2022 IPS ECD Conference - Presentations
Heidi Barnard MA (Hons) PIEMA MCIWM CRWM Head of Sustainability, Supply Chain Coordination Limited Management Function of the NHS Supply Chain
IPC & sustainability - Let's talk about Net Zero, Greener NHS, Social Value and Sustainability
Heidi spoke about what the path to net zero looks like. The carbon footprint increased 2.8 times during the pandemic, predominantly because of the increase in PPE. Heidi described that the new model of purchasing will be value based rather than value over cost. We all know that IPC is often blamed for not being ‘environmentally friendly’ but Heidi gave some good examples of how that is not true. Heidi described the move to board-based containers that are cheaper and easier to dispose of, the pledge to reduce single use plastic in catering and the remanufacturing of devices. A number of reusable products are proving to be successful such as sharps containers and the ongoing quest to develop quality reusable PPE. Plus don’t forget to check out the glove MOOC https://networks.sustainablehealthcare.org.uk/networks/ahp-susnet/mooc-glove-use-open-pre-registration
Dr David Jenkins Consultant Medical Microbiologist, Infection Prevention doctor & BSAC President, University Hospitals of Leicester NHS Trust
Designing hospitals now for the next half-century and beyond
David spoke about designing hospitals that will be fit for the next half century and beyond. David works in Leicester and one of their buildings was built in 1771 and is still used for outpatients! He used the literature to demonstrate to us how the environment can be a huge risk to the patient and how ‘place’ is tricky to change.
Conversely he showed how single ensuite rooms provided demonstrable protection to patients from acquiring healthcare associated infections. Single rooms limit spread, delineate space, serve as psychological barrier. Arguments against are they are difficult to staff, expensive to build, increase the number of water outlets and there is some debate if they cause ‘harm’ to the patient. David finished with the warning that healthcare is unpredictable and that we cannot to build hospitals as we have always done and that we should design in flexibility.
Tracey Gauci Consultant Practitioner - Infection Prevention at Hywel Dda University Health Board
Hinching in Healthcare: top ten tips’ - What to look for when choosing and using disinfectants
Tracey's presentation title 'Hinching in Healthcare' created a chuckle particularly around the naming of mops… Tracey said that when she started nursing in the early 1980’s she was told that the environment had nothing to do with causing infection but of course the evidence tells us differently now.
Tracey went on to describe her Hinching in Healthcare top tips starting at the basics- do your staff know the difference between cleaning and disinfection? Do we know what the right disinfection for the job is? Do we need to rethink the use of bleach? Contact times was a crucial point as once the disinfection is dry it stops working and microorganisms left can survive. We were given an uncomplicated guide to understanding log reductions through a nice demonstration of tearing a piece of paper up! We need to remember to involve users in selection of products, and that they are given the correct PPE. Tracey finished on ‘cleaning hacks’ on using the ‘S’ shape, go top to bottom, clean to dirty, remember contact time and use 1 wipe, 1surface, 1 direction!
Dr Nicole Stoesser Consultant in Infection at the Oxford University Hospitals NHS Trust and Clinician-scientist working in the Modernising Medical Microbiology group within the University of Oxford.
The link's the sink: Sinks and the transmission of Gram-negative pathogens in healthcare settings - how big is the problem and what can we do about it?
Nicole told us that the ‘sinks the link’. She started with why we need sinks and showed us how biofilms can readily spread along pipework and what happens when we ‘feed’ the sink. But do sinks contribute to patients acquiring infection/colonisation or do patients share their microorganisms to sinks? It seems that evidence isn’t yet clear but probably is the sinks donating! However, we need to make sure that sinks are used for the job they were designed for.
Nicole told us about a CPE outbreak in Manchester in a cardiac unit where they stripped out the plumbing and refitted the unit. Regular sampling was undertaken when the unit reopened and on other units and also of patient samples. They used whole genomic sequencing to understand circulating strains. They found that 29% of sites were positive for CPE and around 4% of patients. The newly refurbished unit was only clear for 2 weeks before the CPE reappeared! So, what interventions can be taken? Not entirely clear… but maybe heating devices, waterless facilities, chemical or biological treatment? None are yet known to be terribly effective! Plus, do ‘ancient’ biofilm protect against new biofilm? So many questions yet to be answered!
Professor Cath Noakes Deputy Director Leeds Institute for Fluid Dynamics School of Civil Engineering University of Leeds
Everything you wanted to know about air cleaners but were afraid to ask
Cath promised to tell us everything we wanted to know about air cleaners but were afraid to ask! She like David, spoke about old hospital design where there was high ceilings, windows on either sides unlike now with suspended ceilings and narrow window openings. A frightening fact was that 68% of our hospital ventilation doesn’t meet current standards. Cath described to us how ‘filtered’ air cleaners work, in particular what a HEPA filter does.
She showed us how to calculate how an air cleaner can contribute to the total air changes in a room which I won’t try to describe here! She then went on to talk about UV, how it damages DNA, inactivates microorganisms but doesn’t remove them. Other technologies such as ionisers/plasma devices/photocatalytic oxidation for example, ‘emit’ to the room and so exposes staff and patients. These devices are of a safety concern still. But how do we know air cleaners work? Most of the research comes from lab studies and Cath demonstrated how these studies are undertaken. Real world studies are limited but Cath is due to publish on the use of air cleaners in schools in Bradford soon. The practical advice Cath gave was to look at power and installation, noise and heat load, size and space, costs, and maintenance. Phrase of the talk- ‘Use it to boost it!’
Dr Mark Garvey Consultant Clinical Scientist in Microbiology and the Deputy Director of Infection Prevention and Control for the Infection Prevention and Control Service at University Hospitals Birmingham NHS Foundation Trust
Has IPC got a role in hospital productivity?
It fell to Mark to sum it all up! Do IPC practices hinder productivity? Mark gave many examples of how good IPC practice from point of care testing at the front door to having a dental nurse promoting mouthcare actually prevent unnecessary admissions or reduce length of stay. It was really informative, and I think we were all super impressed at the proactive work going on in Birmingham!
To conclude, it was a super day with superb speakers, and I cannot wait to do it again next year. Big thanks to our delegates, Niamh and Graham form the working party, the IPS stand and to our Essity (Tork) and Sodexo sponsors!
Lisa Butcher - IPS President & Lead for ECD