infection prevention
infection prevention
By Amanda Sivek , PhD , a-IPC
Supplemental Disinfection Technology Use in Long Term-Care Facilities : How , When and Why
Editor ’ s note
This article is a summary of “ UV Light and Hydrogen Peroxide Vapor Disinfection in LTC Settings : What You Need to Know ” copresented at the 2023 Kairos Education Conference & Exhibit with James Davis , manager of infection prevention and control services at ECRI .
Before the COVID pandemic , the Centers for Disease Control and Prevention CDC ) estimated that 1 million to 3 million residents of long-term care facilities experienced a serious infection every year . Infection prevention and control ( IP & C ) practices can help vulnerable residents avoid getting infections from healthcare workers , other residents , and visitors . Environmental IP & C practices address cleaning and disinfection of environmental surfaces within residents ’ rooms and day / common rooms .
At ECRI , we receive many questions from our members about supplemental disinfection technologies like ultraviolet ( UV ) light and hydrogen peroxide vapor ( HPV ) devices that are used in a variety of healthcare settings . Let ’ s discuss how UV light and HPV disinfection work , when these technologies could be used in long term care , and considerations for safely using UV and HPV devices in long term care facilities , such as assisted living facilities , nursing homes , and skilled nursing facilities .
How does UV light and HPV disinfection work ?
UV-C light ( 200-280 nm ) and UV-B light ( 280-315 nm ) damage DNA / RNA to prohibit replication of microorganisms , ultimately killing them . UV-C light does not occur naturally on the Earth and is a known carcinogen . UV light disinfection effectiveness depends on the target surface ’ s distance from the UV light source , shadowing of the surface , and soil load on the target surface . UV light devices used in long term care facilities include UV room disinfection devices , air disinfection devices , UV mobile device disinfection boxes , handheld UV wands and UV phone boxes .
HPV decontamination devices use highly concentrated chemical sterilants to create a pure gas form of hydrogen peroxide that fills an enclosed , unoccupied space . HPV can decontaminate porous and nonporous surfaces within the treated space . A type of HPV decontamination device used in long term care facilities is a portable device with five components : a controller that initiates and tracks HPV device cycles ; a dehumidifier that maintains the relative humidity within range to sustain HPV ; a vaporizer that creates and disperses HPV with a measured amount of hydrogen peroxide ; an aerator unit that breaks down HPV into water vapor and oxygen after the hydrogen peroxide contact time ; and at least one hydrogen peroxide sensor that measures HPV concentration within an enclosed area and around sealed outer doors .
When could UV and HPV devices be used in long-term care facilities ?
UV and HPV are supplemental disinfection modalities . They can be used after manual cleaning and disinfection methods are performed as shown in the following schematic :
Clean surfaces per facility ’ s protocol
Disinfect surfaces per facility ’ s protocol / product ’ s instructions for use ( IFU )
Supplemental disinfection per equipment ’ s IFU
Before using a supplemental disinfection method in a long-term care facility , the first step is to vacate the resident ’ s room , day room , or resident common area . It is imperative for staff and residents to avoid exposure to UV light and HPV . UV-C light is a carcinogen . Hydrogen peroxide vapor may cause asphyxiation in enclosed areas ; other effects from inhalation may include gas embolism , unconsciousness , and respiratory arrest . Bottom line : Stay out of the room when supplemental disinfection devices are in use .
Typical UV Room Device Workflow
After vacating the room , the typical workflow for using a UV room disinfection device is to manually clean and disinfect surfaces within the space , following product IFUs . Next , the room is prepared by placing any safety sensors and the UV device within the room in the designated spots per facility protocol . Finally , the user selects the appropriate cycle , leaves the room , and initiates the disinfection cycle . After the 10- to 40-minute cycle completes , the user reenters the room and moves the device to the resident ’ s bathroom , another spot in the day / common room , or removes the device from the room .
Typical HPV Device Workflow Before using a HPV decontamination device in a
10 november 2023 • www . healthcarehygienemagazine . com