BEND, Ore. — After testing an ultraviolet light disinfection system for five months last year, St. Charles Bend has acquired three Tru-D SmartUVC devices that are now being used to kill some of the nastier germs found around the hospital.
Since the start of the year, the hospital has used the devices to combat the flu virus and to disinfect a surgical tool sterilization room after a sewage pipe leak.
But their primary task has been to reduce the cases of hospital-acquired infections, particularly a bacteria known as Clostridium difficile, which doctors often call “C. diff.”
“We have reduced the number of C. diffs that we’re seeing; that’s the good news,” said Randy Barnes, director of hospitality services at St. Charles Bend. “The bad news is we have seen a spike in C. diff coming in.”
C. diff is a particularly difficult bacteria to kill. It accounts for nearly a half million infections and 15,000 deaths each year. The bacteria form spores that can survive on surfaces for up to five months, and hospitals have traditionally relied on bleach as part of a labor-intensive manual cleaning process that often has less than ideal results.
Barnes said the hospital has used the UV devices to disinfect rooms after patients with C. diff are discharged with a goal of preventing other patients from acquiring the infection. But the hospital is seeing more patients infected with C. diff when they come to be treated for other concerns. C. diff is commonly thought of as a hospital-acquired infection, but people are often infected outside of the hospital, as well.
St. Charles Prineville had eight cases of C. diff last year, after years of having almost none. Barnes secured a loaner UV device for Prineville to test this year.
At the Bend hospital, two of the devices are used primarily for disinfecting patient rooms, while a third is used to sterilize operating rooms. Infection control staff prioritize use of the device targeting C. diff first, then Methicillin-resistant Staphylococcus aureus, known as MRSA, and vancomycin-resistant enterococci, or VRE.
If no rooms have been exposed to those pathogens, the devices are used to sterilize other patient rooms and for spot cleaning in other areas.
“We’ve expanded it throughout the whole hospital,” Barnes said.
The devices have been used to sterilize the cardiac catheterization lab, as well as to disinfect the incubators used by preemies in the neonatal intensive care unit.
“They have a very complicated tubing system,” he said. “To ensure infection prevention, we’ll let the nurses clean them as usual, and then we’ll have Tru-D bathe them.”
The devices, which can be rolled from room to room, have long glass tubes that emit short-frequency ultraviolet C light which breaks up bacterial DNA. The light can bounce in all directions, and the devices monitor the flood of light shutting off once the room has been sufficiently bathed in UV light to damage bacterial DNA and keep it from multiplying.
After a patient is discharged, staffers complete a manual cleaning of the patient’s room. The device is then rolled in and used. The room is cordoned off, as the UV light is harmful to human skin. If someone opens the door to the room during the disinfection process, the device will automatically shut off.
Barnes said the standard cleaning process after a C. diff patient is discharged calls for a manual cleaning, which takes about 30 minutes, followed by a bleach wipe-down that takes up to an hour.
“So we were up to 90 minutes to totally clean an isolation room that had a patient with C. diff,” he said. “By moving in the light, it only takes 30 minutes.”
St. Charles has been dealing with high demand for beds, and saving 30 minutes to make a room available for the next patient has helped to reduce backlogs. It’s also helped to avoid cases where a piece of equipment is taken from an unsterilized room because it is needed elsewhere.
“By Tru-D-ing everything, we don’t do that, and we’ve actually made it a safer environment,” Barnes said. “And everybody is happy we’re no longer using bleach wipes on a consistent basis. It’s highly caustic and affects your respiratory system. It destroys equipment and furniture over time.”
The devices have been used to sterilize 670 hospital rooms so far this year and to disinfect emergency room areas during the flu outbreak.
When a sewage pipe burst earlier this month, flooding a room where surgical tools are cleaned and sterilized, the hospital used all three Tru-Ds to bathe the area with UV light during renovation. Hospital officials planned one last UV sterilization of the room Friday night, before they resumed packing surgical equipment packs Saturday morning.
St. Charles Redmond and Madras do not have the volume of C. diff cases to justify purchasing a device of their own, but Barnes has taken units up to Redmond to disinfect operating rooms used for total joint replacements once a month.
“They leave a lot of bioburden, all the tissue and bone pieces,” he said. “They wanted assurance that the one OR they use is infection prevention clean.”