Following the addition of Ultraviolet-C (UVC) light disinfecting technology to its cleaning and disinfection protocols, Children's Hospital New Orleans saw a significant decrease in hospital onset C. difficile infections. A complement to the hospital's existing manual cleaning procedures, UVC disinfection technology floods patient rooms or other spaces with UVC light, killing drug-resistant organisms that might lead to hospital-acquired infections.
Kicking Hospital-Acquired Infections to the Curb
According to Joseph Ward, director of Environmental Services at Children's Hospital, several factors guided the decision to implement UVC technology—and, specifically, to use Tru-D SmartUVC to carry out the disinfection process. Ward's ultimate goal was patient safety: "We needed to be proactive with providing thorough room disinfection while reducing hospital-acquired infections and providing the safest possible environment."
Leron Finger, M.D., the hospital's chief quality officer, says Children's Hospital wanted a comprehensive approach to room disinfection. He says, "Just like every hospital, we are strong proponents of hand hygiene and terminal room cleaning, but we thought that if there was another opportunity with UVC disinfection to achieve zero hospital-acquired infections, we wanted to explore that option."Hospital-acquired infections affect more than 2 million patients annually, and the risk of infection poses specific challenges in pediatric environments.
Integrating a New Technology
Ward says the Tru-D device matched efficacy in combating infectious organisms with efficiency for environmental services staff. "Ease of use was important," he says. "The Tru-D device is only required to be positioned in the room once in order to be effective." He says this gives his team members the ability to focus on other tasks while UVC disinfection takes place, without needing to move the device before it completes its cycle.
Finger also highlights efficiency as a key factor in selecting a device. "If the UVC device was something that had to be moved every couple of minutes, that would make it much more challenging to integrate into the workflow of our team." In addition to its ability to disinfect from a single placement, the Tru-D device tracks the amount of ultraviolet light it delivers, automatically shutting off when it has emitted the appropriate dose.
Vendor support during implementation also affected Children's Hospital's decision-making process. Ward says a team from Tru-D worked closely with the hospital's infection control and environmental services teams, collaborating to define disinfection targets and training environmental services staff on the new technology. Initially, the hospital used UVC disinfection only in its operating rooms, but over the past four years, usage has expanded to patient rooms, emergency rooms and sterile pharmacy rooms. "Tru-D continued to provide support until our program was fully implemented," Ward says.
This phased rollout of the technology helped hospital personnel become accustomed to the new procedures. "We started in the microenvironment of the operating room, and after we established some success in how to integrate it into the daily workflow, we expanded its use," Finger says.
Best Practices for Other Hospitals
Finger highlights a decrease in C. difficile infections as a successful outcome of the Tru-D integration, but he also points out the technology is one piece of a larger set of protocols. "It's an add-on to all the other complementary strategies we already have in place for disinfection. We do not take anything away or substitute UVC for something else in our existing standards of care."
Nationwide, environmental hygiene plays a role in 10-25 percent of the incidence of hospital acquired infections. UVC disinfection can help to eliminate the environment as an infection vector, but it is most effective when combined with other infection prevention measures like chemical disinfection, hand hygiene and anti-microbial and diagnostic stewardship.
Finger and Ward appreciate the time and labor that any hospital incurs when revamping cleaning and disinfection protocols. Ward advises other hospitals, "Consider the studies, read the testimonials from other customers and weigh the pros and cons of using UVC as a key tool in reducing the spread of infections and making environments safer for patients. Integration of how the technology works in relation to your staffing operations is important to consider."
"Hospitals are working on a constellation of projects every day," Finger says. "Conduct a gap analysis of what your needs are and where you'll get the biggest bang for your buck. For Children's Hospital New Orleans, the ease of use of integrating Tru-D into the daily activities of team members combined with the end result of a decrease in hospital-acquired infections made it a prudent choice with an important safety outcome."
Tru-D is the only UVC disinfection device with a randomized clinical trial that showed Tru-D was able to reduce the relative risk of colonization and infection caused by epidemiologically-important pathogens among patients admitted to the same room by a cumulative 30% in hospital settings with 93% compliance of standard disinfection protocols. Individual hospital results may vary.