Infection prevention and control challenges of using a therapeutic robot

Abstract

This work was part of a National Institute for Health Research participatory action research and practice development study, which focused on the use of a therapeutic, robotic baby seal (PARO, for personal assistive robot) in everyday practice in a single-site dementia unit in Sussex. From the beginning of January 2017 until the end of September 2017, the cleaning and cleanliness of PARO was monitored through a service audit process that focused on the cleaning, amount of use and testing of contamination of PARO being used in everyday clinical practice with individuals and in group sessions. Its use and cleaning followed protocols developed by the study team, which incorporated hand hygiene and standard precaution policies. Its cleanliness was determined using an adenosine triphosphate (ATP) luminometer, with a benchmark of 50 relative light units (RLU). A reading of ATP below 50RLU is the level of cleanliness recommended for social areas in hospital settings. Throughout the study period, monitoring showed that all swab zones on PARO were within the benchmark of the 50RLU threshold for cleanliness. PARO has an emerging evidence base as a useful therapeutic device. However, introducing such devices into clinical practice may encounter barriers or concerns from an infection prevention and control (IPC) perspective. This study of PARO in clinical practice aims to address the IPC concerns raised and offers cleaning and testing protocols and results.

Living well in older age: what can we learn from the Japanese experience?

“…Paro has been evaluated and found to improve mood, improve engagement reduce stress (Rabbitt, Kazdin and Scassellati 2015) and improve quality of life (Joranson et al 2016). Concerns about infection control in clinical environments are unfounded; a recent study concluded that the Paro seal could be kept clean using biocide wipes (Dodds, Martyn and Brown 2018). Our experiences confirm that knowing Paro was artificial had no bearing on the perception that he was real.…”

What Makes a Social Robot Good at Interacting with Humans?

“…PARO has demonstrated benefits in reducing stress, anxiety, and antipsychotics use among older people with dementia [25][26][27]. However, there is a growing evidence base indicating the benefits, resistance and antipathy to using social robots in care settings [28]. There is a need for gaining an in-depth understanding towards the application of PARO, i.e., what worked, in which situation, and how.…”

Microbial contamination and efficacy of disinfection procedures of companion robots in care homes

“…We are aware of only two studies on infection control and Paro [32], only one of which reported a cleaning procedure based on use of the robot on a UK National Health Service (NHS) dementia ward for 9 months [33]. Dodds et al included a broad cleaning protocol discussing risk reduction measures and processes before, during and after use of Paro.…”

“…The protocol described by Dodds et al [33], therefore, has limited quantitative microbiological support, as noted by Rowson and colleagues [34]. Furthermore, the research was limited only to Paro, that is reported to have anti-bacterial fur [37], thus restricting generalisability of results to a wider selection of companion robots that do not generally have anti-microbial coverings.…”

“…Furthermore, the research was limited only to Paro, that is reported to have anti-bacterial fur [37], thus restricting generalisability of results to a wider selection of companion robots that do not generally have anti-microbial coverings. There was also no identification of microbes conducted, and samples were taken periodically over 9 months, rather than before and after cleaning [33]. Thus, no comparison was provided to demonstrate the impact of the cleaning on either microbial load or removal of specific microbes.…”