PATIENT HYGIENE PRODUCTS

Transcription

Simple Interventions. Extraordinary Outcomes.
PATIENT HYGIENE PRODUCTS
GLOBAL EDITION
CONTENTS:
Oral Hygiene................................2
Skin Antisepsis...........................13
Prepackaged Bathing.................17
Shampoo Cap.............................21
Incontinence Care......................23
Heel Protection..........................29
ABOUT COMFORT PERSONAL CLEANSING®
Since 1971, US-based manufacturer Sage
Products, Inc.—known internationally as
Comfort Personal Cleansing Products—has
developed innovative, disposable healthcare products trusted
by leading healthcare facilities worldwide. Our core belief is in
prevention—that evidence-based interventions will improve
outcomes. Our goal is to help healthcare facilities improve
patient safety and outcomes by preventing healthcare-associated
infections, skin breakdown and other adverse nosocomial events.
DENTAL PLAQUE:
A biofilm that causes
VAP infection.
The oral cavity is a proven source of Hospital-Acquired Pneumonia
(HAP), including Ventilator-Associated Pneumonia (VAP).1,2 Bacteria
that cause hospital-acquired respiratory disease colonize in the
oropharyngeal area, including dental plaque.3 These pathogens
can be aspirated into the lungs and cause infection.4 Non-vent
patients with dysphagia, stroke, COPD and malignancy are also
at risk for HAP.5,6
Three Risk Factors for VAP2
■
Colonization of dental plaque
■
Bacterial colonization of the oropharyngeal area
■
Aspiration of subglottic secretions*
Dental Plaque biofilm: Normal oral flora
and their glue-like properties attach exogenous
pathogens to the surface of the teeth, forming a
multi-organism biofilm. This biofilm can fragment
and travel in oral secretions. If aspirated, it may
lead to infection (pneumonia).10
* Routine suctioning minimizes oral secretions
which can migrate to the subglottic area.
Incidence and Mortality Rates of VAP
■
Mortality rates can reach as high as 76%. (Chastre)7
■
VAP is the most common infectious complication
among ICU patients, accounting for up to 47% of
all infections. (Cason)8
Costs of VAP
■
Costs can exceed £25,000/ €28,000 per instance
of VAP. (Rello)9
In addition to increased infection risk, the
biofilm grows thicker and calcifies in the
alveolus, rendering gases exchange ineffective.
Subsequently, under mechanical ventilation, the biofilm can
potentially attach and accumulate in the endotrach lumen,
increasing airway resistance and Work of Breathing (WOB).10
REFERENCES
1. Schleder B, et al., J Advocate Health Care. 2002 Spr/Sum; 4(1): 27-30. 2.Tablan OC, et al., Guidelines for preventing health-care-associated pneumonia, 2003, Recommendations of CDC and Healthcare Infection Control Practices Advisory Committee (HICPAC),
2003. 3. Scannapieco FA, J Periodontology. 1999 Jul; 70(7): 793-802. 4. Fourrier F, et al., Crit Care Med. 1998; 26: 301-8. 5. Kollef MH, et al., Chest. 2005;128(6): 3854-62. 6. Marik PE, N Eng J Med. 2001;344(9):665-71. 7. Chastre J, Fagon JY, Am J Respir Crit
Care Med. Vol 165. pp 867-903, 2002 8. Cason, CL, et al., Am J Crit Care. 2007 Jan; 16 (1): 28-38. 9. Rello J, et al., Chest. 2002 Dec;122(6):2115-21 10. Professor John G. Thomas, MS, PhD., HCLD, Department of Pathology, West Virginia University, School
of Medicine.
+1 815-455-4700
2
Biofilm Forming Over 12 Hours
Biofilm (Dental Plaque)
Forming Over a 24-Hour Period
3h
5h
7h
8h
9h
10h
11h
12h
13h
Photos courtesy of Center for Biofilm Engineering at MSU-Bozeman
FRANCE
Figure I: Bacteria beginning to form.
Dental plaque Study (Fourrier)1
“…Specific dental hygienic measures must be considered with the
primary goal of preventing plaque colonization.”
“…Dental plaque must be considered a specific reservoir of
colonization and subsequent nosocomial infection in ICU patients.”
JAPAN
Importance of Brushing Study (Mori)2
Brushing Essential in Reducing VAP by 62.5% in the ICU
“Dental plaque, which is the major cause of oral contamination,
is the thickest biofilm in the living body and cannot be eliminated by
gargling or wiping. Therefore, cleanliness of the oral cavity cannot be
obtained by means other than mechanical cleaning including tooth
brushing and washing….This study found that oral care consisting of
tooth brushing and washing reduced the incidence and risk of VAP in
ICU patients, and that it delayed the onset of VAP.”
Figure II: More and more bacteria adhere and existing bacteria begin to
multiply forming a microcolony.
GERMANY
Trends in Ventilator-Associated Pneumonia
Rates Within the German Nosocomial Infection
Surveillance System - KISS (Zuschneid)3
The average ICU pool measured 10.5 cases of VAP/1,000 vent
days in 181,275 patients with 224,138 total vent days.
Figure III: Bacteria spread in all directions becoming a macrocolony;
bacteria beginning to grow in multiple layers.
GREECE
Incidence and Risk Factors for VentilatorAssociated Pneumonia in 4 Multidisciplinary
Intensive Care Units in Athens, Greece
(Apostolopoulou)4
“32% of ventilated ICU patients in 4 multidisciplinary ICUs
developed VAP. Additionally, and not surprisingly, these VAPs
were associated with an increased length of stay.”
Figure IV: Bacteria macrocolonies spread and overlap resulting in full biofilm.
Photos courtesy of Center for Medical Biofilm Research, University of Southern California.
REFERENCES
1. Fourrier F, et al., Crit Care Med. 1998; 26: 301-8. 2. Mori H, et al., Intensive Care Med. 2006 Feb;32(2):230-6. Epub 2006 Jan 25. 3. Zuschneid I, et al., Infect Control Hosp Epidemiol. 2007 Mar;28(3):314-8 4. Apostolopoulou E, et al., Respiratory Care. 2003
Jul;48(7):681-88
3
www.sageproducts.com
BEATING BIOFILM
WITH COMPREHENSIVE
ORAL CARE:
Brushing and suctioning
address biofilm (plaque).
“If oral care is not started upon admission, the mouth could
become colonized with harmful bacteria within the first 48 hours.
Plaque on the teeth can provide a breeding ground for this growth
of bacteria.…The most effective way to remove plaque is to use
a brush.” (Campbell)1
Toothette® Oral Care delivers a comprehensive approach to oral
hygiene based on cleaning, debriding, suctioning and moisturizing
the entire oral cavity.
Innovative Tools
Suction Toothbrush
Helps remove dental plaque,2,3 debris and
oral secretions, all known to harbor potential
respiratory pathogens.4,5,6,7 Each suction
toothbrush has 4,000 bristles, or “contact points”
to effectively remove dental plaque.
Comprehensive Protocols
The key to a successful oral hygiene program is an evidencebased protocol. Staff education and involvement with the protocol
drives compliance, which is essential in achieving positive
prevention outcomes. Download a customizable Oral Care Protocol
at: www.sageproductsglobal.com/en/clinSupport/SampleProtocols.cfm.
Suction Swab
Helps remove debris and oral secretions—while
stimulating oral tissues2,8,9— between brushings.
Soft-Tipped Covered Yankauer
Removes debris and oral secretions. Between
uses, its exclusive sleeve retracts to help contain
secretions and protect itself from environmental
debris. Included with Q•Care® q8° kit.
Oropharyngeal Suction Catheter
Soft and flexible, it facilitates suctioning of
oropharyngeal secretions above the vocal cords.
Included with Q•Care® q8° kit.
REFERENCES
1. Campbell DL, Ecklund MM. Development of a research-based oral care procedure for patients with artificial airways. NTI News (a publication of AACN’s National Teaching Institute). 7 May 2002. 2. Scannapieco FA, et al., Crit Care Med. 1992 Jun;20(6):740-5.
3. Scannapieco FA, J Periodontology. 1999 Jul;70(7):793-802. 4. Fourrier F, et al., Crit Care Med. 1998;26:301-8 5. Sole ML, et al., Am J Crit Care. 2002 Mar;11(2):141-9. 6. DeWalt EM, Nurs Res. 1975 Mar-Apr;24(2):104-8. 7. Schleder B, et al., J Advocate Health
Care. 2002 Spr/Sum;4(1):27-30. 8. Schleder BJ, Nursing Mgmt. 2003 Aug;34(8):27-33. 9. Oral Health Care Drug Products for Over-the-Counter Human Use; Tentative Final Monograph; Federal Register, 53(17):2436-61.
+1 815-455-4700
4
Effective Cleansing and Moisturizing
Easy burst pouches dispense
solution in seconds
Sodium Bicarbonate
Treated swab heads cleanse and refresh the teeth and gums while stimulating
oral tissues. Mechanically cleans, refreshes and deodorizes the oral cavity.
Perox-A-Mint® Solution
Mechanically cleans and debrides with 1.5% hydrogen peroxide. As an oral
debriding agent, it aids in the removal of phlegm, mucus or other secretions
associated with occasional sore mouth.1 Releases bubbles of oxygen by
enzymatic action when peroxide comes into contact with the tissues.2
Alcohol-Free Mouthwash
1
Cleans and refreshes without drying or irritating. Contains 0.05%
cetylpyridinium chloride.
Before opening, place thumbs
on burst pouch
Mouth Moisturizer
Water-based formula soothes and moisturizes lips and oral tissue with vitamin
E and coconut oil.
Benefits of 0.05% Cetylpyridinium Chloride
In order to evaluate the oral antiseptic properties of Toothette® Alcohol-Free
Mouthwash against other brands, a study was performed that compares
antiseptic products tested in vitro against 3 types of microorganisms. Although
performed on a cosmetic product, this study was conducted in strict accordance
to the FDA Tentative Final Monograph for Oral Antiseptic Drug Products.3
This monograph reviews cetylpyridinium chloride along with other
antiseptic ingredients.
2
Squeeze to release fluid
Solutions Comparison Testing Results4
PRODUCTS
BACTERICIDAL (LOG10) REDUCTION OVER 30 MINUTES
S. Mutans
A. Viscosus
BACTERIOSTATIC
C. Albicans
≥ 7.9
≥ 6.9
≥ 7.9
No growth
≥ 7.9
≥ 6.9
≥ 7.9
No growth
≥ 6.8
≥ 7.4
≥ 7.9
No growth
Biotene Mouthwash
0.1
0.3
0.1
Growth
0.12% CHG Oral Rinse‡
≥ 7.9
≥ 6.9
≥ 7.9
No growth
Toothette® Oral Care Alcohol-Free Mouthwash†
®
*
Cepacol Antibacterial Mouthwash
®
Listerine Antiseptic Mouthwash
®
**
***
† Toothette® Oral Care Alcohol-Free Mouthwash, which contains 0.05% cetylpyridinium chloride (CPC), is regulated in the EU under Council Directive
76/768/EEC as a cosmetic.
‡ 0.12% Chlorhexidine Gluconate (CHG) Oral Rinse is regulated in the EU under Council Directive 76/768/EEC as a cosmetic.
* Registered trademark of Combe Incorporated ** Registered trademark of McNeil-PPC, Inc. *** Registered trademark of GlaxoSmithKline
REFERENCES
1. Oral Health Care Drug Products for Over-the-Counter Human Use; Tentative Final Monograph; Federal Register, 53(17):2436-61. 2. Oral Health Care Drug Products for Over-the-Counter Human Use; Establishment of a Monograph; Federal Register, 47(101):22760-930.
3. Oral Health Care Drug Products for Over-the-Counter Human Use; Tentative Final Monograph; Federal Register, 59(27):6084-124. 4. Laboratory data on file.
5
U.S.
Centers for Disease Control and Prevention
(CDC) Guidelines1,*
for Preventing Healthcare-Associated Pneumonia
“…Develop and implement a comprehensive oral-hygiene
program (that might include use of an antiseptic agent) for patients in
acute-care settings or residents in long-term--care facilities who are at
risk for health-care--associated pneumonia(II).”
* In addition to other interventions.
NETHERLANDS
Decontamination of the Digestive Tract and
Oropharynx in ICU Patients (Bonten)2
“…oropharyngeal decontamination with antiseptic agents, such as
chlorhexidine, might be an alternative in environments with high levels
of antibiotic resistance.”
Clean
Brushing and suctioning mechanically removes bacterial
biofilms (dental plaque) from teeth and oral tissues.
SINGAPORE
Ministry of Health3
Nursing Management of Oral Hygiene Clinical Practice Guidelines 2004
“Toothbrushes should be the first line of oral cleansing
method unless the patient is prone to bleeding, pain or aspiration.
Brush teeth at least twice a day, preferably soon after waking
in the morning and before going to bed. Use soft-bristled,
small-ended toothbrush.”
U.K.
National Institute for Health and Clinical
Excellence (NICE) Guidelines4
Technical Patient Safety Solutions for Ventilator-Associated
Pneumonia in Adults
The NICE guidance covers patients who are on a ventilator and states,
“make sure an antiseptic is included as part of the mouth care routine
for these patients.”
Debride
Swabbing and suctioning with Perox-A-Mint® solution
helps remove dead, loosened biofilms.6
Efficacy of Oral Chlorhexidine in Oral Care (Wise)5
“...studies unfortunately do not address the essential need for
mechanical cleaning prior to chlorhexidine use...”
“...chlorhexidine is excellent at inhibiting plaque formation in a clean
mouth but is of otherwise limited efficacy...”
Moisturize
Water-based Mouth Moisturizer soothes and
moisturizes oral tissues.
REFERENCES
1. Tablan OC, et al., Guidelines for preventing health-care-associated pneumonia, 2003, Recommendations of CDC and Healthcare Infection Control Practices Advisory Committee (HICPAC), 2003 2. Bonten M, et al., N Engl J Med. 2009;360:20-31 3. Nursing
management of oral hygiene. Clinical practice guidelines, Singapore Ministry of Health. 2004 Dec. 4. National Institute For Health And Clinical Excellence (NICE) Guidelines - Technical Patient Safety Solutions For Ventilator-Associated Pneumonia In Adults. August
2008. 5. Wise M et al., Critical Care 2008, 12:419 (doi:10.1186/cc6886) 6. Oral Health Care Drug Products for Over-the-Counter Human Use; Tentative Final Monograph; Federal Register, 53(17): 2436-61.
+1 815-455-4700
6
RESULTS:
Reduced risk of costly infection.
Patients breathe easier.
Reducing bacterial colonization in the mouth and on the surface
of the teeth of ICU patients decreases the frequency of VAP.1,2
Comprehensive oral care can address three VAP risk factors—bacterial
colonization of the oropharyngeal area, aspiration of subglottic
secretions, and colonization of dental plaque with respiratory
pathogens.3
Cost Avoidance
In 17 months, one 350-bed U.S. hospital reduced VAP over 75%,
avoiding €1.18 million in costs.‡ Along with a ventilator bundle and
head-of-bed elevation, they upgraded from swabs only to Q•Care®
cleansing and suctioning every 2 to 4 hours.5
Clinical Results
Reducing VAP
One U.S. hospital implemented comprehensive oral care and reduced
VAP by more than 60%. Their protocol featured Toothette® brand
products and called for oral care every 2 to 4 hours.3,*
* Other contributing risk factors exist, but were not addressed in this study.
Reducing HAP
In a 2-year Japanese study at 11 nursing homes, pneumonia risk
was significantly reduced in patients receiving oral care. In fact,
mortality due to pneumonia was about half that of patients not
receiving oral care.4
REFERENCES
‡ U.S. dollars converted to Euros. 1. Vollman K, Garcia R, Miller L,AACN News. 2005 Aug;22(8):12-6. 2. Mori H, et al., Intensive Care Med. 2006 Feb;32(2):230-6. Epub 2006 Jan 25. 3. Schleder B, et al., J Advocate Health Care. 2002 Spr/Sum;4(1):27-30.
4. Yoneyama T, et al., J Am Geriatrics Soc. 2002;50(3):434-8 5. Sherman Hospital saves $1.6 million on VAP-related costs. Case study, 2005 (available at http://www.sageproducts.com/company/media2.asp?ArticleID=51).
7
24-HOUR SUCTION SYSTEMS
Q·Care® Oral Cleansing and Suctioning
For mechanically ventilated patients
Suctioning and removal of biofilm plus enhanced protocol compliance.
Convenient q4° and q8° packaging for complete 24-hour care.
Brush teeth for
60 Seconds
■
Intuitive packaging lays out each step of oral care to easily
match your q4° or q8° protocol.
■
Ready to perform oral care in under 10 seconds.
■
Suction Toothbrush helps remove biofilm (plaque) and oral
secretions. Suction Swab helps remove debris and secretions
between brushings. Both mechanically clean and refresh with
sodium bicarbonate while stimulating oral tissue.
■
User-friendly thumb port (6404-X) provides easy suction control.
Suction handle (6808-X) provides variable suction control and
allows quick tool changes.
■
Burst pouches release cleansing solution right in the package;
no mixing needed.
■
Mouth Moisturizer soothes and
moisturizes lips and oral tissues with
vitamin E and coconut oil.
Also available in 6808-X:
+1 815-455-4700
■
Soft-tipped Covered Yankauer
helps remove debris and secretions.
Sleeve protects between uses.
■
Soft, flexible Oropharyngeal
Suction Catheter helps remove
secretions from the oropharyngeal
area above the vocal cords.
8
APIC releases Guide
to the Elimination of
Ventilator-Associated
Pneumonia
A HISTORY OF
INNOVATION
Over 90%
Sage Products is the true pioneer
of clinical oral care. Our history
of innovation has helped set the
standard now recognized in
professional guidelines.
Developing comprehensive,
24-hour systems incorporating
user-friendly tools with the ability
to be taken bedside, our products
have increased compliance to
reduce VAP and HAP risk.
of all clinical oral care
in the U.S. is trusted
to the Toothette®
Oral Care brand.
2008
SHEA releases A
Compendium of Strategies
to Prevent HealthcareAssociated Infections in
Acute Care Hospitals
2007
2006
®
Sage launches Q•Care
Systems with user-friendly
Thumb Port tools to make
compliance easier.
Sage launches
Q•Care® Rx with
0.12% Chlorhexidine
Gluconate (CHG)
Oral Rinse.
2005
AACN adds
comprehensive oral care
to its Procedure Manual
for Critical Care.
2003
Sage launches first 24-hour
Q•Care® Cleansing and
Suctioning System with Suction
Handle tools. This included a new
space-saving design and bracket,
allowing the kit to be hung bedside
for increased compliance.
CDC recognizes
and cites Bonnie
Schleder’s study
in its Guidelines for
Preventing HealthcareAssociated Pneumonia.
2002
An early study prototype design was
replaced by compliance-enhancing
Q•Care® Systems.
2001
Sage developed the first
comprehensive oral care kit,
called “Complete Care.”
With the help of Bonnie Schleder,
MS, RN, CCRN, a comprehensive
Oral Care protocol was developed.
Her study results were published
in Journal of Advocate Healthcare.
9
24-HOUR SUCTION SYSTEMS
For mechanically ventilated patients
q4° ORAL CLEANSING
AND SUCTIONING SYSTEM
WITH THUMB PORT TOOLS
(Connects directly to standard suction lines)
2 Packages of 1 Suction Toothbrush
with Sodium Bicarbonate, Alcohol-Free
Mouthwash, Mouth Moisturizer, and
Applicator Swab
BEDSIDE BRACKET
with removable adhesive strip
for wall-mounting
for mounting on IV poles,
bedrails, etc.
25 brackets/case
25 brackets/case
Reorder #6697
Reorder #6698
4 Packages of 1 Suction Swab with
Sodium Bicarbonate, Perox-A-Mint® Solution,
Mouth Moisturizer, and Applicator Swab
20 systems/case
Reorder #6404-X
q8° ORAL CLEANSING
1
Covered Yankauer with Suction
Handle and Y-Connector
2
Packages of 1 Suction Toothbrush
with Sodium Bicarbonate, Alcohol-Free
Mouthwash, Mouth Moisturizer, and
Applicator Swab
1
Package of 1 Suction Swab with Sodium
Bicarbonate, Alcohol-Free Mouthwash,
1
Package of 1 Oropharyngeal
Suction Catheter
LENGTH OF STAY (LOS)
YANKAUER HOLDER
bracket with flexible,
removable adhesive strip
4 bags of 25
100/case
Reorder #6696
25 systems/case
Reorder #6808-X
q4° ORAL CLEANSING
WITH THUMB PORT TOOLS
AND 0.12% CHG ORAL RINSE*
2 Packages of 1 Untreated Suction Toothbrush
with single use bottle of 0.12% CHG Oral Rinse
and Untreated Swab
4 Packages of 1 Suction Swab with
Sodium Bicarbonate, Perox-A-Mint® Solution,
20 systems/case
Reorder #6934-X
* please inquire about availability of this product
+1 815-455-4700
10
SINGLE-USE SUCTION SYSTEMS
For non-ventilated patients at risk for aspiration pneumonia
UNTREATED
SUCTION TOOTHBRUSH SYSTEM
1
Untreated Suction Toothbrush
100 systems/case
Reorder #6577-X
UNTREATED
WITH ALCOHOL-FREE MOUTHWASH
1
Untreated Suction Toothbrush
with Alcohol-Free Mouthwash, Applicatior Swab
and packet of Mouth Moisturizer
100 systems/case
Reorder #6573-X
SUCTION SWAB SYSTEM
WITH PEROX-A-MINT® SOLUTION
2
Suction Swabs with Sodium Bicarbonate and
Perox-A-Mint Solution, packet of Mouth Moisturizer
100 systems/case
Reorder #6513-X
UNTREATED
WITH 0.12% CHG ORAL RINSE*
1
Untreated Suction Toothbrush with single use bottle
of 0.12% CHG Oral Rinse
100 systems/case
Reorder #6977-X
* please inquire about availability of this product
11
NON-SUCTION SYSTEMS AND COMPONENTS
For patients who are able to expectorate
SINGLE USE ORAL SWAB SYSTEM
WITH PEROX-A-MINT® SOLUTION
2
ULTRA-SOFT TOOTHBRUSH
Individually wrapped
Swabs with Sodium Bicarbonate, Perox-A-Mint®
Solution and packet of Mouth Moisturizer
72/case
Reorder #6082
100 systems/case
Reorder #6013-X
TOOTHETTE® PLUS
ORAL SWABS
MOUTH MOISTURIZER
14g tube
With Sodium Bicarbonate, Individually wrapped
144/case
800/case
Reorder #6083-X
Reorder #6075-X
Untreated, Individually wrapped
800/case
Reorder #6070-X
TOOTHETTE®
UNTREATED ORAL SWABS
Quality you can
count on!
1000/case
Reorder #5602UT-X
TOOTHETTE®
ADULT BITE BLOCK
144/case
■
100% in-process adhesion testing
of foam swab heads.
■
ISO 13485:2003 certified.
■
CE marked.
Reorder #4000
+1 815-455-4700
12
MRSA INFECTION MAY
DOUBLE MORTALITY:
At-risk patients need an effective
means of skin decolonization.
Interventions designed to reduce antibiotic resistance and control
MRSA in hospitals are vital to minimize morbidity and mortality due to
infections caused by resistant organisms.1
Hospital-acquired infections (HAIs) affect about 1 out of 10 patients
and are a cause of significant morbidity and mortality.2 Of particular
signficance are MRSA HAIs, a leading cause of hospital-acquired
infections. Compared with patients with bacteraemia caused by
methicillin-susceptible S. aureus, those with MRSA bacteraemia have
nearly twice the mortality rate, significantly longer hospital stays, and
significantly higher median hospital costs.3
Prevalence, Length of Stay and Mortality
Infection Rates by Geographical Region4
MRSA
Severe underlying illness or comorbid conditions
■
Prolonged hospital stay
■
Exposure to broad-spectrum antimicrobials
■
Presence of foreign bodies such as central
venous catheters
■
Frequent contact with the healthcare system or
healthcare personnel
Eastern Europe
Oceania
8.7%
10.4%
9.3%
■
The number of cases of MRSA has been rising sharply—from 2,422 in
1997 in England and Wales, to 7,684 in 2003/4 in England alone.
Official figures show that about 15% of reported MRSA cases result
in death.5
■
In the past 10 years, an increase in the prevalence of MRSA infections
has been observed in Germany.6 Data from 11 German hospitals shows
that MRSA patients stay in the hospital 11 days longer, exhibit a 7%
greater mortality rate and create significantly higher total costs.7
Risk Factors for MRSA colonization
and HAI3
■
Western Europe
Costs
■
Additional cost to one healthcare Trust for care of patients with a
healthcare-acquired infection was £3.6 million.2
■
According to the Ontario Ministry of Health and Long Term Care, MRSA
colonization created an additional cost of €1,112, while managing a
patient with MRSA cost an additional €23,800.‡,8
REFERENCES
‡ Canadian dollars converted to Euros. 1. Whyte D et al., The Incidence of S. Aureus bacteraemia in acute hospitals of the Mid-Western Area, Ireland, 2002-2004. Euro Surveill. 2005;10(5):pii=538. 2. Masterton R, Teare E. Clinical governance and infection control in
the United Kingdom, Journal of Hospital Infection (2001)47:25-31 3. Calfee et al., SHEA/IDSA Strategies to prevent transmission of MRSA. Supplement Article: SHEA/IDSA Practice Recommendation. Infection Control and Epidemiology, 2008 Oct Vol. 29, Supplement
1. 4. Vincent JL et al., JAMA. 2009;302(21):2323-2329 5. MRSA: Statistics in UK and Europe. www.privatehealth.co.uk 6. Friedrich A, et al., EUREGIO MRSA-NET Twente/Münsterland - A Dutch-German Cross-Border Network for the Prevention and Control of
Infections Caused by Methicillin-Resistant Staphylococcus Aureus. Euro Surveill. 2008;13(7-9). 7. Resch A et al., The cost of resistance: incremental cost of methicillin-resistant Staphylococcus aureus (MRSA) in German Hospitals. Eur J Health Econ (2009) 10:287-297
8. Ontario Ministry of Health and Long-Term Care: Provincial Infectious Diseases Advisory Committee.
13
THE SOLUTION THAT
STAYS ON SKIN:
2% CHG leave-on solution
in a gentle, exfoliating cloth
outperforms 4% rinse-off solution.1,2
2% Formula Proven Effective
Antiseptic Body Cleansing Washcloths (2% CHG) have been proven to
leave more residual CHG on the skin than 4% solution.1,2 One study
found that the non-abrasive, polyester cloth “most likely promotes a
gentle exfoliation of skin cells that allows for a more thorough
antiseptic effect immediately after application.”3 Our rinse-free formula
keeps CHG active for 6 hours after application.
UK Department of Health Rapid
Review Panel (RRP)4
Antiseptic Body Cleansing Washcloths:
“Basic research and development, validation and recent in-use
evaluations have shown benefits that should be available to
National Health Service (NHS) bodies to include as appropriate
in their cleaning, hygiene or infection control protocols.”
(Level 1 Recommendation)
No-Rinse vs. Rinse-off CHG1
In one study, 2% no-rinse CHG Cloths were shown to improve
antiseptic persistence on patients’ skin more than 4% rinse-off
solution. Researchers found “…the amount of CHG that remains on
the skin after a no-rinse application is significantly higher than a CHG
application that is rinsed off. This finding indicates that most of the
CHG is likely rinsed off the skin during or after the application of the
product, leaving very little CHG on the skin.”
Society for Health Epidemiology
of America (SHEA)
“To gain maximum antiseptic effect of chlorhexidine, it must be
allowed to dry completely and not be washed off.”5
I. Routinely bathe adult ICU patients with chlorhexidine (B-III).6
a. Use chlorhexidine rather than regular soap and
water or other nonmedicated cleansing regimens for
routine patient cleansing.6
By reducing or
eliminating the
Infectious Agent,
the Chain of
Infection can
be broken. This
is known as
Source Control.
b. A variety of chlorhexidine products that could be
used are available. These include...2% chlorhexidine
impregnated cloths.6
Chain of
Infection
REFERENCES
1. Ryder M, Improving skin antisepsis: 2% no-rinse CHG cloths improve antiseptic persistence on patient skin over 4% CHG rinse-off solution. Poster presented at Assoc for Professionals in Inf Control and Epidemiology (APIC), June 2007. 2. Edmiston CE, et al.,
Comparative of a new and innovative 2% chlorhexidine gluconate-impregnated cloth with 4% chlorhexidine gluconate as topical antiseptic for preparation of the skin prior to surgery. American J of Inf Control (AJIC). Mar 2007;35(2):89-96. 3. Edmiston C, Seabrook
GR, Comparison of a new and innovative 2% chlorhexidine gluconate (CHG) impregnated preparation cloth with the standard 4% CHG surgical skin preparation. Poster presented at 2007 Assoc of periOperative Registered Nurses (AORN) Congress, Orlando, FL, Mar
2007. 4. United Kingdom Department of Health, Health Protection Agency, April 2008. 5. Anderson D et al., SHEA/IDSA Strategies to prevent Surgical Site Infections in Acute Care Hospitals. Supplement Article: SHEA/IDSA Practice Recommendation. Infection
Control and Epidemiology, 2008 Oct Vol. 29, Supplement 1. 6. Calfee D et al., SHEA/IDSA Strategies to prevent Transmission of Methicillin-Resistant Staphylococcus aureus in Acute Care Hospitals. Supplement Article: SHEA/IDSA Practice Recommendation. Infection
Control and Epidemiology, 2008 Oct Vol. 29, Supplement 1.
+1 815-455-4700
14
REDUCED RISK OF
MRSA BACTERAEMIA
Easy-to-use cloths work
against a broad spectrum
of organisms.1,2
Proven Results Against MRSA,
VRE & Acinetobacter
A Simple, Effective strategy
■
■
A study using 2% CHG Cloths for daily bedside bathing found
the incidence of Acinetobacter was decreased by 84% in the Trauma
Intensive Care Unit and by 100%, to 0 incidences, in the Respiratory
Intermediate Care Unit.3
■
In another study, 9-month results for bathing with Antiseptic Body
Cleansing Washcloths (2% CHG) found “…bathing MICU (Medical
Intensive Care Unit) patients with disposable cloths containing 2%
Chlorhexidine Gluconate reduced the microbial density of VRE on
patients’ skin.”4
■
In a 6-year UK study,
introduction of
Antiseptic Body
Cleansing Washcloths in
2007 was associated
with a 99% decrease in
MRSA bateraemias
while reducing MRSA
acquisition by 80%.5
Bacteraemia
“Cleansing patients with chlorhexidine-saturated cloths is
a simple, effective strategy to reduce VRE contamination of
patients’ skin, the environment and healthcare workers’ hands,
and to decrease patient acquisition of VRE.”6
Acquisitions
Admitted with MRSA
REFERENCES
1. Time Kill and MIC Testing conducted by an independent laboratory; data on file. 2. Testing conducted by an independent laboratory; data on file. 3. Blanchard K, Jefferson J, Mermel L, Control of nosocomial acinetobacter in a university-affiliated medical center.
The Warren Alpert Medical School of Brown University. Poster presented at Assoc for Professionals in Infection Control and Epidemiology (APIC), June 2007. 4. Vernon MO, et al., Arch Intern Med. 13 Feb 2006;166:306-12. 5. Wyncoll D, Batra R, Beale R, Addition
of 2% CHG baths to a bundled protocol leads to reduced rates of MRSA bacteraemia and colonisation. Poster presented at SCCM Critical Care Conference, Jan 2009. 6. Bleasdale SC, et al., Skin Cleansing with 2% Chlorhexidine Gluconate (CHG): Infection Control and
Clinical Benefits of Source Control. Presented at 2006 Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). Sept 2006, San Francisco, CA.
15
ANTISEPTIC BODY CLEANSING WASHCLOTHS
2% Chlorhexidine Gluconate solution in a soft, disposable washcloth
For skin antisepsis
CHG stays on skin for effective, persistent full-body decolonization.
Source Control to
Prevent Infection
■
Premoistened and ready to use right from the package.
No additional supplies needed.
■
2% CHG solution requires no rinsing and stays on the skin
for maximum antimicrobial persistence.
■
Proven to rapidly reduce bacteria that can cause
infection, including S. aureus, VRE, MRSA, etc.1
Provides a cumulative antiseptic effect with
multiple applications.
■
Easily enhances skin decolonization efforts for
a wide range of immunocompromised patients.
■
Helps reduce risk of transmitting
pathogens from colonized patients
to staff, other patients, visitors, and
surrounding environment.
■
ANTISEPTIC BODY
CLEANSING WASHCLOTHS
Large, thick washcloths hold the maximum
amount of CHG solution for consistent
CHG coverage. Makes it easier to
cleanse difficult-to-reach areas.
96 packages/case
Reorder #9601-X
ANTISEPTIC BODY
CLEANSING WASHCLOTHS
Decolonizes skin
with 2% CHG
6 Washcloths/package
Cloth size: 19cm x 19cm
Heavyweight washcloth
removes dirt & debris
Moisturizes with
Aloe & Vitamin E
2 Washcloths/package
Cloth size: 19cm x 19cm
40 packages/case
Reorder #9602-X
REFERENCES
1. Time Kill and MIC Testing conducted by an independent laboratory; data on file.
+1 815-455-4700
16
TRADITIONAL BATHING:
Basin and tap water
are a potential source
of contamination.
Patient bath water is a proven, significant source of high-level
bacteria contamination.1 In fact, the basin itself can be a reservoir
of contamination.1 In addition, soap and water present multiple
threats to skin integrity.2
Factors for Potential Contamination
Basin Bath Water Test Results1
Of basins tested containing soap and water in one U.S. hospital:
■
All samples were positive for bacterial growth.
■
61% had counts >105 cfu/ml.
■
60.8% were positive for gram-negative bacteria.
■
Over 35% of samples with gram-negative bacteria
had counts >105 cfu/ml.
■
Bath water, gloved hands and objects handled by nurses
during bathing tested positive for S. aureus, including
MRSA, Acinetobacter sp., Pseudomonas sp., E. coli
and other organisms.
1,3,4,5
■
The basin
■
Patient bath water
■
Tap water contamination
The traditional method of a bed bath can result in excessive drying
of the skin, an increased oxygen demand, greater nursing time and the
potential for microorganism spread within the environment. As skin
changes with aging and dries, roughens the texture and reduces the
tone and elasticity, the average hospitalized patient’s skin is at risk for
skin breakdown on admission.6
CDC Guidelines for Environmental Infection
Control in Healthcare Facilites7,*
The Basin: A Proven HAI Hazard
■
A recent study at three U.S. hospitals tested 92 basins. Some
form of bacteria was found in 98% of the basins tested, including
MRSA and VRE.8
■
Another study finds basins become storage bins for used patient
care items, are used for multiple activities like emesis and
incontinence clean-up, and come in contact with the patient
via water from head to toe.5
■
Mechanical friction during bathing adds skin flora to the basin.9
Recommendations - Water
I. Controlling the Spread of Waterborne Microorganisms
B. Eliminate contaminated water or fluid
environmental reservoirs wherever possible
(e.g., in equipment or solutions). Category 1B
Category 1B. Strongly recommended for implementation and supported by certain experimental, clinical, or
epidemiological studies and a strong theoretic rationale.
*Excerpt from recommendations of CDC and HICPAC.
REFERENCES
1. Shannon RJ, et al., J Healthcare Safety, Compliance & Infection Control. Apr 1999;3(4):180-4. 2. Bryant RA, Rolstad BS, OstWound Mgmt. June 2001;47(6):18-27. 3. Carr D, Adv in Skin and Wound Care. February 2009;22(2) 4. Anaissie EJ, Penzak SR, Dignani
C, Arch Intern Med. 8 Jul 2002;162(13):1483-92. 5. Lineweaver L, et al., Bugs Be Gone: Identify Potential Source of HAIs, the Basin. Poster presented at Institute for Healthcare Improvement (IHI), Orlando, FL, December 2007. 6. Vollman K, CAHQ Journal. 2007
Quarter 4:15-19, 43. 7. Centers for Disease Control and Prevention. Guidelines for environmental infection control in health-care facilities: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC).MMWR 2003;52 (No.
RR-10):5,14. 8. Johnson D, Lineweaver L, Maze L, Patients bath basins as potential sources of infection: a multicenter sampling study. AJCC, Vol 18 No. 1, Jan 2009. 9. O'Flynn J, Kosair Children's Hospital. Patient bath basins are a potential risk factor for HAIs in
acute care. Poster presented at Association for Professionals in Infection Control and Epidemiology (APIC) June 2007.
17
GERMANY
■
A study conducted in a Surgical Intensive Care Unit and 12 peripheral wards
found Pseudomonas aeruginosa in 150 of 259 (58%) tap water samples
taken from patient rooms.1
■
The same study concludes, “tap water from faucets contaminated with
P. aeruginosa plays an important role in the propagation of this pathogen
among patients. A high number of transmissions were shown to occur
both from faucet to patient and from patient to faucet.”1
ITALY
■
Legionella spp. was found in 86.8% of hot water samples taken
from 11 private Italian healthcare facilities over a one-year period.
L. pneumophilia was found in 82.6% of samples.”2
■
One report concludes that “once the water system is contaminated,
control of Legionella may be protracted, difficult, and expensive, and
cases of hospital-acquired Legionnaires’ disease are likely to recur.”3
FRANCE
■
In a new wing of a teaching hospital in Tours, France, tests for
Legionella were negative for two years after routine water sampling.4
■
In 2005, samples tested positive. Measures to eradicate Legionella included
replacing showerheads and flexible pipes, descaling and treating pipes with
chlorine, and thermal shock to the central water system. Follow-up samples
tested positive. Two months later, another sample tested positive. All
eradication measures had to be performed again.4
POLAND
■
One hospital found that “Legionella bacteria are
widespread in our environment.” As the study
states, “those at particular risk include older
people, those treated for long periods by
antibiotics, immuno-compromised patients in
oncology and transplantology units, diabetics,
smokers and people with chronic respiratory
tract infections. This is the reason why the
contamination of hot-water systems in
hospitals and nursing houses with
Legionella is thought to be highly
risky for certain patients.”5
REFERENCES
1. Reuter S, et al., Analysis of transmission pathways of Pseudomonas aeruginosa between patients and tap water outlets. Crit Care Med. 2002;30(10):2222-28. 2. Legnani PP, et al., Legionella contamination of hospital water supplies: monitoring of private healthcare facilities
in Bologna, Italy. J of Hosp Infect. 2002;50(3): 220-223. 3. Borella A, et al., Surveillance of legionellosis within a hospital in northern Italy: May 1998 to September 1999. Euro Surveill. 1999;4(11):188-120. 4. van der Mee-Marquet N, et al., Legionella anisa, a Possible
Indicator of Water Contamination by Legionella pneumophila. J of Clin Microbiol. 2006 January; 44(1):56-59. 5. Pancer K, et al.,The Influence of Contamination of a Hospital Hot-water System with Legionella pneumophila on Serum Antibody Production by Staff Members.
Indoor and Built Environment 2006; 15(1):105-109.
+1 815-455-4700
18
COMFORT BATH®:
The hygienic standard
removes potential contamination
and assures full body
skin assessment.
The traditional bath requires moisturizing after completion, making it a twostep process. Prepackaged disposable bathing products have soft cloths, a
cleansing agent that is pH-balanced with gentle surfactants, contains lotion
and provides a method for the cloths to retain warmth if the bath process
is interrupted.1
Comprehensive Protocols
The key to a successful skin cleansing program is an evidencebased protocol. Staff education and involvement with the protocol
drives compliance, which is essential in achieving positive
prevention outcomes. Download a customizable Bathing Protocol
at: www.sageproductsglobal.com/en/clinSupport/SampleProtocols.cfm.
Comfort Personal Cleansing®
28-Count Warmer
Our new and improved warmer allows you to warm
Comfort Personal Cleansing products to a consistent,
reliable temperature. Using the digital display, you can
easily track product utilization, manually control the
warmer’s temperature, and even record audio cues for
clinical reminders, staff education and more. It’s quiet,
energy efficient and internationally compatible.
REFERENCES
1. Vollman K, CAHQ Journal. 2007 Quarter 4:15-19, 43.
19
IDENTIFY SKIN ISSUES. REDUCE
CONTAMINATION RISK.
Skin Check™: Promoting Daily Skin Inspection
■
Skin Check Guide empowers all levels of staff to observe and
communicate skin issues to the patient’s nurse.
■
Convenient peel-and-stick labels allow caregivers to indicate which part
of the body needs to be checked for potential skin problems.
■
One study shows the use of Skin Check helped reduce the rate of
hospital-acquired pressure ulcers at one facility by 67%.1 In another
study, incidence of pressure ulcers decreased from 7.14% at baseline to
zero at the end of the 4-month study. Nonlicensed staff members’
knowledge in 6 key areas related to pressure ulcer development
increased to 100%.2
A Costly Decision
One US facility removed Comfort Bath to save money by
returning to the basin bath. But after returning to the basin,
the facility saw a 92% increase in urinary tract infections
(UTIs) and over €74,800 in additional costs.‡,5 Not
surprisingly, the facility reinstated Comfort Bath.
Proven Hygienic and Cost-Effective
■
One study proves Comfort Bath’s disposable washcloths effectively clean
while offering fewer opportunities to recontaminate skin.3
■
The same study found it was also cost-competitive, took less time,
required fewer products, and nurses expressed a clear and significant
preference for the disposable bath.3
■
Comfort Bath’s formula contains only USP/EP purified water so you never
have to worry about contaminated tap water.4
REFERENCES
‡ US dollars converted to Euros. 1. Bayerl K, Boushley G, Effective utilization of nurse assistants for skin inspection and rapid response resulting in improved staff communication and patient outcomes. Poster presented at IHI's National Forum on Quality Improvement in
Health Care, Orlando, FL., Dec. 2006. 2. Carr D, Adv in Skin and Wound Care. February 2009;22(2) 3. Larson EL, et al., Am J CritCare. May 2004;13(3):235-41. 4. Meets standards set by the United States Pharmacopeia (USP) and European Pharmacopeia (EP).
5. McGuckin M, Shubin A, Interventional Patient Hygiene (IPH): case study at the bedside. University of Pennsylvania, Department of Physical Medicine & Rehab, Philadelphia, PA. Presented at the American Professional Wound Care Association National Conference,
Philadelphia, PA, April 2007.
+1 815-455-4700
20
COMFORT BATH®
Cleansing Washcloths
For basinless bathing
The most trusted name in basinless bathing has set the standard for
total body cleansing and skin assessment with all-in-one, premoistened cloths.
Opportunity for
Skin Inspection
■
High-quality, polyester blend washcloths are ultra-soft,
yet durable.
■
Maximum amount of rinse-free cleansing solution and
moisturizers cleanse, nourish and soften skin.
■
Dermatologist-tested formula; proven hypoallergenic,
gentle and non-irritating. Available in refreshing clean
scent, or fragrance free.
■
May be warmed in a 1,000W microwave or Comfort
Personal Cleansing® Warmer.
■
Fully insulated, resealable packaging helps keep
washcloths warm.
■
Latex-free; contains USP/EP purified water.
Also available:
■
Comfort Shampoo Cap enhances patient satisfaction.
Helps nurses provide a warm, soothing shampoo and
improves the way patients feel.
■
Eliminates the need to move patients to running water.
■
Eliminates mess, cleanup and the need to change wet
bed linens.
Washcloths are gentle
even on fragile skin
Formula’s pH is closest to
normal, healthy skin
Moisturizes with
Aloe & Vitamin E
21
FRAGRANCE-FREE
ESSENTIAL BATH®
FRAGRANCE-FREE
ESSENTIAL BATH®
8 Medium-weight
Washcloths/package
5 Medium-weight
Washcloths/package
60 packages/case
84 packages/case
Reorder #7803-X
Reorder #7411-X
ESSENTIAL BATH®
IMPREVA BATH®
8 Medium-weight
Washcloths/package
8 Standard-weight
Washcloths/package
60 packages/case
60 packages/case
Reorder #7413-X
Reorder #7988
COMFORT RINSE-FREE
SHAMPOO CAP
1 Cap/package
28-COUNT WARMER
1 Warmer/case
Reorder #7938
40 caps/case
Reorder #7409-X
CART
Shampoo Cap easily cleans and
conditions hair in minutes!
1 Cart/case
Reorder #7920
+1 815-455-4700
22
INCONTINENCE
AND IMMOBILITY:
Significant risk factors
for pressure ulcers.
The odds of having a pressure ulcer were 37.5 times greater in
patients who had both impaired mobility and fecal incontinence than
in patients who had neither.1 One study shows 54% of incontinent
patients suffered from Incontinence-Associated Dermatitis (IAD), while
21% had two or more peri-skin injuries.2,3 IAD is defined as “an
inflammation of the skin that occurs when urine or stool comes into
contact with perineal or perigenital skin.”4 IAD is also a major risk
factor for pressure ulcers.1,5 A correct distinction between pressure
ulcers and IAD is important in practice because the preventive
measures to be taken are different.6
Pressure Ulcer Prevalence in Hospitals
Europe
■
A European Pressure Ulcer Advisory Panel (EPUAP) pilot survey
found an overall pressure ulcer prevalence of 18.1%. It included
5,947 patients from Belgium, Italy, Portugal, Sweden and the UK.7
■
An estimated 412,000 people, mostly hospital inpatients, develop
a new pressure ulcer annually in the UK.8
IAD Risk Factors4
23
GRADE
# OF CASES
PROPORTION
Grade IV
143
6.9%
Grade III
199
9.6%
Grade II
282
13.6%
Grade I
1,454
70%
■
Fecal Incontinence
■
Frequency of incontinence
Europe, Canada, Japan
■
Poor skin condition
■
■
Pain
■
Poor skin oxygenation
■
Fever
■
Compromised mobility
■
Double (urinary and fecal) incontinence
■
Tissue tolerance impairments
■
Moisture
■
Alkaline pH
Some countries have conducted their own pressure ulcer
prevalence survey, including Germany (5.3 to 28.3%),
Iceland (8.9%), Italy (8.3%), Japan (5.1%), Netherlands (23.1%),
Spain (8%) and Canada (25%).9
Costly Consequences
IAD vs. Pressure Ulcer 3
NETHERLANDS AND U.K.
IAD treatment costs are not yet known. However, they are
suspected to be grouped with costs for other skin injuries, such
as pressure ulcers.4 Recent European cost models indicate that total
pressure ulcer costs may consume 1% (Netherlands) and 4% (UK)
of healthcare expenditure.8,9
.
U.K.
The total cost to heal pressure ulcers is £1.4 to £2.1 billion annually.8
Most of this cost is nursing time.9 Expected mean cost to heal one
ulcer is £1,064 for Grade 1, £4,402 for Grade 2, £7,313 for Grade 3
and £10,551 for Grade 4.8
IAD Due to Contact with Urine or Feces
CANADA
■
Location is where the skin lays in or on urine or feces;
not only over a bony prominence.
A 100-bed acute care facility with a pressure ulcer prevalence of 25%
(national average), spends more than €524,800 annually to treat
pressure ulcers.10,‡
■
Early injury is bright red, then bright red and weepy.
■
Post-acute skin is purplish and very dry, peeling like
a sunburn.
■
No satellite lesions unless also has fungal.
UNITED STATES
Each year, the average hospital incurs €274,900 to €481,100
in direct costs to treat pressure ulcers.10,‡ In fact, just one complex,
full-thickness pressure ulcer can cost as much as €48,100 to
heal, while less serious pressure ulcers cost between €1,375
and €20,600.5,‡
Pressure Ulcer
■
Located over a bony prominence.
■
Over coccyx (tailbone) or ischia (butt bones); they are usually
round or oval shaped.
■
Over sacrum, may be butterfly shaped or oval if mostly on
one side.
■
Well-defined edges—no satellite lesions.
REFERENCES
‡ US dollars converted to Euros. 1. Maklebust J, Magnan MA, Adv Wound Care. Nov 1994;7(6):25, 27-8, 31-4 passim. 2. Gray M, Lerner-Selekof J, Junkin J, CE symposium in conjunction with the 2006 WOCN Conference, Minneapolis, MN, 2006 Jun. 3. Junkin J,
Moore-Lisi G, Lerner-Selekof J, What we don’t know can hurt us: pilot prevalence survey of incontinence and related perineal skin injury in acute care. Poster presented at the Clinical Symposium on Advances in Skin and Wound Care (ASWC), Las Vegas, NV, 2005
Oct. 4. Gray M, et al., J Wound Ostomy Continence Nurs. 2007 Jan-Feb;34(1):45-54. 5. Amlung SR, Miller WL, Bosley LM, Adv Skin &Wound Care. Nov/Dec 2001;14(6):297-301. 6. DeFloor T, et. al, Prevention and treatment of incontinence-associated dermatitis:
literature review. J Adv Nurs Jan 2009;65(6):1141-1154. 7. Defloor T, et al., J Eval Clin Practice 13 (2007) 227-235. 8. Bennett G, et al., The cost of pressure ulcers in the UK. Age and Ageing. 2004;33:230-235. 9. Pressure Ulcer Prevention in all Hospital and Homecare Settings. European Pressure Ulcer Advisory Panel : Review 7,2. (accessed 01-13-10 at http://www.epuap.org/review7_2/page8.html). 10. Robinson C, et al., Ost/Wound Mgmt. May 2003;49(5):44-51.
+1 815-455-4700
24
DELIVER PROVEN PROTECTION
AGAINST INCONTINENCE-ASSOCIATED DERMATITIS:
Easy-to-use, 5-in-1 Barrier Cloths
promote treatment and
prevention of skin breakdown.
Current prevention of IAD consists of cleansing, moisturizing,
and the application of skin protectants or moisture barriers.
Combined products can be used to optimize time efficiency and
to encourage adherence to the skin care regime. These include
moisturizing cleansers, moisturizer skin protectant creams and
disposable washcloths that incorporate cleansers, moisturizers and
skin protectants into a single product.1 (DeFloor)
European Pressure Ulcer Advisory Panel (EPUAP)
Pressure Uler Prevention/Treatment Guidelines2,*
EUROPE
Risk Assessment Tools and Risk Factors
2. Goal: Maintain and improve tissue tolerance
to pressure in order to prevent injury.
Comfort Shield® Barrier Cloths provide easy, all-in-one incontinence care.
Each premoistened, disposable cloth delivers one-step perineal cleansing,
moisturizing and deodorizing—all while treating and protecting skin
with 3% dimethicone. You can be confident a barrier is applied every time.
Plus, Peri Check™ Guide helps promote early identification of IAD.
■
Find the source of excess moisture due to
incontinence, perspiration, or wound drainage and
eliminate, whenever possible. When moisture
cannot be controlled, interventions that assist
in preventing skin damage should be used.
*In addition to other interventions. Based on one or more of the following evidence:
(1) results of one controlled trial, (2) results of at least two case series/descriptive studies
on pressure ulcers in humans, or (3) expert.
5-in-1 Barrier Cloths:
Dimethicone barrier
Shield Barrier Cloth is squeezed,
revealing dimethicone barrier.
pH balanced,
rinse-free cleanser
Enriched with
Aloe & Vitamin E
Deodorizer
Heavyweight cloth
25
RESULTS:
Elimination of Incontinence-Associated Dermatitis.
Reduced risk of pressure ulcers.
Skin Protectant Recommended
Proven IAD Treatment8
Protecting the skin of incontinent patients is just as
important as cleansing and moisturizing.3 Failure to apply a
barrier can lead to IAD.4 One review paper which looked at
25 different studies concludes a skin protectant is
recommended for patients considered at risk for IAD.1
Proven IAD
Prevention
One study’s comprehensive
pressure ulcer prevention
program featuring Comfort
Shield, improved compliance
and reduced sacral/buttock pressure ulcers by 89%!5
Another facility using Comfort Shield was able to reduce
IAD rates by 77% over an 11-month period.6 In yet another
facility, the number of patient referrals for skin problems
due to incontinence decreased by 86% following
implementation of Comfort Shield.7
Day 1
72-year-old Canadian patient with severely denuded, blistered skin
and extreme pain from incontinence.
Day 4
After 3 days using Shield Barrier Cloths, patient’s skin vastly
improved; no discomfort.
REFERENCES
1. DeFloor T, et. al, Prevention and treatment of incontinence-associated dermatitis: literature review. J Adv Nurs Jan 2009;65(6):1141-1154. 2. Pressure Ulcer Prevention in all Hospital and Home-care Settings. European Pressure Ulcer Advisory Panel : Review
7,2. (accessed 01-13-10 at http://www.epuap.org/review7_2/page8.html). 3. Haugen V, Gastroenterology Nursing. 1997;20(3):87-90. 4. Maklebust J, Magnan MA, Adv Wound Care. Nov 1994;7(6):25, 27-8, 31-4 passim. 5. Clever K, et al., Ost/Wound Mgmt. Dec
2002;48(12):60-7. 6. Wolfman A, It’s Easy: Preventing Incontinence-Associated Dermatitis and Early Stage Pressure Injury, 3rd Congress of the World Union of Wound Healing Societies, 2008. 7. Dieter L, Drolshagen C, Blum K, Research poster abstract presented
at the 2006 WOCN Conference, Minneapolis, MN, 2006 Jun. 8. Sluser S, Consistency the key for treating severe perineal dermatitis due to incontinence. Poster presented at the Clinical Symposium on Advances in Skin and Wound Care (ASWC), Las Vegas, NV,
2005 Oct.
+1 815-455-4700
26
IAD PREVENTION
Comfort Shield® Barrier Cloths
For incontinent patients
All-in-one cloths apply a protective barrier to the skin every time—
100% protocol compliance to barrier application.
Consistently
Apply a
Barrier
■
Proven barrier protection. 3% dimethicone formula was proven
equivalent to traditional tube barrier creams.1 Breathable, transparent
dimethcone barrier makes skin assessment easy without removal.
■
Helps maximize compliance to your incontinence care protocol by
delivering an effective barrier every time it’s used.
■
Helps “protect skin from excessive moisture and incontinence”
as recommended by the Registered Nurses Association of
Ontario (RNAO).2
■
Helps prevent perineal dermatitis; helps seal out wetness.
■
May be warmed in a 1,000W microwave or Comfort Personal
Cleansing® Warmer.
■
Fully insulated, resealable packaging helps keep cloths warm.
■
Hypoallergenic, gentle and non-irritating.
Keep supplies at the bedside of at-risk
patients with Comfort Shield Barrier Station!
■ Convenient access to supplies helps ensure barrier application
after every incontinence episode. One facility reduced IAD
incidence to zero and boosted compliance to 97% after adding
Shield Barrier Station.3
27
COMFORT SHIELD®
BARRIER CLOTHS
COMFORT SHIELD®
BARRIER CLOTHS
with dimethicone
with dimethicone
8-pack
peel and reseal package
large size cloths
3-pack
easy-tear package
large size cloths
48 packages/case
90 packages/case
Reorder #7905-X
Reorder #7453-X
COMFORT SHIELD®
BARRIER CLOTHS
COMFORT SHIELD®
BARRIER STATION
with dimethicone
with removable adhesive strips
32-pack
resealable tub
large size cloths
for wall-mounting near bedside
24 stations/case
Reorder #7599
12 packages/case
Reorder #7996P-X
Peri Check™ Guide
■
Remove guide.
■
Observe skin condition.
■
Communicate areas of concern to nurse.
REFERENCES
1. West DP, Northwestern Univ Dept of Dermatology, Chicago, IL, Feb 2000. 2. Risk assessment & prevention of pressure ulcers (revised). Registered Nurses Association of Ontario (RNAO),Toronto, Ontario, 2005 Mar (accessed 01-13-10 at:
http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=7006&nbr=4215). 3. Schmitz T, Location, location, location: Getting your incontinence care process bedside yields reduction in skin injury. Poster Presented at Institute for Healthcare
Improvement (IHI), Orlando, FL, 2007 Dec.
+1 815-455-4700
28
HEEL PRESSURE ULCERS:
A prevalent and costly problem in hospitals.
The heel and ankle bone are the second and fifth most common
sites for pressure ulcer development.1 In a study of 5,947 patients
Enormous costs
■
The annual cost of treating heel pressure ulcers is a staggering €1.5
to €2.4 billion.6,‡
■
The cost of treating a grade I pressure ulcer is £1,064/€1,234.
The cost of treating a grade IV pressure ulcer is £10,551/€12,238.7
■
Costs increase with wound grade, ranging from €1,325 to €19,900
for a grade I, II or III ulcer, to €46,000 for a complex, full-thickness
grade IV ulcer.8,‡
in 25 hospitals in 5 European countries, pressure ulcer prevalence
was 18.1% (Grade I-IV).
GRADE
# OF CASES
PROPORTION
Grade IV
143
6.9%
Grade III
199
9.6%
Grade II
282
13.6%
Grade I
1,454
70%
The sacrum and heels were the most affected locations. Only 9.7%
of the patients in need of prevention received fully adequate preventative
care. (DeFloor)2,3
Risk Factors for Pressure Ulcers4,5
■
Impaired mobility
■
Surgery
■
Diabetes
■
Peripheral Vascular Disease
■
Metastatic cancer
■
Spinal cord injury
Calculate your costs
■
For the cost to treat just one grade IV pressure
ulcer, over 200 Prevalon® heel protectors could
be purchased!
1
Determine your prevalence rate:
Number of patients with a pressure ulcer
Total number of patient population
100
2
Determine your total cost of treatment:
Pressure Ulcer Prevalence rate
Cost (example: grade 1 = €1,234)7
Total cost of treating pressure ulcers
29
PREVENTION & TREATMENT:
EPUAP Guidelines recommend
off loading heels.
European Pressure Ulcer Advisory Panel
(EPUAP) Pressure Ulcer Prevention/
Treatment Guidelines9
Support Surfaces
3.1 Ensure that heels are free of the surface of the bed.
(Strength of evidence = C)
3.2 Heel protection devices should elevate the heel
completely (off load) in such a way as to distribute the
weight of the leg along the calf without putting pressure
on the Achilles tendon.The knee should be in slight flexion.
3.3 Use a pillow under the calves to elevate the heels
(floating heels). (Strength of evidence = B)
3.4 Inspect the skin of the heels regularly.
Prevalon® Pressure-Relieving Heel Protector completely off
loads the heel delivering total, continuous pressure relief. It helps
minimize pressure, friction and shear on the feet, heels and ankles
of non-ambulatory patients. This provides extra protection for at-risk
heels, much more than special support surfaces like beds,
mattresses and overlays.10
Prevalon: An Engineered Pillow
Comfort grip interior
reduces movement
of foot within boot
Special Population: Operating Room Patients
4
5
Elevate the heel completely (off load) in such a
way as to distribute the weight of the leg along
the calf without putting all the pressure on the
Achilles tendon. The knee should be in slight
flexion. (Strength of evidence = C)
Pontoon bottom
for added stability
Elevate the individual’s heels during surgery to
reduce the risk of pressure ulcer occurrence on
the heel. (Strength of evidence = C)
Open, floated heel
REFERENCES
‡ US dollars converted to Euros. 1. Amlung SR, Miller WL, Bosley LM, Adv Skin Wound Care. Nov/Dec 2001;14(6):297-301. 2. Defloor T, et al., J Eval Clin Practice 13 (2007) 227-235 3. Clark M, et. al, EPUAP Abstracts 2002. 4. Maklebust J, Magnan MA, Adv
Wound Care. Nov 1994;7(6):25, 27-8, 31-4 passim. 5. Levin M, Adv Wound Care. Mar/Apr 1997;10(2):24-30. 6. Beckrich K, Aronovitch SA, Nursing Economic. Sep/Oct 1999;17(5):263-71. 7. Bennett G, et al., 2004; Cost of Pressure Ulcers in UK; Age and Ageing
33:230-5. 8. Young ZF, Evans A, Davis J, J Nurs Admin (JONA). Jul/Aug 2003;33(7/8):380-3. 9. European Pressure Ulcer Advisory Panel (EPUAP), EPUAP Review Volume 10, Issue 1, 2009, pp. 1-28 10. Coats-Bennett U, Critical Care Nursing Quarterly. May
2002;25(1):22-32.
+1 815-455-4700
30
Evidence-based Protocol
Incorporating a heel pressure ulcer prevention protocol—combined
with implementation of pressure-relieving devices and early
identification of high-risk patient populations—has been proven
to reduce the risk of developing heel pressure ulcers.1 This sample
protocol, authored by Joyce Black, is available for download at:
www.sageproductsglobal.com/en/clinSupport/SampleProtocols.cfm.
To ensure proper use of Prevalon®,
a Decision Tree* was presented at
the 2008 Symposium on Advanced
Wound Care (SAWC) Conference—
clearing up the mystery behind the use
of “rigid” ankle-foot orthotics (AFOs)
and heel protectors for the
non-ambulatory patient.2
* Developed by Christine Baker, RN, MSN, CWOCN, APN
REFERENCES
1.Walsh J, DeCampo M, Waggoner D, Keeping heels intact: evaluation of a protocol for prevention of facility-acquired heel pressure ulcers. Poster presented at the Symposium on Advanced Wound Care, San Antonio, TX, Apr 2006. 2. Fowler E, Williams Scott S, Head
Over Heels: Best Practices for Preventing Heel Ulcers. Poster presented at the Symposium on Advanced Wound Care, San Diego, CA April, 2008.
31
RESULTS:
Faster healing, proven prevention
of heel ulcers and contractures.
Clinical Results
A study at a 550-bed nursing home assessed the impact of a
heel pressure ulcer protection protocol using Prevalon®. The
facility saw a 95% reduction in heel pressure ulcer development.1
Proven Treatment!
Before Prevalon:
Financial Benefits
Two years of failure to heal
Besides a 100% prevention in both heel ulcers and foot drop,
an evaluation of Prevalon in one facility compared to the
projected costs of treating heel pressure ulcers revealed an
annual revenue preservation of €1.30 million!2,‡
€853,056
€900K
28
patients4
€750K
€503,710
€600K
369
patients4
€450K
€300K
€150K
€56,957
€30K
each
average
cost9
After Prevalon:
2nd Month of Intervention
€1.3K
each
average
cost9
€50K
0
Intervention with Prevalon for heel protection and silver
alginate for wound dressing for two months completely
closed wound from existing stage IV pressure ulcer and
it eventually healed completely.3
REFERENCES
‡ US dollars converted to Euros. 1. Burda V, A successful heel ulcer prevention program resulting in 95% reduction of heel ulcer incidence. Poster presented at the Symposium on Advanced Wound Care, Tampa, FL, Apr 2007. 2. Meyers T, et al., Strategies to Prevent
Heel Pressure Ulcers and Plantar Flexion Contracture in the Ventilated Patient. Poster presented at 3rd Congress of the World Union of Wound Healing Societies: June 4-8, 2008 Toronto, Canada. 3. Garrett D, Intervention with a new heel protection device and silver
alginate dressing to prevent amputation of lower leg due to stage IV ulcer of the heel and malleolus. Case study conducted at Salem Village Nursing and Rehabilitation Center, Joliet, IL, Oct 2006.
+1 815-455-4700
32
HEEL ULCER TREATMENT AND PREVENTION
Prevalon® Pressure-Relieving Heel Protector
For non-ambulatory patients
Easy-to-apply, advanced protection against heel pressure ulcers.
Standard and petite sizes fit most patients.
Off load heels for
Pressure
Relief
■ Open, floated heel design
completely off loads heel.
Allows for easy monitoring
between assessments.
■ Easy to apply and stays
on patient’s foot. Stretch
panels adjust in seconds for a secure, comfortable fit.
■ Built-in pillow-style cushioning provides proven,
familiar support surface.
Works with DVT
compression devices
■ Reduces foot rotation inside the boot. Soft, comfort-
grip interior minimizes friction and shear, while
keeping foot in proper position
■ Contracture Strap delivers maximum support to
the bottom of the foot. Helps prevent plantar
flexion contracture.
■ Helps maintain patient’s freedom of movement.
Durable, low-friction exterior slides easily over
bed sheets.
Also available:
■
33
Integrated foot and leg stabilizer wedge
helps reduce lateral rotation and damage to
the peroneal nerve.
PREVALON® STANDARD SIZE (fits 25-46cm calf circumference)
PREVALON®
PRESSURE-RELIEVING
HEEL PROTECTOR
with Integrated Wedge
Standard size
8 heel protectors/case
Reorder #7355-X
NHS Supply Chain FET1501
PREVALON®
PRESSURE-RELIEVING
HEEL PROTECTOR
Standard size
Reorder #7300-X
PREVALON® PETITE SIZE (fits 15-25cm calf circumference)
Fits most patients
PREVALON® PETITE
PRESSURE-RELIEVING
HEEL PROTECTOR
for smaller patients
Reorder #7310-X
■ Standard Size is available for patients with calf
circumference of 25-46cm and feet larger than 23.65cm.
■ Petite Size fits calf circumference of 15-25cm and feet
smaller than 23.65cm. It’s designed to fit the smaller foot,
ankle and calf for a secure, comfortable fit.
+1 815-455-4700
34
THE INTERVENTIONAL
PATIENT HYGIENE COMPANY
Born from a core belief in prevention,
Interventional Patient Hygiene is a nursing
action plan focused on fortifying patients’ host
defenses with evidence-based care.
By promoting a return to the basics of nursing
care, our advanced patient hygiene products
and programs help healthcare facilities improve
clinical outcomes by reducing the risk of hospitalacquired infection and skin breakdown.
DISTRIBUTED BY:
XX%
Cert no. XXX-XXX-XXXX
80012D © Comfort Personal Cleansing Products 2010

PATIENT HYGIENE PRODUCTS

Transcription

Similar documents

PRODUCT INFORMATION Oral Hygiene p. 1 Antiseptic Body

Prevention of Occipital Pressure Ulcers In Neonates

8 Series Line Chart_611

Stomach ulcers - BMJ Best Practice

Ulcers (traumatic and aphthous) and Herpes: Diagnosis and

Local treatment of established pressure ulcers

Tech Sheets

An Independent Supplement by Mediaplanet to USA

A Pedorthic Guide to Shoe Modifications

Boot Scootin` Boogie Line Dance Steps

personal hygiene - Cardinal Health Canada

Published version - Queen Mary University of London

STERIS Skin Health Solutions

Evaluation of BBL™ CHROMagar™ MRSA for Detection

section m: skin conditions