VOL. 128 | NO. 81 | Thursday, April 25, 2013
Light Years Ahead
By Jennifer Johnson Backer
About 1 out of every 20 hospitalized patients in the U.S. will acquire another infection during the course of their treatment, according to the Centers for Disease Control and Prevention.
Vanessa Patton of Environmental Services for Methodist University Hospital sets up a TRU-D room disinfection unit, which uses UV light to combat the superbugs that live in hospital environments.
(Photo: Lance Murphey)
These infections, dubbed health care-associated infections, can be devastating for patients, and costly for hospitals.
There are few recent studies on the cost that infections acquired in health care settings inflict on the U.S. health care system, but an older study adjusted in 2007 dollars showed these infections collectively cost $6.65 billion, according to the CDC. Recent evidence also showed that some types of hospital-acquired infections are on the rise, and that the costs may be substantially higher than the estimated $6.65 billion.
Hospital staff across the country take measures like hand-washing, the use of isolation, wearing masks and gloves, and thoroughly disinfecting surfaces by hand to prevent the spread of pathogens like methicillin-resistant Staphylococcus aureus, better known as MRSA, Clostridium Difficule, or C.diff, and Vancomycin-resistant Enterococci, or VRE.
But some of these pathogens can exist for days, weeks or months on hospital surfaces – long after an infected patient has left the room. Studies show hospital staff can leave up to 50 percent of hospital surfaces untouched, paving the way for dangerous pathogen transfer from patient to patient.
More than 50 hospitals across America, including Methodist Le Bonheur Healthcare in Memphis, are using a device that uses natural ultraviolet light to disinfect and reduce pathogens on both visible hospital room surfaces and in shadowed areas. The device, TRU-D rapid room disinfection, was developed in Memphis by Lumalier Corp.
Chuck Dunn, president of Lumalier, said using UVC light to kill pathogens and organisms isn’t a new scientific development, but it’s never been widely used in health care settings. That’s because most UVC devices can’t disinfect shadowy areas and show they are delivering consistent outcomes.
“When science didn’t know how to reach these shadowed areas, the technology didn’t seem very useful because it only would have been getting part of the room,” Dunn said.
TRU-D, which resembles an elongated R2-D2 character from the Star Wars universe, is a portable disinfection system that can calculate the precise pathogen-lethal dose of UVC light needed to disinfect the environment – including shadowed spaces. The unit is rolled into a room, the door is closed, and housekeeping staff are able to monitor the room’s disinfection status remotely using sensor technology. Dunn estimates most rooms take about 20 to 30 minutes to disinfect.
The first TRU-D was sold in 2007 to Mercy Hospital of Folsom, Calif., and the technology has since spread rapidly, with more than 100 units in use across the U.S. The Affordable Care Act imposes penalties for hospital re-admissions and ties patient outcomes and satisfaction to reimbursement. As hospitals and other health care organizations strive to reduce unnecessary infections and maximize reimbursements, Dunn said he expects TRU-D adoption to rise.
Health care-associated infections drive up the cost of care an average of $13,973 per infection, data from the CDC show.
“Hospital administrators are reaching out for solutions because these reimbursements are so critical,” Dunn said. “Having a technology that works and a political environment that is causing hospitals to make improvements is leading to a groundswell of hospitals choosing automation to help disinfect.”
At $124,500 per unit, TRU-D is a significant investment for most hospitals, but Dunn said most hospitals quickly recoup the investment as they reduce infections, and their associated costs.
“The end game and reward is improved patient outcomes,” he said. “Every hospital that is using our device is seeking ways to fund additional devices.”
There are other technologies that can disinfect rooms and prevent the spread of dangerous pathogens, but most are cumbersome and fraught with error. Vaporized hydrogen peroxide can be pumped into a hospital room, and it’s effective – but the vents, door cracks and other openings have to be sealed first. It’s also more dangerous if the room isn’t properly sealed.
Shelia Wilson, a manager with University of North Carolina Hospitals, said the hospital system is currently using four TRU-D devices to disinfect rooms. Normally, UNC Hospitals has one, but the hospital system is participating in a $2 million study funded by the CDC to conduct research in the science of health care-associated infections using TRU-D.
Daniel Sexton, medical director of the Duke Infection Control Outreach Network, has said previously TRU-D was selected for the study because the automatic system is proven to significantly reduce environmental pathogens and eliminate human error in the disinfection process. The study is examining the impact of a thoroughly disinfected patient environment to reduce and prevent hospital-acquired infections.
Wilson said UNC Hospitals has used the TRU-D units in operating rooms, hospital rooms and burn units.
“We are fallible because we are humans,” she said. “It (TRU-D) takes the human error out of the system.”