SecurAcath: A device to secure catheters without requiring sutures or adhesives (#2851)

Creation
Draft
Initial
Detailed
Accepted
Adoption
Idea Description
Supplementary Information
Innovation 'Elevator Pitch':
Compared to adhesive securement devices, SecurAcath provides continuous securement from catheter placement and never needs to be changed.
Overview of Innovation:
Challenge/problem identified:

Patients may experience several complications when peripherally inserted central catheters (PICC) are moved or dislodged at the insertion site. During weekly routine dressing changes, the adhesive dressing are removed, leaving the catheter unsecured and at risk of movement and migration, which can lead to these adverse patient impacts:
  • Interruptions or delays in therapy
  • Increased length of hospital stay or extended treatment plan
  • Increased readmissions to hospital
  • Repeat procedures
  • Damaged vessels from catheter movement, pistoning or recatheterisation
  • Medical adhesive related skin injury (MARSI)
  • Complications including catheter occlusion, phlebitis, thrombosis and infection.
The cost of replacing an adhesive securement on a weekly basis is around £5. Replacement costs of catheters can range from £150 to £1,500. Additional costs to consider are extending treatments and complication management.



Solution:

Compared to adhesive securement devices, SecurAcath provides continuous securement from catheter placement and never needs to be changed.

The concept for SecurAcath came from an Interventional Radiologist at the University of Minnesota. He encountered patients with catheter securement issues on a daily basis and identified unmet needs for a robust catheter securement device that could overcome the challenges that adhesive devices and sutures caused.

SecurAcath does not require sutures or adhesives. It secures at the insertion site using small, flexible securement feet placed in the subcutaneous tissue below the dermis. This allows for improved site cleaning, less catheter manipulation and eliminates risk of accidental dislodgement or migration during routine dressing changes. Because SecurAcath lasts the life of the line, this lowers the total cost of patient care by dramatically reducing the complications related to routine adhesive securement changes and sutures.

The SecurAcath app can be downloaded via the App or Android store and used for training and educational purposes.


Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
Similar Content2
Innovation 'Elevator Pitch':
A new type of surgical suture – stitch – that reduces the rate of surgery-linked infection (surgical site infection) such as MRSA, through the use of an antimicrobial triclosan coating.
Overview of Innovation:
Challenge/problem identified:

32% of hospital acquired infections are surgical site infections (SSI), most of which can be prevented.

Patients with an SSI are twice as likely to spend time in an intensive care unit and are five times more likely to be readmitted after discharge. They are also twice as likely to die.

50% of healthcare associated infections (HCAls) are associated with in-dwelling devices (Leaper D. et al., 2010). Sutures are often the overlooked implant.
The costs for an SSI are around €2,000-€4,000, while 9.8 days is the average extended length of stay (Leaper et al., 2004).



The solution:
 
Ethicon Plus Antibacterial Sutures are the only sutures available containing a coating of the antiseptic triclosan.

The triclosan used in Plus Sutures —IRGACARE® MP — is the purest form available and is shown in vitro to inhibit bacterial colonisation of the suture for seven days or more.

Since their approval, Plus Sutures have been clinically evaluated in multiple independent studies, published in peer reviewed journals including 25 randomised controlled trials (RCTs); 10 non RCTs; and eight meta-analyses.

All eight of the meta analyses published since 2012 conclude that there is a statistically significant reduction in SSIs when using Plus Sutures.

To find out more – click here.

 
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Innovation and adoption
Benefit to NHS:
NICE 2008 Clinical Guidelines on Surgical Site Infection estimate the average cost of treating one SSI at £4,300.

PHE’s report “Surveillance of surgical site infections in NHS hospitals in England” states that in Apr 2016 to Mar 2017, data on 139,691 procedures and 1,635 surgical site infections (SSIs) detected during the inpatient stay or on readmission following the initial operation were collected by 201 NHS hospitals and 8 independent sector NHS treatment centres for 17 surgical categories under surveillance.

Looking at cardiac procedures only in one large NHS hospital teaching trust, 830 procedures were carried out over a 12-month period with an average SSI rate of 6%. If this trust converted to Plus Sutures, the estimated efficiency savings generated would be around £116,670, applying a 30% relative risk reduction in SSI and assuming the cost to treat SSI as advised by NICE. Furthermore, 141 bed days associated to SSIs would also be released.

Preventing SSIs also offers significant patient benefit, including a reduction in their length of stay, the antibiotics needed for treatment and avoidance of disruption to their personal life.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
The NHS Innovation and Technology Payment (ITP) programme went live on 1 April 2018. Four innovations will be fast-tracked into use through the programme, supported by the AHSN Network. One of these is Plus Sutures – selected for central funding by NHS England.
 
Plus® Antibacterial Sutures are the only commercially available sutures with antibacterial protection.
 
Coated VICRYL Plus, MONOCRYL Plus and PDS Plus Sutures offer:
  • Proven in vitro to inhibit bacterial colonization of the suture for 7 days or more -1,2,3
  • Reduces the risk of biofilm formation on the suture - 4,5
  • Effective against the most common organisms associated with SSIs
  • Prospectively planned meta-analyses of randomized clinical trials were performed on the use of suture containing triclosan to lower surgical site infection rates - 6,7
 To view the references and out Plus Sutures One Pager – click here.
Current and planned activity: 
The NHS Innovation and Technology Payment (ITP) programme went live on 1 April 2018 with the aim of removing barriers to the spread and adoption of innovative products or technologies and the need for multiple price negotiations.
 
Innovations are directly funded by NHS England and are available to NHS organisations from April 2018 for one year, after which the support will be reviewed.
 
We would like WMAHSN to help to raise awareness of the ITP programme and Plus Sutures to enable regional NHS to realise savings by preventing SSIs and realising the significant patient benefit Plus Sutures offer, including a reduction in their length of stay, the antibiotics needed for treatment and avoidance of disruption to their personal life.
Return on Investment (£ Value): 
Very high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
Simple
Read more
Hide details
Innovation 'Elevator Pitch':
Catheters cause 250,000 serious infections, 3,000 deaths & up to £500m in healthcare costs a year research reports. UroShield prevents bacterial biofilm formation, increases antibiotic efficacy & decreases pain & discomfort of urinary catheter use.

Overview of Innovation:
90,000 Britons are fitted with a urinary catheter each year. Catheters are essential for a wide range of conditions that compromise the ability to empty the bladder effectively, such as prostate cancer patients and those with incontinence and neurological conditions like multiple sclerosis and spinal injury.
 
Indwelling catheters serve as an environment for bacterial attachment, biofilm formation and subsequent urinary tract infections (UTI). Biofilm formation is a thick, bacterial ‘glue’ that sticks to the surface of the catheter plastic and is highly resistant to antibiotics, making infections difficult to treat. Such catheter-acquired infections are one of the most common iatrogenic complications and may lead to increased mortality rates, extended hospital stays and increased medical costs for healthcare providers.
 
UroShield uses soundwaves to ‘shake’ away bacteria, protecting patients from painful and potentially life-threatening bladder infections. It is composed of 2 components: A disposable actuator which clips onto the external portion of the catheter and a portable battery powered driver.



The device sends out low-frequency ultrasound waves (Surface Acoustic Waves) which run longitudinally along both the inner and outer surfaces of the catheter. These surface acoustic waves prevent bacteria from docking and adhering to the catheter and subsequently prevent the formation of biofilm.
 
If there is a biofilm already present or one does form, the ultrasound waves help to break up the normally impenetrable biofilm matrix to allow access of the antibiotic to the biofilm. This increases the antibiotic efficacy by working synergistically so that patients may have a shorter course and lower dose of antibiotics.


In addition, independent studies from leading Universities have shown that the UroShield device enhances the immune systems’ ability to fight biofilm. In further studies the Uroshield device achieved a 90% reduction in the presence of common bacteria most likely to cause infection including E. coli and Staphylococcus epidermidis.
 
The action of the ultrasonic waves on the surfaces of the catheter interfere with the attachment of bacteria, prevents infections developing, reduces catheter encrustation and blockages and decreases or eliminates the need for antibiotics, reducing risk and improving patient outcomes. This in turn reduces the costs associated with indwelling catheter complications that may lead to increased medication and extended hospital stays.
Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
WMAHSN priorities and themes addressed: 
Wellness and prevention of illness / Innovation and adoption
Benefit to NHS:
Reducing health care-associated infections (HCAIs) remains high on the Government’s
safety and quality agenda and in the general public’s expectations for quality of care.
 
Patients with invasive devices such as urinary catheters are at a greater risk of developing a HCAI (NICE, 2012). In addition to increased costs, each one of these infections means additional use of NHS resources, greater patient discomfort and a decrease in patient safety.
 
UroShield is a breakthrough device to prevent or treat catheter-related trauma.
 

 
Once the urinary catheter has been placed into the patient’s bladder, the actuator is clipped on the extracorporeal part of the catheter and the device is activated. UroShield harnesses the known therapeutic effects of ultrasound such as tissue healing and muscle relaxation to significantly decrease catheter-associated pain and discomfort. This is extremely easy for nurses to use and maintain, with a simple clip around the catheter to be changed monthly and disposed of in standard waste.
 
UroShield could have huge implications for reducing A&E admission rates as 224,670 admissions for UTIs were reported in 2009 and 2010 and since then numbers have continued to increase, with 43-56% of all UTIs being associated with indwelling. Between 2013/2014, the NHS spent £434 million treating 184,000 hospital admissions for a UTI.
 
UroShield could play a key role in achieving CQUIN targets for CAUTI rates and the reduction in E. coli Bloodstream Infections through the initial prevention of infection.
 
E. coli is one of the main pathogens responsible for causing UTIs and CAUTI, of which Gram-negative CAUTIs are often a source of bacteraemia. E. coli account for 55% of all BSIs and of these UTIs are responsible for 45% of E. coli BSIs. E. coli BSIs have increased by 20% over the last five years and the trend is still rising, which is of grave concern.
 
E. coli BSI are therefore a huge patient safety issue and are set to cost the NHS £2.3 billion by 2018. These contributed to over 5,500 NHS patient deaths in 2015 and there is £45 million quality premium which is incentivised by Ruth May to reduce healthcare associated Gram-negative BSIs by 50% across the NHS by 2021. The goals are to: prevent the need for antibacterial prescription, to reduce the dose or length or antibiotics as a minimum, and to reduce hospital admissions and HCAIs.
Initial Review Rating
5.00 (1 ratings)
Benefit to WM population:
Over 1 million patients a year have a catheter for a short time while in hospital & those using them at home for longer periods have them changed every 3 months & infections can be missed between changes.
 
An untreated urinary tract infection (UTI) may spread to the kidney, causing more pain & illness & lead to sepsis, a life-threatening reaction to an infection.
 
Long-term catheterisation carries a significant risk of symptomatic UTI, which can lead to serious complications such as bloodstream infections (NICE 2012). The diagnosis of a CAUTI increases the use of antibiotics which will increase the burden & development of antimicrobial resistance (DH, 2007).
 
Recurrent lower UTIs have a detrimental effect on patients quality of life. Patients experience a psychological burden because they live with the anxiety of sudden acute episodes. The resulting social handicap is known to induce feelings of self-devaluation or culpability, which can lead to clinical symptoms of depression.
 
UroShield could protect thousands of patients from painful & potentially life-threatening bladder infections reducing the psychological burden & anxiety patients experience.
 
The innovation is currently being trialled in NHS hospitals with leading urologists including a consultant & surgeon at the Royal Marsden in London describing the device as ‘game-changing’.
 
Uroshield comprises an electronic driver (8-hour battery life) weighing 5g & a disposable clip that fits around the catheter tube, the driver transmits continuous ultrasound waves to the clip via a small cable. The rechargeable device can be switched on & off & a small screen on the driver indicates power supply & battery life.
 
Clinical trials have shown the acoustic sound waves generated by the UroShield device along the urinary catheter result in a significant decrease in catheter-associated pain & discomfort.
 
Click the image below to read the full article.


 
UroShield significantly reduces bladder washouts in catheterised patients & thus could reduce visits from district nurses to generate significant cost & time savings. For example, one patient required daily bladder washouts & since UroShield no longer requires any at all. Patients can have greatly extended catheter life, reducing the frequency of catheter change & maintenance & nurse callout time associated with this. Alongside freeing time & resources, UroShield could also assist Infection Prevention Nurses in achieving CQUIN targets based on catheter-associated infection rates.
Current and planned activity: 
We are speaking with over 80 primary and secondary care sites with regards to UroShield. We currently have 6 NHS sites evaluating UroShield in small scale patient service evaluations alongside a double-blind randomised controlled trial producing positive data proving the efficacy of UroShield.
 
We are also working to provide Health Economic Data which will further support the use of UroShield across various healthcare settings. To support this we are looking to work with a NHS partner in the West Midlands to undertake a small-scale (service) real-life evaluation of UroShield to demonstrate patient and fiscal benefits of using the device.
 
UroShield can help you to support the delivery of the national ‘reducing the impact of serious infections (Antimicrobial Resistance and Sepsis’ CQUIN by creating a new, improved pattern of care for patients, reducing their risk of painful and potentially life-threatening bladder infections.
Return on Investment (£ Value): 
high
Return on Investment (Timescale): 
1 year
Ease of scalability: 
2
Read more
Hide details
0
0
Votes
-99999

Created by

Share and Follow