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Archive July 2016 XVII, No. 7

The Whole Truth About Whole-Room Disinfection

Automated antimicrobial devices reach the corners and crevices that sprays and wipes sometimes miss.

Nancy Havill, MT(ASCP), MHA, CIC


Ultraviolet-C energy SEE THE LIGHT Ultraviolet-C energy kills microbes on the surfaces it illuminates, but multiple cycles might be required to completely illuminate all surfaces.

The first time we trialed whole-room disinfection technology, our hospital was facing a Clostridium difficile outbreak that had caused 3 patient deaths in a month. When heightened precautions failed to decrease the infection rate, our director of epidemiology got in touch with a manufacturer who was planning the U.S. launch of a device that claimed to sterilize rooms with hydrogen peroxide vapor. That was more than a decade ago, when there were few automated surface disinfection systems on the market. The field has since expanded to include ultraviolet light, aerosolized hydrogen peroxide, ozone and even cluster ion technologies (see "Your Options in Whole-Room Disinfection"). If you're seeking to step up your facility's infection prevention efforts with whole-room disinfection, here's how to evaluate your options.

  • Microbiological efficacy. This is the best place to start your selection process. It can be difficult to compare technologies, since they work differently. We conducted our own validation studies while trialing manufacturers' equipment. As an emergency response, our hydrogen peroxide trial had real-time stakes in terms of proving its effectiveness. Over the course of a year, we sought to decontaminate as many patient rooms and wards as possible, as quickly as possible, and we saw a major decrease in C. diff. rates.

When ultraviolet light systems entered the market a few years later, though, we conducted another trial, examining the UV light's microbiological efficacy in 25 patient rooms over the course of a year. We cultured 5 high-touch sites (bed rail, over-bed table, TV remote, bathroom grab bar and toilet seat) in each room before and after UV treatment to determine its microbial reduction. We also inoculated small metal disks with consistent amounts of C. diff. spores and stationed them around the rooms (over-bed table, floor beneath bed, chair, toilet seat and shower floor) at different distances from the light source during treatment, to gauge results. Some rooms received a single cycle with the UV unit placed in the middle of the room, while others received 2 cycles, with the unit moved to the bathroom for the second round.

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