YOU’RE INVITED TO A WEBINAR LED BY DR. WILLIAM JARVIS…

IMPROVING PATIENT SAFETY THROUGH ENHANCED ENVIRONMENTAL DISINFECTION ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

EVENT DATE: WEDNESDAY, SEPTEMBER 22, 2010

TIME: 1:00 PM EST

SPEAKER: DR. WILLIAM JARVIS

HOSTED BY: INFECTION CONTROL TODAY

SPONSORED BY: XENEX HEALTHCARE

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Led by Dr. William Jarvis, this educational presentation covers the epidemiological significance of environmental surfaces on HAIs and the opportunity to improve patient safety through enhanced disinfection.  Attendees will learn about new technologies in environmental disinfection and develop a plan for evaluating and selecting those technologies.

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Dr. William Jarvis

 Dr. Jarvis is an acknowledged world leader in hospital-acquired (nosocomial) infection control. He is a highly published expert in infectious diseases, infection control, epidemiology, public health, and pediatrics. His areas of most intense expertise  include antimicrobial-resistant bacterial infections (especially Methicillin-resistant Staphylococcus aureus [MRSA], Vancomycin-resistant Enterococcus [VRE], or Vancomycin intermediate-resistant or resistant S. aureus [VISA or VRSA]), surgical site infections, fungal infections, bloodstream infections, surveillance, outbreak investigations, infections associated with medical devices or procedures, national surveillance systems (National Nosocomial Infections Surveillance [NNIS] system), and patient safety. Dr. Jarvis has published over 500 articles, book chapters, and editorials on these topics.

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Xenex develops pulsed xenon UV disinfection systems for the advanced cleaning of the patient environment in healthcare facilities. The Xenex system is the fastest, safest, most cost-effective, and most portable and easy to use system available today among room disinfection technologies. The Xenex mission is to significantly reduce the number of HAIs that impact the health and lives of millions of patients and their families and become the new standard method for disinfection in healthcare facilities worldwide.

Wiping out the bugs with environmental cleaning

Healthcare facilities have an ongoing battle with bugs, both microscopic and multi-legged. We’ve all heard stories of hospitals or departments being closed temporarily due to, for example, bed bugs or outbreaks of multiresistant bacteria. However, such reports don’t necessarily mean the facility in which the bugs were found were unclean or unsafe. Microscopic and multi-legged bugs are drawn to healthcare facilities like moths to a flame. The important thing is to be ready for them when they arrive. 

The patient-environment : Disinfecting rooms

Total disinfection of a room and its contents is a relatively new idea, but the time is ripe for this innovation in this age of multidrug-resistant bacteria. Room disinfection may be a lot less time consuming, less disruptive to routine, and more cost-effective than you might think.

Patients are significantly more likely to contract an antibiotic-resistant infection when they’re placed in a room where the previous occupant had an infection, and studies point toward ineffective housekeeping in U.S. hospitals across the board, explained Brian Cruver, CEO, Xenex Healthcare Services LLC, makers of the Xenex pulsed xenon automated room disinfection system.

Some recent studies have found that as little as 20% to 50% of surfaces are adequately cleaned, Cruver noted. Unfortunately, process improvements tend to be short-lived when it comes to environmental services protocols and manual cleaning efforts, he observed. “The hospital may implement a new program, do some new training, and the cleanliness rate would go up for a short period of time, but ultimately people are going to go back to their old habits. There’s human error involved, and there are certain organisms that are becoming resistant to chemicals,” he said, highlighting just a few reasons why automated disinfection is starting to make sense for a growing number of facilities.

The Xenex system is designed to target key high-touch surfaces, such as the remote control, telephone, tray table, and bed rails, places where there is a lot of transfer between the nurse and the patient and the doctor, said Cruver.

Using a pulsing xenon bulb, the Xenex system can disinfect a standard hospital room in as little as 5 minutes, achieving a 3- to 6-log reduction, killing all major classes of microorganisms without contact or chemicals. “For a spore protocol, we’d run it a little longer. If we’re going after Clostridium difficile, we want to make sure we get it, and those are harder to penetrate because they’re spores. If the room is much larger, such as a 350 sq. ft. suite, we might run [the device] in multiple positions.”

The UV light has long been accepted as a disinfectant, said Cruver. “What’s new is for it to be portable and practical within the hospital setting. Our device is about 3 ½ ft. tall. Anyone can wheel it around a hospital.”

Xenex recently completed a trial at a leading U.S. cancer hospital. “They were running at 107% capacity,” recalled Cruver. “Their big concern was room turnover time, cleaning time, and making sure we don’t disrupt the operations.” Cruver noted that the cancer hospital that participated in the environmental study is now deploying Xenex in other units and that a number of facilities are in evaluation stages with the Xenex system.

“We’ve designed the system to work within the constraints of an operating hospital, not one where they’ve shut down a wing because they’ve had an outbreak and they have all the time in the world to sterilize those rooms. We’re looking to fit our device into the hospital operation day-to-day, hit all the terminal cleaning, intensive care units (ICUs), units where patients may be immunocompromised. That way we’re lowering the overall microbial load in the hospital and lowering the overall infection rates. That’s the goal.”

Xenex Healthcare Services LLC is confident hospitals will see the light — ultraviolet light, that is — when it comes to the company’s new device for disinfecting surfaces.

Armed with venture capital and a small sales staff, the Austin-based startup is introducing its portable, UV light-based device to hospital leaders nationally as a way to eradicate health care acquired infections. The company tested the market for its new product a few weeks ago at the Association for Professionals in Infection Control and Epidemiology conference in New Orleans, and so far there has been strong interest from hospital administrators and infection control professionals, said Brian Cruver, CEO of Xenex Healthcare Services.

The product, which has been available for a few months, is about 4 feet tall and uses a pulsed UV light to disinfect surfaces in patient and operating rooms. The company said it eliminates more than 99.9 percent of microorganisms that its light touches.

Xenex’s primary investor, Cutstone Ventures LLC, has invested less than $10 million in the company so far.

The timing for the new product coincides with the Obama administration’s and states’ efforts to decrease health care acquired infections, or HAIs, such as methicillin-resistant Staphylococcus aureus, commonly called MRSA, and Clostridium difficile.

The American Recovery and Reinvestment Act set aside $50 million to support states in preventing and reducing HAIs.

More people die from HAIs than from AIDS, breast cancer, and vehicle accidents combined, Cruver said. “The problem really is that big. It’s the fourth-leading cause of death.”

And HAIs are hurting hospitals’ bottom lines. The Centers for Disease Control and Prevention reports that HAIs cost U.S. hospitals $28.4 billion to $45 billion in direct medical costs annually.

“Hospitals are certainly aware of it and actively looking for a solution,” Cruver said. “But when it comes to disinfecting the surfaces in the room, … what they are doing now is inadequate.”

There’s been a huge effort to reduce HAIs and track the number of infections occurring at hospitals, said Amanda Engler, spokeswoman for the Texas Hospital Association.

A state law passed during the most recent legislative session, which was supported by the association, requires hospitals and ambulatory surgical centers to report certain types of infections. Texas hospitals will begin such public reporting in 2011.

Cruver believes Xenex can help hospitals meet its goals for reducing infections.

Today, hospitals use liquids, bleach wipes or more cumbersome devices with UV light to disinfect rooms. In many cases, similar devices are equipped with highly toxic mercury bulbs. Xenex uses a xenon bulb to generate UV light.

There have been UV-based devices on the market for about 50 years, but what makes Xenex’s different is that it is portable, adds only eight minutes to patient turnover time and can be used easily by hospital infection prevention teams, Cruver said. Some devices can take about four hours to disinfect a room, he said.

Xenex’s device was developed by the company’s two chief scientists, who began commercializing it about two years ago at the Houston Technology Center, an incubator for emerging technology.

When Cruver came on board about 18 months ago, he brought Morris Miller of Cutstone. Cutstone has invested in other Texas companies, including CardioSpectra, Das Keyboard and Inventables.

Miller said Cutstone was drawn to the investment because of the severity of the problem Xenex hopes to solve. Miller, who has been talking to hospitals about the device, said he’s seen tremendous interest in the few months the company has been selling it.

“It’s been the warmest reception to any technology I’ve seen,” he said. “It’s apparent that hospitals want to use this in their operating rooms and standard patient rooms.”

Xenex has six sales associates and plans to add staff as needed. The company recently moved to office space east of I-35 on Highway 71. Its headquarters include space for inventory and a lab for testing products. The device is manufactured elsewhere.

Xenex plans to sell and lease its device to hospitals, and provide maintenance. As part of that maintenance, the company will replace the device’s bulbs, which will need to be changed three or four times a year. Hospitals can expect to pay about $60,000 annually to lease a device, including maintenance.

“Using one Xenex device is going to cost less than treating one MRSA infection, which is around $60,000,” Cruver said.

Engler said hospitals will soon have a financial incentive to reduce HAIs. Under new health care legislation, the government will penalize hospitals for certain hospital-acquired conditions by reducing or denying Medicare payments.

Helping Hospitals Attack Clostridium Difficile and Other Superbugs

Interview of Dr. Mark Stibich, Xenex Healthcare, by Amanda McGowan, Editor

While the danger of infection for patients has always been a top concern at health care facilities, the increased cost associated with hospital-acquired infections makes finding solutions to manage infection-causing microorganisms even more crucial. Recently, a UK study published in the June 1 print edition of the journal Clinical Infectious Diseases found that Clostridium difficile (C. diff) can spread through the air a second time even after it has settled, making it even more difficult to contain and remove from hospitals. C. diff is bacteria that causes deadly intestinal infections in patients, and it was previously thought to be spread only by contact with contaminated surfaces.

More than three million C. diff infections occur in U.S. hospitals each year. One of the “superbugs,” it is becoming increasingly difficult to treat due to antibiotic resistance. Additionally, C. diff is extremely difficult to remove from the hospital setting and, under current cleaning practices, has been shown to remain in the environment for months.

New technologies available today can quickly and safely disinfect hospital rooms of C. diff and many other deadly organisms. Here, Dr. Mark Stibich, the chief scientific officer for Xenex Healthcare Services, talks with Surgical Products about his company’s technology to help control these infection risks. The company’s unique pulse xenon UV technology has been proven effective in deactivating and removing C. diff from both surfaces and the air, helping to make hospitals safer for patients.

Surgical Products: Why is the new finding reported in Clinical Infectious Diseases about the spread of C. diff important to hospitals to know and understand?

Dr. Stibich: The study shows that after they settle, C. diff spores can be spread a second time. It’s clear that when a toilet flushes, for example, the spores are aspirated and they fly up all over the place, but this new study is reporting that they can then be disturbed by a passer-by or a curtain moving. This finding helps us see how the spore can migrate after it lands on a surface. This increases the range of contamination from the initial placement and is important to understand.

Surgical Products: How prevalent are infections caused from C. diff in hospitals today?

Dr. Stibich: It varies. Some hospitals may be having a C. diff outbreak while other hospitals have it under control. Still, every infection control person I’ve spoken with is very concerned about C. diff., especially since the tools that are being used right now to clean the C. diff and other organisms out of hospital rooms are not sufficient. Hospital cleaning staff would have to wipe every surface in a room—from the floor to the ceiling—with bleach, and even then, it doesn’t kill all the C. diff. So, the real challenge in infection control is how do we provide that clean, safe environment for the next patient given the current resources?

Surgical Products: Can you explain how Xenex’s technology helps health care facilities solve this problem?

Dr. Stibich: Our product utilizes a pulse xenon ultraviolet light, a xenon flashlamp that flashes twice a second. Xenon is an inert gas, but when you pulse it with this high intensity, you produce ultraviolet C radiation (UVC). UVC is filtered out by the ozone layer, but it penetrates the cell wall and the DNA of microorganisms, such as viruses, bacteria, bacterial spores. The DNA in the organism absorbs that energy and becomes fused together. Once that happens, the organism can no longer reproduce and is no longer infections.

The is portable and can be wheeled from room to room in a hospital – making it easy to use by hospital cleaning staff. It produces a high intensity flash that lets us disinfect a room in less than 10 minutes. Our device fits in with operational and practical concerns in the facility. It is a major advance, is faster and is safer than other automated cleaning methods and quickly and effectively disinfects surfaces to provide a clean, safe environment for patients.

Surgical Products: Can you explain the steps health care personnel would take in using this device in a hospital?

Dr. Stibich: An operator, such as an environmental service worker or housekeeping staff member, would wheel the device in the room, clean the bathroom, wheel the device in the bathroom, set it, close the bathroom door, and then let it run for say three to four minutes in the bathroom.

While it’s in the bathroom, they can work on cleaning the main room. When the main room is “visually clean,” or when there is no visual dirt in the room, they would bring the device out and place it in one or two positions in the room, leave the room and let it run. After that is done, they would go in and retrieve the device. When the bulb is not flashing, the room is safe to enter.

It can be used in any department and in any unit. We recommend using the device across the hospital – in isolation room terminal cleans, operating rooms or even using it in bathrooms and public spaces. However, we would also like to see it used for disinfecting isolation or contact precautions rooms. There are studies that show an increased risk for a patient entering these rooms based on the diagnosis of the previous patient, and that increased risk can be up to four times the baseline risk at the facility.

By using the device in between patients, the next patient that is being admitted will be protected from whatever is left behind from the patient before them. That is one area we really prioritize when speaking with hospitals because of the data that is out there.

Surgical Products: What microorganisms is UVC effective against?

Dr. Stibich: The UVC at the intensity that the Xenex device uses is a broad spectrum disinfectant capacity, so it’s effective against viruses, bacteria, and spores such as C. diff.

Surgical Products: Why is it important for hospitals to find a solution for controlling infection?

Dr. Stibich: There are two sides this. One is the moral argument that hospitals should be a safe place for a patient. Everything that can be done should be done to reduce the risk of acquiring an additional infection or an additional problem when coming to the hospital.

On the cost side, hospital-acquired infections cost the U.S. healthcare system more than $30 billion each year. A single MRSA infection costs about $60,000 in additional care. Our technology’s cost, using it for a whole year, is less than the cost of one MRSA infection.

Given healthcare costs now and the increasing pressure on hospitals, we feel that the argument is very solid for advancing the technology used to disinfect the environment and saving hospitals money and protecting patients.