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2015 HSR&D/QUERI National Conference Abstract

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3149 — Using an Innovative Pulsed Xenon Ultraviolet Ray Technology and Other Interventions to Reduce Hospital Associated Infections

Zeber JE, Central Texas VA; Copeland LA, Central Texas VA; Stock EM, Central Texas VA; Jinadatha C, Central Texas VA; Hendricks J, South Texas VA; Chen Q, Kansas University Medical School;

Objectives:
Hospital associated infections (HAI) affect 1.7 million patients and cause 100,000 deaths annually, yet preventive strategies remain only partially effective. HAI are transmitted via healthcare worker contact or contaminated room surfaces; the increase of antibiotic-resistant organisms compounds the problem. We implemented novel pulsed-xenon ultraviolet ray (PX-UV) devices for disinfecting rooms, along with other strategies to transform patient care while reducing unnecessary treatment costs.

Methods:
Aims of the ongoing PX-UV project targeted device effectiveness on laboratory samples, reducing actual infection rates, and cost-effectiveness of the portable machines. Early work seeks to understand implementation challenges, gauging perceptions of barriers to widespread adoption. This real-world trail compares two facilities using PX-UX devices with two control sites employing standard manual cleaning efforts, examining 36 month pre-post rates (through Spring 2015) of HAI incidence, microbial surface counts, and associated treatment costs. Poisson regression and time series models control for patient severity characteristics. Other promising efforts underway include air disinfection devices in operating suites addressing surgical infections and copper-infused room coatings to thwart microbial buildup on high-touch surfaces.

Results:
We found 99.4 and 98.1 percent reductions in MRSA and heterotrophic plate counts, respectively (IIR 7.0-12.9, p < .01). More importantly, early evidence suggests HAI declines of approximately half where devices were deployed. Besides genotyping MRSA isolates to track exactly where transmission occurs, other laboratory tests demonstrate PX-UV significantly disinfects even absent manual cleaning and without bacteria developing longitudinal resistance. Unfortunately, device usage rates remain low due to housekeeping time restrictions and bed-turnover priorities. Negotiations continue to retrofit 50 hospital rooms for copper surfaces and soon install operating room devices, approaches conceivably less obtrusive on daily hospital activities.

Implications:
Within the context of proliferating disinfection options to eliminating room pathogens, we found dramatic improvements in laboratory clinical benefits of PX-UV technology. Emerging optimistic results highlight both tremendous promise and potential barriers of introducing innovative advances, advocating ongoing vigilance to protect veterans from HAI that perniciously evolve with containment strategies.

Impacts:
Pragmatic clinical interventions supported by insightful research can tackle crucial healthcare concerns, but understanding why effective strategies fail to take root requires involving multiple stakeholders to efficiently bridge theory, technology and translational promise.