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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
• 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%
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.
Often the case for development and/or adoption is based on the economic case for infection avoidance
What works …… ?
hand hygiene aseptic techniques prudent antibiotic
prescribing.
“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”
We know if the basic
science works because the Rapid Review
Panel tells us …
THERAPIDREVIEWPANEL
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
…… we also need to know
HCAI TECHNOLOGY INNOVATION PROGRAMME
SHOWCASE HOSPITALS
1. The Royal Wolverhampton Hospitals NHS Trust2. Imperial College Healthcare NHS Trust 3. Calderdale and Huddersfield NHS Foundation Trust4. Southampton University Hospitals NHS Trust5. County Durham and Darlington NHS Foundation
Trust6. The Lewisham Hospital NHS Trust 7. Central Manchester University Hospitals NHS
Foundation Trust8. 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 Ltd3. Bioquell Hydrogen Peroxide Vapour System4. Convatec Flexiseal (faecal management system) 5. Hollister Zassi (bowel management system) 6. 3M CleanTrace ATP Testing7. InteguSeal (microbial sealant) Kimberly-Clark
(2009/10)
www.clean-safe-care.nhs.uk - (technologies tab)
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 The environment as a key vector for a key vector for infection….. the infection….. the role of cleaningrole 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 HoffmanConsultant Clinical ScientistLaboratory of Healthcare-associated InfectionHealth 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 HoffmanConsultant Clinical ScientistLaboratory of Healthcare-associated InfectionHealth Protection Agency
Key Issues
– 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 AdvisorDH 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
Our specially formulated CHG-based handwashing solutions for use in your Resurgent equipment.
Contains skin conditioning agents.
Design Bugs Out…..
what’s it all about?
“Ifthingsaredesignedtobecleanedmoreeasilyandmadefrommaterialsthataremoreeasilycleanedthentheyare
likelytogetcleanedbetterandbecleanermoreoften”
HCAI TECHNOLOGY INNOVATION PROGRAMME …. new ways of helping fight infection
– Newstylehandcleansingsystems– AffordablepointofcarerapidscreeningforMRSAin<30minutes(andC.difficile)
– Nontoxicsporicidalcleansingagent–“lifebeyondchlorine”
– Pathogendetectioninthehealthcareenvironment–alarms(visual,colour,noiseetc)whenbioloadreachesapredefinedlimite.g.
– Disinfectionoftheentirepatientbedareainoneprocessgivingthepublicconfidenceof“nearinfectionfreebeds”.
– Moreautomatedcleaning–especiallyforsiderooms
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
HCAI TECHNOLOGY INNOVATION PROGRAMME
NHS “SMART IDEAS” PROGRAMME
