Bacteria Kills People

Copper Kills Bacteria

Todd Linden

President and CEO

Grinnell Regional Medical Center

Peter Sharpe

Vice President

Irwin P Sharpe and Associates

Why Copper Matters to a Hospital CEO

Because it matters to my board

It matters to my physicians

It matters to my CFO

and most importantly it matters to my patients

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

ldquoGo West Young Man Go Westrdquo

Home to Grinnell College

First Prepaid Health Plan 1921

Why Copper Matters to a Hospital CEO

Because it matters to my board

It matters to my physicians

It matters to my CFO

and most importantly it matters to my patients

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

ldquoGo West Young Man Go Westrdquo

Home to Grinnell College

First Prepaid Health Plan 1921

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

ldquoGo West Young Man Go Westrdquo

Home to Grinnell College

First Prepaid Health Plan 1921

ldquoGo West Young Man Go Westrdquo

Home to Grinnell College

First Prepaid Health Plan 1921

We Are a Tweener

First Curve to Second Curve Markets

The Guardian reported Antibiotic-resistant bacteria with the potential to cause untreatable infections pose a catastrophic threat to the population the chief medical officer for Britain warns in a report calling for urgent action worldwide

How medicine is killing us all Antibiotics superbugs and the next global pandemic

In The News

First Curve to Second Curve Markets

The Guardian reported Antibiotic-resistant bacteria with the potential to cause untreatable infections pose a catastrophic threat to the population the chief medical officer for Britain warns in a report calling for urgent action worldwide

How medicine is killing us all Antibiotics superbugs and the next global pandemic

In The News

The Guardian reported Antibiotic-resistant bacteria with the potential to cause untreatable infections pose a catastrophic threat to the population the chief medical officer for Britain warns in a report calling for urgent action worldwide

How medicine is killing us all Antibiotics superbugs and the next global pandemic

In The News

Antibiotic Resistant Bacteria

Klebsiella pneumoniae Methicillin-resistant

Staphylococcus aureus Clostridium difficile

Extensively Drug Resistant Tuberculosis Drug-resistant Gonorrhea Shiga toxin-producing Escherichia coli

According to the CDC this particular class of superbug called carbapenem-resistant

Enterobacteriaceae or CRE has been found only in hospitals or nursing homes rather than in the community

Nearly All Antibiotics Are Now Obsolete

In the last 34 years Big Pharma has only come up with two new classes of antibiotics Both are now obsolete

According to the CDC this particular class of superbug called carbapenem-resistant

Enterobacteriaceae or CRE has been found only in hospitals or nursing homes rather than in the community

Nearly All Antibiotics Are Now Obsolete

In the last 34 years Big Pharma has only come up with two new classes of antibiotics Both are now obsolete

Nearly All Antibiotics Are Now Obsolete

In the last 34 years Big Pharma has only come up with two new classes of antibiotics Both are now obsolete

Antibiotic sales for livestock rose 16 percent between 2009 and 2012 More sub-therapeutic antibiotic is used in Iowa for livestock production than used to tread humans in the entire USA

Record-High Sales of

Antibiotics for

Livestock Production

In The News

Between 5 and 10 of patients admitted to hospitals in developed countries contract at least one hospital-acquired infection during their stay

Source Centers for Disease Control and Prevention ldquoThe Direct Medical Costs of Healthcare-Associated Infections in US Hospitals and the Benefits of Preventionrdquo httpwwwcdcgovHAIpdfshaiScott_CostPaperpdf March 2009

Hospital Associated Infections (HAIs)

Hospital Associated Infections (HAIs)

The cost of HAIs

bull 2 Million infectionsyear

bull 100000 deathsyear

bull $45 Billion ndash annual cost to treat infections

bull Antibiotics becoming less effective and new ones not being developed fast enough

Direct cost of HAIs for typical hospital is $8 million per year to treat infections dagger

Source Centers for Disease Control and Prevention ldquoThe Direct Medical Costs of Healthcare-Associated Infections in US Hospitals and the Benefits of Preventionrdquo httpwwwcdcgovHAIpdfshaiScott_CostPaperpdf March 2009

daggerSource American Hospital Association ldquoFast Facts on Hospitalsrdquo fileCUsersbxmea1Downloads101207fastfactspdf 2012 AHA Annual Survey

Hospital Associated Infections (HAIs)

HAIs add on average $43000 to hospital charges

Source Kirkland KB Briggs JP Trivette SL Wilkinson WE Sexton DJ The impact of surgical site infections in the 1990s attributable mortality excess length of hospitalization and extra costs Infect Control Hosp Epidemiol 199920725-30

WITH HAI

NO HAI $9377

$52096

Hospital Associated Infections (HAIs)

Readmissions due to HAIs wonrsquot be reimbursed

Patients that developed clinical cultures for MRSA VRE or C difficile during hospital stay were 60 percent more likely to be readmitted within 30 days than patients with negative or no clinical cultures Source Kirkland KB Briggs JP Trivette SL Wilkinson WE Sexton DJ The impact of surgical site infections in the 1990s attributable mortality excess length of hospitalization and extra costs Infect Control Hosp Epidemiol 199920725-30

Readmission Penalties

Hospital-Acquired Conditions

Beginning in FY 2015 adds a 1 percent penalty to hospitals in the top quartile

of rates of Hospital-Acquired Conditions resulting in reductions in payment of $15 billion over 10 years

ldquoSince both in importance and time health precedes disease so we ought to consider first how health may best be preserved and then how one may best cure diseaserdquo

-Galen of Pergamon

C170 AD

Contaminated Surfaces

Susceptible Patients

Hands of Healthcare workers

Family Visitors

Infected Patients

Transmission of Infectious Bacteria

Use All Available Options

Wash Hands Clean

Disinfect Alcohol gels

Protect

BUSINESS CASE bull Hand Hygiene

bull Chemical cleaners amp disinfectants

bull Inherently bactericidal surfaces

bull Extended Cleaning with Robots

bull Ultraviolet

bull Hydrogen Peroxide

Proposed Solutions for Clean Hospital Environments

Text

Transmission of Infectious Bacteria

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Between 5 and 10 of patients admitted to hospitals in developed countries contract at least one hospital-acquired infection during their stay

Source Centers for Disease Control and Prevention ldquoThe Direct Medical Costs of Healthcare-Associated Infections in US Hospitals and the Benefits of Preventionrdquo httpwwwcdcgovHAIpdfshaiScott_CostPaperpdf March 2009

Hospital Associated Infections (HAIs)

Hospital Associated Infections (HAIs)

The cost of HAIs

bull 2 Million infectionsyear

bull 100000 deathsyear

bull $45 Billion ndash annual cost to treat infections

bull Antibiotics becoming less effective and new ones not being developed fast enough

Direct cost of HAIs for typical hospital is $8 million per year to treat infections dagger

Source Centers for Disease Control and Prevention ldquoThe Direct Medical Costs of Healthcare-Associated Infections in US Hospitals and the Benefits of Preventionrdquo httpwwwcdcgovHAIpdfshaiScott_CostPaperpdf March 2009

daggerSource American Hospital Association ldquoFast Facts on Hospitalsrdquo fileCUsersbxmea1Downloads101207fastfactspdf 2012 AHA Annual Survey

Hospital Associated Infections (HAIs)

HAIs add on average $43000 to hospital charges

Source Kirkland KB Briggs JP Trivette SL Wilkinson WE Sexton DJ The impact of surgical site infections in the 1990s attributable mortality excess length of hospitalization and extra costs Infect Control Hosp Epidemiol 199920725-30

WITH HAI

NO HAI $9377

$52096

Hospital Associated Infections (HAIs)

Readmissions due to HAIs wonrsquot be reimbursed

Patients that developed clinical cultures for MRSA VRE or C difficile during hospital stay were 60 percent more likely to be readmitted within 30 days than patients with negative or no clinical cultures Source Kirkland KB Briggs JP Trivette SL Wilkinson WE Sexton DJ The impact of surgical site infections in the 1990s attributable mortality excess length of hospitalization and extra costs Infect Control Hosp Epidemiol 199920725-30

Readmission Penalties

Hospital-Acquired Conditions

Beginning in FY 2015 adds a 1 percent penalty to hospitals in the top quartile

of rates of Hospital-Acquired Conditions resulting in reductions in payment of $15 billion over 10 years

ldquoSince both in importance and time health precedes disease so we ought to consider first how health may best be preserved and then how one may best cure diseaserdquo

-Galen of Pergamon

C170 AD

Contaminated Surfaces

Susceptible Patients

Hands of Healthcare workers

Family Visitors

Infected Patients

Transmission of Infectious Bacteria

Use All Available Options

Wash Hands Clean

Disinfect Alcohol gels

Protect

BUSINESS CASE bull Hand Hygiene

bull Chemical cleaners amp disinfectants

bull Inherently bactericidal surfaces

bull Extended Cleaning with Robots

bull Ultraviolet

bull Hydrogen Peroxide

Proposed Solutions for Clean Hospital Environments

Text

Transmission of Infectious Bacteria

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Hospital Associated Infections (HAIs)

The cost of HAIs

bull 2 Million infectionsyear

bull 100000 deathsyear

bull $45 Billion ndash annual cost to treat infections

bull Antibiotics becoming less effective and new ones not being developed fast enough

Direct cost of HAIs for typical hospital is $8 million per year to treat infections dagger

Source Centers for Disease Control and Prevention ldquoThe Direct Medical Costs of Healthcare-Associated Infections in US Hospitals and the Benefits of Preventionrdquo httpwwwcdcgovHAIpdfshaiScott_CostPaperpdf March 2009

daggerSource American Hospital Association ldquoFast Facts on Hospitalsrdquo fileCUsersbxmea1Downloads101207fastfactspdf 2012 AHA Annual Survey

Hospital Associated Infections (HAIs)

HAIs add on average $43000 to hospital charges

Source Kirkland KB Briggs JP Trivette SL Wilkinson WE Sexton DJ The impact of surgical site infections in the 1990s attributable mortality excess length of hospitalization and extra costs Infect Control Hosp Epidemiol 199920725-30

WITH HAI

NO HAI $9377

$52096

Hospital Associated Infections (HAIs)

Readmissions due to HAIs wonrsquot be reimbursed

Patients that developed clinical cultures for MRSA VRE or C difficile during hospital stay were 60 percent more likely to be readmitted within 30 days than patients with negative or no clinical cultures Source Kirkland KB Briggs JP Trivette SL Wilkinson WE Sexton DJ The impact of surgical site infections in the 1990s attributable mortality excess length of hospitalization and extra costs Infect Control Hosp Epidemiol 199920725-30

Readmission Penalties

Hospital-Acquired Conditions

Beginning in FY 2015 adds a 1 percent penalty to hospitals in the top quartile

of rates of Hospital-Acquired Conditions resulting in reductions in payment of $15 billion over 10 years

ldquoSince both in importance and time health precedes disease so we ought to consider first how health may best be preserved and then how one may best cure diseaserdquo

-Galen of Pergamon

C170 AD

Contaminated Surfaces

Susceptible Patients

Hands of Healthcare workers

Family Visitors

Infected Patients

Transmission of Infectious Bacteria

Use All Available Options

Wash Hands Clean

Disinfect Alcohol gels

Protect

BUSINESS CASE bull Hand Hygiene

bull Chemical cleaners amp disinfectants

bull Inherently bactericidal surfaces

bull Extended Cleaning with Robots

bull Ultraviolet

bull Hydrogen Peroxide

Proposed Solutions for Clean Hospital Environments

Text

Transmission of Infectious Bacteria

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Hospital Associated Infections (HAIs)

HAIs add on average $43000 to hospital charges

Source Kirkland KB Briggs JP Trivette SL Wilkinson WE Sexton DJ The impact of surgical site infections in the 1990s attributable mortality excess length of hospitalization and extra costs Infect Control Hosp Epidemiol 199920725-30

WITH HAI

NO HAI $9377

$52096

Hospital Associated Infections (HAIs)

Readmissions due to HAIs wonrsquot be reimbursed

Patients that developed clinical cultures for MRSA VRE or C difficile during hospital stay were 60 percent more likely to be readmitted within 30 days than patients with negative or no clinical cultures Source Kirkland KB Briggs JP Trivette SL Wilkinson WE Sexton DJ The impact of surgical site infections in the 1990s attributable mortality excess length of hospitalization and extra costs Infect Control Hosp Epidemiol 199920725-30

Readmission Penalties

Hospital-Acquired Conditions

Beginning in FY 2015 adds a 1 percent penalty to hospitals in the top quartile

of rates of Hospital-Acquired Conditions resulting in reductions in payment of $15 billion over 10 years

ldquoSince both in importance and time health precedes disease so we ought to consider first how health may best be preserved and then how one may best cure diseaserdquo

-Galen of Pergamon

C170 AD

Contaminated Surfaces

Susceptible Patients

Hands of Healthcare workers

Family Visitors

Infected Patients

Transmission of Infectious Bacteria

Use All Available Options

Wash Hands Clean

Disinfect Alcohol gels

Protect

BUSINESS CASE bull Hand Hygiene

bull Chemical cleaners amp disinfectants

bull Inherently bactericidal surfaces

bull Extended Cleaning with Robots

bull Ultraviolet

bull Hydrogen Peroxide

Proposed Solutions for Clean Hospital Environments

Text

Transmission of Infectious Bacteria

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Hospital Associated Infections (HAIs)

Readmissions due to HAIs wonrsquot be reimbursed

Patients that developed clinical cultures for MRSA VRE or C difficile during hospital stay were 60 percent more likely to be readmitted within 30 days than patients with negative or no clinical cultures Source Kirkland KB Briggs JP Trivette SL Wilkinson WE Sexton DJ The impact of surgical site infections in the 1990s attributable mortality excess length of hospitalization and extra costs Infect Control Hosp Epidemiol 199920725-30

Readmission Penalties

Hospital-Acquired Conditions

Beginning in FY 2015 adds a 1 percent penalty to hospitals in the top quartile

of rates of Hospital-Acquired Conditions resulting in reductions in payment of $15 billion over 10 years

ldquoSince both in importance and time health precedes disease so we ought to consider first how health may best be preserved and then how one may best cure diseaserdquo

-Galen of Pergamon

C170 AD

Contaminated Surfaces

Susceptible Patients

Hands of Healthcare workers

Family Visitors

Infected Patients

Transmission of Infectious Bacteria

Use All Available Options

Wash Hands Clean

Disinfect Alcohol gels

Protect

BUSINESS CASE bull Hand Hygiene

bull Chemical cleaners amp disinfectants

bull Inherently bactericidal surfaces

bull Extended Cleaning with Robots

bull Ultraviolet

bull Hydrogen Peroxide

Proposed Solutions for Clean Hospital Environments

Text

Transmission of Infectious Bacteria

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Readmission Penalties

Hospital-Acquired Conditions

Beginning in FY 2015 adds a 1 percent penalty to hospitals in the top quartile

of rates of Hospital-Acquired Conditions resulting in reductions in payment of $15 billion over 10 years

ldquoSince both in importance and time health precedes disease so we ought to consider first how health may best be preserved and then how one may best cure diseaserdquo

-Galen of Pergamon

C170 AD

Contaminated Surfaces

Susceptible Patients

Hands of Healthcare workers

Family Visitors

Infected Patients

Transmission of Infectious Bacteria

Use All Available Options

Wash Hands Clean

Disinfect Alcohol gels

Protect

BUSINESS CASE bull Hand Hygiene

bull Chemical cleaners amp disinfectants

bull Inherently bactericidal surfaces

bull Extended Cleaning with Robots

bull Ultraviolet

bull Hydrogen Peroxide

Proposed Solutions for Clean Hospital Environments

Text

Transmission of Infectious Bacteria

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Hospital-Acquired Conditions

Beginning in FY 2015 adds a 1 percent penalty to hospitals in the top quartile

of rates of Hospital-Acquired Conditions resulting in reductions in payment of $15 billion over 10 years

ldquoSince both in importance and time health precedes disease so we ought to consider first how health may best be preserved and then how one may best cure diseaserdquo

-Galen of Pergamon

C170 AD

Contaminated Surfaces

Susceptible Patients

Hands of Healthcare workers

Family Visitors

Infected Patients

Transmission of Infectious Bacteria

Use All Available Options

Wash Hands Clean

Disinfect Alcohol gels

Protect

BUSINESS CASE bull Hand Hygiene

bull Chemical cleaners amp disinfectants

bull Inherently bactericidal surfaces

bull Extended Cleaning with Robots

bull Ultraviolet

bull Hydrogen Peroxide

Proposed Solutions for Clean Hospital Environments

Text

Transmission of Infectious Bacteria

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

ldquoSince both in importance and time health precedes disease so we ought to consider first how health may best be preserved and then how one may best cure diseaserdquo

-Galen of Pergamon

C170 AD

Contaminated Surfaces

Susceptible Patients

Hands of Healthcare workers

Family Visitors

Infected Patients

Transmission of Infectious Bacteria

Use All Available Options

Wash Hands Clean

Disinfect Alcohol gels

Protect

BUSINESS CASE bull Hand Hygiene

bull Chemical cleaners amp disinfectants

bull Inherently bactericidal surfaces

bull Extended Cleaning with Robots

bull Ultraviolet

bull Hydrogen Peroxide

Proposed Solutions for Clean Hospital Environments

Text

Transmission of Infectious Bacteria

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

-Galen of Pergamon

C170 AD

Contaminated Surfaces

Susceptible Patients

Hands of Healthcare workers

Family Visitors

Infected Patients

Transmission of Infectious Bacteria

Use All Available Options

Wash Hands Clean

Disinfect Alcohol gels

Protect

BUSINESS CASE bull Hand Hygiene

bull Chemical cleaners amp disinfectants

bull Inherently bactericidal surfaces

bull Extended Cleaning with Robots

bull Ultraviolet

bull Hydrogen Peroxide

Proposed Solutions for Clean Hospital Environments

Text

Transmission of Infectious Bacteria

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Contaminated Surfaces

Susceptible Patients

Hands of Healthcare workers

Family Visitors

Infected Patients

Transmission of Infectious Bacteria

Use All Available Options

Wash Hands Clean

Disinfect Alcohol gels

Protect

BUSINESS CASE bull Hand Hygiene

bull Chemical cleaners amp disinfectants

bull Inherently bactericidal surfaces

bull Extended Cleaning with Robots

bull Ultraviolet

bull Hydrogen Peroxide

Proposed Solutions for Clean Hospital Environments

Text

Transmission of Infectious Bacteria

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Use All Available Options

Wash Hands Clean

Disinfect Alcohol gels

Protect

BUSINESS CASE bull Hand Hygiene

bull Chemical cleaners amp disinfectants

bull Inherently bactericidal surfaces

bull Extended Cleaning with Robots

bull Ultraviolet

bull Hydrogen Peroxide

Proposed Solutions for Clean Hospital Environments

Text

Transmission of Infectious Bacteria

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

BUSINESS CASE bull Hand Hygiene

bull Chemical cleaners amp disinfectants

bull Inherently bactericidal surfaces

bull Extended Cleaning with Robots

bull Ultraviolet

bull Hydrogen Peroxide

Proposed Solutions for Clean Hospital Environments

Text

Transmission of Infectious Bacteria

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Text

Transmission of Infectious Bacteria

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

bull Why we clean

bull When we clean

bull How well we clean

bull What is a ldquosaferdquo level of risk

Putting Cleaning in Perspective

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Lower RISK of transmission

Eliminate Bacteria

Fewer infections

Better outcomes

amp lower costs

Why We Clean

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Evaluating Patient Zone Environmental Hygiene

in view of evidence that transmission of many healthcare acquired pathogens is related to

contamination of near patient surfaces and equipment

hospitals should develop programs to optimize the thoroughness of high touch surface cleaning as part of

terminal room cleaning at the time of patient discharge or transfer

When We Clean

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Daily Cleaning

When We Clean

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Terminal Cleaning

When We Clean

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Bacterial Contamination

Even though healthcare equipment and furnishings are designed to be easily cleanedhellip

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Dr Carling IL Dept of Public Health

How Well We Clean

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

How Well We Clean

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Kramer A BMC Infectious Diseases 20066130

Type of bacterium Duration of persistence

Acinetobacter 3 days - 5 months

Clostridium difficle (spores) 5 months

Escherichia coli 15 hours - 16 months

Enterococcus spp incl VRE and VSE

5 days - 4 months

Norovirus 3 weeks

Rotovirus 3 months

Listeria spp 1 day - months

Pseudomonas aeruginosa 6 hours - 16 months

Salmonella typhi 6 hours - 4 weeks

Staphylococus aureus incl MRSA

7 days - 7 months

How Long Pathogens Survive in Hospital Environment

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Increased Risk from Prior Room Occupant

Environmental cleaning intervention and risk of acquiring multidrug-resistant organisms from prior room occupants

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enteroccoci (VRE) had been found to confer a 40 increased risk of acquisition

Arch Intern Med 2011 Mar 28171(6)491-4 doi 101001archinternmed201164

Datta R1 Platt R Yokoe DS Huang SS

Risk of Acquiring Antibiotic-Resistant Bacteria From Prior Room Occupants FREE

We found a 40 increased odds of transmission of MRSA and VRE attributable to the carrier status of prior room occupants strongly suggesting a role for environmental contamination despite room cleaning methods that exceeded national standards Susan S Huang MD MPH Rupak Datta BS Richard Platt MD MS

Arch Intern Med 2006166(18)1945-1951 doi101001archinte166181945

Looking Clean Isnrsquot Enough

Griffith CJ Cooper RA Gilmore J Davies C Lewis M An evaluation of hospital

cleaning regimes and standards J Hosp Infect 2000 45 19ndash28

httpinfectionthelancetcom Vol8 February2008

Visibly Clean

82 - 91

Microbiologically

Clean

30 - 45

Free from organic

soil

10 - 24

ldquoThe current research fits into the growing body of

evidence that the hospital environment is dirty is

not being cleaned well enough and that this failure

to clean the environment is leading to hospital-

acquired infections and deathsrdquo

Edmond A Hooker MD DrPHof the department of health services

administration at Xavier University Cincinnati

ldquoHospitals must stop ignoring the hospital

environment as the source of hospital acquired

infections (HAIs)rdquo

We Clean

Whatrsquos the Level of Risk

Whatrsquos the Level of Risk

How clean is clean Proposed methods for hospital cleaning assessment 1 A Al-Hamada S Maxwellb

Journal of Hospital Infection Volume 70 Issue 4 December 2008 Pages 328ndash334

Whatrsquos the Level of Risk

ldquoThe current research fits into the growing body of

evidence that the hospital environment is dirty is

not being cleaned well enough and that this failure

to clean the environment is leading to hospital-

acquired infections and deathsrdquo

Edmond A Hooker MD DrPHof the department of health services

administration at Xavier University Cincinnati

ldquoHospitals must stop ignoring the hospital

environment as the source of hospital acquired

infections (HAIs)rdquo

We Clean

Whatrsquos the Level of Risk

Whatrsquos the Level of Risk

How clean is clean Proposed methods for hospital cleaning assessment 1 A Al-Hamada S Maxwellb

Journal of Hospital Infection Volume 70 Issue 4 December 2008 Pages 328ndash334

Whatrsquos the Level of Risk

Whatrsquos the Level of Risk

Whatrsquos the Level of Risk

How clean is clean Proposed methods for hospital cleaning assessment 1 A Al-Hamada S Maxwellb

Journal of Hospital Infection Volume 70 Issue 4 December 2008 Pages 328ndash334

Whatrsquos the Level of Risk

Whatrsquos the Level of Risk

How clean is clean Proposed methods for hospital cleaning assessment 1 A Al-Hamada S Maxwellb

Journal of Hospital Infection Volume 70 Issue 4 December 2008 Pages 328ndash334

Whatrsquos the Level of Risk

How clean is clean Proposed methods for hospital cleaning assessment 1 A Al-Hamada S Maxwellb

Journal of Hospital Infection Volume 70 Issue 4 December 2008 Pages 328ndash334

Whatrsquos the Level of Risk

bullHand washing under 50 compliance bullDaily Cleaning Not thorough enough with patient in room bullTerminal Cleaning

Not often enough (avg every 5 days) Not thorough enough gt50 of time

bullSupplemental Cleaning Not often enough (Only after terminal cleaning) Additional resources (Equipment PTE Training) Rooms out of service for 2-6 hours

bullPathogens survive for weeks to months

Current Environment of Care (EOC)

People shed gt 1 million skin cells per day (Patients staff visitors)

bullCurrent protocols are not working HAI are still a problem Bacteria levels exceed accepted levels of risk

Is Built Environment a Source for Infections

Cleaner Hospitals with Copper Alloys

ldquoalthough the evidence remains suboptimal a number of high-

quality investigations now support environmental disinfection

as a control strategy And based on these data current

guidelines for pathogens such as C difficile MRSA VRE and

norovirus emphasize the importance of environmental

disinfection as a control measurerdquo

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Bacterial Contamination Growing evidence is showing thathellip

hellipcopper surfaces have the ability to continually kill bacteria between scheduled cleanings Source GRMC preliminary data

How Copper Alloys Might Help Improve EOC

bull Inherent ability to kill bacteria

bullEPA Registered for public health claims

bullSupplement regular cleaning

bullContinuously active between cleanings24 hours a day

bullAfter installation

Do not rely on active human intervention

No additional PTEs

No special training

bullProven effectiveness

EPA-Required Efficacy Testing

EPA only allows companies to make public health claims for products approved and registered by EPA

EPA requires that Antimicrobials

bull Demonstrate efficacy

bull Present no harm to human health

bull Present no harm to environment

bull Be registered and labeled according to EPA guidelines

55

EPA Efficacy Test 1 ndash Kill bacteria within 2 hours

Source Environmental Protection Agency ldquoTest Method for Efficacy of Copper alloy Surfaces as a Sanitizerrdquo httpcuverrocomsitesdefaultfilestest_method_copper_alloy_surfaces_as_sanitizerspdf

EPA-Required Efficacy Testing

56

120

EPA Efficacy Test 2 ndash Permanence

Efficacy Will Not Wear Away

(Itrsquos solid metal)

EPA-Required Efficacy Testing

57

An Evidence Based Design Approach

58

Bacteria continue to grow on stainless while virtually all

bacteria on copper has been killed

EPA Efficacy Test 3 ndash Continuous reduction

Source Environmental Protection Agency ldquoTest Method for the Continuous Reduction f Bacterial Contamination on Copper Alloy Surfacesrdquo httpcuverrocomsitesdefaultfilestest_meth_contin_reduc_surfacespdf

MSKCC Cancer Center

RHJ VA Medical Center

Funded by the US Department of Defense under the aegis of the Telemedicine

and Advanced Technologies Research Center (TATRC) a section of the Army

Medical Research and Materiel Command (USAMRMC)

Efficacy of Copper Alloys in Clinical Environment

Efficacy of Copper Alloys in Clinical Environment

Copper Alloy Surfaces placed in ICUrsquos

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

Is Built Environment a Source for Infections

Cleaner Hospitals with Copper Alloys

ldquoalthough the evidence remains suboptimal a number of high-

quality investigations now support environmental disinfection

as a control strategy And based on these data current

guidelines for pathogens such as C difficile MRSA VRE and

norovirus emphasize the importance of environmental

disinfection as a control measurerdquo

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Bacterial Contamination Growing evidence is showing thathellip

hellipcopper surfaces have the ability to continually kill bacteria between scheduled cleanings Source GRMC preliminary data

How Copper Alloys Might Help Improve EOC

bull Inherent ability to kill bacteria

bullEPA Registered for public health claims

bullSupplement regular cleaning

bullContinuously active between cleanings24 hours a day

bullAfter installation

Do not rely on active human intervention

No additional PTEs

No special training

bullProven effectiveness

EPA-Required Efficacy Testing

EPA only allows companies to make public health claims for products approved and registered by EPA

EPA requires that Antimicrobials

bull Demonstrate efficacy

bull Present no harm to human health

bull Present no harm to environment

bull Be registered and labeled according to EPA guidelines

55

EPA Efficacy Test 1 ndash Kill bacteria within 2 hours

Source Environmental Protection Agency ldquoTest Method for Efficacy of Copper alloy Surfaces as a Sanitizerrdquo httpcuverrocomsitesdefaultfilestest_method_copper_alloy_surfaces_as_sanitizerspdf

EPA-Required Efficacy Testing

56

120

EPA Efficacy Test 2 ndash Permanence

Efficacy Will Not Wear Away

(Itrsquos solid metal)

EPA-Required Efficacy Testing

57

An Evidence Based Design Approach

58

Bacteria continue to grow on stainless while virtually all

bacteria on copper has been killed

EPA Efficacy Test 3 ndash Continuous reduction

Source Environmental Protection Agency ldquoTest Method for the Continuous Reduction f Bacterial Contamination on Copper Alloy Surfacesrdquo httpcuverrocomsitesdefaultfilestest_meth_contin_reduc_surfacespdf

MSKCC Cancer Center

RHJ VA Medical Center

Funded by the US Department of Defense under the aegis of the Telemedicine

and Advanced Technologies Research Center (TATRC) a section of the Army

Medical Research and Materiel Command (USAMRMC)

Efficacy of Copper Alloys in Clinical Environment

Efficacy of Copper Alloys in Clinical Environment

Copper Alloy Surfaces placed in ICUrsquos

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

Cleaner Hospitals with Copper Alloys

ldquoalthough the evidence remains suboptimal a number of high-

quality investigations now support environmental disinfection

as a control strategy And based on these data current

guidelines for pathogens such as C difficile MRSA VRE and

norovirus emphasize the importance of environmental

disinfection as a control measurerdquo

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Bacterial Contamination Growing evidence is showing thathellip

hellipcopper surfaces have the ability to continually kill bacteria between scheduled cleanings Source GRMC preliminary data

How Copper Alloys Might Help Improve EOC

bull Inherent ability to kill bacteria

bullEPA Registered for public health claims

bullSupplement regular cleaning

bullContinuously active between cleanings24 hours a day

bullAfter installation

Do not rely on active human intervention

No additional PTEs

No special training

bullProven effectiveness

EPA-Required Efficacy Testing

EPA only allows companies to make public health claims for products approved and registered by EPA

EPA requires that Antimicrobials

bull Demonstrate efficacy

bull Present no harm to human health

bull Present no harm to environment

bull Be registered and labeled according to EPA guidelines

55

EPA Efficacy Test 1 ndash Kill bacteria within 2 hours

Source Environmental Protection Agency ldquoTest Method for Efficacy of Copper alloy Surfaces as a Sanitizerrdquo httpcuverrocomsitesdefaultfilestest_method_copper_alloy_surfaces_as_sanitizerspdf

EPA-Required Efficacy Testing

56

120

EPA Efficacy Test 2 ndash Permanence

Efficacy Will Not Wear Away

(Itrsquos solid metal)

EPA-Required Efficacy Testing

57

An Evidence Based Design Approach

58

Bacteria continue to grow on stainless while virtually all

bacteria on copper has been killed

EPA Efficacy Test 3 ndash Continuous reduction

Source Environmental Protection Agency ldquoTest Method for the Continuous Reduction f Bacterial Contamination on Copper Alloy Surfacesrdquo httpcuverrocomsitesdefaultfilestest_meth_contin_reduc_surfacespdf

MSKCC Cancer Center

RHJ VA Medical Center

Funded by the US Department of Defense under the aegis of the Telemedicine

and Advanced Technologies Research Center (TATRC) a section of the Army

Medical Research and Materiel Command (USAMRMC)

Efficacy of Copper Alloys in Clinical Environment

Efficacy of Copper Alloys in Clinical Environment

Copper Alloy Surfaces placed in ICUrsquos

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

ldquoalthough the evidence remains suboptimal a number of high-

quality investigations now support environmental disinfection

as a control strategy And based on these data current

guidelines for pathogens such as C difficile MRSA VRE and

norovirus emphasize the importance of environmental

disinfection as a control measurerdquo

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Bacterial Contamination Growing evidence is showing thathellip

hellipcopper surfaces have the ability to continually kill bacteria between scheduled cleanings Source GRMC preliminary data

How Copper Alloys Might Help Improve EOC

bull Inherent ability to kill bacteria

bullEPA Registered for public health claims

bullSupplement regular cleaning

bullContinuously active between cleanings24 hours a day

bullAfter installation

Do not rely on active human intervention

No additional PTEs

No special training

bullProven effectiveness

EPA-Required Efficacy Testing

EPA only allows companies to make public health claims for products approved and registered by EPA

EPA requires that Antimicrobials

bull Demonstrate efficacy

bull Present no harm to human health

bull Present no harm to environment

bull Be registered and labeled according to EPA guidelines

55

EPA Efficacy Test 1 ndash Kill bacteria within 2 hours

Source Environmental Protection Agency ldquoTest Method for Efficacy of Copper alloy Surfaces as a Sanitizerrdquo httpcuverrocomsitesdefaultfilestest_method_copper_alloy_surfaces_as_sanitizerspdf

EPA-Required Efficacy Testing

56

120

EPA Efficacy Test 2 ndash Permanence

Efficacy Will Not Wear Away

(Itrsquos solid metal)

EPA-Required Efficacy Testing

57

An Evidence Based Design Approach

58

Bacteria continue to grow on stainless while virtually all

bacteria on copper has been killed

EPA Efficacy Test 3 ndash Continuous reduction

Source Environmental Protection Agency ldquoTest Method for the Continuous Reduction f Bacterial Contamination on Copper Alloy Surfacesrdquo httpcuverrocomsitesdefaultfilestest_meth_contin_reduc_surfacespdf

MSKCC Cancer Center

RHJ VA Medical Center

Funded by the US Department of Defense under the aegis of the Telemedicine

and Advanced Technologies Research Center (TATRC) a section of the Army

Medical Research and Materiel Command (USAMRMC)

Efficacy of Copper Alloys in Clinical Environment

Efficacy of Copper Alloys in Clinical Environment

Copper Alloy Surfaces placed in ICUrsquos

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

Bacterial Contamination hellipcleaning does not kill all bacteria

(Electron microscope photo shows live bacteria in a scratch on recently sanitized stainless steel surface) - ldquoFormation of Biofilms by Listeria monocytogenes under Various Growth Conditionsrdquo Amy Wong Food Research Institute University of Wisconsin January 2005 Journal of Food Protection

Bacterial Contamination Growing evidence is showing thathellip

hellipcopper surfaces have the ability to continually kill bacteria between scheduled cleanings Source GRMC preliminary data

How Copper Alloys Might Help Improve EOC

bull Inherent ability to kill bacteria

bullEPA Registered for public health claims

bullSupplement regular cleaning

bullContinuously active between cleanings24 hours a day

bullAfter installation

Do not rely on active human intervention

No additional PTEs

No special training

bullProven effectiveness

EPA-Required Efficacy Testing

EPA only allows companies to make public health claims for products approved and registered by EPA

EPA requires that Antimicrobials

bull Demonstrate efficacy

bull Present no harm to human health

bull Present no harm to environment

bull Be registered and labeled according to EPA guidelines

55

EPA Efficacy Test 1 ndash Kill bacteria within 2 hours

Source Environmental Protection Agency ldquoTest Method for Efficacy of Copper alloy Surfaces as a Sanitizerrdquo httpcuverrocomsitesdefaultfilestest_method_copper_alloy_surfaces_as_sanitizerspdf

EPA-Required Efficacy Testing

56

120

EPA Efficacy Test 2 ndash Permanence

Efficacy Will Not Wear Away

(Itrsquos solid metal)

EPA-Required Efficacy Testing

57

An Evidence Based Design Approach

58

Bacteria continue to grow on stainless while virtually all

bacteria on copper has been killed

EPA Efficacy Test 3 ndash Continuous reduction

Source Environmental Protection Agency ldquoTest Method for the Continuous Reduction f Bacterial Contamination on Copper Alloy Surfacesrdquo httpcuverrocomsitesdefaultfilestest_meth_contin_reduc_surfacespdf

MSKCC Cancer Center

RHJ VA Medical Center

Funded by the US Department of Defense under the aegis of the Telemedicine

and Advanced Technologies Research Center (TATRC) a section of the Army

Medical Research and Materiel Command (USAMRMC)

Efficacy of Copper Alloys in Clinical Environment

Efficacy of Copper Alloys in Clinical Environment

Copper Alloy Surfaces placed in ICUrsquos

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

Bacterial Contamination Growing evidence is showing thathellip

hellipcopper surfaces have the ability to continually kill bacteria between scheduled cleanings Source GRMC preliminary data

How Copper Alloys Might Help Improve EOC

bull Inherent ability to kill bacteria

bullEPA Registered for public health claims

bullSupplement regular cleaning

bullContinuously active between cleanings24 hours a day

bullAfter installation

Do not rely on active human intervention

No additional PTEs

No special training

bullProven effectiveness

EPA-Required Efficacy Testing

EPA only allows companies to make public health claims for products approved and registered by EPA

EPA requires that Antimicrobials

bull Demonstrate efficacy

bull Present no harm to human health

bull Present no harm to environment

bull Be registered and labeled according to EPA guidelines

55

EPA Efficacy Test 1 ndash Kill bacteria within 2 hours

Source Environmental Protection Agency ldquoTest Method for Efficacy of Copper alloy Surfaces as a Sanitizerrdquo httpcuverrocomsitesdefaultfilestest_method_copper_alloy_surfaces_as_sanitizerspdf

EPA-Required Efficacy Testing

56

120

EPA Efficacy Test 2 ndash Permanence

Efficacy Will Not Wear Away

(Itrsquos solid metal)

EPA-Required Efficacy Testing

57

An Evidence Based Design Approach

58

Bacteria continue to grow on stainless while virtually all

bacteria on copper has been killed

EPA Efficacy Test 3 ndash Continuous reduction

Source Environmental Protection Agency ldquoTest Method for the Continuous Reduction f Bacterial Contamination on Copper Alloy Surfacesrdquo httpcuverrocomsitesdefaultfilestest_meth_contin_reduc_surfacespdf

MSKCC Cancer Center

RHJ VA Medical Center

Funded by the US Department of Defense under the aegis of the Telemedicine

and Advanced Technologies Research Center (TATRC) a section of the Army

Medical Research and Materiel Command (USAMRMC)

Efficacy of Copper Alloys in Clinical Environment

Efficacy of Copper Alloys in Clinical Environment

Copper Alloy Surfaces placed in ICUrsquos

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

How Copper Alloys Might Help Improve EOC

bull Inherent ability to kill bacteria

bullEPA Registered for public health claims

bullSupplement regular cleaning

bullContinuously active between cleanings24 hours a day

bullAfter installation

Do not rely on active human intervention

No additional PTEs

No special training

bullProven effectiveness

EPA-Required Efficacy Testing

EPA only allows companies to make public health claims for products approved and registered by EPA

EPA requires that Antimicrobials

bull Demonstrate efficacy

bull Present no harm to human health

bull Present no harm to environment

bull Be registered and labeled according to EPA guidelines

55

EPA Efficacy Test 1 ndash Kill bacteria within 2 hours

Source Environmental Protection Agency ldquoTest Method for Efficacy of Copper alloy Surfaces as a Sanitizerrdquo httpcuverrocomsitesdefaultfilestest_method_copper_alloy_surfaces_as_sanitizerspdf

EPA-Required Efficacy Testing

56

120

EPA Efficacy Test 2 ndash Permanence

Efficacy Will Not Wear Away

(Itrsquos solid metal)

EPA-Required Efficacy Testing

57

An Evidence Based Design Approach

58

Bacteria continue to grow on stainless while virtually all

bacteria on copper has been killed

EPA Efficacy Test 3 ndash Continuous reduction

Source Environmental Protection Agency ldquoTest Method for the Continuous Reduction f Bacterial Contamination on Copper Alloy Surfacesrdquo httpcuverrocomsitesdefaultfilestest_meth_contin_reduc_surfacespdf

MSKCC Cancer Center

RHJ VA Medical Center

Funded by the US Department of Defense under the aegis of the Telemedicine

and Advanced Technologies Research Center (TATRC) a section of the Army

Medical Research and Materiel Command (USAMRMC)

Efficacy of Copper Alloys in Clinical Environment

Efficacy of Copper Alloys in Clinical Environment

Copper Alloy Surfaces placed in ICUrsquos

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

EPA-Required Efficacy Testing

EPA only allows companies to make public health claims for products approved and registered by EPA

EPA requires that Antimicrobials

bull Demonstrate efficacy

bull Present no harm to human health

bull Present no harm to environment

bull Be registered and labeled according to EPA guidelines

55

EPA Efficacy Test 1 ndash Kill bacteria within 2 hours

Source Environmental Protection Agency ldquoTest Method for Efficacy of Copper alloy Surfaces as a Sanitizerrdquo httpcuverrocomsitesdefaultfilestest_method_copper_alloy_surfaces_as_sanitizerspdf

EPA-Required Efficacy Testing

56

120

EPA Efficacy Test 2 ndash Permanence

Efficacy Will Not Wear Away

(Itrsquos solid metal)

EPA-Required Efficacy Testing

57

An Evidence Based Design Approach

58

Bacteria continue to grow on stainless while virtually all

bacteria on copper has been killed

EPA Efficacy Test 3 ndash Continuous reduction

Source Environmental Protection Agency ldquoTest Method for the Continuous Reduction f Bacterial Contamination on Copper Alloy Surfacesrdquo httpcuverrocomsitesdefaultfilestest_meth_contin_reduc_surfacespdf

MSKCC Cancer Center

RHJ VA Medical Center

Funded by the US Department of Defense under the aegis of the Telemedicine

and Advanced Technologies Research Center (TATRC) a section of the Army

Medical Research and Materiel Command (USAMRMC)

Efficacy of Copper Alloys in Clinical Environment

Efficacy of Copper Alloys in Clinical Environment

Copper Alloy Surfaces placed in ICUrsquos

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

EPA Efficacy Test 1 ndash Kill bacteria within 2 hours

Source Environmental Protection Agency ldquoTest Method for Efficacy of Copper alloy Surfaces as a Sanitizerrdquo httpcuverrocomsitesdefaultfilestest_method_copper_alloy_surfaces_as_sanitizerspdf

EPA-Required Efficacy Testing

56

120

EPA Efficacy Test 2 ndash Permanence

Efficacy Will Not Wear Away

(Itrsquos solid metal)

EPA-Required Efficacy Testing

57

An Evidence Based Design Approach

58

Bacteria continue to grow on stainless while virtually all

bacteria on copper has been killed

EPA Efficacy Test 3 ndash Continuous reduction

Source Environmental Protection Agency ldquoTest Method for the Continuous Reduction f Bacterial Contamination on Copper Alloy Surfacesrdquo httpcuverrocomsitesdefaultfilestest_meth_contin_reduc_surfacespdf

MSKCC Cancer Center

RHJ VA Medical Center

Funded by the US Department of Defense under the aegis of the Telemedicine

and Advanced Technologies Research Center (TATRC) a section of the Army

Medical Research and Materiel Command (USAMRMC)

Efficacy of Copper Alloys in Clinical Environment

Efficacy of Copper Alloys in Clinical Environment

Copper Alloy Surfaces placed in ICUrsquos

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

EPA Efficacy Test 2 ndash Permanence

Efficacy Will Not Wear Away

(Itrsquos solid metal)

EPA-Required Efficacy Testing

57

An Evidence Based Design Approach

58

Bacteria continue to grow on stainless while virtually all

bacteria on copper has been killed

EPA Efficacy Test 3 ndash Continuous reduction

Source Environmental Protection Agency ldquoTest Method for the Continuous Reduction f Bacterial Contamination on Copper Alloy Surfacesrdquo httpcuverrocomsitesdefaultfilestest_meth_contin_reduc_surfacespdf

MSKCC Cancer Center

RHJ VA Medical Center

Funded by the US Department of Defense under the aegis of the Telemedicine

and Advanced Technologies Research Center (TATRC) a section of the Army

Medical Research and Materiel Command (USAMRMC)

Efficacy of Copper Alloys in Clinical Environment

Efficacy of Copper Alloys in Clinical Environment

Copper Alloy Surfaces placed in ICUrsquos

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

An Evidence Based Design Approach

58

Bacteria continue to grow on stainless while virtually all

bacteria on copper has been killed

EPA Efficacy Test 3 ndash Continuous reduction

Source Environmental Protection Agency ldquoTest Method for the Continuous Reduction f Bacterial Contamination on Copper Alloy Surfacesrdquo httpcuverrocomsitesdefaultfilestest_meth_contin_reduc_surfacespdf

MSKCC Cancer Center

RHJ VA Medical Center

Funded by the US Department of Defense under the aegis of the Telemedicine

and Advanced Technologies Research Center (TATRC) a section of the Army

Medical Research and Materiel Command (USAMRMC)

Efficacy of Copper Alloys in Clinical Environment

Efficacy of Copper Alloys in Clinical Environment

Copper Alloy Surfaces placed in ICUrsquos

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

MSKCC Cancer Center

RHJ VA Medical Center

Funded by the US Department of Defense under the aegis of the Telemedicine

and Advanced Technologies Research Center (TATRC) a section of the Army

Medical Research and Materiel Command (USAMRMC)

Efficacy of Copper Alloys in Clinical Environment

Efficacy of Copper Alloys in Clinical Environment

Copper Alloy Surfaces placed in ICUrsquos

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

Efficacy of Copper Alloys in Clinical Environment

Copper Alloy Surfaces placed in ICUrsquos

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

0

20

40

60

80

100

Bed Call Chair Tray Monitor IV Pole

Total

Bacteria 97

Total

Staph 90

VRE 9

MRSA 6

Total

Staph 90

VRE 5

MRSA 3

Total

Staph 71

VRE 4

MRSA 3

Total

Staph 82

VRE 1

Total

Staph 46

VRE 2

Total

Staph 38

VRE 1

Total

Staph 48

Total

Bacteria 82

Total

Bacteria 90

Total

Bacteria 62

Total

Bacteria 51

Total

Bacteria 68

GramNeg 3 GramNeg 3

MRSA 2 MRSA 1 MRSA 2

GramNeg 1 GramNeg 1 GramNeg 2

GramNeg 6

Percent of Surfaces Sampled Positive for Bacteria

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00

cm

2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

Average Bacteria Count

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

13147

6224

3327

2610

527 794

0

1400

2800

4200

5600

7000

8400

9800

11200

12600

14000

CF

U1

00 c

m2

Control Surfaces

250 CFUcm2

Level of Risk

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

Average Bacteria Count

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Control Surfaces--Plastic wood stainless chrome coatings 2008 - 2011

Comparison of Copper to Control Surfaces

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

1290000

1096019

258000

1680000

87000

237143

17700 63513 31800 24000 90000 9714 0

250000

500000

750000

1000000

1250000

1500000

1750000

Controlhellip

Control Surfaces = 1092 - 1126 Phase I-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole 2008 - 2011

Comparison of Copper to Control Surfaces

Maximum Bacteria Count

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

3959070

2512314

1365120

343410 167932

469637

184560 513248 364140 123390 224809 63057 0

400000

800000

1200000

1600000

2000000

2400000

2800000

3200000

3600000

4000000

4400000

Control Surfaces

Control Surfaces = 1092 - 1126 Phase II-III Copper Surfaces = 473 - 526 Phase II-III

Bed Call Chair Tray Data IV Rails Button Arms Table Input Pole

2008 - 2011

Comparison of Copper to Control Surfaces

Cumulative Bacteria Count

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

(Control Surfaces--Plastic wood stainless chrome coatings)

97 92

89

100 100 100 95

0

10

20

30

40

50

60

70

80

90

100

BedRail

ChairArms

DataInput

Avg AllSurfaces

CF

U1

00

cm

2

ICU Touch Surface

96

Reduction in Median Bioload Copper vs Control

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

7 9

13

21

0

5

10

15

20

25

lt500 501 - 2000 2001 - 8000 gt8000

HA

I A

cq

uis

itio

n d

urin

g

Pa

tient S

tay

CFU per 100 cm2 Cumulative Bacteria on the 6 high-touch Objects in Room (CFU 100 cm2)

Salgado et al

Correlation Between Bacteria and HAIs

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

919

81 34

966

Reduction with Copper

Control

Surfaces

14 38

962

Colonizations

HAIrsquos

Copper

Surfaces 0

50

100

150

Colonizations

HAIs

-64

-58

Copperrsquos Impact on Infection Rates

986

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

GRMC Clinical Trials

MedSurg Unit

Research Conducted by

Shannon Hinsa PhD Michael G Schmidt PhD

Associate Professor Biology Department Chair of Biological Chemistry Major Grinnell College Grinnell IA

Director Office of Special Programs Professor and Vice Chair Department of Microbiology and Immunology Medical University of South Carolina Charleston SC

Preliminary Findings

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

Collaborative Effort

bull Grinnell Regional Medical Center

bull GRMC Fitness Center

bull Grinnell College

bull Medical University of S Carolina

bull Olin BrassCuVerro

bull Fabricators

70

bull Administrative Staff

bull MedSurg Team

bull Infection Prevention

bull Nursing

bull Facilities Management

bull Environmental Services

Fabricators Using CuVerro

bull American Standard Brands

bull AmFab

bull Colonial Bronze

bull EatonArrow Hart Division

bull Elkay

bull Frigo Design

bull Gojo

bull Grace Premier Fitness

bull Herman MillerNemschoff

bull Just Manufacturing

bull Larco

bull Midbrook Medical

bull MR Label

bull Operator Interface Technology

bull Pedigo

bull Rocky Mountain Hardware

bull Sloan Valve

bull Trimco

bull TSM

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

GRMC MedSurg

Unit

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

High-Touch Surfaces

bull Alcohol dispenser

bull Automatic door

openers

bull Bedside table

bull Cabinet pulls

bull Door levers

bull Faucets

bull Flush valves

bull Free weight equipment

72

bull Grab bars

bull IV poles

bull Keyboards and mice

bull Light switches

bull Over-bed tables

bull Receptacles wall

plates

bull Sinks

bull Soap dispensers

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

Clinical Findings Show Consistency ICU amp MedSurg

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

Median Reduction in Bacteria after copper alloy intervention

100

100

67

96

97

100

84

100

84

91

100

92

100

94

97

95

20 40 60 80 100 120

Door levers

Pass thru levers

Pass thru pulls

Bedside pulls

Grab bars

Toilet handle

Cart pulls

IV Pole

GP Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Keyboard

Overbed table

Reduction in Median Bioload

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

0

7

0

0

0

23

4

7

15

18

42

5

4

20 40 60 80 100 120

Door levers

Pass thru levers

Grab bars

Toilet handle

Cart pulls

IV Pole

Patient Sink

Faucet lever

Light switch

Auto door plate

Alcohol dispenser

Soap dispenser

Overbed table

Percent Surfaces with Zero Bacteria

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5Median Microbial Burden

Control Objects

Comparison of the Bioload in Active Hospital Environments

90

R

edu

ctio

n

91

R

edu

ctio

n

96

R

edu

ctio

n

96

R

edu

ctio

n

93

R

edu

ctio

n

Bioload Reduction--Hospital Conformity

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

BUSINESS CASE

Brass Ring for Infection Reduction

Is Eliminating Bacteria

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

High Risk

Some Risk

No Risk Zero CFU100 cm2

1-250 CFU100 cm2

250+ CFU100 cm2

61 72

25

Control Surfaces

3

21

43

Copper

36

Schmidt MG Medical University of SC

New Standard for Infection Risk

GRMC Trials Preliminary Data Schmidt Hinsa-Leisure

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

One of the oldest alloys

protecting humankind

Could be newest ally in fight agains infections

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

For Improved Hospital Hygiene

Consider Copper Alloy Surfaces

Products made with CuVerro

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

reg

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim

Experience of Care

Population Health

Per Capita Cost

The Goal The Triple Aim