According to the Centers for Disease Control and Prevention, on any given day, about one in every 25 hospital patients has at least one healthcare-associated infection (HAI). HAIs continue to remain a high profile and serious issue, becoming even more visible with recent and highly publicized outbreaks of the Ebola virus, deadly strains of enteroviruses and new strains of influenza, such as H3N2 and H3N2v.
As the public looks for answers, hospitals and other healthcare facilities are boosting their infection control programs and protocols, adding new technologies and infection control methods to their existing infection control practices. Among these is the use of ultraviolet light for decontamination.
In this Q & A, Sanford Green, president of Spectra254, discusses UVC light, how HAIs are changing hospitals’ infection control practices and the unique role nurses play in preventing the spread of HAIs.
What is UVC light and how does UVC light decontamination work?
UVC light is ultraviolet C light, which is short-wavelength light that is shorter than visible light. At certain wavelengths and lengths of time, UVC light is capable of killing microorganisms by disrupting their DNA, making them unable to reproduce and thereby rendering them harmless. Unlike UVA and UVB light, which can cause sunburns, UVC light is completely absorbed by the atmosphere.
UVC light decontamination devices utilize high output UVC lamps to emit a constant dosage of UVC light around a room. Cycle times as short as five minutes are effective in areas as large as 400 square feet. The light pattern is 360 degrees to maximize the coverage area and minimize shadowing. The UVC light in decontamination devices is produced using a germicidal lamp similar to a fluorescent overhead light. In most cases, one room is treated at a time.
What sort of bugs can be eliminated by UVC light technology?
UVC technology has been independently tested for its effectiveness in killing MRSA, influenza, the norovirus, salmonella, HIV, mold, Ebola, Clostridium difficile (C. diff), staph and many other viruses, bacteria, spores and super bugs.
The industry generally uses C. diff spore elimination as the benchmark for efficacy, because C. diff is the most difficult to kill, remaining active outside the body for up to three months on solid surfaces.
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How is UVC being used, by whom and where?
UVC is being used in both acute and post-acute healthcare settings, in operating rooms, patient and isolation rooms, laboratories within hospitals, emergency departments and waiting rooms. Historically, hospitals have been the primary users of the technology because of the need for greater infection control protocols.
Post-acute care facilities, nurse-assisted living, general ambulatory, clinics and even private medical practices are now adding UVC sanitation systems to strengthen their infection control practices, largely due to the potential for acquired infections and the high cost of treating them. Acquired Infections are not covered by insurance plans. UVC decontamination systems are quick, safe and easy to operate.
In some cases in post-acute care, doctors’ offices and health clinics don’t have environmental staff onsite. In those circumstances, UVC is the only significant means of decontamination available.
UVC systems are also being used in both collegiate and professional sports, disaster recovery services, environmental cleaning companies and by the federal government.
What is the history of UVC light and its uses?
UVC light was first recognized for its bacterial elimination ability in the 1870s and the first UVC light was invented in 1906. UVC decontamination systems have been used to clean air and water since the 1950s. A large majority of our municipal water departments today utilize UVC technology as a final process in recycling our drinking water.
In the last four years, the use of UVC sanitation systems has grown in healthcare. This is due to the documented increase in HAIs and Medicare’s Hospital Readmissions Reduction Program. Today, hospitals that score poorly on meeting quality standards and in patient satisfaction can lose up to 2% of their Medicare reimbursements. As a quick example, a typical 300 bed hospital with below-standard metrics would be penalized approximately $1.3 million.
Does UVC light decontamination replace chemical cleaning or should it be used in addition to chemical cleaning? How is UVC light decontamination different from chemical cleaning?
UVC light treatment does not replace chemical cleaning, also known as terminal cleaning. It is a complement to chemical cleaning. Chemical cleaning can eliminate spills and large masses of contaminant. However, statistics show that terminal cleaning is only effective up to 50%. UVC light, on the other hand, can raise the disinfection rate to 99.9%. It is a green technology that does not expose medical staff to chemical fumes. For the nursing and environmental cleaning staff, it provides a much greater assurance that the room is completely sanitized and ready for the next patient. It also provides peace of mind. When patients know that their healthcare providers are using all of the technologies available to prevent infection and provide a safe, clean environment, the patient experience is improved and the recovery time is shorter. That kind of reassurance is something patients value.
Are there any risks associated with using UVC light?
To be effective, decontamination systems must emit very high dosages of UVC energy. Therefore, they are always operated when rooms are unoccupied. In a hospital environment, that would be upon every patient discharge, and prior to the admittance of a new patient to the room.
There are safety features on all systems that prevent the system from operating while the room is occupied, and turn the system off automatically if someone accidently enters the room during a cycle.
It is absolutely safe for patients and staff to occupy a room directly after decontamination. Also, UVC light doesn’t harm equipment or any objects within the room itself.
What kinds of protocols are being developed in medical facilities in response to Ebola and other HAIs?
Protocols vary from facility to facility. There is a focus on changing garments more frequently, decontaminating office and other equipment and, in some cases, facilities are disposing of everything in infection-exposed isolation rooms.
The CDC has issued specific protocols on the disposal of objects exposed to HAIs. In addition to a greater use of technologies like UVC systems, there is a greater focus on protecting healthcare workers and on patient processing. The CDC has updated guidelines for healthcare workers as well.
What role can nurses play in infection control and HAI prevention?
A nurse is typically the first provider of care, playing a significant role in HAI prevention. Nurses can be the first line of protection for a patient and a community by following infection control guidelines, encouraging others to practice good sanitization habits and by advocating for the establishment of concrete infection control protocols. In some facilities, such as small doctors’ offices, nurses may do the actual cleaning of rooms between patients, therefore playing an even more significant role in HAI prevention. Nurses and other hospital staff already have so much to do. Technologies like UVC light decontamination systems can make their jobs a little easier by starting with a room that is 99.9% sanitized.
Sanford Green is senior executive of Spectra254, a maker of UVC light decontamination systems.