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Your options for attacking bacteria that survive manual cleaning.
GOT YOU COVERED High-tech disinfecting devices treat high-touch areas where staff members might miss during manual cleaning.
Whole-room disinfection systems don’t replace the need to carefully wipe down high-touch areas or mop OR floors, but they do attack bacteria on surfaces that even the most diligent member of your turnover team might have missed.
“It’s not a magic bullet,” says Jim Davis, MSN, CIC, a senior infection specialist at ECRI Institute, a healthcare research organization in Plymouth Meeting, Pa. “It’s an environmental control that should augment good manual cleaning and disinfection.”
Your options in whole-room disinfection include:
Ultraviolet light breaches the cell walls of viruses, bacteria and spores to deactivate their DNA and kill them in the air and on surfaces. Two types of devices use UV-C for germicidal irradiation: continuous light systems with 1- to 2-hour cycles and xenon-based pulsed light systems with 5- to 10-minute cycles. Both require direct illumination to treat targeted surfaces.
Hydrogen peroxide vapor systems deliver a heat-generated odorless vapor, which uses oxidative processes to kill microorganisms. When the systems are in use, a room’s doors, ducts and ventilation ports must be sealed.
Aerosolized hydrogen peroxide is uniformly sprayed with a pressure-generated aerosol, which delivers a residue-free mist that is typically made up of 5% to 6% hydrogen peroxide and a very small percentage of silver.
Ozone gas has been used in conjunction with high-powered air filtration and UV light to rid surfaces and air of microbe colonization.
Cluster ion air purifiers actively seek out pathogens via electromagnetic charge. On contact, their stored energy is unleashed through the pores of cell walls, destroying bacteria from the inside out.
Mercury UV-C light devices use low-pressure mercury gas bulbs that primarily emit a strong, narrow band of the UV-C spectrum. These devices use a dose targeted for specific types of bacteria on surfaces.
Right method for you?
Base your whole-room disinfection choice on how a system works in practice and the value you place on reducing the risk of healthcare-acquired infections (HAIs). Each system’s disinfection agent and its mechanism of action require specific preparations to achieve optimal results. A room’s size and shape, the layout of its equipment and fixtures, and the reflectivity of its surfaces can all impact effectiveness.
UVC light systems need clear lines of sight to treat surfaces; if the light doesn’t hit a particular spot, it doesn’t disinfect it. That means you might have to reposition the unit between multiple cycles and move equipment around the room to ensure all surfaces are treated.
Systems that use hydrogen peroxide and other combinations of mists and vapors are less dependent on line of sight. They are, however, potentially more labor intensive because you have to cover air vents and seal OR doors before activating the devices. Time also is needed for chemicals to sufficiently dissipate before you can re-enter a disinfected room.
You ultimately have to decide what type of disinfection device is worth the investment. Compare the initial capital investment, per-use disposables and the associated labor costs with the hundreds of thousands of dollars a healthcare-acquired infection can cost your facility to treat. OSM
FYI: Multiple ultraviolet fixtures are mounted to ceilings, walls and above doors in the OR to eliminate shadowed areas. The mounting system eliminates the need to place the device in multiple positions to treat all areas of the room and requires no extra staff to operate. The daily disinfection cycle takes less than 10 minutes when used as part of a terminal-cleaning protocol. The system provides data logging and a touchscreen interface, which let operators monitor lamp intensity and fixture functionality.
FYI: The 3 Bioquell models — which are based on usage and room size — use a 35% hydrogen peroxide solution to disperse a vapor that covers every exposed surface in the room and eliminates 99.9999% of contaminants, the company says. The technology reaches fungi, bacteria, viruses and spores from ceiling to floor, and decontaminates difficult-to-clean areas. You must seal rooms with tape to prevent vapor from escaping during use. You do not have to reposition the system and run several cycles, and there is no residue or odors left behind. Once a cycle is complete, the room can be reoccupied immediately.
FYI: The Clorox Healthcare Optimum-UV Enlight System includes 4 62-inch UV-C lamps and emits energy in a full circle over the height of the device to kill more than 30 HAI-causing pathogens within an 8-foot direct line of sight. The ultraviolet lamps emit a predominantly discreet wavelength of approximately 254 nm, the ideal wavelength to kill microorganisms by inactivating their DNA. The system has 4 infrared motion sensors to prevent operation if people are present and stops immediately if it detects motion in the room. It includes an intuitive touchscreen, advanced data collection and reporting capabilities. The room can be occupied immediately after the cycle.
FYI: The no-touch aerosolized hydrogen peroxide system uses a 5% hydrogen-peroxide-based disinfectant and ensures uniform delivery throughout a room. It treats up to 10,000 cubic feet in less than an hour and eliminates 99.9999% of infection-causing pathogens, says the company. The system delivers an EPA-validated 6-log kill rate of C. difficile spores to all exposed surfaces within a room.
FYI: The Illuvia system is designed to continuously remove airborne bacteria from ORs, including instrument and implant areas. It uses C-UVC technology and HEPA filtration to eliminate air microorganisms and provides real-time monitoring of air levels. The C-UVC technology is housed internally and is safe for continuous use in occupied spaces. The diffused, low- velocity, non-turbulent air flow does not create disruptive air currents. The system reduces OR bacterial contamination levels by 50% to 70% as shown in multiple peer-review studies, says the company.
FYI: The IPT 3200 with UV technology delivers the highest energy output with rapid, single-cycle, whole-room disinfection while delivering more germicidal power quickly. It disinfects direct, indirect and shadowed surfaces with a documented high clinical pathogen kill rate. The IPT 3200 automatically selects appropriate run times based on room size and characteristics, and disinfects entire rooms without repositioning, says the company. It is equipped with a cloud-based system to document treatments for data storage and statistical analysis.
FYI: The Helios system implements 3 emitters that allow it to disinfect surface areas with a single cycle and no repositioning. A “laser mapping” feature scans the room and automatically creates a disinfecting plan. The system can also direct UV-C energy into a user-defined area, such as multi-bedded bays, portable workstations and around surgical tables. For added flexibility, the unit’s emitters can be decoupled and utilized individually in small spaces such as bathrooms. The system instantly shuts off the 3 emitters if it detects movement during a cycle. Data indicate that it eradicates several multi-drug resistant organisms, says the company.
FYI: This remote-controlled system uses 8 sensors to scan a room’s size, geometry, surface reflectivity and contents to deliver an automated, measured dose of UVC light using mercury bulbs to all surfaces, including shadowed areas, during a single cycle and without repositioning. It is designed to break down the DNA of bacteria, viruses and spores, leaving them unable to reproduce. The system notifies you when a cycle is complete with an audio alert or text message. The cloud-based, data-tracking technology transfers usage data to a customized portal to provide real-time results through graphics and exportable data.
FYI: The “germ-zapping robot” features pulsing xenon bulbs that produce bursts of ultraviolet C (UV-C) light, which penetrate the cell walls of bacteria, viruses, mold, fungus and spores. Their DNA is instantly fused so that they’re unable to reproduce or mutate. No warm-up or cool-down periods required. A cloud-based portal lets you know who used it where.
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