Infection prevention and control continues to be a challenge for healthcare facilities. Healthcare-associated infections (HCAIs) cost NHS England around £2.7billion per year (including specialised care)* and the cost to manage a patient who acquires an HCAI is 3x higher than that of managing a patient without one. Find out more about how automated room disinfection works.

 

Download now: Guide to reducing modern Healthcare-Associated Infections

guide to reducing HCAIs

Infection prevention and control has been a high priority in England. However, new infections are in danger of spreading.

Download the guide to stay ahead of the short and long-term consequences of HCAIs and explore the latest approaches to integrated environmental infection prevention.

Download Now

 

Automated room disinfection works alongside manual cleaning

Contaminated surfaces in a healthcare setting can increase the risk of a patient contracting an infection. Conventional cleaning and disinfection methods go some way to reduce this risk but as these processes are very manual, assurance is difficult. Variation may be caused by the materials, chemicals and the operators used in the process.

For this reason, automated room disinfection (or decontamination) devices are increasingly being considered as an adjunct to manual cleaning as they can be an effective way to reduce the risk of infection even further than cleaning can alone.

“It's important to develop Infection Prevention processes and technologies, alongside implementation of the new National Standards of Healthcare Cleanliness, to evolve how we keep healthcare spaces clean and safe”

        Yvonne Spencer, Clinical Lead for Integrated Facility Management at Sodexo

 

Automated room disinfection (ARD) devices don’t clean; they simply disinfect. So they’ll never replace the important step of cleaning and mechanically removing dirt, dust and debris. Rather, room disinfection is an additional step that takes place after a room has been cleaned.

 

Hydrogen Peroxide or UV-C Technology? Understanding the Difference

When choosing an automated room disinfection device there are several factors to consider:

  • Efficacy – does the device kill the target pathogens?
  • Speed – how long will a room/area be out of action while the device is in operation?
  • Ease of use – is it a simple, easily replicable disinfection process?
  • Validation – how can you prove the device has done its job after an application?
  • Storage and transport – is the device safe and easy to store and move around the site?
  • Safety – what are the risks of operating the device and how are they mitigated?
  • Material compatibility – will the disinfection process damage the fabric of the building or the equipment in the room?
  • Cost – the total cost of the ARD service must consider the cost of the device, its consumables and the labour required to deliver the service.
     

ARD devices fall into two main categories, those that disperse gaseous hydrogen peroxide, and those that emit ultraviolet C (UV-C) light.

Hydrogen peroxide vapour (HPV) devices are seen by the infection control community as the gold standard in terms of clinical efficacy and they are currently the most used automated room disinfection devices in the UK. Devices that emit UV-C light are newer to the market and are gaining in popularity.

 

What HPV and UV-C devices are available?

The following table summarises the key differences.

Most efficient solution for...

EFFICACY 

Both HPV and UV-C devices reduce bacterial contamination, including spores, more significantly than cleaning can alone, but HPV is significantly more effective. UV-C is significantly less effective for areas of the room that are out of the direct line of the light(5)

HPV 

SPEED 

When using HPV the area needs preparation in order to prevent the gaseous vapour leaving the room. What’s more, the vapour needs time to disperse and settle. With UV-C the area is only out of action for as long as the light itself is emitting and no special room preparation is needed. A single room can be turned around in less than 30 minutes with UV-C but takes approximately 2 1/2 hours with HPV

UV-C

EASY OF USE

Both HPV and UV-C devices can be used by a single operative with simple training but UV-C is easier to use because it has no consumables and no special room preparation is needed. When using HPV the room being decontaminated needs to be sealed with tape to avoid the vapour escaping and smoke detectors need to be switched off

UV-C

VALIDATION 

On-board computers are standard on all devices to log the deployments and confirm successful cycles

EITHER

STORAGE AND TRANSPORT

All devices are built to be robust and possible for a single person to move them. HPV devices require chemical cartridges that must be stored. Storage of replacement bulbs may be required for UV-C machines

EITHER
SAFETY

Because strong chemicals are used in HPV devices they are higher risk. All devices come with safety features

UV-C

MATERIAL COMPATABILITY

A lot of testing has been done on the material compatibility of both HPV and UV-C devices and the risk is low. HPV is a vapour so all vents and doors must be sealed off to avoid the gas escaping into surrounding environments and smoke detectors must be switched off

UV-C
COST

Generally HPV devices are less expensive than UV-C devices but when you factor in the consumable costs of HPV (the chemical cartridges and room sealing equipment) the cost differential erodes. Cost analysis shows that with intensive usage i.e. When used proactively, UV-C becomes more cost effective

EITHER

 

A reactive or proactive service? Understanding the difference

There are two ways in which automated room disinfection devices are used.

  • REACTIVELY to control infection:

 

Proactive vs reactive.jpgYour infection prevention and control team should specify the use of an automated desinfection device in response to specific infections. This may be for a single room, a number of rooms or a multi bedded bay and the deployment will need to happen quickly. 

In order to respond to this need as quickly as possible, an on-site automated room desinfection device should be utilised by a fully trained operational team as and when required. The objective of this reactive activity is to control the spread of an infection.

 

  • PROACTIVELY to prevent infection:

 

Proactive vs reactive 2.jpgUsing an on-site automated room desinfection device, fully trained operational teams should complete a scheduled program of room desinfection which has been developed in collaboration with the cleaning and IPC teams.

The objective of this proactive activity is to work alongside the cleaning processes to reduce the overall levels of pathogens and therefore prevent infections. Know more about the top five FAQs about Infection Prevention Programmes.

 

A proactive approach to automated room disinfection will achieve the greatest reduction in infections. For this reason, a combined proactive & reactive service is the ideal model. The exact room disinfection programme should be developed in collaboration with cleaning and infection prevention and control teams. Read more about the main differences between infection control and infection prevention.

 

Integration into the standard Terminal Clean Procedure

On completion of a standard terminal clean*, ARD technology can be deployed to remove more pathogens than is possible with the standard cleaning process alone. By adopting this additional process it is possible to achieve a more than 50% reduction in C.difficile* and MRSA infections.*

guide to reducing HCAIs

*A terminal clean is an enhanced clean of an empty patient/resident room after a patient/resident with a known infection has permanently left the room.

Download the guide to stay ahead of the short and long-term consequences of HCAIs and explore the latest approaches to integrated environmental infection prevention.

 

Introducing Protecta+

As part of our Protecta+ Cleaning and Infection Prevention programme, Sodexo can deliver an automated room disinfection service as an enhancement to our cleaning service.

Learn More

 

Sources

*Guest JF, Keating T, Gould D , et al; Modelling the annual NHS costs and outcomes attributable to healthcare associated infections in England; BMJ Open 2020; 10: e033367. doi 10.1136/bmjopen 2019

*Nagaraja A, Visintainer P, Haas JP, Menz J, Wormser GP, Montecalvo MA. Clostridium difficile infections before and during use of ultraviolet disinfection. Am J Infect Control. 2015.

*Jinadatha C, Villamaria FC, Ganachari-Mallappa N, et al. Can pulsed xenon ultraviolet light systems disinfect aerobic bacteria in the absence of manual disinfection? Am J Infect Control. 2015.

 

September 28, 2021

Back to the list