Enhanced disinfection leads to reduction of microbial contamination and a decrease in patient colonization and infection

ObjectiveTo evaluate the efficacy of multiple ultraviolet (UV) light decontamination devices in a radiology procedure room.DesignLaboratory evaluation.MethodsWe compared the efficacy of 8 UV decontamination devices with a 4-minute UV exposure time in reducing recovery of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and Clostridium difficile spores on steel disk carriers placed at 5 sites on a computed tomography patient table. Analysis of variance was used to compare reductions for the different devices. A spectrometer was used to obtain irradiance measurements for the devices.ResultsFour standard vertical tower low-pressure mercury devices achieved 2 log10CFU or greater reductions in VRE and MRSA and ~1 log10CFU reductions in C. difficile spores, whereas a pulsed-xenon device resulted in less reduction in the pathogens (P<.001). In comparison to the vertical tower low-pressure mercury devices, equal or greater reductions in the pathogens were achieved by 3 nonstandard low-pressure mercury devices that included either adjustable bulbs that could be oriented directly over the exam table, a robotic base allowing movement along the side of the table during operation, or 3 vertical towers operated simultaneously. The low-pressure mercury devices produced primarily UV-C light, whereas the pulsed-xenon device produced primarily UV-A and UV-B light. The time required to move the devices from the corner of the room and set up for operation varied from 18 to 59 seconds.ConclusionsMany currently available UV devices could provide an effective and efficient adjunct to manual cleaning and disinfection in radiology procedure rooms.

mentioning

confidence: 99%

A comparison of the efficacy of multiple ultraviolet light room decontamination devices in a radiology procedure room

Cadnum

Jencson

Gestrich

et al. 2019

“…1 Contaminated surfaces can act as a source of healthcare personnel hand contamination and may represent a risk to newly admitted patients whose rooms have not been adequately disinfected following discharge of previous patients who were colonized or infected with pathogens. [2][3][4] In many healthcare facilities, only 50% of surfaces in patient rooms are routinely disinfected by environmental services personnel. 5 As a result, additional strategies may be needed, such as the use of mobile ultraviolet light (UV) devices to minimize contamination of environmental surfaces in hospitals.…”

Section: Introductionmentioning

confidence: 99%

Understanding ultraviolet light surface decontamination in hospital rooms: A primer

Boyce¹,

Donskey

2019

Ongoing challenges in maintaining optimum manual cleaning and disinfection of hospital rooms have created increased interest in “no-touch” decontamination technologies including the use of ultraviolet light (UV). Trials have shown that some UV devices can decrease surface contamination and reduce healthcare-associated infections. Despite substantial marketing of these devices for use in healthcare settings, few data are available regarding the doses of UV-C necessary to yield desired reductions in healthcare pathogens and the ability of mobile devices to deliver adequate doses to various surfaces in patient rooms. This review summarizes the physical aspects of UV that affect the doses delivered to surfaces, the UV-C doses needed to yield 3 log10 reductions of several important healthcare-associated pathogens, the doses of UV-C that can be achieved in various locations in patient rooms using mobile UV-C devices, and methods for measuring UV doses delivered to surfaces.

“…UV disinfection has been shown to be effective at killing pathogens, and in preventing environmental transmission. 4,[16][17][18] However, UV equipment is costly and may require specialized training for operation. To achieve broad room coverage, multiple UV machines must be purchased.…”

Section: Discussionmentioning

confidence: 99%

“…Step 4 UV tech disinfects room 13 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) 11 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) .1940…”

Section: Waitunclassified

Reduced isolation room turnover time using Lean methodology

Ankrum

Neogi

Morckel

et al. 2019

Objective:To prevent environmental transmission of pathogens, hospital rooms housing patients on transmission-based precautions are cleaned extensively and disinfected with ultraviolet (UV) light. To do so consistently requires time and coordination, and these procedures must avoid patient flow delays and associated safety risks. We sought to improve room turnover efficiency to allow for UV disinfection.Design:A 60-day quality improvement and implementation project.Setting:A quaternary academic pediatric referral facility.Interventions:A multidisciplinary healthcare team participated in a 60-day before-and-after trial that followed the Toyota Production System Lean methodology. We used value-stream mapping and manual time studies to identify areas for improvement. Areas addressed included room breakdown, room cleaning, and wait time between cleaning and disinfection. Room turnover was measured as the time in minutes from a discharged patient exiting an isolation room to UV disinfection completion. Impact was measured using postintervention manual time studies.Results:Median room turnover decreased from 130 minutes (range, 93–294 minutes) to 65 minutes (range, 48–95 minutes; P < .0001). Other outcomes included decreased median time between room breakdown to cleaning start time (from 10 to 3 minutes; P = .004), room cleaning complete to UV disinfection start (from 36 to 8 minutes; P < .0001), and the duration of room cleaning and curtain changing (from 57 to 37 minutes; P < .0001).Conclusion:We decreased room turnover time by half in 60 days by decreasing times between and during routine tasks. Utilizing Lean methodology and manual time study can help teams understand and improve hospital processes and systems.