Guidelines For Sustainable Use Of Health Technology In Infection Prevention

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What is sustainable use?

This would be the first question. According to the convention of biological diversity (1992) sustainable use is the usage of biological components in a way that does not do any long-term harm of biological diversity.

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Sustainable use followed the principles of SDG (Sustainable Development Goal). So, it is very important to build up proper guidelines and implementing them in every sector. Hospital acquired infections (HAIs) or nosocomial infections are one of the most common bane to the healthcare industry. So, we must follow some rules to prevent this kind of infections. Here some guidelines are given below:

Hand Wash

Hand Washing has always been the most standard precaution since time immemorial. This fact is very true as proper hand washing can kill up to 99.99% of germs and bacteria. But, sadly due to the hectic nature of work of healthcare professionals, hand washing protocols have very low compliance rate. Hospitals are beginning to implement a badge for healthcare professionals that will force them to comply with hand washing according to World Health Organization’s standards. A badge either light up red to signal to the patient that the healthcare provider has not washed or vibrates silently telling this healthcare provider to wash within two minutes. Such a simple piece of technology can definitely help save lives.

Silver-Lined Clothing

Speaking of HAIs, most of these infections are acquired from healthcare team who go from patient to patient spreading around everyone else’s bacteria. One piece of clothing technology is slowly making its way into the market to help curb that problem. Silver-lined clothing, that serves as an under scrub, not only protects the healthcare professional from infection but also prevents the spread of microorganisms from patient to patient. It is a stretchable, breathable, and quick drying fabric that has been massively tested revealing the death of microorganisms within minutes of contact, just enough time for a nurse to scroll down the hallway to next patient.

Face-Hugging Mask

Even in the operating room where sterility is gold, infections can still occur. The rate of these infections can be reduced with the use of a new design in facemasks. The Smart-Seal Surgical Mask is a face-hugging mask that seals in to user’s mouth and nose. These masks filter up to 99.9% of bacteria preventing infection all throughout.

Gloves

The procedure is the application of gloves ensure that the cuff each glove covers the wrist of the isolation. There are two main indications for the use of gloves in preventing healthcare acquired infections:

  • To protect hands from contamination with organic matter, microorganisms and chemicals.
  • To reduce the risks of transmission of microorganisms to both patients and staff.

There are basically two types of gloves one is Nitrile another is Vinyl. For sustainable use we need to be potential to meet the needs and aspirations of present and future generations. We need to use bio-degradable gloves so that they will be not harmful to our environment.

UV-C (Ultraviolet germicidal irradiation) Disinfection

It is a disinfection method that uses UV-C light or short-wavelength ultraviolet light. This light kills or inactives microorganisms by destroying nucleic acids and disrupting their DNA, leaving them unable to perform vital cellular functions. This system is used for water disinfection, air disinfection, waste water treatment, laboratory hygiene and also in food and beverage protection.

Here five reasons are given why healthcare institution are adding UV-C disinfection machines for prevention of infection.

Manual cleaning is inconsistent. Hospitals need the right products and reliable disinfection procedures. Manual disinfection can certainly be effective, but the problem is this: no two rooms will ever be cleaned to exactly the same specifications, regardless of how explicit or detailed the standard procedure may be. Human error will always be part of manual disinfection.”

You can never over-emphasize, the importance of evaluating current Cleaning and disinfection protocol and continuous improvement, yet it may not be enough,” Gauthier says. By utilizing UV disinfection, the inevitable differences in the disinfection process from room to room become less pronounced, further protecting patients and facilities from healthcare-acquired infections. Healthcare settings can benefit from the additional assurance afforded by the application of UV-C disinfection devices.

Manual disinfection isn’t 100 percent efficacious. Numerous studies show standard manual cleaning or disinfection of surfaces can reduce, but often does not eliminate, important pathogens such as C. diffcile and MRSA. Of 1,917 patient rooms cleaned using standard processes and detergent, nearly 25 percent still contained strains of MRSA, according to a 2014 study in BMJ Journals. This finding suggests hospitals cannot rely on manual cleaning alone to fully eradicate pathogens and deter HAIs.

Antibiotic resistant organisms can survive on surfaces for weeks to months. “Even viruses, such as noroviruses, can survive on surfaces outside the body for seven to 14 days without much difficulty,” Gauthier says. Research into UV-C’s ability to eliminate antibiotic-resistant organisms is promising. There are numerous studies supporting the efficacy of UV-C in reducing the viability of a broad range of problematic pathogens, particularly antibiotic resistant strains. For example, a 2017 study published in the Journal of Applied Microbiology subjected antibiotic resistant strains of Escherichia coli (E. coli) to UV energy, and found UV disinfection processes dramatically reduced the survival of antibiotic-resistance genes of E. coli. Hospitals can use UV energy as a disinfecting technology in addition to manual cleaning and disinfection to help eliminate the particularly robust organisms that cleaning wipes and disinfectants may not reach.

UV-C helps cover surfaces wipes and chemicals may miss. UV-C machines work to fill the gaps that wipes and chemicals miss when cleaning a patient room, which can help hospitals achieve the best possible cleaning practices. UV-C machines, which serve as a ‘no touch’ method of room decontamination, can reduce key pathogens on surfaces in patient rooms, according to a study published in Current Opinion in Infectious Diseases. The study authors recommend using a ‘no touch’ system for terminal room disinfection after discharging patients to reach areas of patient rooms that are not easily accessible for cleaning via wipes and chemicals, such as keyboards, monitors and workstations on wheels. State of the art UV-C technologies offer portability and compact footprints facilitating terminal cleaning and daily use, helping to minimize the buildup of pathogens over time.

UV-C can help meet patient expectations for cleanliness. When asked what impressed them most about the healthcare industry, the greatest number of respondents chose a visible commitment to infection prevention, according to a survey of 1,000 patients conducted by the Health Industry Distributors Association.

“Cleaning and disinfection is something that is very important to patients,” Gauthier says. “Utilizing a UV system is a very visible way of showing patients and families that the hospital is committed to reducing infections as best they can.”

As hospitals and health systems work to reduce healthcare-associated infections, a number of harmful pathogens, such as Clostridium difficile, may evade traditional disinfectants and manual cleaning processes. To eliminate these pathogens from high-touch surfaces, hospitals can incorporate UV disinfection technology. Today’s technology uses a subtype of ultraviolet light called UV-C. Adding treatment with UV-C into cleaning routines can help to effectively kill bacteria and pathogens and reduce HAI rates.

For many hospitals, current cleaning interventions may not completely address the risk of HAIs. A study published in American Journal of Infection Control found patients admitted to rooms that previously held a patient infected with a multidrug-resistant organism were significantly more likely to contract that infection. “This risk could be 1.5 to 3.5-times higher, which supports the fact that the environment can play a role in the spread of infection, and for a variety of reasons, healthcare facilities may not be cleaned and disinfected as well as they could be,” says Jim Gauthier, senior clinical advisor of infection prevention at Diversey, a Charlotte, N.C.-based cleaning and hygiene product provider.

Incomplete or insufficient cleaning of surfaces most commonly in contact with patients can contribute to infection rates. In fact, it is estimated that 20-40% of HAIs result from transmission of pathogens by a healthcare worker after touching another patient or a contaminated surface, Gauthier says.

HAIs not only threaten the safety of patients and staff, but can also be a significant expense for hospitals due to longer patient stays, more treatment costs and less reimbursement for procedures. In the U.S. alone, HAIs range between $28 billion and $45 billion in annual direct hospital costs, according to a study published in Expert Review of Pharmaco-economics & Outcomes Research.

Reducing HAIs is especially important in an era of value-based medicine. In 2008, CMS began denying hospitals payment for the treatment of some conditions that occurred during a patient’s hospital stay and were not present on admission. Three of the 10 hospital-acquired conditions selected for this policy involve HAIs, according to a study published in Medical Care.

“An increasingly important driver of finance in healthcare, especially in the U.S., is how we perform,” Gauthier says. “Performance measures, such as Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile infection (CDI) acquisitions, factor into the reimbursements that are paid to healthcare facilities.”Diversey, which provides cleaning technologies in areas from healthcare to hospitality, offers a framework for hospitals to fight off HAIs through UV-C disinfection programs. The company’s portable UV-C machines disinfect hospital rooms, hard surfaces, and noncritical equipment and devices.

When deciding to incorporate this technology into cleaning routines, hospital executives can examine numerous published studies providing understanding of what makes a UV-C disinfection program an effective business move, how UV-C disinfection technology works, what questions to ask when considering UV-C and how to effectively operate UV-C devices.

UV-C disinfection programs eliminate bacteria that manual processes may miss infection prevention experts agree: Thorough cleaning and disinfection of environmental surfaces are essential elements of effective infection prevention programs. However, traditional manual cleaning and disinfection practices in hospitals are often suboptimal. Inconsistent manual cleaning processes, time pressure and lack of an auditing process can affect the efficacy of manual disinfection.

To be sure, no-touch disinfection technologies should not replace manual cleaning and disinfection processes. However, adjunct technologies, such as UV-C disinfection machines, can become a critical part of how healthcare settings control HAIs, Gauthier says. “Cleaning and disinfection is something that is very important to patients,” Gauthier says. “Utilizing a UV system is a very visible way of showing patients and families that the hospital is committed to reducing infections as best they can”.

How UV-C technology works

Before hospitals add UV-C technology to their cleaning routines, there are several components to understand about how UV-C machines work. To combat HAIs, healthcare staff can implement what Rick Dayton, Chief Architect of Diversey, calls the “1-2 Punch.” “The 1-2 Punch is the combination of the right chemical and manual cleaning solutions and the addition of a robust UV-C technology that can really help to fight HAIs. And, of course, the 1-2 Punch is best delivered by a well-trained EVS staff,” Dayton says. UV-C technology works by UV-C energy penetrating through the cell walls of bacteria, viruses and bacterial spores and into the DNA strand to ultimately disrupt the cell’s ability to replicate. After exposure to UV-C energy, the pathogen is unable to replicate itself. “It’s an environmentally friendly, effective and non-chemical approach to preventing infection,” Dayton says.

To properly apply the UV-C portion of the “1-2 Punch”, hospital staff must understand the two primary factors that make or break the application of UV energy: the angle at which UV is applied and the distance between the object being disinfected and the UV source.

To properly address these key criteria, Diversey’s MoonBeam™3 UV-C disinfection device has three individual UV lamps on adjustable arms. These arms can be positioned at nearly any angle to target UV-C light, and users can position the heads of the device to optimize UV-C dosing. Finding a system that is fast and simple to operate helps enable consistent usage of the system, and the Diversey technology provides fast cycle times, typically three to ten minutes, and a simple operating system that can be used by almost any staff member.

Dayton frequently demonstrates the physics supporting why it is important to apply UV energy at the correct angle. “With UV energy, when you’re applying light directly onto the surface, that’s when you maximize the amount of energy applied to that surface, enabling faster kill of pathogens.”

One way to set up UV-C devices in a patient room is to have two devices — one on either side of the patient’s bed. If UV-C is being used in the OR, the device can be placed at the foot of the operating table. “You want to have the ability to directly impact the surfaces with direct light for the fastest cycle and greatest efficacy,” Dayton says.

It is also critical to get the energy as close to the surface as possible, Dayton says. “The bulb output may be constant, but the farther away you get, the lower the applied energy. The energy actually decreases by the square of the distance from the bulb. It is not a linear relationship for electromagnetic energy.”

No Re-Use Policy

Syringes, needles, blades are highly prohibited to reuse. It is one of the most common reasons to infection. This six guide lines are not enough for prevention of infection by using sustainable health technology. We have to aware of it, educate and train health care professionals so that they can implement this type of health technology.

03 December 2019

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