This study evaluated the effectiveness of using ultraviolet-C (UV-C) radiation for environmental disinfection in reducing healthcare-associated infections (HAIs) at a hospital in California. The study found that implementing a dedicated service model for facility-wide UV-C treatment significantly reduced the incidence of HAIs by 34.2% compared to the period before UV-C intervention. Regular UV-C treatments of patient rooms and high-touch surfaces maintained lower HAI rates and reduced the total number and incidence of HAIs by 28.8% compared to traditional cleaning methods alone. The results suggest that continuous, monitored UV-C disinfection of the hospital environment can decrease disease transmission and improve patient outcomes.
Evaluation of Biological effects of X-radiography and computed tomography sca...Muhammid Al-Baghdadi
This document reports on a study that evaluated the biological effects of X-radiography and computed tomography (CT) scans on oral microflora. 432 patients were divided into two groups, with one group exposed to X-radiography and the other to CT scans. Samples were taken from patients' oral cavities before and after exposure to measure the viability of normal oral flora. The results showed that radiation, especially from CT scans, increased the bacterial count for most species after exposure. Fungal isolates and one bacterial species decreased. Some isolates were not affected by X-radiography. Radiation was found to disturb the microbial balance in the oral cavity by increasing densities of most species. Limiting radiation exposure is important to prevent effects
"Beds of Roses" Reducing HCAI Conference June, 2014conorstapleton
- Nurses are often responsible for cleaning patient environments and equipment, but studies show cleaning is often inadequate, with many surfaces missed. Extra cleaning can significantly reduce healthcare associated infections.
- Pillows and mattresses may harbor pathogens if not properly disinfected between patients. Studies have found high contamination rates of pillows with pathogens like MRSA. Clear guidelines are needed for decontamination of beds and pillows.
- Responsibility for cleaning is often unclear or divided between nurses and housekeeping. A pictorial manual clearly outlining cleaning duties can help address this. Overall, more attention to monitoring and improving environmental cleaning is still needed.
Infection Control and Antibiotic Stewardship Symposia presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
This document summarizes a study that observed hand hygiene compliance at a petting zoo through hidden video recordings. The study implemented various interventions to increase hand washing but had limitations like the Hawthorne effect from visitors aware of cameras. Future studies could improve by adding more hand sanitation stations, collecting longer-term data from multiple zoos, and concealing cameras better to get more accurate results on effective interventions.
Guideline for disinfection and sterilization in healthcare facilities, 2008[1]Manel Ferreira
This document provides guidelines for disinfection and sterilization in healthcare facilities. It discusses various methods of cleaning, disinfection and sterilization for patient care equipment. It categorizes items based on risk of infection as critical, semi-critical or non-critical and provides recommendations for processes to reduce risk of infection from each category. New topics covered include inactivation of antibiotic resistant and emerging pathogens, toxicological concerns, and disinfection of equipment used in ambulatory and home care settings.
Service Ecology: Design Issues for Hospital Infection Prevention and Control ...ServDes
This document discusses the development of a tablet-based visualization tool called VisionOn to help train hospital staff on infection prevention and control. It aims to address issues like the lack of adherence to IPC protocols, lack of understanding of pathogens, and outdated IPC training materials which all contribute to the growing problem of antimicrobial resistance. The tool would visualize data on the key actors in the hospital service ecosystem - healthcare workers, pathogens, and the hospital environment - and their interactions, drawing from observational studies on hand touchpoints. This approach could help improve staff training and understanding of infection risks and protocols.
This document provides guidelines for standardizing immunohistochemistry (IHC) testing in veterinary diagnostic laboratories. It addresses topics such as antibody selection, fixation, antigen retrieval, controls, buffers, and detection systems. The validation of an IHC test is important for both infectious diseases and neoplasms. Proper standardization and validation of IHC techniques will improve diagnostic accuracy in veterinary pathology. Following these guidelines will help obtain reproducible and consistent IHC results within and between laboratories.
Evaluation of Biological effects of X-radiography and computed tomography sca...Muhammid Al-Baghdadi
This document reports on a study that evaluated the biological effects of X-radiography and computed tomography (CT) scans on oral microflora. 432 patients were divided into two groups, with one group exposed to X-radiography and the other to CT scans. Samples were taken from patients' oral cavities before and after exposure to measure the viability of normal oral flora. The results showed that radiation, especially from CT scans, increased the bacterial count for most species after exposure. Fungal isolates and one bacterial species decreased. Some isolates were not affected by X-radiography. Radiation was found to disturb the microbial balance in the oral cavity by increasing densities of most species. Limiting radiation exposure is important to prevent effects
"Beds of Roses" Reducing HCAI Conference June, 2014conorstapleton
- Nurses are often responsible for cleaning patient environments and equipment, but studies show cleaning is often inadequate, with many surfaces missed. Extra cleaning can significantly reduce healthcare associated infections.
- Pillows and mattresses may harbor pathogens if not properly disinfected between patients. Studies have found high contamination rates of pillows with pathogens like MRSA. Clear guidelines are needed for decontamination of beds and pillows.
- Responsibility for cleaning is often unclear or divided between nurses and housekeeping. A pictorial manual clearly outlining cleaning duties can help address this. Overall, more attention to monitoring and improving environmental cleaning is still needed.
Infection Control and Antibiotic Stewardship Symposia presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
This document summarizes a study that observed hand hygiene compliance at a petting zoo through hidden video recordings. The study implemented various interventions to increase hand washing but had limitations like the Hawthorne effect from visitors aware of cameras. Future studies could improve by adding more hand sanitation stations, collecting longer-term data from multiple zoos, and concealing cameras better to get more accurate results on effective interventions.
Guideline for disinfection and sterilization in healthcare facilities, 2008[1]Manel Ferreira
This document provides guidelines for disinfection and sterilization in healthcare facilities. It discusses various methods of cleaning, disinfection and sterilization for patient care equipment. It categorizes items based on risk of infection as critical, semi-critical or non-critical and provides recommendations for processes to reduce risk of infection from each category. New topics covered include inactivation of antibiotic resistant and emerging pathogens, toxicological concerns, and disinfection of equipment used in ambulatory and home care settings.
Service Ecology: Design Issues for Hospital Infection Prevention and Control ...ServDes
This document discusses the development of a tablet-based visualization tool called VisionOn to help train hospital staff on infection prevention and control. It aims to address issues like the lack of adherence to IPC protocols, lack of understanding of pathogens, and outdated IPC training materials which all contribute to the growing problem of antimicrobial resistance. The tool would visualize data on the key actors in the hospital service ecosystem - healthcare workers, pathogens, and the hospital environment - and their interactions, drawing from observational studies on hand touchpoints. This approach could help improve staff training and understanding of infection risks and protocols.
This document provides guidelines for standardizing immunohistochemistry (IHC) testing in veterinary diagnostic laboratories. It addresses topics such as antibody selection, fixation, antigen retrieval, controls, buffers, and detection systems. The validation of an IHC test is important for both infectious diseases and neoplasms. Proper standardization and validation of IHC techniques will improve diagnostic accuracy in veterinary pathology. Following these guidelines will help obtain reproducible and consistent IHC results within and between laboratories.
The survey assessed perceptions of infection control committee members in Brazilian hospitals concerning infection surveillance and control programs. It found that while most hospitals perform surveillance and isolation for multidrug-resistant organisms, a significant portion lack written infection control protocols and antimicrobial stewardship programs. There were also regional disparities, with the North having less standardized surveillance compared to other regions. Many professionals underestimated the true prevalence of antimicrobial resistance in their hospitals. The survey highlights a need for more standardized infection control policies and use of local antimicrobial susceptibility data across Brazilian hospitals.
Field Based Application of Automated Image Processing Using Windows Phone Gui...Melvin Marzan
This document discusses a study on using a Windows phone application called Lifelens along with a specialized lens to diagnose malaria. The study aims to test the efficacy, sensitivity, and reliability of this new diagnostic method in field settings, and compare it to existing diagnostic methods like microscopy and rapid diagnostic tests. The objectives are to measure the sensitivity and specificity of Lifelens, and to evaluate its practicality, cost-effectiveness, and accuracy for diagnosing malaria in community and field settings.
Webinar: Defeating Superbugs: Hospitals on the Front Lines Modern Healthcare
About the Webinar: Defeating Superbugs: Hospitals on the Front Lines
http://www.modernhealthcare.com/article/20140917/INFO/309179926
Hospitals across the country are facing a grim reality in which some of the most deadly healthcare-associated infections they encounter are untreatable with first- or even second-line antibiotics. These “superbugs” affect at least 2 million Americans each year and lead to 23,000 deaths. And their threat is growing, public health officials warn. This editorial webinar and “Defeating Superbugs” white paper will explore the steps providers must take to ramp up surveillance efforts, promote appropriate antibiotic use and control outbreaks. Our panel of experts will share their organizations' experiences as well as proven strategies for success.
Registration for this webinar includes Modern Healthcare's “Defeating Superbugs” white paper, with proven tips and strategies for promoting appropriate antibiotic use, improving infection surveillance, identifying drug-resistant infections and dealing with outbreaks.
KEY TAKEAWAYS
- Best practices for effective antimicrobial stewardship
- Real-world examples of effective interventions, including universal rapid testing for drug-resistant MRSA
- Tips for engaging senior leadership
- Aggressive strategies for controlling outbreaks
PANELISTS
Lance Peterson
Director of the Clinical Microbiology and Infectious Disease Research Division
NorthShore University HealthSystem, Evanston, Ill.
Anurag Malani
Medical Director for the Infection Prevention and Antimicrobial Stewardship Programs
St. Joseph Mercy Hospital, Ann Arbor, Mich.
Robert Weinstein
Chief Medical Officer for Population Health
Chairman of the Department of Medicine, Cook County Health and Hospitals System; Professor, Rush University Medical Center, Chicago
MODERATOR
Maureen McKinney
Editorial Programs Manager
Modern Healthcare
This document outlines Patient Safety Goal 4 to tackle antimicrobial resistance as part of WHO's 3rd Global Patient Safety Challenge. It describes 3 indicators to monitor the incidence of MRSA, ESBL-Klebsiella Pneumoniae, and ESBL-E.coli infections. Data on newly identified multidrug resistant organism cases will be collected and the infection rates calculated monthly. Strategies like implementing antibiotic guidelines, stewardship programs, and national campaigns aim to optimize antibiotic use and contain the spread of antimicrobial resistance.
CDC Director Releases After-Action Report on Recent Anthrax Incident; Highlights Steps to Improve Laboratory Quality and Safety http://www.cdc.gov/od/science/integrity/docs/Final_Anthrax_Report.pdf
Role of the Laboratory in Antimicrobial Resistance DataAnuj Sharma
The document discusses the role of microbiology laboratories in collecting, analyzing, and circulating antimicrobial resistance data. It outlines how laboratories provide antibiograms, which summarize local bacterial susceptibility patterns to guide empiric antibiotic therapy. The data can also be used for quality improvement, infection control, outbreak detection, and surveillance of resistance trends over time. The document recommends following Clinical and Laboratory Standards Institute guidelines for generating high quality antibiograms and discusses how data can be managed and shared using software tools like WHONET.
1) The Ebola virus outbreak in the United States posed new challenges to the healthcare community as facilities had to treat their first cases.
2) The virus highlighted weaknesses in public health infrastructure and protocols for handling infectious diseases. Healthcare workers felt increased anxiety after two nurses in Dallas were infected while treating an Ebola patient.
3) In response, the CDC issued frequent guidance updates and healthcare facilities worked to strengthen protocols for safely treating potential Ebola patients and properly disposing of contaminated medical waste and equipment.
Providing Tools for a Healthier, More Abundant Quality of LifeBrian Milner
“Aging should be a continued stage of development and growth, rather than a period of decline.” ~The Eden Alternative Antimicrobial Stewardship. Disease Control & Prevention
24x7 Automated Behavior Tracking For Rodent Safety Pharmacology & PhenotypingInsideScientific
Actual Analytics Ltd and its development partners present an exclusive webinar describing the applications of a novel Home Cage Analysis system for tracking behavior in group housed rodents, with retained identity, in regular IVC racked home cages.
In this webinar, Dr. Will Redfern of AstraZeneca and Dr. Sara Wells of MRC Harwell discuss 24/7 monitoring of group-housed rodents in their true IVC racked home cage environment for safety pharmacology and phenotyping applications.
Discussions describe the types of new insights that can be obtained from 24/7 monitoring of research animals including activity differences in single and group animals and body temperature profiles in response to drug treatment. Presenters show how they are using this system in various applications from safety pharmacology in rats through to phenotyping studies in mice.
This document discusses Clostridium difficile (C. difficile) infection, including that it affects 40% of patients in hospital settings, surpasses MRSA infections, and is transmitted through the fecal-oral route. Risk factors include antibiotic use, advanced age, and recent surgery or chemotherapy. Signs and symptoms range from mild to severe diarrhea and systemic complications. Prevention strategies discussed include hand hygiene, contact precautions, environmental cleaning, and antibiotic stewardship.
Antibiotic Stewardship: A National and International ImperativePYA, P.C.
J. Michael Keegan, MD, an infectious disease specialist who leads the antibiotic stewardship team at PYA, discussed antibiotic stewardship at the South Dakota Pharmacists Association’s (SDPHA) Annual Convention in Deadwood, South Dakota.
The document discusses the importance of hospital antibiograms for monitoring antimicrobial resistance trends and supporting clinical decision making. It outlines recommendations from the Clinical and Laboratory Standards Institute (CLSI) for creating an antibiogram, including only using final verified results, analyzing data at least yearly, including common species with at least 30 isolates, and calculating percentage susceptibility without intermediate results. The document provides examples of supplemental analysis that can stratify data by location, resistance characteristics, specimen type, or clinical service. It emphasizes the utility of combination antibiograms for guiding therapy against pathogens often treated with drug combinations.
Knowledge, Attitudes, and Practice towards Mobile Phone Hygiene among Healthc...Premier Publishers
AIM: To analyze the level of knowledge, attitude and practice of health care workers regarding mobile phone hygiene in Riyadh Elm University. METHODS: A total of 153 respondents completed the questionnaire. A 26 variable questionnaire was employed to assess knowledge, attitude and practice regarding mobile phone hygiene amongst health care workers after obtaining consent and institutional permission. RESULTS: A response rate of 92.8% resulted in 153 questionnaires to be assessed. The study results showed that 62.5% of the respondents used mobile phones regularly, for professional or personal use and 82.4% of them considered mobile phones as a source of nosocomial infection. 90.2% of them opined that they would clean their mobile phones regularly following the COVID 19 (Coronavirus) infection. CONCLUSION: Easily available disinfectant materials must be employed in health care settings to disinfect mobile phone. Educational interventional programs must be advocated to ensure proper phone hygiene.
Antimicrobial resistance (AMR) poses a major threat to global healthcare. If left unchecked, more deaths will occur from resistant infections than cancer by 2050. Local actions are needed to tackle AMR through appropriate antimicrobial use. The document discusses various tools and strategies available for local antimicrobial stewardship groups, healthcare professionals, and the public to raise awareness and promote prudent antibiotic use. Public awareness campaigns like the European Antibiotic Awareness Day (EAAD) educate about only taking antibiotics when necessary. Local examples show how engaging stakeholders and monitoring antibiotic prescribing can reduce unnecessary use. Coordinated global and local efforts are required to slow the development of AMR.
Code of practice for clinical biochemistry chemical pathologistsVnhDng7
The document provides guidelines for clinical biochemists and clinical biochemistry services. It discusses management of services, staffing and workload, and safety. Key points include that clinical biochemists should take on management roles and ensure high quality services. Staffing levels should be adequate for workload. Safety is a joint responsibility and periodic inspections should be conducted. The guidelines are intended to help provide effective, reliable and safe pathology services.
Realize preventive medicine through predictive risk profiling, determining baseline markers of wellness and variability, and engaging in personalized pre-clinical interventions
Blood Culture Contamination at RUMC, A clinicians PerspectiveLuis Beverido
This document discusses reducing blood culture contamination rates at RUMC. It notes that target contamination rates are 2-3% and the median rate is 2.92%. The document explores how contamination affects patient care/safety, costs, and financial implications. It provides data on RUMC's contamination rates by unit from July-September 2013. The document proposes strategies to reduce contamination through education and process changes.
INFECTION CONTROL TRENDS newsletter
Volume 1 | Issue 2 | January 2019 Circulation: Quarterly | All-India | e-Copy format
ACCREDITATION & QUALITY IN INFECTION CONTROL
CHIEF EDITOR Dr. Ranga Reddy
EDITOR Dr. T V Rao
EDITOR & CONCEPT Dr. Dhruv Mamtora
TEAM MEMBER Sister Solbymol
ACCREDITATION & QUALITY IN INFECTION CONTROL
The document discusses the changing role of infection control nurses in healthcare. It notes that infection control is a team effort involving various medical professionals. Infection control nurses play a vital role in preventing the spread of infections in hospitals by educating other nurses and staff on hygiene procedures. Their responsibilities include monitoring infection rates, implementing guidelines, and reporting occurrences. With the rise of antibiotic-resistant infections, the visibility and responsibilities of infection control nurses have increased. Proper hand hygiene is emphasized as one of the most important tools for reducing infection rates.
The B-Safe system aims to prevent the spread of viruses like HIV and hepatitis C among intravenous drug users. It consists of a portable case containing a syringe that is sanitized using ultraviolet-C light. When a user closes the case for five minutes after injecting, the light deactivates viruses in the syringe that may be transmitted if the syringe is reused. The system seeks to address the risks of blood residue remaining in reused syringes. Current prototypes need further development and testing before the cases can be distributed to active drug users for real-world testing of effectiveness and usability.
1) A hospital implemented ultraviolet room disinfection from February to July 2013 after standard terminal cleaning to reduce Clostridium difficile infections.
2) Over 4,600 disinfection interventions were performed, with 674 being spore treatments averaging 19 minutes.
3) The C. difficile infection rate during the intervention period was 24.95% lower than the previous year, showing ultraviolet disinfection may be an effective tool for prevention. However, the impact on hospital operations needs consideration as an additional cleaning step.
The survey assessed perceptions of infection control committee members in Brazilian hospitals concerning infection surveillance and control programs. It found that while most hospitals perform surveillance and isolation for multidrug-resistant organisms, a significant portion lack written infection control protocols and antimicrobial stewardship programs. There were also regional disparities, with the North having less standardized surveillance compared to other regions. Many professionals underestimated the true prevalence of antimicrobial resistance in their hospitals. The survey highlights a need for more standardized infection control policies and use of local antimicrobial susceptibility data across Brazilian hospitals.
Field Based Application of Automated Image Processing Using Windows Phone Gui...Melvin Marzan
This document discusses a study on using a Windows phone application called Lifelens along with a specialized lens to diagnose malaria. The study aims to test the efficacy, sensitivity, and reliability of this new diagnostic method in field settings, and compare it to existing diagnostic methods like microscopy and rapid diagnostic tests. The objectives are to measure the sensitivity and specificity of Lifelens, and to evaluate its practicality, cost-effectiveness, and accuracy for diagnosing malaria in community and field settings.
Webinar: Defeating Superbugs: Hospitals on the Front Lines Modern Healthcare
About the Webinar: Defeating Superbugs: Hospitals on the Front Lines
http://www.modernhealthcare.com/article/20140917/INFO/309179926
Hospitals across the country are facing a grim reality in which some of the most deadly healthcare-associated infections they encounter are untreatable with first- or even second-line antibiotics. These “superbugs” affect at least 2 million Americans each year and lead to 23,000 deaths. And their threat is growing, public health officials warn. This editorial webinar and “Defeating Superbugs” white paper will explore the steps providers must take to ramp up surveillance efforts, promote appropriate antibiotic use and control outbreaks. Our panel of experts will share their organizations' experiences as well as proven strategies for success.
Registration for this webinar includes Modern Healthcare's “Defeating Superbugs” white paper, with proven tips and strategies for promoting appropriate antibiotic use, improving infection surveillance, identifying drug-resistant infections and dealing with outbreaks.
KEY TAKEAWAYS
- Best practices for effective antimicrobial stewardship
- Real-world examples of effective interventions, including universal rapid testing for drug-resistant MRSA
- Tips for engaging senior leadership
- Aggressive strategies for controlling outbreaks
PANELISTS
Lance Peterson
Director of the Clinical Microbiology and Infectious Disease Research Division
NorthShore University HealthSystem, Evanston, Ill.
Anurag Malani
Medical Director for the Infection Prevention and Antimicrobial Stewardship Programs
St. Joseph Mercy Hospital, Ann Arbor, Mich.
Robert Weinstein
Chief Medical Officer for Population Health
Chairman of the Department of Medicine, Cook County Health and Hospitals System; Professor, Rush University Medical Center, Chicago
MODERATOR
Maureen McKinney
Editorial Programs Manager
Modern Healthcare
This document outlines Patient Safety Goal 4 to tackle antimicrobial resistance as part of WHO's 3rd Global Patient Safety Challenge. It describes 3 indicators to monitor the incidence of MRSA, ESBL-Klebsiella Pneumoniae, and ESBL-E.coli infections. Data on newly identified multidrug resistant organism cases will be collected and the infection rates calculated monthly. Strategies like implementing antibiotic guidelines, stewardship programs, and national campaigns aim to optimize antibiotic use and contain the spread of antimicrobial resistance.
CDC Director Releases After-Action Report on Recent Anthrax Incident; Highlights Steps to Improve Laboratory Quality and Safety http://www.cdc.gov/od/science/integrity/docs/Final_Anthrax_Report.pdf
Role of the Laboratory in Antimicrobial Resistance DataAnuj Sharma
The document discusses the role of microbiology laboratories in collecting, analyzing, and circulating antimicrobial resistance data. It outlines how laboratories provide antibiograms, which summarize local bacterial susceptibility patterns to guide empiric antibiotic therapy. The data can also be used for quality improvement, infection control, outbreak detection, and surveillance of resistance trends over time. The document recommends following Clinical and Laboratory Standards Institute guidelines for generating high quality antibiograms and discusses how data can be managed and shared using software tools like WHONET.
1) The Ebola virus outbreak in the United States posed new challenges to the healthcare community as facilities had to treat their first cases.
2) The virus highlighted weaknesses in public health infrastructure and protocols for handling infectious diseases. Healthcare workers felt increased anxiety after two nurses in Dallas were infected while treating an Ebola patient.
3) In response, the CDC issued frequent guidance updates and healthcare facilities worked to strengthen protocols for safely treating potential Ebola patients and properly disposing of contaminated medical waste and equipment.
Providing Tools for a Healthier, More Abundant Quality of LifeBrian Milner
“Aging should be a continued stage of development and growth, rather than a period of decline.” ~The Eden Alternative Antimicrobial Stewardship. Disease Control & Prevention
24x7 Automated Behavior Tracking For Rodent Safety Pharmacology & PhenotypingInsideScientific
Actual Analytics Ltd and its development partners present an exclusive webinar describing the applications of a novel Home Cage Analysis system for tracking behavior in group housed rodents, with retained identity, in regular IVC racked home cages.
In this webinar, Dr. Will Redfern of AstraZeneca and Dr. Sara Wells of MRC Harwell discuss 24/7 monitoring of group-housed rodents in their true IVC racked home cage environment for safety pharmacology and phenotyping applications.
Discussions describe the types of new insights that can be obtained from 24/7 monitoring of research animals including activity differences in single and group animals and body temperature profiles in response to drug treatment. Presenters show how they are using this system in various applications from safety pharmacology in rats through to phenotyping studies in mice.
This document discusses Clostridium difficile (C. difficile) infection, including that it affects 40% of patients in hospital settings, surpasses MRSA infections, and is transmitted through the fecal-oral route. Risk factors include antibiotic use, advanced age, and recent surgery or chemotherapy. Signs and symptoms range from mild to severe diarrhea and systemic complications. Prevention strategies discussed include hand hygiene, contact precautions, environmental cleaning, and antibiotic stewardship.
Antibiotic Stewardship: A National and International ImperativePYA, P.C.
J. Michael Keegan, MD, an infectious disease specialist who leads the antibiotic stewardship team at PYA, discussed antibiotic stewardship at the South Dakota Pharmacists Association’s (SDPHA) Annual Convention in Deadwood, South Dakota.
The document discusses the importance of hospital antibiograms for monitoring antimicrobial resistance trends and supporting clinical decision making. It outlines recommendations from the Clinical and Laboratory Standards Institute (CLSI) for creating an antibiogram, including only using final verified results, analyzing data at least yearly, including common species with at least 30 isolates, and calculating percentage susceptibility without intermediate results. The document provides examples of supplemental analysis that can stratify data by location, resistance characteristics, specimen type, or clinical service. It emphasizes the utility of combination antibiograms for guiding therapy against pathogens often treated with drug combinations.
Knowledge, Attitudes, and Practice towards Mobile Phone Hygiene among Healthc...Premier Publishers
AIM: To analyze the level of knowledge, attitude and practice of health care workers regarding mobile phone hygiene in Riyadh Elm University. METHODS: A total of 153 respondents completed the questionnaire. A 26 variable questionnaire was employed to assess knowledge, attitude and practice regarding mobile phone hygiene amongst health care workers after obtaining consent and institutional permission. RESULTS: A response rate of 92.8% resulted in 153 questionnaires to be assessed. The study results showed that 62.5% of the respondents used mobile phones regularly, for professional or personal use and 82.4% of them considered mobile phones as a source of nosocomial infection. 90.2% of them opined that they would clean their mobile phones regularly following the COVID 19 (Coronavirus) infection. CONCLUSION: Easily available disinfectant materials must be employed in health care settings to disinfect mobile phone. Educational interventional programs must be advocated to ensure proper phone hygiene.
Antimicrobial resistance (AMR) poses a major threat to global healthcare. If left unchecked, more deaths will occur from resistant infections than cancer by 2050. Local actions are needed to tackle AMR through appropriate antimicrobial use. The document discusses various tools and strategies available for local antimicrobial stewardship groups, healthcare professionals, and the public to raise awareness and promote prudent antibiotic use. Public awareness campaigns like the European Antibiotic Awareness Day (EAAD) educate about only taking antibiotics when necessary. Local examples show how engaging stakeholders and monitoring antibiotic prescribing can reduce unnecessary use. Coordinated global and local efforts are required to slow the development of AMR.
Code of practice for clinical biochemistry chemical pathologistsVnhDng7
The document provides guidelines for clinical biochemists and clinical biochemistry services. It discusses management of services, staffing and workload, and safety. Key points include that clinical biochemists should take on management roles and ensure high quality services. Staffing levels should be adequate for workload. Safety is a joint responsibility and periodic inspections should be conducted. The guidelines are intended to help provide effective, reliable and safe pathology services.
Realize preventive medicine through predictive risk profiling, determining baseline markers of wellness and variability, and engaging in personalized pre-clinical interventions
Blood Culture Contamination at RUMC, A clinicians PerspectiveLuis Beverido
This document discusses reducing blood culture contamination rates at RUMC. It notes that target contamination rates are 2-3% and the median rate is 2.92%. The document explores how contamination affects patient care/safety, costs, and financial implications. It provides data on RUMC's contamination rates by unit from July-September 2013. The document proposes strategies to reduce contamination through education and process changes.
INFECTION CONTROL TRENDS newsletter
Volume 1 | Issue 2 | January 2019 Circulation: Quarterly | All-India | e-Copy format
ACCREDITATION & QUALITY IN INFECTION CONTROL
CHIEF EDITOR Dr. Ranga Reddy
EDITOR Dr. T V Rao
EDITOR & CONCEPT Dr. Dhruv Mamtora
TEAM MEMBER Sister Solbymol
ACCREDITATION & QUALITY IN INFECTION CONTROL
The document discusses the changing role of infection control nurses in healthcare. It notes that infection control is a team effort involving various medical professionals. Infection control nurses play a vital role in preventing the spread of infections in hospitals by educating other nurses and staff on hygiene procedures. Their responsibilities include monitoring infection rates, implementing guidelines, and reporting occurrences. With the rise of antibiotic-resistant infections, the visibility and responsibilities of infection control nurses have increased. Proper hand hygiene is emphasized as one of the most important tools for reducing infection rates.
The B-Safe system aims to prevent the spread of viruses like HIV and hepatitis C among intravenous drug users. It consists of a portable case containing a syringe that is sanitized using ultraviolet-C light. When a user closes the case for five minutes after injecting, the light deactivates viruses in the syringe that may be transmitted if the syringe is reused. The system seeks to address the risks of blood residue remaining in reused syringes. Current prototypes need further development and testing before the cases can be distributed to active drug users for real-world testing of effectiveness and usability.
1) A hospital implemented ultraviolet room disinfection from February to July 2013 after standard terminal cleaning to reduce Clostridium difficile infections.
2) Over 4,600 disinfection interventions were performed, with 674 being spore treatments averaging 19 minutes.
3) The C. difficile infection rate during the intervention period was 24.95% lower than the previous year, showing ultraviolet disinfection may be an effective tool for prevention. However, the impact on hospital operations needs consideration as an additional cleaning step.
An infection control nurse informed the PICU consultant that two patients have been found to have MDR Acinetobacter infections. This may constitute an Acinetobacter outbreak. The consultant should confirm it is an outbreak by investigating patients and the environment, calculating the attack rate, and comparing it to the background rate. If confirmed, treatment and prevention measures should be implemented, including isolation, cohorting, strict sterilization and disinfection procedures.
Healthcare Associated Infections (HAIs): Research NewsletterErin K. Peavey
In the US “One in 25 patients have a hospital-acquired
infection...Each day, over 205 deaths occur from HAIs...”
— Centers for Disease Control, 2011
An overview of this month’s article follows with bullet-points of the advantages and disadvantages of various environmental interventions in the prevention of Healthcare-Associated Infections (HAIs), often referred to as hospital-acquired infections. Paragraph summaries of Cleaning Strategies, Materials, Room Design and Hand-Hygiene are listed below. These provide broad themes and findings from the article. Reading the full article is always of benefit for a fuller understanding and is recommended. Click here to access the full article on the HERD Journal website.
This document discusses infection control in dialysis units. It provides background on the high rates of infection in dialysis patients, who are immunosuppressed and undergo frequent medical procedures and hospitalizations. The second leading cause of death in dialysis patients is infection. The document then outlines strategies recommended by the CDC and other experts to reduce infection rates, including surveillance and feedback, hand hygiene, chlorhexidine use, catheter care guidelines, and staff education. Standard precautions like environmental cleaning and proper use of personal protective equipment are also emphasized.
This document provides an overview of using ultraviolet (UV) light as a supplemental approach to manual disinfection for emerging pathogens in healthcare facilities. It discusses:
1) The CDC/EPA approach to selecting manual disinfectants for emerging pathogens by using a pathogen hierarchy and known efficacy data as a bridge until new testing protocols are developed.
2) How UV light is also highly effective at inactivating pathogens according to the UV pathogen hierarchy, with dosages required for inactivation known for some pathogens.
3) The need for both manual cleaning/disinfection and UV treatment, as environmental conditions can impact UV effectiveness, and manual cleaning is still required to remove soils that could shield pathogens. A bundled
zewail academy ic مكافحة العدوى 6 محاضرات _12 ساعة.pdfد حاتم البيطار
This document outlines the objectives and topics to be covered in a lecture on infection control and prevention. The lecture will define key terms, explain modes of transmission and portals of entry for microorganisms. It will also cover universal precautions, the role of healthcare workers in preventing infection spread, hand hygiene, personal protective equipment, cleaning vs sterilization vs disinfection, and the differences between pandemic, epidemic and endemic. The historical context including the contributions of Semmelweis, Lister and Pasteur will be discussed. The CDC guidelines for infection control in dentistry and safe injection practices will also be reviewed.
The document discusses decontamination of medical devices in the NHS. It outlines the importance of effective decontamination to reduce healthcare associated infections and minimize risks of disease transmission. It also examines current guidelines and challenges related to decontamination processes. Regulatory bodies are working to improve standards and ensure uniformity in decontamination practices across the NHS.
Optical sensing techniques for quality control of cathetersmbaltazar
This document discusses using optical spectroscopy techniques like reflectance spectroscopy for quality control testing of antimicrobial coatings on catheters. It describes how one catheter manufacturer is using an Ocean Insight spectrometer setup to measure coating concentration and uniformity onsite, providing a faster and less destructive alternative to traditional HPLC testing. The spectrometer measurements showed high correlation to HPLC results, demonstrating its effectiveness for ensuring catheter coating quality meets standards. Preventing device infections is important for patient safety and reducing healthcare costs.
This document discusses infection control in surgical practice. It begins by outlining how surgical procedures expose patients to microorganisms and increase the risk of surgical site infections. Effective infection control requires an organized hospital-wide program to monitor infections, analyze data, implement corrective actions, and educate staff. Key aspects of infection control include proper hand hygiene, appropriate use of antibiotics, sterilization of surgical equipment, and classification of surgical wounds according to infection risk. Host factors like age, health status and operative factors like surgery duration influence infection risk. Strict adherence to infection control standards helps reduce surgical complications and healthcare costs.
This randomized controlled trial evaluated the effect of daily bathing with chlorhexidine-impregnated washcloths versus non-antimicrobial washcloths on the acquisition of multidrug-resistant organisms (MDROs) and hospital-acquired bloodstream infections across nine intensive care and bone marrow transplant units. The study found that chlorhexidine bathing resulted in a 23% lower rate of MDRO acquisition and a 28% lower rate of hospital-acquired bloodstream infections compared to non-antimicrobial bathing. No serious skin reactions were reported with chlorhexidine use.
2nd Annual Infection Control, Sterilization and Decontamination in Healthcare...Tony Couch
After the success of inaugural congress held on 25th-26th February 2016, MnM Conferences is organizing 2nd Annual Infection Control, Sterilization and Decontamination in Healthcare Congress, scheduled for 21st & 22nd March 2017 in London, UK aiming at providing platform to experts from hospitals, academia, and government institutions discussing the innovations, challenges, and future aspects of infection control, decontamination, and sterilization.
Cdc guideline for disinfection and sterilization in healthcare facilities, 2008Enrique Guillen
This document provides guidelines for disinfection and sterilization in healthcare facilities. It discusses various methods of cleaning, disinfection and sterilization for patient care equipment. It categorizes items based on risk of infection as critical, semi-critical or non-critical and provides recommendations for processes to reduce bioburden for each category. New topics covered include inactivation of antibiotic resistant and emerging pathogens, toxicological concerns, and disinfection of equipment used in ambulatory and home care settings. The guidelines are intended to help standardize practices and reduce infection risks when using medical devices and surgical instruments.
Current literature on dental radiology was reviewed in order to seek justification for radiological protection of patients in dental radiography, to explore the different factors affecting patient dose and to derive practical guidance on how to achieve radiological protection of patients in dentistry. Individual doses incurred in dental radiology are in general relatively low, however it is generally accepted that there is no safe level of radiation dose and that no matter how low the doses received are, there is a mathematical probability of an effect. Hence appropriate patient protection measures must be instituted to keep the exposures as low as reasonably achievable (ALARA). The literature review demonstrated that there is considerable scope for significant dose reductions in dental radiology using the techniques of optimization of protection.
Most dental professionals are not convinced of the need for regulatory control of dental radiography practice. They believe doses are too low to warrant regulatory control and consequently patient protective measures. This study shows that individual doses in dental radiology are relatively low. However, there is no safe level of radiation dose and that no
matter how low the doses received are, there is a
mathematical probability of an effect. Consequently, appropriate patient protection measures must be instituted to keep exposures as low as reasonably achievable (ALARA).
1. Candida auris is an emerging multidrug-resistant yeast that can cause severe infections with high mortality rates. It has spread rapidly in healthcare settings globally and has caused numerous outbreaks.
2. C. auris is often misidentified by conventional methods, but can be confirmed by MALDI-TOF or DNA sequencing. It shows high levels of resistance to fluconazole and other antifungals.
3. Controlling the spread of C. auris requires strict infection control practices like contact precautions, environmental disinfection, and screening of patients for colonization. Echinocandins are recommended as first-line treatment despite some resistance emerging.
Seven steps to reduce the risk of infectious disease in hospitalsBassam Gomaa
Healthcare organizations face growing challenges related to infectious disease control. While frequent hand washing and the use of personal protective equipment are the leading weapons against infectious disease spread and hospital-acquired infections, the built environment, including the HVAC systems, also plays an important role. Strides in the development of smart building operation management platforms that easily and cost-effectively integrate with a facility’s existing systems can give healthcare providers a powerful tool with which to enhance the effectiveness of their overall infection control programs.
75,000 people in the US die from hospital-acquired infections each year. Common bacteria like C. diff and MRSA spread in hospitals due to poor hand hygiene, overuse of antibiotics, and inadequate cleaning. Only 6% of hospitals do well at preventing the spread of both bacteria. Hospitals can improve by enforcing hand washing, using antibiotics judiciously, and deploying pulsed UV light robots that can disinfect a room in minutes and reduce infection rates by up to 70%.
Role of infection control in patient safety [compatibility mode]drnahla
Infection Control and Patient Safety
Dr. NAHLA ABDEL KADERوMD, PhD.
INFECTION CONTROL CONSULTANT, MOH
INFECTION CONTROL CBAHI SURVEYOR
Infection Control Director, KKH.
Role of infection control in patient safety [compatibility mode]
PIIS0196655315007579
1. Major article
The effectiveness of UV-C radiation for facility-wide environmental
disinfection to reduce health careeacquired infections
Nathanael A. Napolitano MPH a
, Tanmay Mahapatra MBBS b
, Weiming Tang MD, PhD c,
*
a
Hollywood Community Hospital at Brotman Medical Center, Culver City, CA
b
Department of Epidemiology, University of California, Los Angeles, CA
c
UNC Project China, Division of Infectious Disease, University of North Carolina at Chapel Hill, Chapel Hill, NC
Key Words:
Health careeacquired infection
Incidence proportion
Incidence rate
Reduction
UV-C radiation
Background: Health careeacquired infections (HAIs) constitute an increasing threat for patients
worldwide. Potential contributors of HAIs include environmental surfaces in health care settings, where
ultraviolet-C radiation (UV-C) is commonly used for disinfection. This UV-C intervention-based pilot
study was conducted in a hospital setting to identify any change in the incidence of HAIs before and after
UV-C intervention, and to determine the effectiveness of UV-C in reducing pathogens.
Methods: In a hospital in Culver City, CA, during 2012-2013, bactericidal doses of UV-C radiation
(254 nm) were delivered through a UV-Cebased mobile environmental decontamination unit. The UV-C
dosing technology and expertise of the specifically trained personnel were provided together as a
dedicated service model by a contracted company. The incidence of HAIs before and after the inter-
vention period were determined and compared.
Results: The dedicated service model dramatically reduced HAIs (incidence difference, 1.3/1000 patient-
days, a 34.2% reduction). Reductions in the total number and incidence proportions (28.8%) of HAIs were
observed after increasing and maintaining the coverage of UV-C treatments.
Conclusion: The dedicated service model was found to be effective in decreasing the incidence of HAIs,
which could reduce disease morbidity and mortality in hospitalized patients. This model provides a
continuously monitored and frequently UV-Cetreated patient environment. This approach to UV-C
disinfection was associated with a decreased incidence of HAIs.
Copyright Ó 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc.
Published by Elsevier Inc. All rights reserved.
Infections acquired by a patient from the health care environ-
ment and distinctly different from those with which the patient
presented are defined as health careeacquired infections (HAIs).1
HAIs constitute an increasing threat to hospitalized patients glob-
ally.2
Worldwide, these infections claim the lives of tens of thou-
sands of people each year owing to their complex pathogenesis and
usual resistance to common treatments.3
HAIs have been found to
double the mortality and morbidity risks of any admitted patient,
and to result in an approximately 90,000 deaths annually in the
United States.4
In addition, these infections result in additional
costs to health care institutions and their patients.5
Based on a previous study, environmental surfaces in hospitals
seem to be among the potential contributors for the transmission of
pathogens to hospitalized patients, by providing a reservoir for
contamination.6
Direct contacts with contaminated surfaces and
health care workers are the proposed modes of such transmission.6
Currently, traditional environmental cleaning along with develop-
ment of awareness and education regarding hygiene and sanitation,
including proper handwashing, are considered the primary pre-
vention methods for the reduction of HAI risk. Unfortunately, how-
ever, the effectiveness of these strategies often varies.7,8
Thus, the
development of an effective disinfection method for health care fa-
cilities is critical to ensure efficient reduction of HAI risk for patients.
To address this need, numerous studies have demonstrated
the effectiveness of ultraviolet-C radiation (UV-C) in eradicating a
* Address correspondence to Weiming Tang, MD, PhD, UNC Project China, No. 2
Lujing Road, Guangzhou, China.
E-mail address: weimingtangscience@gmail.com (W. Tang).
Conflict of interest: N.A.N. reports that at the time of this writing, he is an
employee of Hollywood Community Hospital at Brotman Medical Center (HCH/
BMC). N.A.N. is not a shareholder, officer, or employee of Clean Sweep Group Inc. W.
T. reports that he received funding from Clean Sweep Group Inc. W.T.’s sole re-
sponsibility is statistical analysis of epidemiology data from the HCH/BMC pilot
study. He is not a shareholder, officer, or full-time employee of Clean Sweep Group
Inc or HCH/BMC. The funding body played no role in study design, data collection
(data were based on computer records), data analysis and interpretation, writing of
the report, or the decision to submit the manuscript for publication. T.M. reports no
conflicts of interest.
Contents lists available at ScienceDirect
American Journal of Infection Control
journal homepage: www.ajicjournal.org
American Journal of
Infection Control
0196-6553/$36.00 - Copyright Ó 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
http://dx.doi.org/10.1016/j.ajic.2015.07.006
American Journal of Infection Control xxx (2015) 1-5
2. variety of bacterial species.9,10
On exposure to UV-C, the DNA and
RNA of the microorganisms are “deactivated” by the absorption of
photons.11,12
In the present study, we used a mobile environmental
decontamination unit that delivers lethal doses of 254-nm UV-C
radiation to eliminate harmful pathogens. The objective of the
study was to evaluate the effectiveness of implementing hospital-
wide UV-C treatment for environmental disinfection in reducing
the incidence of HAIs.
METHODS
This pilot study was conducted over a 6-month period, from
October 2012 to March 2013, at Hollywood Community Hospital/
Brotman Medical Center Campus (HCH/BMC) in Culver City, CA.
HCH/BMC is a licensed health care facility that provides acute and
subacute care to Culver City, West Los Angeles, and the surrounding
communities. HCH/BMC is licensed for 420 beds, has a daily census
of 180-200 patients, and admits approximately 9000 patients per
year. All acute care units, including 239 beds and 125 patient rooms,
were included in the present study.
This pilot program developed and implemented a dedicated
service model. This model was defined by 3 components: (1) use of
a web-based data and job monitoring tool, SteriTrak, which allowed
for UV-C treatment scheduling, data review, reporting, and device
utilization analysis; (2) UV-C dosing technology delivered by the
UV-Cebased mobile environmental decontamination unit (IRiS
3200m; Infection Prevention Technologies, Auburn Hills, MI), in
conjunction with a Nautiz X5 hand-held controller (Handheld
Group, Lidköping, Sweden) and door motion modules; and (3)
dedicated UV-C device technicians, nonenvironmental services
staff contracted through Clean Sweep Group, Inc (CSGI) and trained
specifically to manage and operate the UV-C device.
The IRiS 3200m is a wheeled mobile device that uses 16 verti-
cally mounted 200 W amalgam lamps to deliver a measured dose of
254-nm UV-C electromagnetic energy. The unit did not require
repositioning within the treatment space. The duration of treat-
ment depended on room volume, reflectivity of surfaces, and
measurement of UV-C.
The technicians were protected from UV-C exposure through the
safeguards engineered into the IRiS 3200m, which includes motion-
sensing technology used in both the 3200m and the door motion
sensors, which automatically extinguishes all UV-Ceemitting lamps
when motion is detected. The CSGI technicians and the HCH/BMC
epidemiologist were responsible for monitoring HAIs and for
scheduling, implementing, and tracking environmental disinfection.
In this study, bacterial identification and sensitivity to antibiotic
testing were done for common health careeacquired pathogens. All
of the data analyzed in this study were collected from in-patient
medical records. The study involved no patient care or treatments.
Phase 1: Efficacy trial
This phase occurred in the months leading up to the pilot study
to assess the microbial reservoir after terminal cleaning of the
environment by the environmental services (EVS) staff, and to test
the efficacy of the IRiS 3200m in delivering lethal doses of UV-C
electromagnetic energy. A sequential series of 54 environmental
cultures were swabbed in empty inpatient isolation rooms. An
adenosine triphosphate (ATP) hygiene monitoring tool (System-
SURE Plus; Hygiena, Camarillo, CA) was used to identify contami-
nated surfaces; the swab locations for samples B and C were fixed to
match that for sample A. The swabbing technique consisted of
using sterile Amies gel transport medium swabs to culture a 2 Â 2
inch square area in a cross-serpentine pattern on 9 adjacent “high-
touch” sites (eg, bed rails, door knobs, call buttons, vital sign
monitors, bedside tables) immediately after discharge (sample A) in
a total of 6 rooms. Successive sets of cultures were swabbed after
normal environmental cleaning (sample B) and then once again the
room had been treated with UV-C (sample C). The decontamination
interventions before collection of samples B and C were adminis-
tered in accordance with recommended standard procedures.
Because this study did not attempt to compare the environ-
mental contamination of surfaces between the patient rooms and
used ATP measurement to determine remaining levels of ATP after
different types of room disinfection, samples were collected from
different surfaces within the same room to capture a variety of
high-touch surfaces. As a result, the surfaces sampled varied among
the rooms.
Samples A consisted of cultures taken after the discharge of the
patient in isolation and before EVS terminal cleaning to assess
baseline microbial contamination. Samples B comprised cultures
taken adjacent to matched A and C samples, after EVS terminal
cleaning and before UV-C disinfection. Samples C comprised sam-
ples taken adjacent to matched A and B samples, after UV-C
disinfection.
The microbiology laboratory at HCH/BMC processed the envi-
ronmental cultures obtained during the efficacy trial. The rooms,
locations, and quantities of swabs used for the efficacy trial are
listed in Table 1.
Phase 2: Pilot study
Location for disinfection
The pilot study included multiple areas, including cardiac and
surgical intensive care, cardiac/telemetry, medical/surgical, and
acute rehabilitation units, and concentrated on every ICU room
with a discharge, regardless of the patient’s isolation status, and
every non-ICU room from which a patient on isolation precautions
had been discharged.
Method of disinfection
The IRiS 3200m with SteriTrak was used for disinfection in this
pilot study. To test the correlation between the coverage of UV-C
treatment and HAI reduction, facility-wide patient rooms were
identified at the beginning of the study and defined based on the
type of unit in which the room was located, and whether the in-
patients in these units were screened for infection-causing patho-
gens and could be isolated and tracked for the duration of the study.
Here we defined the coverage of treatment as the proportion of the
treated rooms out of the total rooms that were eligible for treat-
ment (coverage ¼ number of treated room/total rooms eligible for
treatment  100%). All facility-wide acute and critical care units
(ICU, telemetry, step-down, medical-surgical, and rehabilitation)
Table 1
Number of samples obtained during the phase 1 efficacy trial
Patient room Surface 1* Surface 2* Surface 3*
Total
swabs
A Bed rail Bed table Bathroom floor 9
B Room door
handle
Hamper lid Toilet handle 9
C Room door
handle
Bed rail Bathroom door
handle
9
D Bathroom door
handle
Bed rail Bed table 9
E Call button Bathroom
faucet handle
Bed table 9
Fy
Keyboard Bedside phone Counter 9
Total 54
*Three swabs per surface: before EVS, after EVS, and after UV-C.
y
Nursing station.
N.A. Napolitano et al. / American Journal of Infection Control xxx (2015) 1-52
3. were included; and nonacute or non-inpatient units (psychiatric,
emergency, and operating rooms) were excluded. Patient rooms
that were identified for inclusion in this study were treated with
UV-C once the previous patients had been discharged, and the
rooms were terminally cleaned by EVS.
A total of 125 rooms were included in the facility-wide study for
which the HAI incidence data were used to determine the effec-
tiveness of the intervention. However, owing to workload issues,
we could not cover all rooms at the beginning, and we finally
covered all of them at the third month of the intervention (Table 2).
To make the control period and intervention period comparable,
the rooms that were not covered in the first 2 months of the
intervention period also were not included in the control period.
Standard process for disinfection of hospital rooms
During the study, when a patient was discharged, after the ter-
minal cleaning (bioload removal) of the room and before admission
of the next patient, the UV-C intervention was performed using the
IRiS 3200m unit. The disinfection process involved 4 steps:
1. Room staging. In this step, furniture and clinical equipment
were staged within the space to receive maximum UV-C
exposure.
2. Safety protocol initiation. The space was then cleared of all
people, and a door motion sensor was placed on each entrance.
This eliminated the risk of UV-C exposure to staff, because
activation of a door monitor would automatically shut down
the UV-C unit.
3. Device implementation. CSGI technicians positioned the IRiS
3200m within the space to maximize the disinfection efficacy.
4. Device activation. CSGI technicians activated the IRiS 3200m
remotely from outside the room. The machine then initiated the
programmed cycle. Once the cycle was completed, the machine
shut off automatically, and the room was deemed disinfected
and ready for the next admission. The IRiS 3200m uses
2 treatment settings, one for vegetative organisms (vegetative
treatment) and the other for spore-forming organisms (spore
treatment). The treatment setting was determined by the type
of isolation sign posted on the door, specifying whether the
identified pathogen was vegetative or spore-forming. The mean
vegetative and spore-forming treatment times for the patient
care area square footage within the facility were 8 minutes and
18 minutes per patient room, respectively.
Definitions of HAIs, incidence proportion, and incidence rate
The following inclusion criteria were used by HCH/BMC to
identify HAIs at baseline and intervention stages: (1) cultures
collected after 48 hours of admission; (2) diagnosis at admission
different from the HAI diagnosis; and (3) colonization or infection
contributing to increased length of hospital stay. Patients who
met all of these criteria were treated as incident cases in this study.
The incidence proportion was defined as the number of HAI cases
divided by the total number of hospitalized patients. The incidence
rate was defined as the number of HAI cases (or incidence cases)
divided by the total patient-days for the hospitalized patients.
Data analysis
All data analysis was done with SAS version 9.3 (SAS Institute,
Cary, NC). Poisson regression was used to analyze the relationship
between the coverage of the UV-C treatment and the incidence of
HAIs, with HAI incidence during the study period serving as the
dependent variable and treatment coverage as the independent
variable. The 2-sample t test was applied to test the statistical
significance of the disease reduction. To estimate the overall
reduction in HAI rate, we treated the proportion of HAIs in the
control period as 100%, and by comparing the actual number of
observed HAIs during the intervention period with that in the
control period, we got the proportion of HAIs for the intervention
period. We then used the 2-sample t test to test the difference
between these 2 proportions.
To calculate the incidence rate reduction, we first determined
the expected number of cases without intervention for the inter-
vention period using the following formula: number of expected
cases for the intervention period without intervention ¼ incidence
rate at baseline  total person-time observed at intervention
period. We considered the proportion of expected cases for the
intervention period without intervention to be 100%, and by
comparing the actual number of HAIs during the intervention
period with the expected number of cases for the intervention
period without intervention, we determined the actual disease
proportion. We then used a 2-sample t test to test the difference
between these 2 proportions. We used a similar method for inci-
dence proportion-based detection of disease reduction.
RESULTS
A total of 54 environmental samples were included in this effi-
cacy trial (Table 1). Among these, A samples yielded growth on
55.6% of samples (10/18 positive for growth), B samples yielded
growth on 50% of samples (9/18 positive for growth), and C samples
yielded growth on 11.1% (2/18 positive for growth). There was no
statistical difference in the number of positive cultures before and
after EVS terminal cleaning (P ¼ 1.0, t test). Significantly fewer
positive environmental cultures were collected after the UV-C
intervention compared with after EVS terminal cleaning (P ¼ .03).
The intervention period spanned October 1, 2012, to March 31,
2013. During this period, 44 HAIs were detected in 3011 patients
throughout the facility, and a total of 18,184 patient-days were
accumulated, with an incidence proportion of 1.5% and an inci-
dence rate of 2.4/1000 patient-days (Table 3). Eighty-five patient
rooms out of a total of 125 patient rooms (68.0%) were disinfected
in October, 115 patient rooms (92.0%) were disinfected in
Table 2
Percentage of hospital rooms included in the effectiveness analysis in 1 hospital
Month Percent (n/N)
October 2012 68 (85/125)
November 2012 92 (115/125)
December 2012 100 (125/125)
January 2013 100 (125/125)
February 2013 100 (125/125)
March 2013 100 (125/125)
Table 3
Incidence rate of HAI at baseline and follow-up for patients at 1 hospital
Time
Number of
HAIs Patient-days
Incidence rate
(per 1000 patient-days)
Baseline
(10/2011- 2/2012)
66 17,933 3.7
Study period
October 2012 13 3010 4.7
November 2012 7 2748 2.6
December 2012 4 2947 1.4
January 2013 6 3335 1.8
February 2013 7 3268 2.2
March 2013 7 2876 2.4
Overall 44 18,184 2.4
N.A. Napolitano et al. / American Journal of Infection Control xxx (2015) 1-5 3
4. November, and all 125 patient rooms (100%) were routinely dis-
infected from December 2012 through March 31, 2013.
The results demonstrate that the number of HAIs decreased
significantly with the increased coverage of UV-C treatments
(P <.001, Poisson regression analysis).
HAI reduction
Overall case reduction
To determine overall HAI reduction, we used the pre-
intervention number of HAIs as the expected baseline of HAIs for
the intervention period. Under this assumption, compared with
baseline, the UV-C treatments resulted in a 33.3% reduction in the
number of HAI cases (P <.001). This reduction was determined by
comparing the baseline number of 66 HAIs with the 44 HAIs
detected during the intervention period [100% - {(44/66) Â 100%}].
HAI incidence proportion reduction
At baseline, 66 HAIs were detected among the 3215 patients
facility-wide, for an HAI incidence proportion of 2.0%. Using the
incidence proportion of HAIs at baseline, we expected to identify 66
HAIs during the intervention period [(66/3215) Â 3011]. The inci-
dence proportion during the intervention period was 1.5% (44 HAIs
out of 3011 patients). Compared with baseline, the intervention
resulted in a statistically significant HAI reduction of 28.8%.
HAI incidence rate reduction
During the intervention period, 44 HAIs were identified in a total
of 18,184 patient-days, for an overall incidence rate of 2.4 per 1000
patient-days. Using the HAI incidence rate at baseline, we expected
to identify 66 HAIs during the intervention period [(66/17,933) Â
18,184]. Compared with the baseline period, the reduction in inci-
dence rate was 34.2% (3.7 per 1000 patient-days during the baseline
period; Table 3), which was statistically significant (P <.001).
HAI reduction for specific organisms
Table 4 presents case reduction data for each specific pathogenic
organism based on the incidence proportion calculated in this
study. We found significant reductions in HAIs associated with 3 of
the 5 identified organisms, including a 71.4% decrease for Acineto-
bacter baumannii, a 42.7% decrease for Clostridium difficile, and a
100.0% decrease for Klebsiella pneumoniae. We found no statistically
significant reductions in HAIs caused by methicillin-resistant
Staphylococcus aureus (MRSA) and vancomycin-resistant Entero-
coccus (VRE).
DISCUSSION
Overall, the dedicated service model intervention at HCH/BMC
was potentially correlated with a statistically significant reduction
in the overall number of HAIs caused by A baumannii, C difficile, and
K pneumonia. Previous studies have indicated that malignant
diseases, immune deficiencies, diabetes, and various necessary
procedures in hospitalized patients may increase the risk for
HAIs.13-15
HAIs can increase disease morbidity and mortality in
these patients, which could lead to poor disease recovery and also
extend the total number of days needed to provide care for these
patients. All of these factors might have significantly increased the
average length of stay, morbidity, and mortality of patients.
Through the implementation of dedicated service model, a reduc-
tion in incidence proportion and rate of HAIs was observed.
In this study, statistically significant reductions in HAIs associ-
ated with 3 of 5 organisms were identified. Moreover, reductions in
MRSA and VRE cases were identified as well, although these re-
ductions were not statistically significant. To further reduce HAIs,
more studies, including studies specifically targeting MRSA and
VRE, are needed.
This study was based on data generated under the normal
working conditions, processes and HAI definitions of the hospital.
Furthermore, we used the hospital’s archival HAI data between
October 2011 and March 2012 to establish the baseline parameters.
By doing so, we were able to compare year-to-year data that
accounted for seasonal variance.
The dedicated service model used for this study removed the
common practice of adding UV-C management on to the already
heavy workload of the EVS staff. This model allowed for increased
UV-C device utilization and the efficient application of facility-wide
treatments.
As an observational study, this pilot study had several limita-
tions. First of these was the lack of inpatient screening, because we
were not able to identify patients who might have been admitted
with colonization or infection. Instead, we used surveillance defi-
nitions and criteria set by the Centers for Disease Control and
Prevention’s National Healthcare Safety Network, in which an
infection is considered an HAI if the date of occurrence of the site-
specific infection criterion was on or after the third calendar day of
admission to an inpatient location, with the day of admission as
calendar day 1. A second limitation was that the potential con-
founders could have existed for infection control and prevention
through both clinical practice and EVS, owing to the variability in
hospital staff members’ individual practices and behaviors.
CONCLUSION
In summary, the dedicated service model piloted at HCH/BMC
was potentially associated with a significant decrease in HAIs
associated with 3 of the 5 organisms identified. Our data also
showed a decrease in the HAI incidence proportion and incidence
rate at HCH/BMC. Potential cofounders might have existed owing to
our inability to control them while conducting the study in a
functioning hospital, as well as owing to the variation in behaviors
among staff members. The efficacy of UV-C radiation technology as
a disinfection tool is widely accepted; however, future research
focused on implementing UV-C technology in health care settings
needs to determine its accurate preventive capacity and long-term
benefits.
Table 4
Case reduction for each specific pathogenic organism based on incidence proportion
Study organism
Baseline infection
count
Intervention infection
count
Baseline incidence
rate
Intervention incidence
rate
Incidence rate
change, % P*
A baumannii 7 2 0.39 0.11 À71.80 .005
C difficile 22 12 1.23 0.66 À46.20 <.001
K pneumoniae 8 0 0.44 0 À100.00 <.001
MRSA 7 7 0.39 0.38 À1.20 1
VRE 18 16 1 0.88 À12.30 .14
*Two-sample t test.
N.A. Napolitano et al. / American Journal of Infection Control xxx (2015) 1-54
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