Biomaster's Lesley Taylor shows what healthcare estate specifiers can do to further reduce cost of risk through effective specification of antibacterially protected products to minimize exposure pathways?

1. Lesley Taylor, Regulatory Manager, Addmaster (UK) Ltd
Lesley graduated from the University of Wales, Aberystwyth with a BSc Hons
in Biochemistry and Microbiology.
Lesley’s experience and technical expertise in microbiology and antimicrobials
spans more than 13 years, including work in laboratory testing, sales training
and customer support.
Lesley’s current role at Addmaster is to support our customers with
regulatory advice, giving them the confidence to sell fully compliant products,
worldwide.
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2. Addmaster (UK) Ltd is Europe's leading supplier of high performance, technically
innovative additives to the plastics, textile, paper, paints and coatings industries. We
provide additive masterbatches, liquid or powder dispersions for any application.
The Addmaster product range consists of Biomaster antibacterial additives,
Verimaster anti-counterfeit technology, Scentmaster fragrance and odour control
formulations and Masterpeice a bespoke technical solutions capability.
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3. Biomaster antibacterial additives can be found in a wide range of everyday
applications providing permanent antibacterial product protection to surfaces,
coatings, paints and textiles in healthcare, catering and hospitality settings across
the globe.
Addmaster pioneered the use of antibacterial additives.
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4. I am here to demonstrate how Estates Teams can contribute further in reducing risk
and saving lives, all for little or, in many cases, no extra cost.
Hopefully I have now your attention?
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5. The NHS is under pressure to deliver cost saving and service improvements whilst
facing ever increasing demand from a growing and arguably aging population. These
pressures present significant challenges to healthcare in the UK
Against a background of uncertainty and increasing administrative requirements the
NHS is targeted to save £22bn by 2020 - just 3 years left.
We need to think differently about healthcare estates and service provision and
against this backdrop a focus on cost is essential but not always constructive.
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6. Of course effective estate specification and procurement practice can save cost and
much has been and is being done to procure new estate efficiently and maintain
existing estate cost effectively.
New technologies have been adopted to reduce operational costs in energy and
waste and early wins have been made. Many solutions have been originally
developed for use outside Healthcare in areas such as Education, Housing,
Commercial and Office space. All geared to reduce cost in use and deliver ease of
maintenance. Not all cheaper to buy but offering better whole life value.
Lighting
Water Usage
Waste management
Recycling / Reuse
Power and energy
Modular construction….. Are all areas where innovation has added value and saved
money and not just in healthcare.
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7. And operationally significant gains have ben made in the fight against HAI’s over the
last 10 years but the law of diminishing returns takes hold as achieving that extra 1%
reduction takes more effort and cost . MRSA from 9 per 100,000 bed days in 2007 to
1 per 100,000 to date. And C.dif from around 115 per 100,000 bed days to just
under 20. Not so for E.coli however which, as by 100,000 of population stats show,
have moved from just over 60 to 80 since 2011/2. Data for MSSA a newer strain
shows a slight increase as current practices seem less effective.
So, if risk of HAI’s can be linked to cost, what else can estates teams do to help?
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8. Where there exists risk there exists cost – remedial, consequential, legal and
opportunity cost to name but a few.
As mentioned there have been significant advances in procurement methods and
product capability such as
• Washroom technology and water usage
• Sensor controlled lighting
• BIM – build and design modelling to reduce clashes
However controlled specification of materials can also improve hygiene. Smooth,
shiny, non stick surfaces are easy to clean but not hygienic in an antibacterial sense.
Wall panels with inbuilt antibacterial protection that reduce exposure pathways are
already available from Trovex, CFM and Sealwise among others, helping to break the
chain of infection.
And it is not just building fabric that can be protected but also a building’s fabrics –
seating, soft furnishings such as curtains, blinds, and even gowns and bedding can
also be protected either topically for already in situ applications but more efficiently
at point of manufacture.
Overall, improved hygiene leads to cleaner environments which in turn can reduce
risk and improve health and safety even by simply reducing slips, trips and falls never
mind reducing bacterial and microbial contamination / cross contamination.
However Antimicrobials mean different things to different people in a clinical
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9. setting, at Biomaster we mean:
• NOT Nano silver – Biomaster doesn’t leach and unlike nanoparticle
applications the technology is tried, tested and safe.
• A permanent level of protection for the lifetime of the product in use.
Unlike antibiotics and disinfectants there is no risk of developing bacterial
resistance.
• Approved for use BPR/FDA/ WRASS
The benefits of antimicrobial protection on building fabric and fit out components
are now listed as requirements for the achieving the International WELL Building
Standard as one of a range of measures to improve employee wellbeing
• So in practice how can Estates teams help to reduce operational risks and their
associated costs?
• How is it done? By Breaking the Chain of Infection
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10. By specifying building fabric and equipment that works to minimise bacterial
contamination the risk of cross infection and contamination can be reduced. Floors,
walls, door furniture, washroom facilities, wall coverings and coatings can all work
together to inhibit the growth of pathogens and reduce exposure pathways.
If it makes sense to keep infectious people away from healthy people to avoid
contamination we also need to keep germs away from susceptible people as well.
Infection prevention is now seen as the most sustainable approach to preventing
infectious disease and tackling the problem of antibiotic resistance. Preventing the
spread of bacteria requires cleaning AND hygienic behaviour working together to
minimise exposure pathways. Effective specification of materials reinforces this
partnership, reduces risk and its associated costs.
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11. Biomaster pioneered the modern day use of silver-ion technology and is recognised
as the world’s leader in this field. The benefits of silver as a natural antibacterial,
however, have been known since the time of the Pharaohs.
Silver has been used for thousands of years to prevent the growth of bacteria
without the high toxicity
associated with other metals.
In ancient Greece, Hippocrates, often called the Father of Medicine, wrote that silver
had both healing and anti-disease properties.
In the Middle Ages ,the wealthy would feed their children using a silver spoon to give
them protection against disease. It’s believed that this gave rise to the phrase ‘born
with a silver spoon in your mouth’.
It was also thought that the use of silver cutlery would provide protection against
the plague.
American pioneers travelling west kept their water and milk fresher for longer by
putting a silver coin in the storage barrels, and early settlers in Australia placed silver
forks or spoons into their water tanks in order to keep the water clean.
Up until the introduction of antibiotics in 1938, colloidal silver was used by
physicians as a mainstream antibiotic treatment. More recently, NASA used it to
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12. purify water on the space shuttle.
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13. Biomaster uses silver technology to provide permanent antibacterial product
protection and in doing so complements cleaning protocols by providing a hygienic
platform to protect surfaces between scheduled cleaning events.
It is the responsibility of management and staff in the NHS that ”the
NHS estate has to be maintained to high standards to ensure a safe,
clean patient environment for the delivery of health care”. In order to
do so it is necessary to understand the difference between cleaning
and hygiene. Disinfectant and cleaning regimes remove dirt and some
germs, but for how long? How can high risk areas be kept clean
between cleans?
Biomaster can be specified in a wide range of substrates and products
including;
• Paint & coatings for hospital walls, handrails etc.
• Paper for case note folders, menus
• Plastics for hard surfaces, it casings and screens as well as
consumables packaging
• Textiles for work wear, screens and curtains and linen
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15. So how does it work?
When bacteria come into contact with a Biomaster protected surface, the
silver ions prevent them from growing, producing energy or replicating,
therefore they die.
Biomaster Antibacterial Protection is incredibly durable, long lasting and
highly active. When added, it is dispersed throughout the entire item and
becomes an integral part of the product.
Silver is inorganic and non-leaching which means that, unlike organic
antimicrobial technologies, it stays within the item to which it is added and
doesn’t leach out. The active ingredient provides maximum antibacterial
protection for the lifetime of the product.
The majority of bacteria are reduced by up to 90% in the first two hours of
contact and after 24 hours by 99.9% in most cases. In laboratory tests a
99.9% reduction essentially means that traces of bacteria are undetectable.
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16. You may remember this from the earlier slide, this is from an IFH presentation which
is worth reviewing for an insight into the chain of infection and the exposure
pathways that can cause cross contamination. The recent article from the Journal of
Hospital Infections also demonstrates how cross contamination can occur in a
healthcare bedside environment.
So how do we know we can break the chain of infection using antibacterial
additives? Alongside our extensive experience in the healthcare sector we have a
wealth of analysis, test results and experience from users in other sectors such as
water treatment, catering and hospitality ,food processing and retail.
In their journal article Adams Dancer confirm that antimicrobial surfaces can help in
the control of pathogens in near patient healthcare environments, specifically ICU’s
in this instance. And we also have a clinical study that demonstrates the overall
benefit…
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17. During a trial at Heartllands NHS trust, where two identical bed spaces were
examined over a period of four months – identical in all ways except that one bed
space contained as many antimicrobially treated articles as possible – showed that
as expected there was a 96% minimum reduction of the bacteria found on those
treated articles. Not tremendously interesting I grant you as that was what we
expected.
What was very interesting to find however was that in that bed space there was also
a generic 43.5% reduction of bacteria on the untreated areas of the space. This
demonstrates that by adding as many antibacterial applications as possible has an
effect on the surrounding environment, so why wouldn’t you consider specifying
wall, floor and other surfaces as antibacterial in high risk areas at least?
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18. Bacteria, both good and bad, are a fact of life and they are all around us.
Most bacteria are rendered harmless by the protective effects of our immune
systems and some are beneficial.
But several species of pathogenic bacteria, such as Campylobacter, MRSA,
E.coli, Legionella, Listeria and Salmonella can cause serious infectious
diseases.
Whilst it is impossible to make our everyday environments sterile, and why
would we want to, it makes sense to ensure that for those who may be
vulnerable, the elderly or very young, the immunosuppressed and those
under certain drug therapies are protected from these pathogens in high risk
environments such as hospital wards, waiting rooms, operating theatres,
surgeries, outpatient departments, A&E … the list goes on, far beyond
healthcare.
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19. Recent trials in the hospitality sector have also shown that Biomaster is effective
against Norovirus in fabric applications. The cost of Norivirus outbreaks can be
significant as we all know. What if Biomaster impregnated fabrics helped reduce the
number of outbreaks, restricted the spread through fabric exposure pathways such
as uniforms and linen or reduced downtime when outbreaks occur.
Why wouldn’t you want to take as many precautions as you could to improve this
situation.
Field trials are ongoing and anyone interested in adopting Biomaster for this
opportunity should let me know and we can put you in touch with a leading laundry
services provider, already on framework, that can work with you to trial such a
solution.
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20. A recognised hierarchy exists within hygiene circles to identify areas of risk and
prioritise activity. This pyramid demonstrates those areas.
A huge amount of effort is expended on training people to wash hands and use gels
to reduce bacterial load and minimise cross contamination. Reduction of this
exposure pathway was responsible for most of the gains in reducing HAI’s in the
early stages.
Hand surface contact points and cleaning materials represent a large untapped
opportunity for antibacterial protection.
Using disposable aprons and gloves helped reduce instance of cross contamination
from fabrics such as uniforms and clothing. Changes in laundry practice mean
uniforms can often be worn to and from work, domiciliary and community care
teams have to wear uniforms outside of healthcare environments visiting homes and
other remote centres of care.
And floor and wall surfaces are largely unrecognised as exposure pathways however
carts and trolleys, beds and gurneys and other wheeled items of equipment transit
areas from renal units to paediatrics and A&E. How often and extensively are they
cleaned hygienically and how quickly can they become recontaminated?
Why wouldn’t you want to specify additional protection, especially if it wasn’t overly
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21. expensive to do so?
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22. Biomaster is already used on a wide range of product and services with in the
healthcare sector a selection of these can be found in our Healthcare brochure and
all are available for you to specify directly.
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23. And Biomaster products are also widely available outside of the healthcare sector
with antibacterial benefits appreciated and applied by other brand partners such as
M&S, Dulux, ASDA, and Dyson to name but a few.
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24. So what does it cost?
The answer is that in most cases not much and in many cases a supplier will even
absorb these costs simply to win your business and build their relationship with your
procurement teams. You can use this technology to control your supply chain and
win back control of costs through specification.
There is an extensive network of manufacturers already supplying the healthcare
sector that incorporate Biomaster in wall cladding materials, nurse call systems and
trunking, devices, monitors and carts, clothing and footwear, paints and wall
coverings as well as water filters and pipework.
Biomaster is also very easy to incorporate into your existing supply chain if the
current network cannot provide your requirements. Your specification requirement
gives you control over your supply base, we can work with your procurement teams
to ensure cost effective application of the technology.
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25. We’ve seen why you should consider Antibacterial Protection in building fabric and
“fabrics” and Lord Cater of Coles review of productivity and performance in the
English NHS promotes innovation and new technology to improve outcomes
It works, there is extensive evidence of use in other sectors as well as healthcare,
from food processing and education to hospitality and water treatment.
Its cost effective and easy to procure
It can mediate significant cost and in some instances damages as Bourne Leisure can
attest to.
It simply remains to ask – Why wouldn’t you?
Questions?
Any more we are available on the stand to answer specific queries.
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