By Dennis Boyle / Special to Healthcare Facilities Today

Infection control has certainly changed in recent years. It used to be that washing hands and sterilizing tools and equipment with high temperature water was enough to keep patients, healthcare workers and visitors safe from viruses and bacteria. With the rise of more virulent viruses and antibiotic resistant bacteria in the last five years, public healthcare crises have occurred in pockets of Africa, the United States and around the world, changing how we all look at disinfection. 

Healthcare providers are scrutinizing their infection prevention methods and are adopting new methods of disinfection, often as a compliment to already existing disinfection, such as chemical cleaning. This is changing many providers’ infection protocols as they make their best efforts to meet the new challenges that HAIs currently present. Some providers are focusing on the frequent changing of OR gowns and other garments to prevent the spread of HAIs, while others opt to even dispose of everything in infection-exposed isolation rooms. The CDC has, in fact, created specific protocols on how to safely dispose of objects exposed to HAIs. 

With independent lab tests and peer-reviewed studies validating ultraviolet-C light’s ability to quickly and effectively kill germs, UVC light disinfection systems have become increasingly popular with hospitals in the last one to two years. At the same time, many well-publicized incidents of healthcare-associated infections have occurred at hospitals, which has contributed to an increase in use of UVC light disinfection in hospitals. 

In recent months, use of UVC light disinfection systems has expanded beyond inpatient settings. Other types of healthcare facilities, such as clinics, surgery centers, private practices, rehabilitation facilities and nursing homes, now are using the technology. Given the events and published studies of the last year, this is not surprising.

This year, the Centers for Disease Control and Prevention issued a report showing that approximately half a million Americans are infected with C. difficile, a deadly bacteria previously found only in hospitals, but which is now being found in outpatient settings. The results of the CDC study were unexpected by many in the medical community and have heightened concerns regarding the spread of HAIs in outpatient/ambulatory healthcare facilities.    

Of the several Ebola virus disease outbreaks that have occurred in the last year, several have included outbreaks in outpatient/ambulatory healthcare facilities, as well as in hospitals. Concern around the world about the spread of MRSA, CRE and drug-resistant bacteria has increased decontamination efforts in general as a result. 

Why UVC?

Many in ambulatory healthcare are turning to UVC light disinfection systems to reduce their HAI rates and to augment their existing infection prevention efforts. Some are using UVC light treatment as a complement to chemical cleaning, also known as terminal cleaning. Like hospitals, ambulatory care providers are being forced to consider the potential for healthcare acquired infections and the high cost, both human and financial, of treating them.

Since 2011, the number and severity of HAI’s has increased, as has the financial burden for hospitals. The cost of treating infections has risen by 30 percent in the last four years alone, currently estimated at $30 billion each year in the United States. In this time, increased inpatient stays, readmissions, use of human resources and a reduction in Medicare reimbursements have negatively affected some hospitals’ annual profits. 

The human toll is also increasing. In January of this year, the CDC released a report that shows that as many as one in 25 hospital patients has at least one healthcare-associated infection. It’s also estimated that there were 722,000 HAIs in U.S acute care hospitals in 2011 alone, and of these, that 75,000 died during their hospitalizations. The study reported that more than half of all HAIs occurred outside of intensive care units. 

With these increases, many inpatient and outpatient healthcare providers are turning to UVC light technology to increase infection prevention because the disinfection it offers is quick, safe and easy to implement. To disinfect a room, all that one needs is the UVC light disinfection system, an electrical outlet and a small amount of time. When UVC light disinfection systems are used correctly, air and surfaces are disinfected to a 99.9 percent efficacy rate. Several independent studies have shown that using UVC light for disinfection is not only effective, but that it is also reliable, i.e. results don’t vary significantly from use to use. 

These factors, in combination with the mobility of many systems, make UVC light disinfection particularly well-suited for ambulatory healthcare, where a high-volume of patients are often cared for and in which types of treatment and care can vary widely from patient to patient and facility to facility. Ambulatory healthcare facilities can provide everything from post-surgical physical therapy in a rehabilitation practice to day-surgery to routine preventative care in a neighborhood clinic. UVC light disinfection can be used in all of these locations and the systems themselves are mobile enough to be used in multiple ways and to be moved from room to room as needed.

Advances in UVC light technology in ambulatory care 

As the demand for UVC light disinfection in outpatient healthcare has grown, manufacturers have responded by developing systems specifically for use in ambulatory settings. These disinfection systems are typically easier to move and more compact than larger devices. Designed to disinfect smaller spaces, ambulatory care UVC light disinfection systems also are often made to work even more quickly than full-size UVC light disinfection systems. In some instances, ambulatory care systems can achieve 99.9 percent efficacy in killing surface and air pathogens in a mere five minutes.

The introduction of disinfection options specific to the outpatient healthcare sector is very good news for those trying to boost disinfection in clinics, post-acute care facilities and other ambulatory healthcare environments. Another notable development in the light disinfection industry is the design and manufacture of disinfection systems for emergency care vehicles. Like their ambulatory system counterparts, emergency vehicles present specific challenges and require special application of UVC light technology. Several manufacturers are offering UVC light disinfection systems whose size and speed can meet the disinfection needs of ambulances and other mobile care vehicles, achieving efficacy results equal to those of other UVC light systems. 

The market has also been introduced to UVC light disinfection systems for shared tools and devices. These disinfection systems are typically box-shaped, are about the size of a small microwave oven and can disinfect remote controls, iPads, telephones and other hand-held devices and tools typical in an office or healthcare setting. Some of these systems can sanitize wired and wireless devices, which is of particular useful in ambulatory care settings where handheld and mobile technology such as tablets can be often used. 

Changes in infection control

For those in ambulatory care, they must implement the strict infection control practices now needed in that environment. Hopefully, the trial and error process that inpatient facilities may have experienced will be useful to those in ambulatory care, so that they may institute the best means and protocols possible when it comes to infection control, prevention and disinfection. 

Infection preventionists, doctors, nurses and other healthcare staff are understandably cautious when it comes to HAIs, for the sake of themselves and their patients. But they aren’t the only ones: patients and the general public are concerned as well. In a recent survey, 75 percent of survey respondents reported that they felt it is more important to choose a  hospital based on its infection rate, rather than on its convenience. In the same survey, 97 percent said they have selected hospitals with higher safely scores over less expensive hospitals with lower safety scores. Many facilities’ infection prevention and infection rates must be posted publicly, according to respective state laws, which also has made patients and the public more aware of their hospitals’ efforts. 

Infection prevention of the future

As mentioned previously, according to the CDC, at this moment approximately one in every 25 patients has an infection that was contracted in relation to their hospital care. As this goes to press, there aren’t many statistics available on HAIs in outpatient/ambulatory healthcare facilities. It is clear, however, that HAIs have entered outpatient facilities and are no longer a concern only for hospitals.

Regardless of location, UVC light disinfection technology can provide the added layer of decontamination that many doctors, patients and infection preventionists seek. UVC light technology is easy to use, can be added to existing infection prevention protocols immediately and is a cost-effective and relatively simple way to increase infection control, making it an attractive solution, particularly to those who face shrinking budgets. 

No doubt UVC light disinfection use will continue to increase in both inpatient and outpatient healthcare facilities. As the trend of providing medical care on an outpatient basis continues, UVC light disinfection use in outpatient facilities, could increase dramatically. 

The CDC classifies the spread of HAIs as a ‘winnable battle,’ along with obesity, food safety, motor vehicle injuries and tobacco, which also appear in the ‘Winnable Battles’ section of its website. According to their website, the “CDC has identified eliminating HAIs as a Winnable Battle. With additional effort and support for evidence-based, cost-effective strategies that we can implement now, we can have a significant impact on our nation’s health.”’

In order to impact the transmission of healthcare-acquired infections, healthcare providers and influencers must seek additional resources and technologies that can keep people safe from infections, whether in a dentist’s office, a surgery center or acute care unit. With its 99.9 percent efficacy, UVC light disinfection can be an invaluable resource for healthcare providers in winning this ‘winnable battle.’ 

Dennis Boyle is the Executive Vice President of Global Sales for Spectra254, a manufacturer of UVC light disinfection systems.