

An effective hospital environmental hygiene program includes the right bundle of products and education. No single intervention is the answer, but a combination of programs, including hand hygiene and proper cleaning and disinfection practices, along with new products, processes and new area decontamination technology can go a long way in reducing infections related to the environment.

What are some best practices for addressing tough organisms such as C. difficile, MRSA, VRE and Acinetobacter on hospital environmental surfaces?

In order to eliminate tough organisms, disinfection with bleach, with proper application and contact time, is required. New data shows the role of emerging technologies, such as UV light and hydrogen peroxide mist, in eliminating these pathogens from the hospital environment.

How can infection prevention and environmental services departments work together to facilitate better cleaning?

It all starts with collaboration and shared goals. Infection preventionists can educate environmental services staff on the importance of reducing pathogens in the hospital environment, including helping to explain the relationship between thorough cleaning and infection prevention. Environmental services can provide insight into the challenges of disinfecting patient areas and operating suites.

What are areas of environmental hygiene that further research should be addressing?

Further research is needed to improve the understanding of the epidemiology of the role of the environment in the development of healthcare-associated infections, as well as the clinical and economic value of emerging disinfection technologies such as hydrogen peroxide mist.

Learn more about ASP and its products and services by visiting booth #835 during AHE or visit www.ASPJJ.com for more information.

Hygiena
Steven Nason
Director of Sales and Marketing, Hygiena

Why are hospitals implementing ATP hygiene monitoring programs into their environmental services and infection control departments?

Hospitals by their very nature are very busy public places. Patients, staff and visitors are constantly in direct contact with each other and with the hospital environment. Contaminants can be transferred directly between individuals and via the surfaces touched. We cannot always control the passage of people through our hospitals but we can control the cleanliness. Effective cleaning is important in preventing the transfer of healthcare-associated infections (HAIs). In the past, hospitals have relied on visual inspection to monitor cleaning performance. Unfortunately visual inspection is extremely subjective and impossible when trying to spot possible issues that are invisible to the human eye. With recent changes to insurance reimbursements related to HAI and some states requiring hospitals to publish HAI rates, there is a greater need for a more scientific and rapid approach to monitoring a hospitals hygiene. The Hygiena SystemSURE ATP hygiene monitoring system addresses hospital needs of by offering a solution that detects invisible contamination in high-touch points, provides results in 15 seconds and does it at a very low cost. Additionally, it's a great training tool for new environmental services (EVS) employees, because it shows them immediately if they are cleaning correctly.

What is ATP?

ATP, or adenosine triphosphate, is an energy molecule that is used by living cells as their primary source of energy to drive cell chemistry. Animal, plant, bacterial, and mold cells produce and break down ATP in order to drive a number of biological processes. Because it's a part of all living things, including organisms, it's a perfect molecule to look for when it comes to evaluating hygiene. If proper cleaning is done, there should be very little to no ATP left on the surface.

What are some other options out there instead of ATP hygiene monitoring that hospitals are using and what are the pros and cons?

In the past ATP hygiene monitoring systems have been slightly expensive with the cost of the machine being around $3,000 and each test running above $3. Hospitals had to really think about how they were going to implement the program and then seek the budget approval. Because of this, some low-cost fluorescent gel systems came about. These gels, when shined with a black light, illuminate, thus indicating they have not been removed from the surface. EVS managers use them in training programs to show EVS employees if they've cleaned correctly. These low-cost fluorescent gels are inexpensive but do not meet all the needs of the hospital. Some issues with them are, they are time-consuming to apply and check, they can really only be used during training and not in a continuous monitoring program, and you are left with more paperwork because results have to be manually recorded if recorded at all. By not having a system in place that monitors a hospital’s hygiene continuously, over time hygiene levels can drift because of rotation of cleaning staff, bad habits, peaks in patient discharges and changes in procedures/equipment/cleaning products. This is why more hospitals are electing to go with an ATP hygiene monitoring system. Additionally the cost of Hygiena's ATP system is dramatically less, so cost is not longer an issue

If the costs have come down with these systems, what is the typical cost of having an ATP hygiene monitoring system say in a 250 bed hospital on a monthly basis?

You’re typically looking at a cost of around $1,000 to implement one system, but some hospitals opt for a rental or lease program depending on how many systems they need. The cost of the test devices have come down to $2 a test or less depending on how many locations you want to monitor on a monthly basis. Typically hospitals with 250 beds are spending between $250 and $1,000 a month. Annualized you looking at spending between $3,000 and $12,000 a year. With the cost of one HAI generally costing a hospital $30,000, adding an ATP hygiene monitoring can be a big cost savings if it helps prevent just one HAI-related case.

What is the advantage of the Hygiena ATP hygiene monitoring system over other systems?

I think hospitals should focus on four key points when deciding what ATP hygiene monitoring system to implement: 1) the cost of implementation and life time operating costs. 2) the durability of the system, because in hospitals a lot of people can be using the system and you need something that is durable and will last. 3) Ease of use, it has to be easy. 4) Customer support and training. I didn't mention sensitivity, accuracy or reproducibility of the systems in the decision-making process. The reason I don't mention these criteria is because most of the major system perform very similar and for the purpose that they are used in hospitals, it's not critical to be the most sensitive, accurate or reproducible. However, there are third-party studies done my major laboratories comparing ATP systems on sensitivity, accuracy and reproducibility. You can request them from Hygiena and you can also visit our website to view a comparison of all systems.

Let's look at the four key points:

  1. Cost of implementation and life time operating costs: With the Hygiena system hospitals get to take advantage of new state-of-the-art electronics and design that have lowered the cost of the instruments dramatically and improved performance. In addition, Hygiena's patented test device design and liquid stable chemistry lowers the cost of the test and long term cost of the program. We generally see that a Hygiena system implementation and cost of operating to be between 40 percent and 60 percent less than all other systems.
  2. Durability: Because of the state-of-the-art electronics and design of the Hygiena instrument, the life of the instrument is three to four times as long as other systems on the market. The Hygiena systems use an advanced photodiode sensor that is more durable then photomultiplier sensors used in some other machines. This makes the system more resistant to drops, shaking and coming out of calibration. In addition the Hygiena systems have a removable reading chamber that allows users to clean inside the read chamber tube if for some reason something gets in the tube or the test gets activated in the wrong way. Other systems don't have this option and if liquid from the test or anything else gets inside the read chamber the instrument must get sent back for repair.
  3. Ease of use: Hygiena's system is designed to be used by a technically savvy employee to an employee that never deals with any technology except a cell phone. The seven-button keypad is simple to understand and all symbol based. It doesn't get easier. The free software that comes with the system is just as easy to implement and use. Users can create reports or use the reports that come with the software.
  4. Customer support and training: Hygiena has more than 45 years of experience with ATP hygiene monitoring. We offer all our customers detailed trainings and assistance with our ATP systems. There is always someone that can help over the phone or in person. We also offer free evaluations of the systems so that hospitals can really see how the system works and value it brings.

Learn more about Hygiena and its products and services by visiting booth #308 during AHE or visit www.hygiena.net for more information.

Company
Speaker
Title

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Learn more about COMPANY and its products and services by visiting booth #XXX during AHE or visit www.companyurl.com for more information.

Advanced Sterilization Products
Utpal Khambholja, MD, CCRP
Medical Officer at ASP
View Q&A

Hygiena
Steven Nason
Director of Sales and Marketing, Hygiena
View Q&A


Must-Attend Conference Sessions

  • What’s Your Bed Bug Business Plan?
  • What’s Your Bed Bug Business Plan?

    When: Tuesday, Sept. 27, 3:15-4:30 p.m.

    Why You Should Attend: In this session, attendees understand how they can manage the business risks associated with bed bug infestations in healthcare facilities. The session will cover everything from employee policies and avoiding litigation, to early detection and remediation procedures.

  • Implications of HAI Costs on EVS
  • Implications of HAI Costs on EVS

    When: Wednesday, Sept. 28, 1-2:15 p.m.

    Why You Should Attend: In this session, attendees will learn about how to identify common healthcare pathogens and discuss its implications on supply costs, as well as understand the important role that environmental services plays in the prevention of healthcare-associated infections (HAIs).

  • Search and Destroy: Eliminating Pathogens in the Patient-Care Environment
  • Search and Destroy: Eliminating Pathogens in the Patient-Care Environment

    When: Tuesday, Sept. 27, 1:45-3 p.m

    Why You Should Attend: In this session, attendees will be able to learn about the factors contributing to the persistence of healthcare-associated infections, understand the key considerations when selecting and using disinfectants; and review the steps necessary for eliminating reservoirs of surface pathogens.

  • Utilizing Infection Control to Enhance Quality Assurance and Staff Development Programs
  • Utilizing Infection Control to Enhance Quality Assurance and Staff Development Programs

    When: Wednesday, Sept. 28, 2:30-3:45 p.m.

    Why You Should Attend:This session will help attendees understand grant funding and how it can be utilized to enhance educational, training and quality assurance programs in environmental services, as well as understand the tier approach recommended in CDC’s newly-released guidance document. Attendees will also learn about environmental testing methods that can be incorporated into an effective quality assurance program.

  • The Physiology of Superbugs
  • The Physiology of Superbugs

    When: Monday, Sept. 26, 11 a.m.-12:15 p.m.

    Why You Should Attend: In this session, attendees will be able to identify various microorganisms, classify superbugs within the pathogen hierarchy and relate superbugs to the descending order of resistance with regard to germicidal agents.


Related Content

Environmental Hygiene Digital Issue

This digital issue on environmental hygiene, presented by Infection Control Today magazine, explores key issues relating to environmental cleaning and surface disinfection in the acute-care setting. Featured articles include "AHE Updates Practice Guidance for Environmental Cleaning" and "The Environmental Hygiene Imperative".

If you are planning on attending the event, be sure to stop by and visit ICT in booth #205.

Sponsors

Advanced Sterilization Products
As the industry's infection prevention leader, ASP is focused on helping to ensure the safest possible environments for patients and their families, healthcare workers, providers and communities.
Clorox
Clorox® markets some of the most trusted and recognized brand names for infection control for use on environmental surfaces and medical equipment to help reduce the spread of healthcare-associated infections.
Hygiena
Hygiena is a microbiology and life science company that serves industrial food processors, healthcare institutions, life science researchers and the general public.