The document discusses hospital pillows as potential vectors for infection transmission in healthcare settings. It provides evidence from multiple studies that found reusable hospital pillows often become contaminated with pathogens like MRSA, C. difficile, and E. coli. The interior of pillows can harbor bacteria that match organisms found in colonized or infected patients. The document then introduces SleepAngel pillows, a CE marked medical device pillow with a nanopore filter membrane that has been shown in trials to prevent internal contamination, last longer than standard pillows, and help reduce healthcare-associated infections at hospitals that have implemented their use. Using fewer, longer-lasting SleepAngel pillows can also save hospitals money on laundry, disposal, and product replacement costs over
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Hospital pillows - Infection control risks and measures to reduce them.
1. The pillow is a vector for infection
Reduce infection risks,
Improve patient care,
Save your hospital money
Supported By: Acknowledgement to:
1
2. Pillows as a Risk Area
2
Exterior surface of 100 pillows swabbed
• Previously cleaned with a quaternary ammonium
Pillows as a Risk Area
Lange V. AJIC (2014) 42 S34-35
compound
38% contaminated
• MRSA, VRE, Coliforms, inc E. coli and K. pneumoniae
Concluded
• Reusable hospital pillows may serve as reservoirs
for nosocomial pathogens
• Clear and rigorous guidelines should be established for
decontamination of patient beds and pillows
• Outbreak investigations should include…pillows
and mattresses
• Currently reviewing options such as a barrier pillow
cover Control of CA-MRSA in a Burn Centre
Shik N., Ford S. et al AJIC (2014) 34(5) E100-
102
Burn Centre
• Nurses discovered patient pillows varied in weight and
detected stains on some pillow covers
Presence of small manufactured openings for air exchange
within the pillow core
• Potential for wound drainage contamination and
transfer of microorganisms
2 outbreaks in a Burns Unit
• During the outbreak investigation it was noted that pillows
used in the hospital were not fluid-proof, and when cut open,
many were visibly contaminated with body fluids
Examination of Pillow Cores
Mottar R., Roth M et al AJIC (2006) 34(5) E107-
108
Patient pillows and a control (unused) sent for testing
• Pillow seams and pillow label tags were
found to be a mechanism for pillow
contamination allowing for drainage wicking
from outside the pillow to the pillow core
Multiple pathogens found growing within pillow cores
of all patient pillows
• Correlation to organisms from colonised and
infected patients
• Acinetobacter cultured from a patient with
colonisation of the face
Study looking at 100 standard and 100 barrier pillows
(Sleepangel™, a class 1 medical device)
• Pneumapure™ nanofilter membrane
In use for 3 months and sent for analysis
• External contamination of both types
• Internal contamination of standard pillows,
all barrier pillows contamination free
• 60% of standard pillows failed mechanically at 3
months, no barrier pillows failed
• Whole Trust replacement programme
Significant MRSA and CDI reduction
Pillow is a Vector
Tucker A., Dewhurst, M. Abstract, IPS Conf
2012
4. Does the clinical community care?
Infection control and cross-infection
present a major problem for hospitalsi
greatly increasing risk to health and
causing considerable expense. Bedding
interiors colonised with bacteria, become
a reservoir of infectionii, posing an
increased risk of Hospital Acquired
Infections.
(i) Wilson, Jenny Infection control in
clinical practice Balliere Tindall, London
1995
4
“A key element of this strategy is to control the
dispersal of microbes via contaminated bed
linen, mattresses and other points of close
contact with infected individuals”
Thilagavathi, G. Kannaian, T. 2008 Indian
Journal of Fibre and Textile Research, Dual
antimicrobial and blood repellent finishes for
cotton hospital fabrics
“Often only the bedrail has been sampled during
investigation of outbreaks, rather than more
important potential reservoirs of infection, such
as mattresses and pillows, which are in direct
contact with patients. It is essential that these
items and other bed components are adequately
decontaminated to minimise the risk of cross-infection.”
Creamer E, Humphreys H. The contribution of
beds to healthcare-associated infection: the
importance of adequate decontamination J Hosp
Infect. 2008 May;69(1):8-23.
“As a result evidence is clear: good practice
in infection control in hospital, should
include the deployment of CE medical
device infection control pillows such as
SleepAngel, as well as diligence in cleaning
and disinfection, together with the
implementation of a pillow audit protocol.”
Diane Wake, Chief Operating Officer,
Liverpool & Broadgreen University NHS
Trust, Reducing HCAI Conference, London,
2013
5. Medical device hospital pillow
SleepAngel® with PneumaPure™ Filter Technology
5
Class I Medical Device
6. SleepAngel™ Testing and Validation
Please visit youtube to view this video www.youtube.com/watch?v=EQjKz9eDDB0?list=PLshwoY7GBQqcFmbcX38m
6
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Dr. Bruce Mitchell, Clinical Immunologist and CEO, Airmid Healthgroup
7. Post market evaluation – NHS
Hospital Same story – pillows as a potential vector
7
• They don’t just get used under heads..
Respiratory ward – a problem area (Abx, revolving door)
• Prior to intervention; 0.52 CDI/month
• Post intervention; 0.12 CDI/month
• No other differences (virtually all other wards
increased)
Although antibiotic prescribing targets were raised the ward
was already meeting new standards
Very popular with staff
• Plus: Easy to clean, robust and comfortable for
patients; Less numerically required
• Concern: Disappearing act..
Beds of Roses
Maintenance of safe patient environments by
nurses, Reducing HCAI Conference, London, June, 2014
Martin Kiernan
Chair Education Committee HIS,
Former President of World Infection
Prevention Societies
Nurse Consultant, Southport and
Ormskirk NHS Hospitals Trust
CLICK LINK TO VIEW MARTIN KIERNAN
MASTER CLASS SLIDES
(Slides 33 on refer to hospital pillows)
www.bit.ly/bedsofroses_2014
8. Post market evaluation – NHS
Hospital
8
Reducing HCAI Conference, London 2013
Diane Wake, Chief Executive Officer
(previously Director of Infection
Prevention and Control at Liverpool &
Broadgreen University NHS Trust)
• “One of the most insidious pockets of resistance is
the hospital bedding”
• 100 new SleepAngel pillows and 100 standard
hospital pillows were deployed in wards
• After 90 days, sample pillows were sent for
microbiological analysis:
• Majority of standard hospital pillows tested contained
“potentially dangerous organisms”
• None of the SleepAngel® pillows tested contained
pathogens
• 60% of standard hospitals pillows tested had failed
mechanically (ripped or flattened)
• None of the SleepAngel® pillows tested had failed
mechanically
• Recommendation “to deploy CE marked infection
control pillows such as SleepAngel®”
Highlights of HCAI Reduction Strategy
MRSA reduces from 34 to 4 cases (-94%)
C Diff reduces from 363 to 64 cases (-84%)
9. Reducing HCAI Conference, 2013
9
Please visit youtube to view this video www.youtube.com/watch?v=HK6Xh0aD1VE
10. Save Your Hospital Money
10
SleepAngel™ Cost of Ownership Benefit
• Use less - two per bed not three or four (1)
• Replace less – observed to last up to 4 times longer than wipe down
pillows (2)
• Launder less – pillow laundry becomes obsolete, pillow case laundry is
reduced
• Dispose less – reduce costs associated with product obsolence and
disposal
Our financial model shows that replacing standard wipe down pillows with
SleepAngel™ pillows can achieve meaningful cost savings over the
lifecycle of the product, before the benefits associated with contamination
reduction and infection risk reduction are factored in. Our cost saving
calculator demonstrates how savings are achieved.
(1) Post market observation., Galway University Hospital, Therese Byrne , Purchasing officer in Hermitage Clinic , Dublin
(2) Marie Dewhurst, Infection Control Team Leader, Royal Liverpool and Broadgreen University Hospitals Trust
11. 11
Thank You
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www.sleepangel-medical.com