Study Underscores Need for Personnel, Device Resources to Increase UV Disinfection Utilization

A new quality improvement study aimed to increase ultraviolet (UV) disinfection utilization by developing novel deployment strategies without adding resources in an acute care facility.

Results, published as a preproof in the American Journal of Infection Control, emphasize that use of UV disinfection in acute care settings should be guided by multidisciplinary groups that balance resources against efficacy and use tailored tools to improve efficiency, authors wrote.

“While our study did increase deployment in novel areas and used multidisciplinary partnerships with new tools to deploy devices without additional staffing requirements, we observed a decrease in the median disinfection cycle time per week during a geographically confined pilot (4985 minutes) from baseline (5394 minutes) and during the intervention (1454 minutes) following a second baseline (6641 minutes),” they said.

Limitations of staff resources and machine availability likely contributed to the missed goal of increasing UV disinfection cycles and time throughout hospitals.

Mobile UV disinfection works to render microorganisms nonviable and helps reduce pathogen transmission in hospital settings, and best deployment strategies should consider staffing resources, cost, and physical layout, the report reads.

“The hospital microbiome changes rapidly after patient admission, and contamination at the time of admission is only one moment of environmental contamination that may lead to patient acquisition of significant pathogens,” authors explained. “We hypothesize that increasing deployment of UV disinfection to a broader array of moments during an inpatient hospitalization than post discharge would improve efficiency of resource use and may improve overall effectiveness of UV disinfection.”

To test their theory, a multidisciplinary group complete with infection prevention, environmental services, and nursing unit staff developed a new deployment strategy. The strategy included using UV disinfection machines without adding more resources, reducing the burden on the environmental services leadership, and deploying the machines in nonpatient and procedural areas.

The researchers analyzed weekly UV disinfection minutes, cycles, and proportions of cycles completed during 4 study periods: baseline, pilot, baseline 2, and intervention.

“The intervention consisted of deploying UV disinfection devices to locations for a full week, in a scheduled rotation. The intervention was designed to reduce device transport time between units and increase deployment in environments where pathogen contamination may significantly contribute to patient-to-patient transmission, rather than only using in patient rooms after discharge,” the authors wrote.

In addition to a lower median disinfection cycle time per week observed during the pilot and intervention periods compared with baseline periods, cycles per week were also lower in the intervention period than the 3 preceding periods.

The study was carried out at the University of Pittsburgh Medical Center Presbyterian hospital which has 2 buildings connected by a pedestrian bridge. The hospital has 34 inpatient units and specializes in trauma, organ transplant, heart and vascular services, and neurological care, among other services.

The hospital operated 4 UV disinfection devices throughout the study period, while cycle times were automatically determined by the device and can vary based on room size and configuration.

Overall, the “intervention’s use of novel tools and robust communication increased deployment to non-conventional areas (areas at risk of environmental contamination and transmission outside of patient rooms).”

However, “the median UV disinfection cycles per week decreased 8% during the geographically confined pilot from baseline and decreased 78% during the 52-week intervention from the intervening baseline period.”

“Maximizing UV disinfection deployment, particularly using a strategy to deploy beyond the indication of postdischarge cleaning, will likely require additional personnel and device resources,” researchers concluded.

Reference

Crall, V, Lewis C, Dickman D, et al. Strategies for deployment of ultraviolet disinfection in an acute care facility: a quality improvement initiative. Am J Infect Control. Published online April 26, 2023. doi:10.1016/j.ajic.2023.04.164