|By Cantrell, Susan|
Room disinfection once meant a mop, a bucket and a rag. Not that those aren't good things, they still are the necessary basics, but they can only accomplish so much in a very real battle against life-threatening hospital-acquired infections (HAIs). More sophisticated approaches have become necessary, particularly since antibiotic resistance continues its relentless advance. Nonreimbursed events add a financial incentive to target pathogens more aggressively. These factors, and more like them, have contributed to the evolution of room disinfection.
"Manual cleaning and disinfection is a critical step to limiting the spread of pathogens, but oftentimes there is a disconnect when it comes to compliance," added
Antibiotic resistance is a factor, according to
"As infection prevention plans continue to expand, many hospitals are relying on innovative technology like TRU-D to ensure patient safety, reduce HAIs and guarantee the highest reimbursement rates," said
Healthcare-associated infections like methicillin-resistant Staphylococcus aureus, a bacterium that can cause life-threatening bloodstream infections, pneumonia and surgical site infections, are putting more than patient lives at risk every single day, according to Dunn. They're also poised to take big bites out of hospital budgets across the country - to the tune of millions - as new payment penalties and reporting requirements are being implemented by the government and a majority of private health insurance companies. As a result, many hospital leaders are looking for tools, such as TRU-D SmartUVC, that promote patient safety and ensure high reimbursement payments - keeping both their patient population and their operating budgets as healthy as possible.
With the number of room-disinfection options that have been and are being developed, some good advice on what to look for in such products is in order. Purchasers need to know the capabilities of different products designed for room disinfection offer before deciding which is more appropriate for their facility. Knowing which questions to ask can elicit the information needed.
"Key considerations for purchasers selecting either a manual disinfectant or automated disinfection system include kill claims for the most common healthcare pathogens, fast kill times, safety and ease of use," said Lyles, Clorox Professional Products. "The easier a product is to use, the more likely it is that staff will use it correctly. Purchasers should ask vendors about other factors, such as training and support offered by the manufacturer, as well as costs, i to determine the best product solutions for their facility."
Smith, AGT, offered advice on what to look for in a UVC system. "The effectiveness of a UVC system is the UVC dosage it can deliver to neutralize even the heartiest of pathogens. A purchaser of any system should ask how many joules of UVC energy per meter squared is delivered. Pathogens have genomic analysis | gg reports that will identify the UVC dose required for neutralization. This is known as a dimerization or D90 rating. Many products cannot provide a defined dosage but will have a calculation based on the size of the space and the time the unit is in use. "
"Data show that there is a direct correlation between total delivered energy (total UVC) and log reduction of bacteria and spore. When one considers room size and shadowproducing objects in the room, delivering necessary energy values to all surfaces using one emitter is not possible. So, therein lies questions: How does the non-touch disinfection system overcome shadows? And, given the large distance from an energy emitter to a surface, how does the non-touch disinfection system overcome distance, ie, the Inverse Square Law: as distance increases, energy delivered is reduced to a V* at each increment? The solution is to incorporate multiple energy emitters into the room, thereby eliminating shadows and greatly reducing distance."
Asking for a product demonstration and explanation of the room-disinfection system's capabilities is good advice from
Vendors talked more specifically about how their room-disinfection products work to kill pathogens. Popular UVC products are one effective mode.
Lyles, Clorox Professional Products, talked about their partnership with
An important advantage is a safety feature, explained Lyles. "The Clorox Healthcare OptimumUV System includes four infrared motion sensors that detect the presence of anyone in the room and stop operation of the system for enhanced safety."
Scientific evidence should always be asked for if vendors don't offer it first. Lyles cited relevant findings. "Researchers from the University of
Probably no one needs to be reminded that the subject of cost should be approached as well. Lyles compared cost of their product to competitors'. "Unlike competitors, whose machines contain up to 20 smaller lamps and cost as much as
Smith also highlighted cost-effectiveness plus the convenience of their technology. "AGT's Health Risk Management System (HRMS) is an inexpensive alternative to many of the UVC options on the market. The HRMS can be used right at the source of infection, where the space is occupied, unlike many other UVC products that require a terminal clean. The HRMS is a patented UVC system that disinfects air while unobtrusively doubling as a light fixture. The HRMS provides a constant measured dose of UVC energy at 198 J/M2, which is capable of neutralizing an average of 99.8 percent of known infection-causing pathogens."
Here's how it works: "Using differential pressure, air is drawn into the system at 50 cubic feet per minute" said Smith. "Passing through a MERV 6 filter to remove larger particulates, the air then flows through a set of safety baffles and into a radiation chamber, where pathogens are subjected to high-intensity UVC radiation. The purified air is then exhausted back into the room through a vent at a 30° angle."
Maintenance and its cost are minimal. "The HRMS system requires very simple maintenance, with an annual replacement of the UVC lamp and MERV 6 filter at a retail cost of approximately
Smith offered anecdotal evidence of the product's efficacy. "We installed the HRMS in the
Another proponent of UVC is Surfacide. Lyslo described their product. "The Surfacide triple emitter system incorporates the use of three UVC emitters during the same disinfection cycle. As a result, this overcomes the significant challenges to single emitter UV systems: shadows and distance. The use of three emitters during the same disinfection cycle eliminates shadows while being closer in proximity to all surfaces, thereby allowing more UVC energy to be delivered in less time. Less time, with greater efficacy, is critical, given the challenges of bed management and throughput."
Versatility of this system adds to its value, explained Lyslo. "Value of any non-touch disinfection modality should include flexibility. Can the technology be used for more than a single application, ie, can it be used in operating rooms, patient rooms, and hightouch equipment such as mobile carts, work stations on wheels, etc.? Is the technology limited in use for terminal cleaning only, or can it be easily incorporated during a daily clean? Surfacide's triple emitter system can be de-coupled, so a facility can utilize the technology in multiple ways. Surfacide has a unique 'energy scrub' feature that allows the technology to The R-D Rapid direct all energy to a specific location, eg, a mobile cart or corral of mobile carts, as an adjunct to normal cleaning."
Lyslo offered an additional cost advantage of Surfacide. "Total cost of ownership must include labor costs. Single-emitter systems demand one fulltime employee for each non-touch disinfection system, appreciating that often the system must be moved multiple times in the room. Surfacide's triple emitter system demands less labor, given that once the system is turned on in the room, everything is automatic. Once the system is operating, the environmental services associate can be productive elsewhere in the facility while Surfacide is operating."
Many hospitals often times choose to deploy a fleet of TRU-Ds across a healthcare system. The robot, which uses UV-C light to effectively disinfect hospital environments and is a validated weapon against deadly hospital pathogens, is the only portable UV disinfection system that precisely measures reflected UV-C emissions with Sensor360 to automatically calculate the pathogen-lethal UV dose required for proper and consistent disinfection of health care environments. TRU-D's latest innovation, iTRU-D, is the only secure cloud-based infection prevention data tracking tool available with a UV disinfection robot on the market and addresses the recommendation to report MRSA data and MRSA prevention efforts to key leaders on a regular and frequent basis. With iTRU-D, disinfection data is instantaneously uploaded during every room cycle, and hospital staff has easy access and reporting capabilities through a custom portal.
Baiocchi said, "The R-D Rapid Disinfector UV system is the only UV system that measures, records, and reports. The R-D is not a timeor distance-based UV system; it is a dose-based system. The R-D system is set, or pre-programmed, for the C difficile dose. Other doses may be programmed into the system, if desired. The system will not complete a disinfection cycle until each sensor receives the pre-programmed dose of UVC, which could take approximately 13 to 14 minutes, for a single patient room including bathroom, for C difficile. The proprietary UV sensors take the guesswork out of determining where the UV light goes or, just as importantly, where it does not go."
As for cost, Trapani said, "Obviously, the greater the reduction in HAI cases, the greater the return on investment (ROI). System cost can be recovered relatively quickly by just reducing a few HAI cases per year. ROI is maximized by better understanding when to use UV and how to use UV to better disinfect and reduce more HAIs."
Other factors Trapani advised purchasers to consider include cost of ownership, such as cost of capital equipment up front or amortized over a period of time; costs for employees to operate the system(s); throughput/time to disinfect a room; monthly or annual service agreements; repairs and maintenance costs with replacing bulbs; and down time if a bulb goes out.
The power of cluster ions
Pure cluster ions are behind the success of Xstream 2000 room disinfector.
"Xstream 2000 was released early this year from its plant in
"Studies by major cleaning companies have stated that an operating room, patient room, or ICU is only 50 percent pathogen-free," noted Masterson. "Dr. Asnish Jha,
Masterson has a very personal interest in eradicating HAIs. "[I] almost died of an HAI after minor surgery." Explaining that he spent an 18 additional days in the hospital and 3 months of home care for recovery, Masterson counted the cost: "The hospital paid approximately
Novaerus airborne infection control technology also battles the most feared and difficult-to-manage pathogens.
1. Rutala WA, Gergen MF, Tande BM, Weber DJ. Room decontamination using an ultraviolet-C device with short ultraviolet exposure time. Infect Control Hosp Epidemiol. 2014;35(8):1070-1071.
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