The power of UVC: How 3 health systems slashed their HAI rates through a hybrid approach to infection prevention

Throughout the U.S., healthcare-acquired infections plague many patients and cost hospitals and health systems a large sum of capital. Each year, HAIs infect 2 million Americans and cost the healthcare industry $3.05 billion annually. However, these numbers can be significantly reduced through a comprehensive approach to infection prevention, which entails using UVC light in tandem with terminal cleaning.

During a webinar sponsored by Tru-D SmartUVC and hosted by Becker's Hospital Review Oct. 18, Alice Brewer, director of clinical affairs for Tru-D SmartUVC, discussed published evidence-based literature showing UVC's efficacy in disinfection and how hospitals can utilize various disinfection mechanisms based on their specific needs.

"Evidence-based practices on UVC really should be framed by a strategy focusing on improving safety," said Ms. Brewer. The overall goal of any disinfection program is to limit the spread of disease, which could substantially alter an individual's life. The statistics associated with HAIs are more than just numbers; they indicate individuals who have often had to put their lives on hold to combat infections they acquired within the four walls of a hospital. During the webinar, an individual shared his experience with an HAI. Following a physical at a hospital, the individual experienced nausea and vomiting that persisted throughout the next day. After the patient was hospitalized and had a stool sample test positive for Clostridium difficile, a staff member said this person likely contracted the infection during the physical at that same hospital. The individual's experience did not end during his four-day hospital stay; the antibiotics he took to kill the infection caused him to become very weak and therefore miss three weeks of work.  

The patient noted, "This experience translated into several weeks out of the office, significant out-of-pocket costs and prolonged malaise, all of which were theoretically preventable."

To eliminate the potential for this patient's experience to happen to others, hospitals and health systems should employ a comprehensive approach to infection prevention.

How Tru-D is improving patient safety
A lapse in properly disinfecting an area of a hospital puts patients at risk. Tru-D strives to nix this risk through its UV disinfection robot, which kills pathogens that cause many HAIs, including C. diff. Ms. Brewer noted there are more than a dozen studies conducted by third parties showing the efficacy of Tru-D. The robot works in tandem with other disinfection protocols, including best practices established by the CDC, World Health Organization and Association of periOperative Registered Nurses.

"There is no one thing that will by itself solve all of our problems when it comes to HAIs. We have to have a combination approach with good solid cleaning, hand hygiene, antimicrobial stewardship and the use of emerging technologies and adjunct cleaning processes," said Ms. Brewer.

Tru-D SmartUVC is an adjunct to terminal cleaning in the infection prevention space that is a core part of this hybrid approach. The robot is equipped with patented instrument-grade sensors that use a timed cycle. The sensors' capabilities make sure the robot thoroughly and consistently disinfects all areas of an environment.

One of the first studies analyzing UV inactivation of pathogens in a hospital room was conducted by William Rutala, PhD, MS, MPH, professor in the division of infectious diseases at the University of North Carolina School of Medicine in Chapel Hill. Using the Tru-D device, Dr. Rutala looked at inactivation in direct and indirect lines of sight, finding a 4.04 log10 reduction for direct exposure in decontamination and a 2.43 log10 reduction in indirect exposure in decontamination. The total room average kill rate using the Tru-D device was a 2.79 log10 reduction.

Additionally, the CDC funded a randomized clinical trial on UV disinfection, the Benefits of Enhanced Terminal Room Disinfection Study, testing Tru-D's effectiveness in disinfection when used as an adjunct to manual cleaning. Researchers found adding UVC to standard cleaning, such as quaternary ammonium, yielded a cumulative 30 percent risk reduction in the transfer of multidrug-resistant organisms.

How 3 healthcare systems reduced infection rates
The following three health systems have reported significant success in using Tru-D to decrease infection rates.

University of Wisconsin Health
Despite having a comprehensive CDI prevention bundle in place, Madison-based University of Wisconsin Health had an infections rate of 10 affected individuals per 10,000 patient days. The health system opted to take action to lower this figure and implemented nearly 14 Tru-D robots in October 2016 at a 91.6 percent utilization rate for their C. diff discharges and transfers for a nine-month span. Tru-D aided the health system in accomplishing this goal; the health system recently submitted data showing they achieved a nearly 50 percent reduction with 4.7 infections per 10,000 patient days. The health system also accrued savings totaling $1.3 million during those nine months due to decreased medical care to treat patients with HAIs.

Chesapeake Regional Healthcare
Chesapeake (Va.) Regional Healthcare was a participant in the CDC-funded BETR-D trial, testing the efficacy of Tru-D in improving disinfection when used as an adjunct to manual cleaning. The study provided the health system with Tru-D systems during the clinical trial. At the clinical trial's conclusion, Chesapeake Regional Healthcare opted to purchase four Tru-D robots due to the results it achieved when using the robots. The study found using Tru-D in combination with bleach resulted in a 12 percent decrease in C. diff infections.

Yavapai Regional Medical Center
Prescott, Ariz.-based Yavapai Regional Medical Center was experiencing escalated rates of ongoing C. diff transmission in one of their units. To slash these rates, the nonprofit health system honed in on this specific unit for nearly 38 days starting in December 2016. After a patient was discharged, staff would bring in a Tru-D device following the terminal cleaning process. In April 2017, the health system reported zero HAIs in that unit.

These use cases demonstrate how hospitals have used Tru-D to meet their organizations' unique infection control needs. Where some hospitals may use the robots for their isolation cases, others may employ them in their perioperative areas. Other hospitals may see potential in using Tru-D for both their isolation cases and perioperative areas.

Ms. Brewer said, "It is dependent on hospitals' needs and where their problems are. Then, it is about asking: How do you want to use Tru-D?"

Considering the ROI
The financial investment in such a device cannot be overlooked, especially as health systems and hospitals have leaner budgets. Ms. Brewer noted Tru D-is a substantial investment, which is why having a tool to evaluate return on investment is imperative. To calculate this figure, organizations should assess:
•    The number of HAIs recorded per year
•    Number of surgical site infections per year
•    Annual isolation cases
•    Number of perioperative suites
•    Cost of labor

Equipped with data to show the ROI, hospitals and health systems can get leadership on board. Having an organization strategically focused on improving patient safety is key, and Tru-D holds the potential to boost patient outcomes for hospitals and health systems across the U.S. A leader in the infection prevention space and one of the first researchers to study Tru-D's efficacy, Dr. Rutala said, "We need to say to our CFOs that we need these technologies, and we need to look at the data. The data shows a reduction in infections and we need to invest."

To view the webinar recording, click here.

To view the webinar slides, click here.

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