Title: An Evaluation of the Impact of a Persistent Hand Sanitizing Lotion and a Long Acting Surface Disinfectant on Healthcare Associated Infections (HAI)

Background: Hand sanitization and surface disinfection are cornerstones of effective HAI prevention programs worldwide.  The need for research into the efficacy of hand sanitizers with persistent antimicrobial activity was cited in the CDC Guideline for Hand Hygiene in Health-Care Settings published in 2002.  The same guideline also called for research into how the environment is involved in patient contamination.  This investigation evaluates Germ Pro's novel HAI prevention system that combines the use of a non-alcohol, persistent hand sanitizing lotion which does not easily wash off, plus a long acting surface disinfectant into a single synergistic intervention (the Persistent Action Plan) to determine the impact on HAI rates when added to existing infection prevention practices at a 224 bed community hospital with 144 acute care and 80 skilled nursing beds.

Objective: To determine if adding the two persistent products would alter facility wide HAI rates and specifically those caused by methicillin resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C. difficile).  These pathogens were targeted for investigation due to their epidemiological significance in terms of their well documented prevalence and negative impact on patient outcomes across the healthcare continuum.

Methods: All HAI rates were collected using CareFusion MedMined™ data mining software and calculated as HAI/1000 pt days.  Baseline rates for the 12 month period prior to the investigation were 9.37 for overall HAI, 1.61 for MRSA HAI, and 0.51 for C. difficile HAI.  The products were then implemented adjuvant to existing infection control practices.  The products were first implemented in limited areas (ICU and Emergency) and then gradually across the entire facility.  The phased roll-out allowed monitoring of controlled areas and ensured consistent staff training on the proper use of the products.  The areas in the initial implementation showed immediate decreases in HAI rates and the evaluation was expanded until facility wide use of the products was reached.

Results: Comparison of HAI rate data from the 12 month baseline period to the 12 month period following facility wide implementation of the products was performed.  The overall HAI rate was reduced 27.6% to 6.78, the MRSA HAI rate was reduced 44.9% to 0.89, and the C. difficile HAI rate was reduced 37.8% to 0.32.  Similar reduced rates have been maintained since the end of the investigation with continued use of the products.

Conclusions: Facility wide implementation of the Germ Pro™ Persistent Action Plan resulted in reduced HAI rates for all monitored indicators.  The results of this investigation support the effectiveness of the Persistent Action Plan in addressing both the hand hygiene and environmental disinfection aspects of infection prevention.