While the hospitals in India continue to depend on hand hygiene compliance for disinfection, recent cases at AIIMS and other leading hospitals clearly show that hand hygiene alone is not enough in hospitals as patients infect the room environment and get infected from the same.
A hospital can house significantly dangerous microorganisms such as MRSA and VRE causing infections. In spite of cleaning a patient’s bed, apparatus and everything present in the room, a patient admitted into a room has significant chance of coming down with the same infection the prior occupant had – establishing direct link between the prior occupant and infection risk, which is independent of hand hygiene compliance. Disinfecting the contaminated environment is as important as hand hygiene as Hospital Acquired Infection (HAI) is partially determined by room into which they are admitted. The room environment, thus is a significant contributor to HAIs, and every day, with new resistant organisms such as New Delhi virus, Acinetobacter baumanni and others joining the list of already troubling organisms like MRSA, VRE, Norovirus and C. diff. making the matter worse.
While the traditional cleaning keeps the potential risk unacceptable, available no-touch technologies that can greatly diminish the potential for human error and add a critical layer of extra protection for patient safety become essential for healthcare sector.
No-Touch Disinfection System
No-touch disinfection, also known as “area disinfection,” is to disinfect an enclosed space using ultraviolet light (UV) or hydrogen peroxide vapour (HPV) as source. In no-touch disinfection system, a device generating UV or HPV is placed into a patient’s room (unoccupied) and is controlled from another room. Depending on the technology used, the duration of the disinfection cycle can be between 8 to 240 minutes.
Ultraviolet Disinfection
Being common in everything from laboratories to vacuum cleaners, UV light continues to be a reliable means of disinfection, involves exposing contaminated water to radiation from UV-C light. The treatment works because UV-C light penetrates an organism’s cell walls disrupting the cell’s genetic material – making reproduction impossible. Mercury or xenon gas lamps are usually used for UV-C light radiation. While the optimum UV-C wavelength range to destroy bacteria is between 250nm and 270nm, by striking an electric arc through low-pressure mercury vapour, a lamp emits a broad spectrum of radiation with intense peaks at UV-C wavelengths of 253.7nm and a lesser peak at 184.9nm. But, the broad spectrum nature (meaning that more UV-C wavelengths are produced) combined with the high intensity of the millisecond pulses gives PX-UV disinfection efficacy several times faster than mercury UV-C.
Once this UV-C energy passes through the cell walls of bacteria, viruses and bacterial spores, it gets inside the microorganism and absorbed by the DNA, RNA and proteins and deactivation takes place. The organism can no longer be infectious.
Hydrogen Peroxide Vapour (HPV)
Unlike UV disinfection, HPV systems use chemical reactions to produce a vapour of hydrogen peroxide generating oxygen that reacts with the cell walls of microorganisms, leading to cell lysis and death. Hence dispersing HPV throughout the room simply disinfects the area.
Of the two technologies, HPV and UV-C, UV-C decontamination process is less costly (average cost per room), easier to use and has significantly shorter cycle times. UV-C systems can be deployed and administered with limited training as it needs no monitoring during the process. After activating by a handheld device outside the room, the device automatically gets off once all the sensors on the device receives the prescribed amount of reflected rays.