Erase Pathogens™ R

CLEAN LIKE LIVES DEPEND ON IT. Facts About Hospital-Associated Infections (HAIs): Causes, Cost and Outcomes

1 in 25 1.7 MILLION Patients in U.S. hospitals Approximately 1.7 million HAIs occur have at least one HAI 1 in U.S. hospitals each year 2

HAIs: 99,000 Breast cancer: 41,400

Prostate: 29,430 UP TO $45 BILLION HAIs kill more people in the U.S. than Average amount spent annually breast cancer and prostate cancer combined 2,3 on HAIs by acute-care hospitals 4

30% 72% of healthcare workers adequately of hospital floor sites tested comply with hand hygiene practices 5 positive for C. difficile 6

<50% 2.5x Multiple studies have shown that less A previously infected patient than half of hospital room surfaces are increases the next patient’s risk adequately cleaned and disinfected 7 of contracting C. diff by 2.5x 8

2 MEDLINE The EVS struggle is real.

There are a lot of external factors that Environmental Services (EVS) has to deal with on a daily basis. Many of these concerns create roadblocks to infection prevention initiatives. HFM Magazine published the results of a survey aimed at documenting the top concerns of EVS workers. Here are a few that topped the list:

The Challenges:

1. Pressure to expedite room turns. 42% of hospital staff feels under pressure to expedite room turns for incoming patients, making it difficult to clean and disinfect the patient environment adequately.9

2. Assigned responsibility to clean mobile objects. 41% of hospital staff expressed concern over who in the hospital should be cleaning mobile objects. It isn’t uncommon for nursing and environmental services (EVS) to both assume that the other function is cleaning certain objects, and often surfaces such as IV poles and Workstations on Wheels get skipped entirely.

3. High turnover in EVS. 25% of hospital staff is concerned about the high turnover in EVS and the impact on infection prevention. In general, EVS can be a high turnover department and frequently understaffed and under budgeted, making maintaining effective cleaning even more challenging.

4. No standard practice. 20% of hospital staff is concerned about the lack of objective standards. Facilities often struggle with maintaining adequate cleaning protocols, inconsistent staff compliance with protocols and the need to quickly turn over patient rooms.

5. Lack of knowledge in the role of the environment in cross contamination and transmission. 20% of hospital staff have concerns about this, and rightfully so. Just one contaminated bedrail or doorknob can transmit infectious organisms throughout the hospital within hours. The result: patients constantly at risk.10 In addition, C. difficile, MRSA, VRE and other germs can survive for months on surfaces. Without regular and effective surface disinfection, these pathogens can be a continuous source of transmission to vulnerable patients.11

To help break the chain of infection, surface cleaning and disinfection is one of your first lines of defense.

1-800-MEDLINE (633-5463) | medline.com 3 Tackling the problem. Clear-cut guidelines on how to solve surface contamination don’t exist. That’s why we’ve worked with experts nation-wide to develop a comprehensive surface cleaning and disinfection system. It combines process with evidence-based products and education to help decrease the spread of HAIs.

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4 MEDLINE Helping you do the right thing. Our bundle approach helps you create and maintain a successful cleaning and disinfection program.

First we examine your current protocols. We observe cleaning practices, DISCOVERY evaluate appropriateness of products and perform ATP swabbing to ASSESSMENT quantitatively measure cleanliness. Once complete, you’ll receive specific recommendations to address identified problem areas.

CLEANING EVIDENCE-BASED STAFF PROCESS PRODUCTS EDUCATION

Our Clean by Sequence™ method You choose the right mix of You can access a variety of with numbered microfiber products—evidence-based online and onsite training booklets guide your staff from with quick kill times—to materials to help staff improve surface to surface, so nothing is satisfy the specific needs their skills. missed and cross contamination of your facility. is minimized.

Periodic reviews using ATP testing provide you with data to track OUTCOMES improvements and correct weak spots. Engineered for healthcare, our REPORTING ATP system has patented samplers for covering large areas quickly, data reporting based on CDC recommendations and a full-color display.

To minimize the potential for HAIs, proper cleaning techniques followed by use of the right disinfectants are important weapons in the battle.6

1-800-MEDLINE (633-5463) | medline.com 5 CLEANING PROCESS

Clean by Sequence.™ The CDC recognized 17 different high-touch surfaces that are most vulnerable to the spread of pathogens. Giving your staff a step-by-step system helps ensure thoroughness and consistency. Our clean by sequence process uses a numbered microfiber booklet and “hot spot” map, making it easy to train, implement and follow. The result—optimal cleaning, 5 enhanced outcomes and reduced throughput times. 3a 4 3b PATIENT ROOM 2 1. Door Knob/ Light Switch 6 1 2. Bedside Table Handles/Phone 1 1

3. Call Button 1 7 4. Tray Table

5a. Left Bed Rails

5b 5b. Right Bed Rails

6a. Chair 2 5a 3 6b. Chair 4

7. Room Sink 2

RESTROOM 1. Door Knob/ Light Switch

2. Restroom Sink

3a. Handrails 6a 6b

3b. Handrails

4. Bedpan Cleaner

5. Toilet Flush Handle

6. Toilet Seat

6 MEDLINE Developed using national standards REUSABLE CLEAN from the CDC, AHRQ, APIC and other BY SEQUENCE™ professional associations. MICROFIBER BOOKLETS

Housekeeping staff often use the same cloth to clean the whole room—a cross contamination risk. Our numbered microfiber 5 booklets ensure a separate cloth 3a is used for each surface and no 4 3b surface is missed. They come in three colors: blue for the patient 2 room, orange for restroom use, and purple for other discharge 6 room surfaces and ancillary 1 areas of the hospital. 1 1 7 1 5 7 1 Cleaning Order Surface to Clean

2 5a 3 4 POINT-OF-CARE DEVICES Mobile and shared patient 2 equipment are often overlooked in cleaning protocols. Presaturated disinfectant wipes are an easy way to make sure these devices are frequently disinfected by caregivers.

FLOORS Mop all floor surfaces with a OTHER DISCHARGE 6a 6b micofiber mop, starting farthest ROOM SURFACES from the door and moving towards Counters Standard the door. Use a new mop when room cleaning the bathroom to avoid Fixtures cross contamination. A floor-safe equipment Walls disinfectant with a low contact Bed time is considered best practice Dressers Other instead of a general cleaner without Trash cans disinfection properties.

1-800-MEDLINE (633-5463) | medline.com 7 EVIDENCE-BASED PRODUCTS

Zero in on germs.

Our products give you a powerful weapon Cloths and Mops

in the battle against HAI causing pathogens: Microfiber Super Mop To get access to all the benefits of the ERASE Pathogens program, MDT217741B and MDT217741ORB Dense microfibers pick up choose from a selection of top-tier infection prevention products. and lock in dirt so it doesn’t get pushed around. Required Products: Two out of the four following categories must be purchased to get access to ERASE Pathogens.

Germicidal Wipes Disinfectant Solutions Disinfection Systems

Micro-Kill Bleach Micro-Kill Q3 Concentrated Disinfectant, Cleaner & SolarisTM Lytbot UV Light Germicidal Bleach Wipes Deodorizer EVSCHEM110 Disinfection System EVSSL001 MSC351400AN, MSC351410AN This dispensed disinfectant kills a broad spectrum High energy pulsed UV light and MSC351450AN of microbes, including HIV-1, Hepatitis B, MRSA, VRE leads to micro-organism Kills C. difficile spores and and Rotavirus. The Medline dispenser and metering disintegration, meaning other pathogens. tip in the bottle ensure accurate dilution every time. Solaris Lytbot quickly and Micro-Kill™ One dependably eliminates the Micro-Kill NQ5 EVSCHEM215 MSC351300 and MSC351310 most stubborn pathogens This dispensed disinfectant has a neutral pH and Kills Mycobacterium bovis, from high-risk areas. It low 5-minute contact time. Ideal for use on floors Norovirus, Poliovirus, MRSA, features 360-degree rotation where a low contact time is needed. VRE and more—in one minute. to cover the whole room, as BruTab 6S Disinfectant Tablets BRI1612018N well as three- and five-minute Non bleach disinfectant effective against a broad range cycles that are 15–40% faster of microorganisms including C. difficile. than competitors.

Complementary Products: While not required to gain access to the program, the below products are recommended for a complete infection protection practice.

Exam Gloves Spectrum Advanced Hand Sanitizers Cleaning Validation Tool

Glide-On Powder-Free Gel Pocket Size: 2oz HH70G02, 4oz HH70G04 AccuPoint ATP Sanitation Vinyl Exam Gloves GLIDE511 Gel Table Top: 15oz HH70G15 Monitoring System Meter Enhanced donning technology Contains 70% Ethyl Alcohol, aloe and Vitamin E EVSATPSYSTEM to help don on to hands easier. to get hands clean and smooth. Offers reliable results and documents cleanliness FitGuard Touch Powder-Free Foam Table Top: 7.5oz HH70F75, 18oz HH70F18 levels of your facility. Nitrile Exam Gloves FG3000 Contains 70% Ethyl Alcohol and moisturizers Durable nitrile protection and to help reduce dry skin. AccuPoint ATP Sanitation textured fingertips for Monitoring System Wipes To Go: 20 Pack MSC350320 enhanced grip. Samplers EVSATP9905 Wipes Table Top: 50ct HH70W50, 160ct HH70W160 Sanitation monitoring made On-the-go hand sanitizing wipes kill germs simple with the easy-to-use and bacteria. AccuPoint® HC.

8 MEDLINE Our patent-pending Clean by Sequence™ Microfiber Booklets are designed with the following goals: » Increase compliance in cleaning CDC high-touch surfaces » Reduce cross-contamination by assigning each surface to a separate page » Reduce room turnover time » Increase HCAHP scores

A variety of different colored booklets are available to signal to the patient that the cloths have been changed. Purchasing a blue patient room booklet and an orange patient restroom booklet are required components of the program.

Cloths

Reusable Clean by Sequence™ Microfiber Booklets MDT217690, MDT217691 and MDT217692 Icons are placed on each page of the booklets to represent the CDC high touch surfaces. » Blue booklets for patient room surfaces » Orange booklets for patient bathroom surfaces » Purple booklet (numbered, no icons) for additional discharge surfaces and cleaning ancillary areas of the hospital

1-800-MEDLINE (633-5463) | medline.com 9 STAFF EDUCATION

Add to Their Skills.

Continual training delivers continual improvement. We emphasize a thorough training curriculum that includes both initial and ongoing education for all staff.

Online Education Medline University® gives your housekeeping and nursing staff 24/7 access to the ERASE PATHOGENS course. Topics covered include:

»»Clean-by-sequence process and how to correctly perform each step »»How disinfectants work and why contact times are important »»Specialty cleaning procedures »»Scripting for occupied rooms »»Interactive quizzes to confirm learning and competence »»Nursing and management education

Kudos and Recognition Inspire the best from your clean team with customizable certificates and bulletin board shoutouts.

10 MEDLINE References: 1. Magill, S.S., et al. Multistate Point-Prevalence Survey of Health Care-Associated Infections. The New England Journal of Medicine: https://www.nejm.org/doi/pdf/10.1056/NEJMoa1306801. 2. Klevens, RM, et al. Public Health Reports. 2007; 122:160-166. Available at: https://www.ncbi.nlm. nih.gov/pmc/articles/PMC1820440/. 3. Cancer Facts & Figures 2018. American Cancer Society. Available at: http://www.cancer.org/ research/cancerfactsstatistics/cancerfactsfigures2015/ Accessed January 21,, 2019. 4. The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. Centers for Disease Control and Prevention: https://www.cdc.gov/hai/pdfs/hai/ scott_costpaper.pdf. 5 . Healthcare Worker Hand-Washing Compliance Remains Frustratingly Low. Safe Patient Project, Consumers Union: https://safepatientproject.org/posts/4569-health-care-worker-handwashing-compliance-remains-frustratingly-low. 6. Desphande, A. et al. Are Hospital Floors an Underappreciated Reservoir for Transmission of Clostridium Difficile and Methicillin-Resistant Staphylococcus Aureus? Available at: https://www.researchgate.net/publication/313301242_1647. Are_Hospital_Floors_an_ Underappreciated_Reservoir_for_Transmission_of_Clostridium_difficile_and_Methicillin- Resistant_Staphylococcus_aureus. 7.. Just because you are using a disinfectant, doesn’t mean you are disinfecting: The business case for improving infection prevention. Becker’s Clinical Leadership and Infection Control: https:// www.beckershospitalreview.com/quality/just-because-you-are-using-a-disinfectant-doesn-t- mean-you-are-disinfecting-the-business-case-for-improving-infection-prevention.html. 8. Chemaly, RF, Simmons S, Dale C, et al. The role of the healthcare environment in the spread of multidrug-resistant organisms: update on current best practices for containment. Therapeutic Advances in Infectious Disease. 2014;2(3-4):79-90. doi:10.1177/204993611454328 7. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250270/. 9. Based on lab testing—reports available upon request. 10. Pyrek KM. What’s on That Surface? Current Thought on Microbial Load on Surfaces, Pathogen Persistence, Cleaning Best Practices. October 2014. Available at: http://sd.infectioncontroltoday. com/digital-issues/2014/10/whats-on-that-surface.aspx. Accessed July 18, 2016. 11. Kramer A, Schwebke I, Kampf G. How Long Do Nosocomial Pathogens Persist on Inanimate Surfaces? A Systematic Review. BMC Infectious Diseases. 2006; 6:130. Available at: http://www. ncbi.nlm.nih.gov/pmc/articles/PMC1564025/pdf/1471-2334-6-130.pdf. Accessed July 18, 2016.

Bring our ERASE PATHOGENS Comprehensive Cleaning System into your organization. Contact your Medline Representative for more information or go to medline.com.

Targeted Training Materials Based on ATP testing, we provide customized huddle sheets and other tools to close any identified 1 gaps in practice. High-Touch Surface: Toilet Seat Bodily fluids, which may contain dangerous germs, often contaminate the toilet seat. Germs spread by touch, and the toilet seat touches the skin ofNOTE: many Make people certain that in a day. BecauseHigh-Touch just one gram Surface: of human feces can contain one trillionall surfaces germs, stay wet for it’s extremelyTray important Table to clean the entire toilet seat thoroughly. the full contact time. Tray tables are one of the germiest surfaces1 in a patient’s room. They are also one of the most ignored during cleaning. Why? One reason is that they almost always High-Touch Surface: Whathave to do personal items on them. Another reason is that permission from the patient 1. Firstis needed wipe down to move the their lid. Once belongings. complete, This lift can if feel up. uncomfortable—especially if the Toilet Seat patient is resting. 2. Wipe down the top of the toilet seat. Then flip it Bodily fluids, which may contain dangerousup and cleangerms, the often underside. contaminate the toilet seat. Germs spread by touch, and theBecause toilet seat germs touches spread1-800-MEDLINE the byskin touch of many and peoplepatients use tray(633-5463) tables for keeping | things medline.com 11 handy and eating meals, it’s veryNOTE: important Make certain to clean that them thoroughly. in a day. Because just one gram of3. humanNext, feces lift the can toilet contain seat one up trillion andall surfaces wipe germs, down stay wet the for rim of the toilet bowl. it’s extremely important to clean theBe entire sure toilet to cover seat thoroughly. the inside edgethe full up contact to where time. it turns into the bowl.

4. If necessary, use more than one cloth or side of cloth for heavily soiled areas. What to do NOTE: Make certain that What to do 5.1. AlwaysLet the changepatient gloves know afterthat you cleaning are going the toilet to seat. all surfaces stay wet for 1. First wipe down the lid. Once cleancomplete, the tray lift if table. up. Say, “For your safety, the full contact time. may I please clean your tray table.” 2. Wipe down the top of the toilet seat. Then flip it up and clean the underside. 2. Remove all objects on the table—remote controls, call 3. Next, lift the toilet seat up andbuttons, wipe etc.down If therethe rim are of personal the toilet items, bowl. ask the patient Be sure to cover the insideto edge move up themto where or for it turnspermission into the to bowl. move them yourself.

4. If necessary, use more3. than Remove one cloth all visible or side dirt, of cloth crumbs for heavily and spills. soiled If the areas. cloth becomes too dirty, get a new one. 5. Always change gloves after cleaning the toilet seat. 4. Next, wipe the tray table from one side to the next. Cover every part of the surface.

1. Wash Your Hands. Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/features/handwashing/ REFERENCE: Accessed July 22, 2016.

© 2016 Medline Industries, Inc. All rights reserved. ErasePathogens is a trademark and Medline is a registered trademark of Medline Industries, Inc. MKT1667130 / e16116 / 3 1. Wash Your Hands. Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/features/handwashing/ REFERENCE: Accessed July 22, 2016.

© 2016 Medline Industries, Inc. All rights reserved. ErasePathogens is a trademark and Medline is a registered trademark of Medline Industries, Inc. MKT1667124 / e16110 / 3 Leading the Way in Patient Safety Medline The ERASE PATHOGENS Surface Disinfection Solution is part of the Medline Clinical Solutions program. Medline Clinical Solutions combines specialized Clinical education, evidence-based products and outcomes management to help you Solutions elevate quality of care, meet regulatory standards and reduce costs.

Our solutions include: “ Using the booklets has helped me Our courses cover the basics Education: during training for a few reasons: of care and teach teamwork, leadership and how to implement change. 1. Having the number and description is a great visual reminder to the Products: Our clinically-proven* products employees as to where they are at provide breadth and depth across the in the cleaning process and what step continuum of care. or area needs to come next. 2. I have used these booklets for three training sessions and noticed that Outcomes: Our useful tools ensure that the new hires were more able to stay learnings get applied to practice and help on task with cleaning all of the touch track results. points on a consistent basis especially during the patient room clean. 3. Using the booklet cut down on the Our expertise: cleaning time a small amount as the employee could follow the numbers In the areas of infection prevention, readmission reduction, and descriptions rather than having skin care and diabetes management, Medline offers to look at a slip of paper to see what teams of scientists, nurses and Ph.D.’s who understand touch point they should be getting. today’s healthcare challenges. These experts conduct 4. We reduced cross contamination by detailed analysis, recommend solutions and monitor referencing the information in the implementation and results, with an emphasis on booklet. Using a clean surface every standardization of care. time allowed us to minimize the need to fold, refold and remember which This approach is reinforced by the industry’s broadest side was used.” line of high-quality products and supported by an education program that goes beyond the basics of – Amy Medina care to address challenges such as leadership, Educator at InterMountain communication and onboarding. Healthcare

* Contact Medline Industries, Inc. for data related to this line of products.

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Some products may not be available for sale in Mexico or Canada. We reserve the right to correct any errors that may occur within this brochure. © 2019 Medline Industries, Inc. Clean by Sequence and Erase Pathogens are trademarks and Medline and Medline University are registered trademarks of Medline Industries, Inc. MKT19W60705 / LIT074 / 2.5M / SG / 49