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Implementation and impact of ultraviolet environmental disinfection in an acute care setting
Janet P Haas1, Jonathan Menz2, Stephen Dusza3
1Westchester Medical Center Department of Infection Prevention and Control, Valhalla, NY; Department of Medicine, New York Medical College, Valhalla, NY.
Background:
Multiple-drug-resistant organisms (MDROs) and Clostridium difficile (CD) are significant problems in health care. Evidence suggests that these organisms are transmitted to patients by the contaminated environment.
Methods:
This is a retrospective study of the implementation of ultraviolet environmental disinfection (UVD) following discharge cleaning of contact precautions rooms and other high-risk areas at Westchester Medical Center, a 643-bed tertiary care academic medical center. Incidence rates of hospital-acquired MDROs plus CD before and during the UVD use were evaluated using rate ratios and piecewise regression.
Results:
The average time per UVD was 51 minutes, and machines were in use 30% of available time. UVD was used 11,389 times; 3,833 (34%) of uses were for contact precautions discharges. UVD was completed for 76% of contact precautions discharges. There was a significant 20% decrease in hospital-acquired MDRO plus CD rates during the 22-month UVD period compared with the 30-month pre-UVD period (2.14 cases/1,000 patient-days vs 2.67 cases per 1,000 patient-days, respectively; rate ratio, 0.80; 95% confidence interval: 0.73-0.88, P < .001).
Conclusion:
During the time period UVD was in use, there was a significant decrease in overall hospital-acquired MDRO plus CD in spite of missing 24% of opportunities to disinfect contact precautions rooms. This technology was feasible to use in our acute care setting and appeared to have a beneficial effect.
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