A recent failure in a pharmacy clean room evaluation resulted in 753 patients being infected with meningitis, causing 64 deaths in 20 states. This is one area of a hospital where contamination risk should not be taken lightly.
Centers for Disease Control and PreventionThe Challenge
After two routine tests, a Pharmacy Clean Room failed to meet the acceptable levels of microbes allowed.
Prior to the first test, the surfaces and ducts of the Pharmacy Clean Room were thoroughly cleaned; however, the test was still not successful.
The second assessment round prompted the testing of the reusable medical waste containers in the room. The results revealed extremely high microbial counts on the surface of the containers. The microbial count was determined through an ATP test, the process of rapidly measuring actively growing microorganisms through detection of adenosine triphosphate (ATP). The goal of an ATP test in this scenario was to reduce the ATP count to a target-level of <250 relative light units; the test failed with the average of the highest count being 14,844 – exceeding safe levels.
Our Approach
STEP 1
Propose a Smarter Container
Noting that the failed test was caused by the medical waste containers in the Pharmacy Clean Room, the solution of a containment system that could eliminate the issues was proposed- the Daniels' Medismart container. This containment solution would not only meet the waste generation needs of the area but also maintain safe, acceptable levels of microbiome.
STEP 2
Discourage Micriobome Growth and Encourage Sterilisation
Often medical waste containers from other service partners are delivered in multiple "nested" units - another way to visualise this is to picture containers stacked together. This method of delivery entraps moisture in the bottom of the bin and encourages microbial growth. The Daniels' Medismart container is delivered as a single-sealed unit. All Daniels' containers go through a robotic washing and decontamination process after each use that achieves a level of sterilisation 4x higher than that required by the United States' CDC.
STEP 3
Containment solutions that minimise touches
By introducing hands-free containers that raise the bar in their benchmark of microbiological efficiency, we are further reducing the risk of infection and contamination. This is key for environments like a Pharmacy Clean Room; decontamination is meticulous and held to an ISO standard.
The Solution
The Medismart containers were successfully implemented into the Pharmacy Clean Room's medical waste management practice. It was recognised that a reusable container that underwent routine sanitisation and cleaning would not harbor the unsafe levels pathogen counts experienced with static containers that did not undergo routine cleaning. The Daniels' Medismart containers were subjected to the same rigorous ATP testing - hoping to meet safe levels of microbiome.
The Outcome
The Daniels' Medismart containers passed the ATP test with an unprecedentedly low microbial count, the highest being 103 relative light units. (Remember, the original target level was <250 relative light units.)
With implementation of the Medismart system, no further work-surface tests failed - and since August 2015, the Pharmacy Clean room has passed every microbe test put to it.