Reducing the incidence of hospital acquired infections through the application of UV-C light

 

WHAT IS DRIVING THE NEED FOR UV-C DISINFECTION?

    The Australian Commission on Safety and Quality in Health Care1 reports1 that hospital acquired infections;
  • Affect 1 in every 74 hospitalisations,
  • May occur in the presence or absence of invasive procedures,
  • Results in a prolonged hospital stay that is 18.1 days longer on average than patients without this complication, and
  • In the public hospital system accounts for 148 per 10,000 hospitalisations.

The above can be considered typical, based on public hospital data. Incidence rates and severity vary across the various types of health care facilities and is influenced by the level of diligence applied to infection control.

Hospital cleaning and disinfecting practices are well governed internally and by health authorities. All states and territories have stringent guidelines, checks, inspections, monitoring and compliance frameworks that are best practice by world standards.

Population growth combined with an ageing population is increasing the amount of hospitalisations and placing greater pressures on the health system. Essentially the shear weight of numbers is perpetuating the amount of infecting events and in so doing driving the need for better infection eradication, control and spread prevention.

In the last decade numerous studies were undertaken to determine the benefits of using UV-C Germicidal Irradiation devices for the purpose of reducing the rate of hospital acquired infections (HAI's). Below is a summary of the research and recent developments.

A LITTLE UV BACKGROUND

UV-C Germicidal Irradiation (UVGI) devices has been used for disinfecting purposes for over a century and extensively used in many industries as well as the healthcare sector with great success. The Achilles Heal of UVGI is distance, meaning that the effectiveness of UV is diminished as the distance increases between the UV source (typically a tubular lamp) and the infected surface. The rate of irradiation effectiveness reduces in accordance with the inverse square law. For this reason UVGI devices are most commonly used in applications where the UV light can be positioned in very close proximity to the object requiring disinfection. A good example of this is the instrument disinfecting cabinet.

IT REQUIRES A JOINT VENTURE

Studies unequivocally show that UV disinfection is a complimentary aid to good and well-established hospital cleaning and disinfecting practices. In a study led by researchers from Duke University, funded by US Centers for Disease Control and Prevention and reported in The Lancet in Aug 201822, it was concluded that enhanced terminal room disinfection with the aid UV, led to a decrease in hospital-wide incidence of Clostridium difficile (C.diff) and vancomycin-resistant enterococcus (VRE).

In the trials 4 different terminal room disinfection strategies were investigated involving different standard methods using chemical disinfectants and an enhanced disinfection method that involved complimenting UV-C light disinfection with standard chemical methods.

Researchers that conducted the controlled trials across US hospital stated the study provides further evidence of the benefit of using enhanced terminal room disinfection methods, as standard methods have proven ineffective at eliminating pathogens that can survive on hospital surfaces for days and put other hospital patients at risk of infection. It also stated that, enhanced disinfection overcomes limitations of standard disinfection strategies and is a potential strategy to reduce the risk of acquisition of multidrug-resistant organisms.

Infection control officials from Duke Health3 have since elaborated that the disinfection methods enhanced with UV-C light has reduce infections by 30%. Mayo Clinic, Spartanburg Health and a growing number of hospitals are reporting similar and better outcomes.

RECENT IMPROVEMENTS

In the last year, the effectiveness of UV-C disinfection has been significantly improved. This is primarily due to UV lights being mounted on autonomous mobile platforms. This development allows the light to be positioned much closer to infected surfaces.

Previous units used in hospitals irradiate from fixed positions in the room. After irradiating the room for about 20-30 minutes the unit is typically relocated for a further 20-30 minute session. Autonomous mobile platforms now allow the light source to be moved extremely close to the surfaces being cleaned and in such a manner that more of the room and equipment surfaces are more thoroughly and intensely dosed with UV-C light. It also provides more uniform dosage and facilitates a shorter cleaning time.

Consequently reductions in infections rates are now better than 30%.

Greater up-take of autonomous mobile platforms (robots) across numerous industrial sectors has resulted in increased sophistication, greater capabilities, better safety as well as lower production costs. It is also now being more widely used in various healthcare operations to assist in improving operational efficiency.

 

BETTER HEALTHCARE

Each year Australian public hospitals alone account for 60,000 hospital-acquired infections, at a cost to tax payers in the order of $2.25b. Therefore if the infection rate can be reduced by 30%, 18,000 infections can be prevented and $675m can be saved and redeployed to address other community health challenges.

BENEFITS TO HOSPITAL

A suburban, 500 bed, public hospital that handles 66,000 admissions, experiencing 920 cases of hospital acquired infections could save approximately $10m annually for an investment of $1.6m. It would prevent about 280 HAI cases and free up 5,000 bed-days.

    From the above scenario, the conservative extrapolations are;
  • Capital investment in UV-C Disinfection Robots: $3,000 - $4,000 per bed
  • HAI's prevented: 40 per 10,000 hospitalisations
  • Return on investment: $150 per hospitalisation

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