Hes winter '17 final by Downing and Associates

ER 0 1 IS S’ 7 SU G E UID

VOL. XIII NO. 4

www.healthcareenvironmentalsolutions.com

WINTER 2017

Attention Readers !

Are you looking for Products, Equipment or Services for your business or healthcare facility? If so, please check out these leading companies advertised in this issue:

industry associations Medical Waste Management Assoc (MWMA) – pg 18 Infectious & Non-Infectious Waste Containers & Linen Carts McClure Incustries Inc – pg 4 Rehrig Healthcare Systems – pg 19 Royal Basket Trucks – pg 6 Snyder Industries – pg 17 TQ Industries – pg 17 Infectious Waste Sterilizing Systems Bondtech Corporation – pg 4 Clean Waste Systems – pg 20 Gient Heating Industry Co – pg 15 The Mark-Costello Co – pg 18 Shredders Vecoplan LLC – pg 16 x-Ray film recovery Commodity Resource & Environmental, Inc – pg 5

Study:

Using Antibiotics to Treat Superbugs May Lead to Other Infections

By P.J. Heller

reating multidrug-resistant organisms with antibiotics is commonplace in healthcare facilities. Even so, antibiotic-resistant infections remain a significant threat. Researchers at the University of Michigan, however, suggest that fighting these so-called superbugs is being hindered by targeting individual multidrug-resistant organisms (MDROs) and neglecting the fact that there are multiple circulating MDRO species in healthcare institutions whose propagation is driven by competing risk factors. In effect, the researchers suggest, using antibiotics to treat one particular MDRO may result in others. Rather than simply looking at one MDRO, healthcare practitioners need to consider such bacteria as part of an antibioticresistant ecosystem to see how MDROs interact with one other and with antibiotics. “This single-species view of MDRO epidemiology does not reflect the complex

reality; most healthcare facilities have multiple circulating MDRO species and individuals are often colonized by more than one MDRO,” they say. “Thus, interventions based on a singlespecies perspective can result in unintended consequences.” That conclusion is based on a study of 234 nursing home patients in the Ann Arbor and Detroit areas. Forty percent of the frail elderly patients in the study had more than one MDRO living on their bodies. Patients who had specific pairs of MDROs were more likely to develop a urinary tract infection involving an MDRO. The study, Network of Microbial and Antibiotic Interactions Drive Colonization and Infection with Multidrug-resistant Organisms, was published in the Proceedings of the National Academy of Sciences. Included in the study was a map of interactions among bacteria and classes of antibiotics. Such mapping could eventually help

Continued on page 3

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HEALTHCARE ENVIRONMENTAL SOLUTIONS news

WINTER 2017

Healthcare Environmental Solutions news

Study: Using Antibiotics to Treat Superbugs May Lead to Other Infections Continued from page 1 healthcare providers. For instance, they could treat a patient with a specific antibiotic not only because of its ability to kill one MDRO, but also for its potential downstream impact on other MDROs on the patient or lurking nearby. The study marked the first time this type of approach has been taken to understand the network of interactions that underlie antibiotic use and drive colonization with MDROs, the researchers say. “Our analysis revealed a complex network of interactions: antibiotic use was a risk factor for primary MDRO colonization, which in turn increased the likelihood of colonization and infection by other MDROs,” wrote authors Joyce Wang, Betsy Foxman, Lona Mody and Evan S. Snitkin. “Our work demonstrates the existence of an underappreciated healthcareassociated ecosystem and strongly suggests that effective control of overall MDRO burden will require stewardship interventions that take into account both primary and secondary impacts of antibiotic treatments.” Snitkin, a systems biologist in the Department of Microbiology and Immunology at the University of Michigan Medical School, explained in an interview that treating a patient with an antibiotic for one particular organism could cause other organisms to form. “While you may be controlling one problem, you’re potentially propagating other problems,” he says. “Unless you consider these secondary and tertiary effects, you might not be making a dent in the overall problem of reducing the prevalence of antibiotic resistance in these facilities in general.” To put it into the simplest terms, consider the arcade game Whac-a-Mole, where players wielding a mallet try to hit moles which pop up at random from various holes in the playfield. “It’s kind of like a Whac-a-Mole situation,” Snitkin agrees. “You try to knock down one problem organism and another one pops up.” “A more effective strategy might be taking a more global perspective and consider these secondary and tertiary impacts when making decisions and designing optimal ways to guide antibiotic treatment in these facilities,” he suggests. “Reducing the overall burden of antibiotic-resistant organisms in healthcare facilities will require strategies that consider both the intended and unintended consequences of antibiotic treatment decisions.” Snitkin says research into this area is still in the early stages. The initial study involved the most functionally impaired nursing home residents who had implanted medical devices and were at the greatest risk for undergoing antibiotic treatment and also being colonized with MDROs. Nearly two-thirds of the patients studied were treated with one or more of 50 different antibiotics during the study period. All the

patients used a urinary catheter to empty their bladders for at least three days during the study period. This allowed the researchers to look at patterns of urinary tract infections, which among nursing home and hospital patients often arise from bacteria entering the bladder along a catheter. The findings showed that colonization of such patients’ skin, noses and throats with common MDROs was not random. “We observed a complex network of interactions, with acquisition of each of six different MDRO species being influenced by different sets of antibiotics, and primary MDRO colonization in turn increasing the risk of acquisition and infection by other MDROs,” says Wang, the lead author on the study and a postdoctoral fellow in Snitkin’s lab. The study focused on two of the most dangerous MDROs — vancomycin-resistant Enterococcus (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) — as well as four Gram-negative bacteria that have evolved resistance to two powerful antibiotics and are known to cause numerous infections in hospitals. They were Proteus mirabilis, Acinetobacter baumannii, Escherichia coli and Pseudomonas aeruginosa. “Of the organisms we studied, each organism was influenced by at least one antibiotic and one other organism,” Snitkin says. “I think what really surprised us was that the organisms themselves influenced one another in ways we didn’t appreciate. It’s unclear right now what the basis is for that, what are the interactions happening between these organisms that are potentially facilitating one another’s propagation. We have additional work to do to learn how they might interact with one another with hopes we might be able to interrupt those interactions to control their spread.” Additional studies are planned in other nursing homes and healthcare facilities to try to reproduce the results. Eventually the results could be included in antibiotic stewardship rules which Snitkin says could then be passed down to practicing physicians making decisions on what antibiotics to use. Mody, a leader in studying infection transmission and prevention in nursing homes, is also involved in the follow-up study. It will take place in a different nursing home with residents who are not as ill as those in the initial study. “Antibiotic use is highly prevalent and colonization of MDROs is common,” Snitkin says of people in the new study. “We want to know in this different population do these same sorts of rules apply. Or are there different rules dictated by the characteristics of individual patients and their medical history.” While the focus on antibiotic usage has typically been on academic and acute-care hospitals, Snitkin says nursing homes have WINTER 2017

generally been an understudied part of the healthcare system. “They (nursing homes) are increasingly appreciated to be critically important because there is a tremendous amount of antibiotic use,” he notes. “Just focusing on acute-care hospitals likely will not afford a solution to antibiotic resistance because our healthcare system is highly interconnected [with patients frequently moving back and forth between facilities]. If you don’t control the problem at a network level, at a healthcare network level, you‘re going to have a problem.” In addition to Wang, Mody and Snitkin, the research team included Betsy Foxman, a longtime researcher in the epidemiology of antibiotic resistance and urinary tract infections at the University of Michigan School of Public Health. Funding for the research study came from the Centers for Disease Control and Prevention and by a pilot grant from the U-M Claude D. Pepper Older Americans Independence Center, a research division of the University of Michigan Geriatrics Center funded by the National Institute on Aging of the National Institutes of Health.

healthcare

Environmental solutionsnews Covering Infection prevention, medical waste management & sustainable practices

PUBLICATION STAFF Publisher / Editor Rick Downing Contributing Editors / Writers P.J. Heller • Sandy Woodthorpe Production & Layout Barb Fontanelle • Christine Mantush Advertising Sales Rick Downing Subscription / Circulation Donna Downing Editorial, Circulation & Advertising Office 6075 Hopkins Road, Mentor, OH 44060 Ph: 440-257-6453 • Fax: 440-257-6459 Email: downassoc2@oh.rr.com Subscription information, call 440-257-6453. Healthcare Environmental Solutions news (ISSN #1557‑6388) is published quarterly by Downing & Associates. Reproductions or transmission in whole or in part, without written permission of the publisher, is prohibited. Annual subscription rate U.S. is $19.95. Outside of the U.S. add $10.00 ($29.95). Contact our main office, or mail-in the subscription form with payment. ©

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HEALTHCARE ENVIRONMENTAL SOLUTIONS news

News Briefs

The Healthcare Waste Institute Announces New Chair and Vice Chair Carts, Cart Washer, Towing Systems and Components... • Sani-Trux is the only

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HEALTHCARE ENVIRONMENTAL SOLUTIONS news

WINTER 2017

rlinton, VA – The Health Waste Institute (HWI) proudly announces that Selin Hoboy, Vice President of Legislative and Regulatory Affairs at Stericycle, Inc. has been elected as the new Chair while Rudy Vingris, the Healthcare Business Development manager for Waste Management will remain as Vice Chair. Hoboy will begin her one-year term on January 1, 2018. Hoboy is responsible for managing legislative and regulatory affairs. She has worked in the environmental health and safety industry for over 20 years, and at Stericycle for over 17 years. Selin has supported the waste industry as an active member of the Healthcare Waste Institute. “It is an honor and privilege to be selected as the next Chair for the Healthcare Waste Institute. During a time of much change and opportunity for the industry, I look forward to serving the members in the upcoming year,” said Hoboy. Vingris has been involved extensively in hazardous waste management for over twenty-five years. At Waste Management, Vingris manages the Pharmaceutical & Hazardous Waste Management Program that provides services to healthcare customers that manages and disposes of all pharmaceutical and chemical wastes. “The National Waste & Recycling Association appreciates all the support from outgoing chair Andrea Arredondo and looks forward to continuing the good work with Selin Hoboy,” said Anne Germain, Director of Waste and Recycling Technology at NWRA. The Healthcare Institute is an industry group within the National Waste & Recycling Association. Their mission is to facilitate responsible healthcare waste management.

News Briefs

Checklist Helps Prevent Surgical Site Infections

Maryland Hospitals Receive Low Rankings for Patient Safety

an Diego, CA – A new study demonstrates the effectiveness of using a checklist to help reduce surgical site infections, reports ScienceNewsline.com. Researchers from Stanford University and Jimma University in Ethiopia conducted a study at two hospitals in Addis Ababa, Ethiopia to test the effectiveness of process mapping to promote infection prevention procedures. The checklist procedures included: • Hand and surgical site decontamination • Gown, drape, and glove integrity • Instrument sterility • Prophylactic antibiotic administration • Surgical gauze tracking • Checklist compliance The checklist program resulted in a 180 percent improvement in the use of appropriate hand hygiene prior to surgery and a 92 percent improvement in proper timing of prophylactic antibiotics. In addition, surgical instrument sterilization at the hospitals increased from 7 percent to 87 percent. The research team plans to adapt the process map for use in 10 other hospitals throughout Ethiopia within the next year. The study findings were presented at the American College of Surgeons Clinical Congress 2017.

he latest Leapfrog Group ratings put Maryland hospitals near the bottom nationwide when it comes to avoiding medical errors, accidents, injuries and infections, according a BaltimoreSun.com article. Using publicly reported data, Leapfrog scored the hospitals on 27 individual measures including infection rates and so-called “never events” that include objects left in patients after surgery. Leapfrog also looked at whether there are proper systems in place to prevent and address errors and accidents. Only one of the state’s 44 hospitals, Howard County General Hospital, earned an A, while seven received a B. The majority earned a C, while eight got a D and one — Bon Secours Hospital in West Baltimore — received an F. From 2013 to 2016, the overall rate of medical complications at Maryland hospitals dropped 43 percent and readmissions went down 6 percent. This was the first time Leapfrog included Maryland in its safety rankings. The state’s hospitals operate under a unique federal agreement that emphasizes patient outcomes based on a wider array of measures.

Antibiotic Use, C. diff Rates Increase after Sepsis Program Launch

epsis control programs may be leading to unintended consequences, including the overuse of antibiotics and more cases of Clostridium difficile infections, according to a study published in October issue of American Journal of Infection Control. A team of researchers from New York’s Icahn School of Medicine at Mount Sinai who followed a STOP Sepsis screening initiative, found that the program led to increased antibiotic use and higher C. difficile infection rates. Launched in 2014, the program involves electronic health record (EHR) screening and best practice alerts (BPA) along with patient testing, treatment and monitoring. The Centers for Medicare and Medicaid Services mandates initiating antibiotics therapy in patients with community-acquired pneumonia within six hours of presentation to the emergency department. This can lead to unwarranted treatment with antibiotics for some patients with noninfectious respiratory symptoms, the study authors explained. “As a relatively nonspecific screening tool, the BPA identifies some patients who meet the STOP Sepsis screening criteria, but do not have an infection. Under pressure to meet strict time-sensitive quality metrics, providers may initiate antimicrobial therapy in patients without sepsis, although they were flagged by BPA,” they wrote. The researchers pointed out the somewhat subjective nature of identifying sepsis signs and symptoms. What’s more, telling the difference between inflammatory and infectious conditions can be difficult, they noted. “The importance of making the correct diagnosis should not be ignored at the expense of applying unproven quality indicators to the wrong patient population, especially as various components of traditional sepsis bundles, such as early goal-directed therapy and even the importance of time to antibiotics in sepsis,” the study authors said. Another study observation was that frontline providers interpreted BPA as identifying patients with sepsis, rather than identifying those at risk for sepsis. As a result, overuse of antibiotics could delay optimal therapy for noninfectious conditions, as well as increase the incidence of antibiotic resistant infections, such as Clostridium difficile. Despite its unintended consequences, the study authors point out that the sepsis program has demonstrated positive improvements overall in sepsis-related outcomes. The research could not confirm causality between the program and the antibiotic use and C. difficile rates observed during the study period, however. WINTER 2017

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HEALTHCARE ENVIRONMENTAL SOLUTIONS news

News Briefs

Alabama HAI Rates Fall

ontgomery, AL â€“ Alabama is leading the nation in reducing four categories of hospital-acquired infections, according to the 2016 report by the Alabama Department of Public Health (ADPH). ADPH publishes the Healthcare-Associated Infections annual report to provide information on the number of infections per category and compare Alabamaâ€™s hospital performance to the national average. Since the reporting program began in 2011, the statewide rate for catheter-associated urinary tract infections (CAUTI) has dropped by half. For 2016, Alabama hospitals reported fewer CAUTIs than predicted based on the national performance measures. Of the 92 facilities reporting the infection, there were 403 CAUTIs associated with 452,404 catheter days. This is a decrease from 2015, when 425 CAUTIs were reported by 91 hospitals, over 450,041 catheter days. The state also performed better than the national baseline for central line-associated bloodstream infection (CLABSI) cases. There were 288 CLABSIs associated with 217,972 central line days were reported by 69 Alabama hospitals that met the reporting criteria. Twelve hospitals performed better than the national baseline, and no hospital performed worse. The 2015 CLABSI data showed 352 CLABSIs and 217,434 central line days reported by 70 hospitals. Alabama also performed better than the national average for surgical site infections (SSIs) related to abdominal hysterectomies and colon surgeries. For 6,102 colon procedures, 133 SSIs were identified (excluding superficial SSIs). Among Alabama hospitals required to report SSIs, 66 facilities performed colon surgeries. Of these facilities, 7 had significantly fewer infections compared to the national performance. One facility performed worse than the national baseline. For abdominal hysterectomies, 59 Alabama hospitals performed 7,139 abdominal hysterectomy surgeries in 2016. Thirty-three SSIs associated with these procedures were reported (excluding superficial SSIs). No facilities performed better or worse than the national average.

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HEALTHCARE ENVIRONMENTAL SOLUTIONS news

WINTER 2017

2017

Buyers’ Guide DIRECTORY

CATEGORY LISTINGS Air & Surface Cleaning/ Disinfection Systems 1 Priority Env. Svcs., Inc Abatement Technologies Advanced Vapor Technologies, LLC AmeriVap Systems, Inc Biomist, Inc Bioquell Inc Cleanint ClorDiSys Daylight Medical Hygiena Infection Prevention Technologies, LLC sBioMed LLC Steriliz, LLC TRU-D LLC TSK Products UltraViolet Devices Inc UVAIRx Inc Vaportek Inc Xenex Healthcare Services

Alternative Energy Systems

Automated Equipment & Container Cleaning Systems Aaqua Tools ARE Industries Better Engineering McClure Industries, Inc Neptune Wash Solutions

Automated Wheelchair Disinfection Systems Hubscrub Company

Balers & Compactors Allegheny Shredders American Baler Co Harris IPS Balers Mfg J.V. Manufacturing, Inc Marathon Equipment Co San-I-Pak Inc The Mark-Costello Company

Containers, Carts, Casters & Wheels (Linens) Arrow Casters & Wheels Bomac Carts McClure Industries, Inc PCM Medical Waste Recycling Tecni-Quip Carts

Containers/Carts (Recycling & Document Storage) Big Dog Shred Bins Bomac Carts Jake, Connor & Crew Inc Jedstock Inc McClure Industries, Inc Rehrig Healthcare Systems Schaefer Systems Intl., Inc Scott Distribution LLC / Scott Containers Solutions Inc Tecni-Quip Carts Toter Inc

Containers (Pharmaceutical, Medical Waste, & Sharps) BD Medical Daniels Sharpsmart Envirotain, LLC Jake, Connor & Crew Inc McClure Industries, Inc PCM Medical Waste Recycling Post Medical Inc Rehrig Healthcare Systems San-I-Pak Inc Scott Distribution LLC / Scott Containers Sharpsology Snyder Industries Inc Solutions Inc

Food Waste Containers & Compostable Bags BioBag Ecosafe Zero Waste Jake, Connor & Crew Inc Natur-Tec®

Hand Hygiene Compliance System

NewWay Global Energy PEAT International Inc SunWize Technologies Inc ZeroWaste Energy Systems

DebMed USA LLC WINTER 2017

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

2017 Hazardous & Regulated Waste Disposal & Infection Compliance Services AMS Med Waste LLC Assured Waste Solutions Clean Harbors Curtis Bay Medical Waste Svcs. Golder Associates Inc JT Environmental Consulting Kessler Consulting Inc Medasend Biomedical Inc MedAssure One Sustainabile Method Recycling LLC Pharma-Cycle Inc PharmWaste Technologies Inc Prime Compliance Quest Recycling Services, LLC San-I-Pak Inc Sharps MD Sioux Services LLC Solid Waste Solutions Corp SRI Surgical Stericycle Visionary Solutions LLC

Janitorial Supplies & Services Century Products LLC Geerpres Inc Jani-King International, Inc UniFirst Corporation Rubbermaid Commercial Products LLC TL Services, Inc

Liquid Waste Disposal Systems (Biohazardous) Ansell Sandel Med. Solutions Bemis Health Care DiSorb Systems, Inc Dornoch Medical Systems, Inc Liquitech, Inc Stryker

hes Buyers’ Guide CATEGORY LISTINGS

Medical Waste Device Recycling Implant Recycling Stryker

Medical Waste Treatment Systems (Autoclaves, etc) BioMedical Technology Solutions BN Green Technologies Bondtech Corporation Clean Waste Systems ECODAS Envirotek Honua Technologies The Mark-Costello Company OnSite Sterilization, LLC OZONATOR Industries Paragon Waste Solutions Red Bag Solutions San-I-Pak Inc Sterilis Medical Corporation SteriMed Medical Waste STI Biosafe Vertisa

Motorized Carts, Tugs & Lifting Systems Bayne Premium Lift Systems PHS West Inc Red Devil Equipment Co

Odor Control West Sanitation Services Inc Zorbx

Recycling Services Battery Solutions

Regulatory Services & Training Compliance Publishing Corp

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

WINTER 2017

Sanitizing Products, Hand Cleaners & Dispensing Systems BioMed Protect, LLC Clorox Professional Products CS Medical, LLC Dial Corp, A Henkel Company Ecolab Inc Elyptol, Inc Georgia-Pacific Professional Germ Pro Products GOJO Industries Inc Kimberly-Clark Professional Micro-Scientific® Palmero Health Care Parker Laboratories Proctor & Gamble Professional Disposables Intl. Resurgent Health & Medical Safety-Med Products Spartan Chemical Co, Inc Sporicidin by Contec, Inc Surfacide UltraClenz Vital Vio Wexford Labs Xpedx

Shredding Equipment (Plant-Based & Office Shredders) Allegheny Shredders MBM Corporation Harris Republic Machine Security Engineered Machinery Co Shred-Tech UNTHA America Vecoplan, LLC WEIMA America, Inc Whitaker Brothers

Solvent Recovery Systems B/R Instrument Corp

Spill Control Materials SorbTech Mfg, Inc UltraTech International

Tracking Devices & Software (Healthcare) Walsh Integrated

Trade Associations American Society for Healthcare Engineering (ASHE) Association for the Healthcare Environment (AHE) Copper Development Association Inc Medical Waste Management Association (MWMA) Practice Greenhealth

Uniforms & Work Clothing UniFirst Corporation

Waste Tracking & Routing Software (Medical Waste Collection & Transport) Clear Computing EZshred Software Imec Technologies Inc PC Scale Inc™ RouteOptix Mgmt Systs Inc

X-Ray Film Recovery/ Silver Reclamation AMS Med Waste LLC Arch Enterprises, Inc Commodity Resource & Environmental Inc Pyromet Silver Refiners Rochester Silver Works LLC United DMS of Tennessee LLC

2017 A

1 Priority Environmental Services, Inc Fort Worth, TX (817) 595-0790 www.go1priority.com

Aaqua Tools

Rancho Cordova, CA (800) 777-2922 www.AaquaTools.com

Abatement Technologies Suwanee, GA (800) 634-9091 www.abatement.com

Advanced Vapor Technologies, LLC Everett, WA (800) 997-6584 www.advap.com

hes Buyers’ Guide COMPANY INDEX

American Society for Healthcare Engineering (ASHE) Chicago, IL (312) 422-3800 www.ashe.org

AmeriVap Systems, Inc Dawsonville, GA (800) 763-7687 www.amerivap.com

AMS Med Waste LLC

Lake in the Hills, IL (855) 633-9278 www.amsmedwaste.com

Ansell Sandel Medical Solutions Chatsworth, CA (866) 764-3327 www.sandelmedical.com

Arch Enterprises, Inc Mexico, MO (800) 835-0478 www.archenterprises.com

ARE Industries

Wichita, KS (316) 943-5000 www.areindustries.com

Arrow Casters & Wheels Allegheny Shredders

PO Box 80 Delmont, PA 15626 (800) 245-2497 Joe Barush solutions@alleghenyshredders.com www.alleghenyshredders.com Allegheny Security Grinders are your solution when the highest level of destruction is required. Utilizing our proprietary single-shaft rotary design coupled with screen sizes ranging from 3/8” to 4”, these powerful grinders provide secure dump and run destruction of confidential documents, digital media, plastics, and various types of medical waste.

American Baler Co

Bellevue, OH (800) 843-7512 www.americanbaler.com

Murrieta, CA (888) 449-2228 www.arrowcaster.com

Association for the Healthcare Environment (AHE) Chicago, IL (312) 422.3860 www.ahe.org

Assured Waste Solutions

Gastonia, NC (704) 865-7550 www.assuredwaste.com

B B/R Instrument Corp Easton, MD (410) 820-8800 www.brinstrument.com

Battery Solutions

Howell, MI (800) 852-8127 www.batteryrecycling.com

Bayne Premium Lift Systems Greenville, SC (800) 535-2671 www.baynethinline.com

BD Medical

Franklin Lakes, NJ (201) 847-6800 www.bd.com

Bemis Health Care

Sheboygan Falls, WI (920) 467-4621 www.bemishealthcare.com

Better Engineering

Baltimore, MD (800) 229-3380 www.betterengineering.com

Bomac Carts / Royal Basket Trucks 201 Badger Parkway Darien, WI 53114 (262) 882-5000 Cindy Lapidakis sales@bomaccarts.com www.bomaccarts.com H e a v y - D u t y u t i l i t y ca r t s a re our specialty. From Recycling, Manufacturing, Shipping/Receiving, Commercial Laundry and Mailrooms, our offering meets a broad range of uses in many industries. See ad on pg 6

BioBag

Palm Harbor, FL (727) 789-1646 www.biobagusa.com

Big Dog Shred Bins

Poway, CA (855) 792-4050 www.bigdogshredbins.com

BioMedical Technology Solutions, Inc Englewood, CO (866) 525-2687 www.bmtscorp.com

Biomist, Inc

Wheeling, IL (847) 850-5530 www.biomistinc.com

Bioquell Inc

Horsham, PA (215) 682-0225 www.bioquell.com

BN Green Technologies San Diego, CA (855) 294-2227 www.bngreentech.com WINTER 2017

Bondtech Corporation

1278 Highway 461 Somerset, KY 42503 (800) 414-4231 Elsa Brown elsabrown@bondtech.net www.bondtech.net BONDTECH is a full service company designing, engineering and manufacturing autoclave systems, with material handling, for technical industries such as infectious medical waste treatment, aerospace composites, glass lamination, rubber vulcanizing, wood treating, yarn setting and many other applications in industry and medical waste management. See ad on pg 4

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

2017

hes Buyersâ€™ Guide COMPANY INDEX

Century Products LLC

334 South Warminster Rd Hatboro, PA 19040 (215) 734-1400 / 877-445-DIRT www.cleanearthinc.com Clean Earth is one of the largest specialty waste companies in the country providing disposal and recycling options for an array of hazardous and non-hazardous wastes. Our vast portfolio of technologies services nearly every industry that generates waste including retail, medical, pharmaceutical, energy, infrastructure, commercial and industrial markets. It is our unique capability of providing a one-source, full-service solution to handle multiple waste streams from a single customer that separates us from the competition. Our processes are detailed, our due diligence is tireless, and our results provide unmatched recycling solutions for our customers with the utmost in customer service. See ad on pg 2

Clean Harbors

Norwell, MA (877) 500-6737 www.cleanharbors.com

Cleanint

Georgetown, TX (888)715-0464 www.cleanint.com

Clear Computing

Tinton Falls, NJ (888) 332-5327 www.clearcomputing.com

ClorDiSys

Branchburg, NJ (908) 236-4100 www.clordisys.com 10

Dornoch Medical Systems, Inc

Compliance Publishing Corp

Oakland, CA (800) 537-1415 www.cloroxprofessional.com

Greensboro, NC (800) 927-0981 www.centuryproductsllc.com

Clean Earth, Inc

Clorox Professional Products

Clean Waste Systems

200 Birch Ave S Maple Lake, MN 55358-0304 (877) 478-5195 Peter Jude peter@cleanwastesystems.com www.cleanwastesystems.com Clean Waste Systems is the designer, manufacturer, parts and service company for its patented, OMW1000 Ozone Medical Waste Processing System in the United States and foreign markets. Clean Waste Systems specializes in the design and development of ozone-based technologies using Humidizoneâ„˘ for its sterilization and sanitation processes. See ad on pg 20

Edina, MN (800) 242-9723 www.compliancepublishing.com

Copper Development Association Inc New York, NY (212) 251-7200 www.copper.org

CS Medical, LLC

Creedmoor, NC (877) 255-9472 www.csmedicalllc.com

Curtis Bay Medical Waste Services Baltimore, MD (855) 228-1715 www.curtisbayenergy.com

D Daniels Sharpsmart Commodity Resource & Environmental Inc

116 E Prospect Ave Burbank, CA 91502-9946 (818) 843-2811 / (800) 943-2811 www.creweb.com Commodity Resource & Environmental, Inc. was founded in 1980 as a full-service silver recovery and silver refining company. CRE is one of the largest purchasers and recyclers of medical x-ray film and graphic arts silver bearing film in the United States. CRE also offers a secure HIPAA BAA compliant system for all your x-ray film records and a certificate of destruction and insurance. Ship or deliver your scrap film to CRE for maximizing your recycling profits. CRE was the first NAID (National Association of Information Destruction) AAA certified refiner in the U.S.and we are celebrating 37 years in business. See ad on pg 5

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

WINTER 2017

Chicago, IL (312) 546-8900 www.danielsinternational.com

Riverside, MO (888) 466-6633 www.dornoch.com

ECODAS

Seattle, WA (864) 381-8856 www.ecodas.com

Ecolab Inc

St Paul, MN (877) 927-9726 www.ecolab.com

Ecosafe Zero Waste

Surrey, BC Canada (604) 560-5133 www.ecosafezerowaste.com

Elyptol, Inc

Santa Monica, CA (424) 500-8099 www.elyptol.com

Envirotain, LLC

Hudson, OH (216) 255-5107 www.envirotain.com

Envirotek

Charlotte, NC (704) 351-7311 www.envirotekww.com

Daylight Medical

Middleburgh Hts, OH (800) 459-8500 www.daylightmedical.com

DebMed USA LLC Charlotte, NC (866) 783-0422 www.debmed.com

Dial Corp, A Henkel Company

Scottsdale, AZ (800) 253-DIAL www.dialprofessional.com

DiSorb Systems, Inc Philadelphia, PA (866) 287-6672 www.disorb.com

EZshred

PO Box 8 Chesterland, OH 44026 (877) 392-7123 tjulian@ezshred.com www.ezshred.com EZshred is a simple to learn, yet extremely powerful software system to run your medical waste and shredding business. From scheduling and routing using Google maps to invoicing and creating manifests, EZshred takes care of the details so you have time to manage and grow your business. Also ask about our Android and Apple smartphone apps, recycling, record storage solutions and cloud services!

2017 G

Geerpres Inc

Muskegon, MI (231) 773-3211 www.geerpres.com

hes Buyers’ Guide COMPANY INDEX

Honua Technologies Honolulu, HI (808) 523-3140 www.honuatech.com

J.V. Manufacturing, Inc Springdale, AR (800) 678-7320 www.jv.com

JT Environmental Consulting

Professional

Atlanta, GA (866) 435-5647 www.gppro.com

Orlando, FL (888) 583-6826 www.jtenv.com

Germ Pro Products

Jake, Connor & Crew Inc

Tampa, FL (800) 966-5367 www.germproproducts.com

Gient Heating Industry Co

Chongqing, China (613) 794-6886 info@gient.cn www.gient.net Gient is China’s leading manufacturer of medical waste treatment systems. We provide smart medical waste treatment solutions with latest technologies and lowest cost. See ad pg 15

GOJO Industries Inc Akron, OH (800) 321-9647 www.gojo.com

Golder Associates Inc solutions@golder.com www.golder.com

Harris

Hubscrub Company

1015 Candia Rd Manchester, NH 03109 (603) 624-4243 Karl Soderquist service@hubscrub.com www.hubscrub.com HUBSCRUB is an automated wheelchair cleaning and disinfection system that eliminates all contamination of C-Diff, CRE and MRSA in 6 minutes - independently tested and verified. Disinfection technology is ultra-violet (UV).

Hygiena

Camarillo, Ca (888) HYGIENA www.hygiena.com

Imec Technologies Inc Champaign, IL (217) 643-7488 www.imec.ie

Implant Recycling

Detroit, MI (877) 446-4544 www.implantrecycling.com

Infection Prevention Technologies, LLC

Cordele, GA (800) 468-5657 www.harrisequip.com

Auburn Hills, MI (800) 359-9855 www.infectionpreventiontechnologies.com

HHA Services

IPS Balers Mfg

St Clair Shores, MI (800) HHA-1140 www.hhaservices.com

The Mark-Costello Co

Addison, TX (800) JANIKING www.janiking.com

15351 Texaco Ave Paramount, CA 90723 (562) 630-7950 www.mark-costello.com Celebrating 57 years of specializing and providing solutions to the most complex situations that have made us the leader in the Waste Handling Equipment, On-Site Medical Waste Sterilization Equipment and Industrial Recycling Equipment in the marketplace. See ad on pg 18

Jedstock Inc

MBM Corporation

Kitchener, ON Canada (877) 565-JAKE (5253) www.jakeconnorandcrew.com

Jani-King International, Inc

Middlesex, NJ (732) 356-7888 www.jedstock.com

North Charleston, SC (800) 223-2508 www.mbmcorp.com

Kessler Consulting Inc Tampa, FL (813) 971-8333 www.kesconsult.com

Kimberly-Clark Professional

Roswell, GA (678) 352-6207 www.kcprofessional.com

L Environmental Solutions Lombard, IL (630) 693-0500 www.liquitech.com

Marathon Equipment Co Vernon, AL (800) 269-7237 www.nexgenbalers.com

McClure Industries, Inc

9051 SE 55th Ave Portland, OR 97206 (503) 777-2821 Kim Michael kim@mcclureindustries.com www.mcclureindustries.com McClure Industries, Inc. manufactures over 80 models of Sanitrux laundry, linen and trash carts. Sanitrux are ASTM-E tested and certified Class II fire retardant and meet or exceed all NFPA fire codes. Sanitrux are specifically designed for the tough commercial environment. See ad on pg 4

Medasend Biomedical Inc Garden Grove, CA (800) 200-3581 www.medasend.com

Baxley, GA

www.ipsbalers.com WINTER 2017

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

2017 M Continued

MedAssure

Farmingdale, NJ (732) 363-7444 www.medassureservices.com

hes Buyers’ Guide COMPANY INDEX

Palmero Health Care Stratford, CT (800) 344-6424 www.palmerohealth.com

Paragon Waste Solutions Medical Waste Management Assoc

3030 N 3rd St, #940 Phoenix, AZ 85012 (602) 621-4007 www.medwasteonline.org Association serving transporters, processors and healthcare professionals responsible for their organization’s disposal of medical and regulated waste. See ad on pg 18

Rolling Meadows, IL (847) 454-0835 www.micro-scientific.com

Natur-Tec®

Circle Pines, MN (763) 404-8700 www.natur-tec.com

Neptune Wash Solutions

Golden, CO (720) 390-3169 www.paragonws.com

Parker Laboratories

F (973) 276-9500 www.parkerlabs.com

PC Scale Inc™

Oxford, PA (800) 962-9264 www.pcscaletower.com

PCM Medical Waste Recycling

Pinellas Park, FL (727) 547-6277 www.pcmmedicalwasterecycling.com

PEAT International Inc Northbrook, IL (847) 559-8567 www.peat.com

Pharma-Cycle Inc

NewWay Global Energy

PHS West Inc

Johnson Creek, WI (920) 988-0686 www.newwayglobal.net

Hanover, MN (888) 639-5438 www.phswest.com

Post Medical Inc

OnSite Sterilization, LLC

Pottstown, PA (610) 495-8214 www.askonsite.com

OZONATOR Industries

Regina, SK Canada (877) 662-7555 www.ozonatorindustries.com 12

Cincinnati, OH (513) 983-1100 www.pg.com

PDI®

Orangeburg, NY (800) 444-6725 www.pdihc.com

Aston, PA (610) 497-1743 www.pyromet999.com

Quest Recycling Services, LLC Frisco, TX (877) 321-1811 www.questrecycling.com

PharmWaste Technologies Inc Urbandale, IA (515) 276-5302 www.pwaste.com

Practice Greenhealth

Reston, VA (888) 688-3332 www.practicegreenhealth.org WINTER 2017

Rehrig Healthcare Systems

3002 Belingham Dr Atlanta, GA 30345 (844) 4-Rehrig (473-4744) cmeissen@rehrig.com www.rehrighealthcare.com Combined with a widely recognized commitment to customer service, Rehrig has become a leading supplier to many of the largest and most innovative companies in the world. Now, Rehrig is applying our expertise in secure reusable injection molded containers to help improve the collection of Regulated Medical Waste (RMW) and Sharps. Our new line of products offers sustainable solutions for both generators and disposal companies alike. See ad on pg 19

Republic Machine

Baltimore, MD 21227 (877) 973-3224 www.redbag.com

Louisville, KY (502) 637-6778 www.republicmachine.com

Red Devil Equipment Co

Resurgent Health and Medical

Plymouth, MN (800) 221-1083 www.reddevilequipment.com

Alpharetta, GA (866) 330-4845 www.postmedical.com

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

Proctor & Gamble

Red Bag Solutions

Newport, RI (617) 755-0883 www.pharma-cycle.com

Louisville, KY (502) 561-3404 www.osmllc.net

Wyoming, MI (616) 893-8243 www.thehipaaman.com

Orangeburg, SC (866) 303-4437 www.neptunewash.com

One Sustainabile Method Recycling LLC

Prime Compliance

Attention

Advertisers !

Now is the time to schedule your 4-color logo/photo listing in next year’s Buyers’ Guide Issue. For more information, contact Rick or Donna Downing at 440-257-6453 or downassoc2@oh.rr.com.

Golden, CO (800) 932-7707 www.resurgenthealth.com

Rochester Silver Works LLC

Rochester, NY (585) 743-1415 www.rochestersilverworks.com

RouteOptix Management Systems Inc Kitchener, ON Canada (866) 926-7849 www.routeoptix.com

Rubbermaid Commercial Products LLC Winchester, VA (540) 667-8700 www.rubbermaidcommercial.com

2017

hes Buyers’ Guide COMPANY INDEX

Safety-Med Products Burlington, WI (866) 421-3400 www.safety-med.com

San-I-Pak, Inc

Tracy, CA (209) 836-2310 www.sanipak.com

sBioMed LLC

Orem, UT (801) 922-1111 www.sbiomed.com

Schaefer Systems International, Inc Charlotte, NC (704) 944-4500 www.ssi-schaefer.us

Scott Distribution LLC DBA Scott Containers Grapevine, TX (817) 756-6909 www.scottcontainers.com

Security Engineered Machinery Co, Inc

Snyder Industries Inc

6940 “0” St Lincoln, NE 68510 (888) 422-8683 info@snyderplasticsolutions.com www.medwastecontainers.com Snyder Medical Waste is a specialty division of Snyder Industries, Inc. and was established in 1957. Snyder’s extensive line of returnable containers is considered the industry standard for the collection and transportation of medical waste. See ad on pg 17

Solid Waste Solutions Corp

Evanston, IL (847) 328-5622 www.solidwastesolutionscorp.com

Largo, FL (540) 520-6341 www.sharpsology.com

Sioux Services LLC

Reading, PA (484) 638-1126 www.siouxservices.com

Spartan Chemical Company, Inc

Surfacide

Maumee, OH (800) 537-8990 www.spartanchemical.com

Sporicidin by Contec, Inc

Solutions Inc

6213 Gheens Mill Rd Jeffersonville, IN 47130 (502) 228-2901 / (812) 288-8644 www.medicalwastecontainers.com Solutions, Inc. is a leading provider of medical waste containers and accessories, in both the domestic and international markets. We provide solutions for waste haulers, hospitals, long-term care facilities, nursing homes, funeral homes, laboratories, clinics, research facilities, etc., by supplying our customers unlimited medical waste handling solutions with our large variety of containers, including medical waste containers, and all-purpose containers. See ad on pg 6

Naperville, IL (630) 861-9000 www.surfacide.com

Spartanburg, SC (800) 762-3472 www.sporicidin.com

SRI Surgical

Tampa, FL (813) 891-9550 www.srisurgical.com

Tecni-Quip Carts

Farmington Hills, MI (855) 783-7463 www.sterimedsystems.com

960 Crossroads Blvd Seguin, TX 78155 (800) 826 1245 Jobeth Reilly tqcarts@tqind.com www.tqind.com Tecni-Quip Carts is a manufacturer of durable carts engineered to withstand the stress of transporting waste, biohazardous waste and soiled linen in any situation. All models are extremely durable and will last for years. Custom fabrication for any situation and in ANY quantity is available. Choice of fabrication and Aluminum. Standard features include: Variety of sizes, bumpers, fire retardant properties, equipped with large superior casters and wheels for any type of surface. Friendly and knowledgeable customer service. See ad on pg 17

Steris Corporation

TL Services, Inc

Stericycle

Lake Forest, IL (847) 367-5910 www.stericycle.com

Sterilis Medical Corporation

Rochester, NY (855) 882-2013 www.steriliz.us

Cambridge, ON Canada (800) 465-3214 www.shred-tech.com

Sharpsology

San Jose, CA (866) 476-9493 www.sunwize.com

Steriliz, LLC

Shred-Tech

Tarpon Springs, FL (727) 940-5872 www.wastealliance.net

SunWize Technologies Inc

Plaistow, NH (570) 371-8464 www.sorb-tech.com

Boxborough, MA (508) 875-1070 www.sterilismedical.com

Westboro, MA (800) 225-9293 www.semshred.com

Sharps MD

SorbTech Mfg, Inc

SteriMed Medical Waste Solutions Inc

Mentor, OH (440) 354-2600 www.steris.com

Toter Inc

STI Biosafe

Indianapolis, IN (317) 858-8099 www.stibiosafe.com

Statesville, NC (800) 424-0422 www.toter.com

TRU-D LLC

Stryker (269) 385-2600 www.stryker.com WINTER 2017

Van Buren, AR (877) 474-7227 www.tlservices.com

Memphis, TN (800) 774 5799 www.tru-d.com

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

2017 T Continued

TSK Products

Eatontown, NJ (732) 982-1090 www.tsk-products.com

hes Buyers’ Guide COMPANY INDEX

UVAIRx Inc

Vertisa

Centennial, CO (303) 327-5355 www.uvairx.com

Orlando, FL (407) 852-8277 www.medicalwastetechnology.com

Visionary Solutions LLC

Vaportek Inc

UltraClenz Jupiter, F

Knoxville, TX (865) 482-8670 www.vs-llc.com

Sussex, WI (800) 237-6367 www.vaportek.com

Vital Vio

www.ultraclenz.com

Troy, NY (518) 268-1101 www.vitalvio.com

UltraTech International Jacksonville, FL (800) 764-9563 www.spillcontainment.com

Walsh Integrated

UltraViolet Devices, Inc Valencia, CA (661) 295-8140 www.uvdi.com

UniFirst Corporation Wilmington, MA (800) 455-7654

United DMS of Tennessee LLC Knoxville, TN (865) 637-2560 www.uniteddms.com

UNTHA America

Hampton, NH (603) 601-2304 www.untha-america.com

Vecoplan LLC

PO Box 7224 High Point, NC 27264 (336) 861-6070 Bob Gilmore info@vecoplanllc.com www.vecoplanllc.com Vecoplan engineers, manufactures, and provides parts and service on a range of shredders and systems for processing medical waste, destroying confidential records, and recycling scrap. An integral component in turnkey waste sterilization systems, our machines are used to shred sharps, textiles, plastics, and for red bag processing. AAA NAID compliant for secure destruction of paper, film, disks, and hard drives. See ad on pg 16

Montreal, Que Canada (514) 595-8500 www.walshintegrated.com

WEIMA America, Inc Fort Mill, SC (888) 440-7170 www.weimaamerica.com

West Industries

Baton Rouge, LA (225) 302-5570 www.westindustries.com

Wexford Labs

Kirkwood, MO (800) 506-1146 www.wexfordlabs.com

Whitaker Brothers

Rockville, MD (800) 243-9226 www.whitakerbrothers.com

Xenex Healthcare Services LLC San Antonio, TX (800) 553-0069 www.xenex.com

Xpedx

Loveland, OH (888) 973-3976 www.xpedx.com

ZeroWaste Energy Systems Kleinburg, ON Canada www.zwes.ca

Zorbx

Strongsville, OH (800) 201-5530 www.zorbx.com

Attention Advertisers ! Now is the time to schedule your 4-color logo/photo listing in next year’s Buyers’ Guide Issue. For more information, contact Rick or Donna Downing at 440-257-6453 or downassoc2@oh.rr.com.

MedPac Proposes Streamlining of Hospital Quality Programs

ccording to ModernHealthcare.com, the Medicare Payment Advisory Commission (MedPac) is moving toward streamlined, patient-centric quality reporting requirements that are tied to government reimbursements to hospitals. The changes MedPac plans to propose to Congress next spring include eliminating the Inpatient Quality Reporting Program and the Hospital Acquired Condition Reduction Program. The commission also is asking Congress to merge the Hospital Readmissions Reduction Program and the Hospital Value-Based Purchasing Program into a new program, the Hospital Value Incentive Program. The Hospital Value Incentive Program would score hospitals based on readmissions, mortality and spending rates as well as patient experience while in care. In addition, it would create peer groups to compare hospitals based on the needs of their patients. The proposed value incentive program still withholds two percent of hospitals’ Medicare reimbursements, but hospitals that do better than others in their peer group receive bonuses over and above withheld

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

WINTER 2017

reimbursements. Hospitals performing poorly receive back less than was withheld from them. In a move to support hospitals that are working hard to improve infection control, MedPac’s new hospital quality model removes financial accountability for infections that patients develop while under their care. For fiscal 2017, Centers for Medicare and Medicaid Services (CMS) reports that 769 hospitals with the highest rates of hospitalacquired conditions had their Medicare payments cut. According to The Association of American Medical Colleges, hospitals lost an estimated $430 million from Medicare payment cuts, up 18 percent from the prior fiscal year. Under CMS’ Hospital Readmissions Reduction Program, hospitals face $564 million in readmission penalties next year. That’s up $27 million from the current fiscal year. Meanwhile, to address concerns over the accuracy of its quality program evaluations, CMS plans to launch a pilot that uses clinical data from patients’ electronic health records as well as Medicare claims data.

News Briefs

VA Hospitals Sail Upwind on Patient Safety Measures

ashington – Many Veterans Administration Medical Centers (VAMC) continue to face challenges in achieving efficiency, patient safety and satisfaction measures, according to its internal tracking program. The VA’s Strategic Alliance for Improvement and Learning, or SAIL, uses a five-star ranking scale, with one being the worst and five being the best. Results for 2016, the most recent year released, show that hospitals in Tennessee at Nashville, Murfreesboro, and Memphis scoring one-star rankings. The Phoenix, Arizona facility, where veterans had died waiting for care in 2014, also received one star. Two Texas hospitals at El Paso and Big Spring and the Loma Linda and Fresno hospitals in California received two-star rankings for the second year in a row. Overall, 64 percent (94 out of 146) of the hospitals showed better results than the previous year. Hospitals in Columbus and Cleveland, Ohio received the highest scores, as did those in Fargo, South Dakota, and those in Erie, Butler and Pittsburgh, Pennsylvania, and Minneapolis, Minnesota. According to the VA website, SAIL employs key metrics used by the private sector, as well as additional metrics including access to care, quality of mental health care, employee perception about the organization, nursing turnover and efficiency. SAIL was developed for the VA to drive internal system-wide improvement by identifying and measuring actionable areas of healthcare delivery and quality. These metrics set the VA system apart from other hospitals and systems, which do not report the results to the public or use them in the same way.

UCSF Researchers Use Patient Data to Study C. diff Infection Outbreaks

an Francisco, CA – Using time and location stamps, which are part of patient electronic health records (EHR), researchers traced the spread of Clostridium difficile (C. diff) throughout a hospital, according to a UCSF.edu article. The University of California San Francisco Health Informatics Team mined an enormous amount of data from the EHRs of more than 85,000 individuals who were patients at UCSF Medical Center at Parnassus between 2013 and 2016. Mapping 435,000 patient location changes throughout the Medical Center, they then compared rates of C. diff infection in patients who were exposed to C. diff with rates for patients who passed through the same areas over the next two months – when the area had not been recently used by a patient with C. diff. The study turned up a CT scanner in the Emergency Department that had been a significant source of exposure-related infections. Patients who entered the scanner within 24 hours after C. diff-positive patients were more than twice as likely to become infected with the bacterium themselves. Four percent of the patients who were considered exposed in the scanner contracted C. diff within two months. The overall rate of infection for patients who passed through the scanner was 1.6 percent. The data enabled the hospital to move swiftly to standardize the cleaning practices across all radiology suites. In the three years under review, no other sites at the hospital raised concerns regarding C. diff transmission. The study findings were published in the Oct. 23, 2017, issue of JAMA Internal Medicine.

Target your products, equipment and services to more than 5,000 healthcare facilities and medical waste contractors throughout the U.S. ... Advertise in HES! call Today 440-257-6453

www.gient.net

info@gient.cn WINTER 2017

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

News Briefs

Superbug Treatment: It’s in our Interferons

n alternative treatment for sepsis, urinary tract infections and pneumonia may exist in the body’s own immune system, according to study findings published in PLOS Pathogens Journal. Researchers at Queen’s University Belfast and University of Vienna conducted an experiment in mice which they observed immune cells (interferons, or IFNs) arriving at the site of infection communicate and join forces to eradicate antibacterial-resistant Klebsiella pneumoniae. The study suggests that manipulating levels of Type I IFN or IFN-y might represent a valid strategy for treatment of drug-resistant Klebsiella infections. By targeting the immune system, rather than the pathogen itself, the use of antibiotics could be minimized. Although K. pneumoniae has been known to cause serious infection primarily in immunocompromised individuals, hypervirulent strains that have emerged in recent years can affect not only people susceptible to infections but also those who are healthy and immunosufficient. An unprecedented, and highly publicized outbreak of Klebsiella-related infections that occurred in 2014 in a British hospital raised awareness and forced hospitals to take preventive action. This year, the World Health Organization added Klebsiella to its priority list of multidrug resistant Enterobacteriaceae for research and development of new antibiotics.

Drugs from Carbon Monoxide?

ccording to a CosmosMagazine.com article, scientists from Peoples’ Friendship University of Russia (RUDN) in Moscow have developed a new method that could disrupt the pharmaceutical industry. RUDN scientists are experimenting with a new chemical engineering technique that uses carbon monoxide (CO) as the key agent. Except for protein-based drugs, the most common building block for making pharmaceuticals tends to be molecules that contain nitrogen atomshEs bound to carbon (amines). To create these carbon-nitrogen bonds, a reaction called reductive 2017 News amination is used to remove the oxygen atom and form a new bond. Most commonly, hydrogen is the reducing agent. But the RUDN University team has been experimenting with using carbon monoxide gas instead of hydrogen. The team found that the key to using CO as the reducing agent in the reactions was to find the right catalyst. Initially they focused on catalysts based on the metal iridium. Because the reaction requires high temperatures and high pressures to work well, more study is required. If the scientists can find an efficient method, however, carbon monoxide could drive new drug development.

Ohio Hospitals Reduce Sepsis Mortality

he cost of sepsis runs high – thousands of lost lives and $24 billion in U.S. healthcare costs annually. But Ohio hospitals are successfully reducing sepsis mortality, an InfectionControlToday.com article reports. In Ohio, where sepsis costs have run as high as $6 million a year, hospitals, emergency medical service providers, home caregivers, and community partners have joined to raise awareness and ensure timely clinical care. The Ohio Hospitals Association (OHA) launched an initiative in 2015 that has saved 1,486 lives – a 13.4 percent reduction in sepsis mortality. The Surviving Sepsis Campaign includes quarterly progress reports, access to monthly evidence-based educational and coaching calls, and other resources and support at no cost. Few U.S. adults know the signs of sepsis. The illness typically begins to present at home, beyond the walls of hospitals, where it goes unrecognized until too late. To increase awareness, last year the OHA launched a community partners campaign with OHA member hospitals and providers throughout the continuum of care – from EMTs and home health providers, to hospital ERs, to long-term care facilities.

Vecoplan’s Universal Shredders Pull Double Duty! IT’S A MEDICAL WASTE SHREDDER...

• Vecoplan has years of med-waste experience developing systems used in hospitals world wide for red bag processing • Use as the first or last step in your med-waste treatment system • Shreds sharps and other tough materials • Shreds to an unrecognizable consistency • Turnkey medical waste sterilization systems

...AND A SECURE DESTRUCTION SHREDDER...

Large Hopper Hydraulic Ram Auto-Feeds Material to the Cutting Rotor

Low Speed, High Torque Single Cutting Rotor Consistently Sized, Unrecognizeable Particles

• The same Vecoplan med-waste shredders have also been used for years for confidential data destruction. • Gain control of HIPAA compliance and costs by “in house” destruction of records, disks, drives and other media • Vecoplan shredders are AAA NAID compliant • Vecoplan shredders are currently being used in hundreds of secure destruction operations

Mind Reader Logic Controls Adjust Material Feed, Ram Direction and Feed Speeds

Phone: (336) 447-3565

www.vecoplanllc.com vecoplanllc.com

5708 Uwharrie Road • Archdale, NC 27263

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

WINTER 2017

...ALL IN ONE!

News Briefs

CDC Study Links C. diff Infection with Overall Antibiotic Use in U.S. Hospitals

When Healthcare Workers Come to Work Sick

ising numbers of healthcare professionals (HCP) who work while experiencing influenza-like illness (ILI) are putting patients at risk, according to survey findings published in November issue of the American Journal of Infection Control. The Centers for Disease Control and Prevention (CDC) recommends that healthcare professionals infected with ILI not go to work until they have not had a fever for at least 24 hours. Despite this recommendation, CDC research shows that HCP often continue to work when they are sick. During the 2014-2015 influenza season, a study team from CDC’s National Institute for Occupational Safety and Health collected information using a national nonprobability Internet panel survey. Of 1,914 respondents, forty percent self-reported working while they were sick. The most common reasons cited included believing they could still do their job duties or they weren’t feeling bad enough to miss work. Many of the workers did not believe they were contagious. Others reported they felt obligated to coworkers, or had difficulty in finding someone to cover their responsibilities. Missing work also raised concerns about losing pay, particularly in long-term care facilities. Pharmacists and physicians had the highest frequency of working while experiencing ILI, closely followed by assistants, aides and other clinical personnel, and to a lesser degree, by nontechnical personnel. Presenteeism was most prevalent in hospitals. During the 2014-2015 influenza season, an average of 66.1 deaths per 100,000 individuals occurred. An estimated 19.1 million persons with influenza illness sought medical care and 974,000 persons were hospitalized in US health care settings. The CDC recommends annual vaccination against seasonal influenza for all health care personnel (HCP), but the survey showed that the number of clinical personnel receiving vaccinations was slightly below the standard set by the World Health Organization. The CDC researchers hope that further study will lead to positive changes in perceptions and beliefs about working while sick, as well as new staffing and sick leave policies.

The Med-Tainer™ 10 and 17 Gallon Single Deposit Containers are versatile, “Point of Use”, reusable medical waste containers. These sharps containers offer high volume capacity for needles, lab waste, IV bags, and tubing keeping waste collection costs at a minimum. • FDA 510(k) clearance. • US DOT Marking for transportation of regulated medical waste. • OSHA Markings: Compliant with OSHA Exposure Control Plan (when supplied with decal).

Nest empty containers for return shipment and reuse.

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View our entire line of medical waste containers at:

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WORKHORSE

THE

an Diego, CA – Findings of a seven-year study showed that overall inpatient antibiotic use correlated with increased rates of hospital-onset Clostridium difficile infection (HO-CDI), according to ResearchGate.net. Researchers from CDC’s Division of Healthcare Quality Promotion looked at patient discharge and inpatient treatment with metronidazole or oral vancomycin at 552 acute care hospitals from January 1, 2006 to December 31, 2012. They collected data from the Truven Health MarketScan Hospital Database. The findings, which were presented at the 2017 IDWeek suggest that reducing overall antibiotic can reduce hospital-onset Clostridium difficile infections (HO-CDI). Limiting administration of broad-spectrum antibiotics, such as fluoroquinolones, cephalosporins and carbapenems appears to be an effective strategy. This contrasts with British studies, where only third- and fourth-generation cephalosporins and carbapenems were associated with C. diff epidemics in hospitals and restricted use was a successful strategy. According to the study’s lead investigator, fluoroquinolone decreased significantly between 2006 and 2012, while the use of other high-risk antibiotics, such as third- and fourth-generation cephalosporins and carbapenems, increased. Hospitals that decreased use of third- and fourthgeneration cephalosporins, fluoroquinolones, or overall antibiotic use by 30 percent or greater, achieved a significant reduction in HOCDI. The study findings were presented at the 2017 IDWeek in San Diego in October.

Med-Tainer™ Single Deposit Containers

for Medical Waste

YOUR CHOICE OF FIBERGLASS, ALUMINUM OR STAINLESS ALL MODELS ARE DURABLE & FIRE RETARDANT!

TQ-400 Enclosed Models • 6 Sizes 36 to 90 Cubic Feet Capacity

• SUPER Quiet Wheels & EZ to push! • EVS Collection Carts for Waste, Soiled Linen, Recycling & Bio Boxes • Meets Joint Commission • Designed and Approved for Medical Waste Handling • Variety of Models & Sizes to meet your needs 100%

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WINTER 2017

Bio-Box Models • Built to Customers Requirements

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

News Briefs

Medical Waste Sterilization Systems The Mark-Costello Company

60 Years

Do you know how, where and by whom your waste is actually being treated? √ Transporting untreated medical waste can be hazardous, risky and very costly.

ON SITE Treatment

with our rugged, fully insulated autoclaves; offering a cost efficient, economical solution for treating medical waste.

(562) 630-7950 15351 Texaco Avenue Paramount, CA 90723

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ertified nurse assistants who wear gloves, but fail to change between patients may be causing more harm than good, according to a study published in the September issue of the American Journal of Infection Control. Researchers who observed healthcare providers (HCP), such as Certified Nursing Assistants, found that such “inappropriate” glove use leads to numerous contaminated touch points, particularly when contact with secretions and excretions is high, such as during perineal care and toileting assistance. The study, conducted at a long-term care facility focused on frequency of inappropriate glove use using a validated glove use surveillance (GUST) tool. The process entailed recording types of surfaces, the sequence in which the glove wearers touched surfaces during a patient care event, whether they wore gloves, and whether they changed gloves. Gloves were readily available on all units in public areas, shower rooms, patient rooms, and patient bathrooms to enhance availability and workflow. The facility’s policies and procedures for toileting or perineal care followed Centers for Medicare and Medicaid Services and the CDC/World Health Organization guidance for hand hygiene and glove use during standard precautions. Emphasizing that glove use behavior is as important as hand washing in infection prevention, the study’s lead author concluded that glove use behavior should be monitored alongside hand hygiene and that observations should be shared with staff to improve behaviors and reduce the risk of disease transmission.

NA M O S R

HV ILLE

LIVE F

April 13-15, 2018

Failure to Change Gloves Increases HAI Risk to Patients

The Power of Performance With the medical waste management industry constantly changing, industry professionals need new skills, new information, new tactics and new strategies to grow and succeed. Invest in yourself and your company by attending the 2018 Medical Waste Conference.

www.medwasteonline.org/events | #MWMA2018 All attendees also have access to NAID 2018 Conference & Expo. Take the opportunity to learn more about the secure data destruction industry. *Discount is based off of full registration rate. Discount will already be applied for online registration.

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

WINTER 2017

INCREASED CYCLES FOR MORE SAVINGS

DECREASED NEEDLESTICKS

INCREASE WASTE DIVERSION

GREATER COLLECTION EFFICIENCY

Through focus groups in hospitals and with processors, we developed a full line of Reusable Medical Waste and Sharps Containers for the industry. In addition to the containers, we have also developed wash systems, automation and accessories to support your customers’ needs. Our RMW Containers are up to 49% more efficient in transportation and up to 13% more efficient for waste collection. Our Reusable Sharps Containers are FDA tested for up to 600 cycles as compared to single-use disposable sharps containers. These Sharps Containers are up to 60% more efficient in waste collection than to comparable containers.

WINTER 2017

Rehrig Healthcare Systems 3002 Belingham Drive Atlanta, GA 30345 844-473-4744 www.rehrighealthcare.com

HEALTHCARE ENVIRONMENTAL SOLUTIONS news

Formerly Medical Waste Management

healthcare

Environmental solutionsnews

6075 Hopkins Road • Mentor, OH 44060

PRSRT STD

Ph: 440-257-6453 • Fax: 440-257-6459 Email: downassoc2@oh.rr.com

Cleveland, OH Permit #1737

Covering Infection prevention, medical waste management & sustainable practices

VOL. XIII NO. 4

WINTER 2017