Transcript HCAI TECHNOLOGY INNOVATION PROGRAMME

HCAI TECHNOLOGY INNOVATION
PROGRAMME
Paul Cryer
Programme Manager
Department of Health
HCAI Technology Innovation Programme
Aim
– To speed up the development and adoption of new and
novel medical device and/or cleaning related technologies
to further help combat HCAIs
Outcomes
– Technology that the NHS needs
– Products that add more clinical value at the front-line
– More value per NHS £ spent on HCAI related technologies
– Swifter development and adoption rates
– A broader understanding of the evidence by the NHS and
industry
www.clean-safe-care.nhs.uk - (technologies tab)
HCAI TECHNOLOGY INNOVATIONPROGRAMME
KEY STRANDS
– The Rapid Review Panel ++
– NHS Smart Ideas Programmes
– Design Bugs Out with the Design Council
– Smart Solutions from SMEs
– Product Surgeries for Innovators
– The Science of Cleaning
– Local Technology Reviews
– Showcase Hospitals
– Knowledge Networks
– International HACI Technology Summit and
Awards Programme
– The Innovation Village
Main Causes of Healthcare
Associated Infections in England
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Gastrointestinal – 22%
Urinary tract infection – 20%
Lower respiratory tract infection - 20%
Surgical site infection – 14%
Skin and soft tissue infections – 10%
Blood stream infections (bacteraemia) – 7%
Often the case for development and/or
adoption is based on the economic case for
infection avoidance
2.39 The best estimate of treating healthcare associated infections
therefore remains at least £1 billion, as quoted in our initial report in
2000 and our follow up in 2004.
The cost of treating a healthcare associated infection varies, but
…….estimates that each avoidable healthcare associated infection
costs the NHS £4,300.
The cost of treating a bloodstream infection such as MRSA is likely to
be higher as length of stay is much longer.
What works …… ?
- hand hygiene
- aseptic techniques
- prudent antibiotic
prescribing.
How do we know what
else works …….
THE RAPID REVIEW PANEL
We know if the
basic
science works
because the
Rapid Review Panel
tells us …
“provide a prompt
assessment of new
and novel equipment,
materials and other
products that may be
of value to the NHS in
improving hospital
infection control and
reducing hospital
acquired infection”
However knowing that a
technology works is not
enough …….
…… we also need to know
Does it work
By how much does it work
What’s the overall in-use value and
what barriers can we take away to
improve adoption
HCAI TECHNOLOGY INNOVATION PROGRAMME
SHOWCASE HOSPITALS
1. The Royal Wolverhampton Hospitals NHS Trust
2. Imperial College Healthcare NHS Trust
3. Calderdale and Huddersfield NHS Foundation
Trust
4. Southampton University Hospitals NHS Trust
5. County Durham and Darlington NHS Foundation
Trust
6. The Lewisham Hospital NHS Trust
7. Central Manchester University Hospitals NHS
Foundation Trust
8. Mid Essex Hospital Services NHS Trust
HCAI TECHNOLOGY INNOVATION PROGRAMME
SHOWCASE HOSPITALS TECHNOLGY
EVALUATIONS 2008/9 (RRP1)
1. Bardex IC – silver alloy coated hydrogel
catheters
2. ChloraPrep – Enturia Insight Health Ltd
3. Bioquell Hydrogen Peroxide Vapour System
4. Convatec Flexiseal (faecal management system)
5. Hollister Zassi (bowel management system)
6. 3M CleanTrace ATP Testing
7. InteguSeal (microbial sealant) Kimberly-Clark
(2009/10)
www.clean-safe-care.nhs.uk - (technologies tab)
3M CleanTrace ATP Testing
More recently ….. and
unpublished as yet
• Three surfaces tested (ceramic, laminate and
stainless steel)
• Three organisms used (C.diff, E. coli and MRSA)
• In three parts with the top 10 micro fibre cloths
used by the NHS
– comparison of individual cloth performance
– how large a surface could be cleaned by a
single cloth
– prolonged washing performance
HCAI TECHNOLOGY INNOVATION PROGRAMME
“LOCAL TECHNOLOGY REVEIWS” 2009/10
SHOWCASE HOPSITALS
– An infection control IT system (dashboard) into which other
hospital information systems feed to consolidate data sets;
– Rapid screening for C. Difficile to establish if patients get
decolonisation treatment earlier than under current
regimes;
– The development of a hand hygiene educational DVD;
– A citizens web site for local hospital information on infection
advice and issues;
– A review of infection issues associated with blood pressure
cuffs – an informative study;
– Service evaluation of a 2% chlorhexidine based infection
resistant lines/site protector;
– New hospital wide hand hygiene communications
campaigns;
– A new style dressings mat that provides multiple clean
working surfaces.
– Ultra sonics as a pre cleaning tool
The environment as a
key vector for
infection….. the role of
cleaning
Risks to patients from equipment and
environment
• High Risk - anything that enters a normally sterile
body area (Sterilised)
• Medium - anything in contact with intact mucous
membrane (Sterilised, heat disinfected, chemical
disinfected only if thermolabile)
• Low - anything in contact with intact skin (Sterilised,
heat or chemical disinfected, cleaned (socially)
• Minimal - items not normally in contact with a
patient (Cleaned; disinfected in exceptional
circumstances)
Peter Hoffman
Consultant Clinical Scientist
Laboratory of Healthcare-associated Infection
Health Protection Agency
• The ability to kill a particular target microbe is
a starting point for consideration but other
factors need to be taken into account.
Examples:
– Inactivation by organic matter
– Inability to penetrate lumps, clots, dried
organic matter
– Inadequate coverage (improper immersion,
air bubble, poor coverage etc.)
– Contact time, including time to drying
Peter Hoffman
Consultant Clinical Scientist
Laboratory of Healthcare-associated Infection
Health Protection Agency
Key Issues
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How are colonies sustained and hosted?
How do pathogens move from one host or
location to another?
What turns colonisation into infection and who
is most vulnerable?
How can pathogens be destroyed or
deactivated?
Can the movement of pathogens be inhibited or
prevented?
Nigel Tomlinson.
Principal Scientific Advisor
DH Estates and Facilities
HCAI TECHNOLOGY INNOVATION PROGRAMME
ENVIRONMENTAL SCIENCE
…. for better targeted cleaning
– Testing disinfectant products used in the NHS for
efficacy against C. Difficile spores
– Testing micro fibre – which work and how well?
– Identifying the higher risk areas around the ward in
terms of bacterial contamination and which surfaces
attract which types of bacteria most.
– How and which bacteria move around the ward area
the most and what are the principle routes for
transmission.
– Knowing more about why people do and do not wash
their hands before/after patient contact
Ultra Sonics
Hand Hygiene
Our specially
formulated CHGbased
handwashing
solutions for use
in your
Resurgent
equipment.
Contains skin
conditioning
agents.
Design Bugs Out…..
what’s it all about?
“If things are designed to be
cleaned more easily and made
from materials that are more
easily cleaned then they are
likely to get cleaned better and
be cleaner more often”
National launch of
prototypes April 2009
HCAI TECHNOLOGY INNOVATION PROGRAMME
SME SMART SOLUTIONS
Forward Look
HCAI TECHNOLOGY INNOVATION PROGRAMME
…. new ways of helping fight infection
– New style hand cleansing systems
– Affordable point of care rapid screening for MRSA in
<30 minutes (and C.difficile)
– Non toxic sporicidal cleansing agent – “life beyond
chlorine”
– Pathogen detection in the healthcare environment –
alarms (visual, colour, noise etc) when bio load
reaches a predefined limit e.g.
– Disinfection of the entire patient bed area in one
process giving the public confidence of “near
infection free beds”.
– More automated cleaning – especially for side rooms
HCAI TECHNOLOGY INNOVATION PROGRAMME
NHS “SMART IDEAS” PROGRAMME
The way that C. difficile and MRSA bacteria spread are different
– therefore as a general principle for C. Difficile we want to
keep the bacteria in a known space and with MRSA we want
to minimise person-person contact
…. in the making!
– Two styles of temporary isolation facility for patients with
C.Difficile and MRSA
– Portable hand wash facility
– New style infection reducing toilet/commode
– Air door