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This work was supported by the . Army Medical Research and Materiel Command under Contract No. W86XWH-57-C-5558. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the . Army Medical Research Acquisition Activity.

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How they did it: The vascular access, performance improvement, and infection-prevention teams were first enlisted to develop a campaign to increase awareness, educate, and reduce harm to their patients. A key strategy was to enable clinicians and nonclinicians to recognize that they play an instrumental role in the prevention of infections.

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Education and product changes were made. Medline Remedy advanced skin-care products [were used] on all floors, and hospitals began use of Ultrasorb dry flow pads. Berry described some of the educational changes: mandatory requirement of all nursing staff to complete three pressure-ulcer prevention modules on Medline University, Medline’s free online education resource ( ) measurement and documentation of wounds, wound management, and prevention of pressure ulcers new nurse orientation that includes a 6-hour lecture on pressure-ulcer prevention, given by a wound nurse a skin-and-wound quick reference guide.

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For PIVs only, during the 68-month pre-intervention period, the BSI rate was per 655 patient-days. During the 68-month post-intervention period, the BSI rate dropped to per 655 patient-days, a 56% reduction (P=).

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The presence of ATP on the surface indicates that it has not been adequately cleaned. The primary purpose of cleaning is to remove product residue for product contact surfaces. Effective cleaning simultaneously removes the material capable of supporting microbial survival and growth, as well as many of the microbes themselves. The technology behind ATP systems has been changing quite rapidly over the past few years and now there are ATP systems that can run tests specifically for microorganisms.

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Ideally the devices would be activated and plated as soon as possible. The bacteria will begin growing as soon as they come into contact with the media (upon activation of the device), which may affect results as time passes before plating. If for some reason you cannot plate immediately (., transporting to laboratory) then the devices should be refrigerated to preserve the sample and inhibit bacterial growth.