1. The Health Roundtable Meeting the Granny Test at a Microbiological Level Presenter: Counties Manukau Health Poster Session HRT1306 – Best Practice Health Service Cleaning 18 th and 19 th April 2013 Sydney

2. The Health Roundtable KEY PROBLEM  Cleaning services not achieving good microbial population reduction in high risk rooms  Cleaning services designed to achieve Victorian Standards cleaning success, little correlation to microbial flora  Cleaning Services achieving present goals which are not related to microbial safety for the patient environment

3. The Health Roundtable AIM OF THIS INNOVATION  To meet the Granny Test at a microbiological level  Cleaning services not achieving good microbial population reduction in high risk rooms  Cleaning services designed to achieve Victorian Standards cleaning success, little correlation to microbial flora  Goal therefore to achieve high level reduction in environmental flora

4. The Health Roundtable BASELINE DATA -

5. The Health Roundtable KEY CHANGES IMPLEMENTED  Trial of automated area decontamination technology  Well implemented in critical industries (e.g. CSL)  System chosen post research: vaporized Hydrogen Peroxide (vHP)  Trialed on an active ward for both operational acceptability and antimicrobial efficacy  Unit purchased for National Burns Centre

6. The Health Roundtable OUTCOMES

7. The Health Roundtable Over all Incidence ESBL Not presented as primary study result

8. The Health Roundtable LESSONS LEARNT  Prior to 2005 little focus on environmental decontamination  Now research has demonstrated a clear role for the environment in healthcare associated infection  Good data difficult to obtain due to multimodal transmission  Obligation to mitigate the risk for patients  Manual systems inherently faulty as no good measure available of process efficacy (as against process performance)

9. The Health Roundtable Lessons  Area decontamination effective at eliminating prior contamination in patient environment  Reduced disposal of unused consumerables in isolation rooms. In high acuity areas such as burns can amount to thousands of dollars  To stop new organism establishment must get decontamination right first time