title: Saving costs through the decontamination of the packaging of unused medical supplies using hydrogen peroxide vapor.
abstract: OBJECTIVE. Individually packaged sterile supply items may become contaminated and act as vectors for nosocomial transmission of multidrug-resistant organisms (MDROs). Thus, many hospitals have a policy to dispose of these unused, packaged supply items at patient discharge from the hospital, which has considerable cost implications. We evaluated the frequency of contamination of these items, the efficacy of hydrogen peroxide vapor (HPV) in disinfecting them, and costs associated with discarded supplies. DESIGN. Before-after study. METHODS. A pilot study was performed in the rooms of 20 patients known to be colonized or infected with vancomycin-resistant enterococci (VRE), and a follow-up study was performed in an additional 20 rooms of patients under precautions for various MDROs in 6 high-risk units. Five pairs of supply items were selected. One item of each pair was sampled without exposure to HPV, and the other was sampled after HPV exposure. The cost of discarded supplies was calculated by examining stock lists of supplies stored on the study units. RESULTS. Seven (7%) of 100 items were contaminated with VRE in the pilot study, and 9 (9%) of 100 items were contaminated with MDROs in the follow-up study. None of the items were contaminated after exposure to HPV (P < .02 in both the pilot and the follow-up study). The annual cost of supplies discarded at patient hospital discharge was $387,055. This figure does not include the cost of waste disposal and is therefore likely to be an underestimation of the financial burden. CONCLUSIONS. HPV effectively disinfected the packaging of supply items, which could generate considerable financial and environmental benefits.
authors.affiliation: Bioquell, Horsham, Pennsylvania, USA.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Otter
authors.forename: Elaine
authors.initials: E
authors.lastname: Nowakowski
authors.forename: James A G
authors.initials: JA
authors.lastname: Salkeld
authors.forename: Mike
authors.initials: M
authors.lastname: Duclos
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Passaretti
authors.forename: Saber
authors.initials: S
authors.lastname: Yezli
authors.forename: Tracy
authors.initials: T
authors.lastname: Ross
authors.forename: Karen C
authors.initials: KC
authors.lastname: Carroll
authors.forename: Trish M
authors.initials: TM
authors.lastname: Perl
mesh_terms: D001230:Aspergillus / Q000302:isolation & purification; D017046:Cost Savings; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control; D003666:Decontamination / Q000191:economics* / Q000379:methods*; D024901:Drug Resistance, Multiple, Bacterial; D016983:Enterococcus / Q000302:isolation & purification; D004866:Equipment Contamination / Q000517:prevention & control*; D004865:Equipment and Supplies, Hospital / Q000191:economics / Q000382:microbiology*; D005670:Fusarium / Q000302:isolation & purification; D005740:Gases; D006801:Humans; D006861:Hydrogen Peroxide; D013211:Staphylococcus aureus / Q000302:isolation & purification; D020713:Vancomycin Resistance
chemical_list: D005740:Gases; D006861:Hydrogen Peroxide