Q&A with Yavapai Medical Center
UV disinfection has been proven to be an effective, chemical-free method of enhanced terminal room disinfection. The first randomized clinical trial on UV disinfection, The Benefits of Enhanced Terminal Room-Disinfection (BETR-D) study which was published earlier this year, proved that Tru-D SmartUVC was able to reduce the risk of infection of four targeted multidrug-resistant organisms (MDROs) among patients admitted to the same room by a cumulative 30 percent.
Much of the research on UV disinfection focuses on enhanced disinfection at the time of patient discharge. In most cases, Tru-D is deployed when an isolation/enteric patient leaves the room—either at transport to another wing or out of the hospital completely. However, Kim Horn, MPH, CIC Infection Preventionist of Yavapai Regional Medical Center sought to prove that a solid baseline of cleanliness and disinfection together with terminal room cleaning and disinfection would reduce the incidence of MDROs, specifically C. diff, among patients in the hospital.
Kim Horn and her team conducted a 30-day trial to attempt to reduce the cumulative amount of bioburden in her facility. She outlined a process that included complete disinfection of an entire wing of the hospital, ensuring every piece of equipment that went in and out of a room as well as every nook and cranny—employee restrooms, public restrooms, medical rooms, equipment supply rooms, etc.—was disinfected. After each and every discharge, she and her team disinfected the room with Tru-D, whether it was an isolation case or not, in order to create a baseline of disinfection. For approximately 38 days, the focus was on all discharges on this one unit that had experienced some ongoing transmission of C. diff. Since December 8, 2016 when the study concluded, there has not been a single, reported hospital-acquired infection in the hospital wing used in the trial.*
Question: What prompted you to want to conduct a trial on Tru-D SmartUVC?
Most hospitals use Tru-D SmartUVC at the time of discharge of an isolation patient. While we know UV disinfection has been proven to be an effective method of enhanced terminal room cleaning, we wanted to create a baseline of cleanliness in our facility to remove as much bioburden as possible. In doing so, we hoped to conclude that by removing the bioburden, we would be able to reduce infection rates throughout our facility.
Question: Can you share the structure of the trial?
We focused on one wing of our hospital and made every effort to clean the entire area including equipment and all other contents of a room. During the baseline trial period, we were able to target 80% of our total discharges, locker rooms, staff breaks room, med room, equipment rooms, public restrooms, dietary room, EVS closet, etc. We thoroughly documented each room and its contents using equipment codes, and if something did not have a code/number we assigned it one to ensure we disinfected the entire wing of the hospital in order to establish a baseline of cleanliness.
Question: What were some of the outcomes or takeaways from the trial?
We determined that by creating a solid baseline of cleanliness and reducing as much bioburden as possible throughout the unit, we were able to reduce transmissions. In fact, Yavapai has not had a transmission reported since December 8, 2016.*
Question: How was the trial affected day-to-day cleaning and disinfection at Yavapai?
Now that we have one wing with a baseline of cleanliness and disinfection established, we want to do the same thing with our other wings and also the operating rooms (ORs). We realize there are cross-contamination possibilities with patient rooms and ORs, so by focusing on the ORs in the next phase, we hope to reduce the risk of spreading disease through cross contamination.
*At the time of publication
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