Dartmouth-Hitchcock Medical Center Presents Study Showing Significant Reduction in Intensive Care Unit Infection Rates Using Sprixx Hand Hygiene Personal Dispensers

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A study abstract by Dartmouth-Hitchcock Medical Center presented at the Society of Critical Care Medicine's 38th Critical Care Congress reveals a promising new approach to healthcare hand hygiene and hospital infection rate reductions using new personal sanitizer dispensers with electronic measures.

Ventilator pneumonias were significantly reduced after introduction of the novel device [61% reduction, p=0.001, 95% CI (1.91-9.01)].

A study abstract by Dartmouth-Hitchcock Medical Center (DHMC) of Lebanon, NH presented at the Society of Critical Care Medicine's 38th Critical Care Congress in Nashville, TN reveals a promising new approach to healthcare hand hygiene and hospital infection rate reductions. Tracking before-and-after infection rates in a 26-bed intensive care unit (ICU), researchers found that by introducing the use of personal sanitizer dispensers by the nursing staff, significant improvements in hand hygiene adherence corresponded to reductions in healthcare acquired infections (HAIs).

The study documented improvements in both ventilator-associated pneumonia (VAP) and catheter related blood stream infections (CRBSI). "Ventilator pneumonias were significantly reduced after introduction of the novel device [61% reduction, p=0.001, 95% CI (1.91-9.01)]." The Sprixx body-worn hand sanitizer devices resulted in a, "trend towards reduction in catheter-related bloodstream infections by 50%."

Experts agree hand hygiene is the number one preventative measure against healthcare acquired infections which in the U.S. each year infect over 2 million hospital patients of which 99,000 die. New super-bugs such as MRSA and VRE have increased the threat to patients as the percentage of antibiotic resist hospital infections are rapidly increasing: over 59% of staphylococcus aureus cases in ICUs are now MRSA; over 28% of ICU enterococcus cases are VRE.

The new personal sanitizer dispensers are from Sprixx of Santa Barbara, CA. The dispensers are clipped to the clothing of healthcare providers, and are designed to be operated with one hand on-the-go anytime, anywhere. The Sprixx GJ Personal Dispenser takes a 58 ml replacement cartridge that dispenses an alcohol sanitizer gel "at the point of care" as recommended by the Centers for Disease Control and Prevention (CDC). The dispensers have four attachment options for clothing including: lanyard, belt clip, pocket clip, and scrub clip.

"This Sprixx device and measurement system has demonstrated an ability to support a higher level of clinical hand hygiene adherence which has resulted in significant infection rate reductions. The personal dispensers make it so much easier to respond to every hand hygiene opportunity and the performance feedback keeps the providers engaged in the improvement process" explains study author Randy Loftus, MD. An intensivist in the DHMC Intensive Care Unit, Dr. Loftus sees the use of the device on a broader scale, "Use of this point-of-care device by all health care providers may further reduce healthcare-associated infections hospital-wide."

The Sprixx personal dispensers are part of a multi-component system designed to not only provide better sanitizer delivery technology but comprehensive logistical and cultural support. "Hospitals are extremely complex environments and the demands on healthcare providers are extreme," explains Sprixx Vice President of Research and Development, Ron Cagle. "It's not always enough just to ask providers to wash their hands; we have to give them the tools and systems to truly make it possible."

The personal dispensers include the ability to record time stamp records every time the dispenser is used. The results are downloaded using a USB cable that connects a computer to the dispensers. The Sprixx Hand Hygiene System's (SHHS) uses the electronic performance data to empower frontline healthcare providers to improve their hand hygiene. The key measure is Average Hourly Episodes (AHE) which is calculated by Total Hand Hygiene Episodes/Hours (decimal). Different positions have varied AHE goals for their shift to fit their duties and hand hygiene frequency requirements. The system generates a poster that graphs the AHEs for each provider's shift yet only identifies providers by a reference number. A handout is generated for each provider that graphs her/his hourly hand hygiene episodes for each working hour of the shift. This allows providers to see their individual performance from within the context of the group and group goals. Shared purpose and group governance are then the primary force for positive change. A reference on page 21 of the CDC guidelines helps establish Average Hourly Episodes as a valid measure as well as an initial range of expectations; "nurses in pediatric wards had an average of eight opportunities for hand hygiene per hour of patient care compared with an average of 20 for nurses in intensive-care units."

The system is compliant with the hand hygiene recommendations made by the Centers for Disease Control & Prevention (CDC), the World Health Organization Patient Safety Challenge, and the Institute for Healthcare Improvement (IHI). It is built and implemented using the best-practices methods of our day: the Geneva Hand Hygiene Model, IHI Improvement Process, and Six Sigma principles.

Dartmouth-Hitchcock Medical Center (DHMC), internationally renowned, nationally ranked, and regionally respected, integrates high-quality patient care, advanced medical education, and translational research to provide a full spectrum of health care. DHMC is located on a 225-acre campus in the heart of the Upper Connecticut River Valley, in Lebanon, New Hampshire. For more information about DHMC, visit http://www.dhmc.org.

The Society of Critical Care Medicine (SCCM) is the leading organization dedicated to ensuring excellence and consistency in the practice of critical care. From heart attack and stroke, to severe respiratory insufficiency, overwhelming infection, burns and gunshot wounds, the SCCM recognizes the unique needs of the critically ill patient of any age -- infant to adult -- and strives to secure the highest quality care for all patients facing life-threatening conditions. The SCCM is the only professional organization devoted exclusively to the advancement of multiprofessional intensive care through excellence in patient care, education, research, and advocacy. The 14,000 SCCM members in 80 countries include a diverse group of highly trained professionals who provide care in specialized care units and work toward the best outcome possible for seriously ill patients. These professionals include: Intensivists, Critical Care Nurses, Critical Care Pharmacists/Pharmocologists, and Respiratory Therapists

Sprixx is a DBA of Harbor Medical, Inc., of Santa Barbara, CA. Sprixx holds an exclusive patent license for body-worn, single-hand operated sanitizer dispensing and is the developer of the Sprixx Hand Hygiene System. For more information on Sprixx, phone 805-570-5312, visit http://www.sprixx.com, or email rcagle(at)sprixx.com.


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