scholarly journals Evaluating the Utility of UV Lamps to Mitigate the Spread of Pathogens in the ICU

2020 ◽  
Vol 10 (18) ◽  
pp. 6326
Author(s):  
Andrew Gostine ◽  
David Gostine ◽  
Jack Short ◽  
Arjun Rustagi ◽  
Jennifer Cadnum ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Uv Light ◽  
Prospective Trial ◽  
Relative Reduction ◽  
Post Inoculation ◽  
Patient Room ◽  
Dna Virus ◽  
Viral Dna ◽  
Uv Lamps

Contaminated surfaces in a hospital serve as reservoirs for pathogen spread. The aim of this study was to evaluate UV lights in preventing the spread of a DNA tracer in an intensive care unit (ICU) through sterilization of highly touched surfaces. In a prospective trial, a non-pathogenic DNA virus was inoculated onto surfaces in an ICU patient room. Investigators swabbed frequently touched surfaces in non-inoculated ICU rooms at 24, 48, and 96 h post inoculation. Culture specimens were analyzed for the presence of viral DNA via PCR. After baseline data were obtained, UV lights were deployed in a standardized fashion onto vitals monitors, ventilators, keyboards, and intravenous (IV) pumps. Inoculation and culturing were then repeated. Prior to UV implementation, the DNA tracer disseminated to 10.10% of tested surfaces in non-inoculated rooms at 48 h. Post UV light deployment, only 1.20% of surfaces tested positive for the DNA tracer after 48 h. UV decontamination significantly retarded the spread of the virus DNA, with a relative reduction of 90% at 48 h from 10.10% of surfaces pre UV to 1.20% of surfaces post UV (p < 0.0001). UV decontamination holds the potential to confer protection to patients by reducing the number of surfaces that can serve as a nidus for transfer.

scholarly journals Evaluating the Utility of UV Lamps to Mitigate the Spread of Pathogens in the ICU

2020 ◽  
Author(s):  
Andrew L Gostine ◽  
David Gostine ◽  
Jack Short ◽  
Arjun Rustagi ◽  
Jennifer Cadnum ◽  
...  
Keyword(s):  
Uv Light ◽  
Herd Immunity ◽  
Prospective Trial ◽  
Baseline Data ◽  
Relative Reduction ◽  
Post Inoculation ◽  
Patient Room ◽  
Dna Virus ◽  
Viral Dna ◽  
Uv Lamps

Introduction: While commonly associated with vaccinations, herd immunity can be applied to aseptic strategies in the hospital. The more decontaminated surfaces in a hospital the greater immunity conferred to patients against the spread of infections. The aim of this study was to evaluate UV lights in preventing the spread of a DNA tracer in an ICU. Methods: In a prospective trial, a non-pathogenic DNA virus was inoculated onto surfaces in an ICU patient room. Investigators swabbed frequently touched surfaces in non-inoculated ICU rooms at 24, 48, and 96-hours post inoculation. Culture specimens were analyzed for the presence of viral DNA via PCR. After baseline data was obtained, UV lights were deployed on to vitals monitors, ventilators, keyboards, and IV pumps. Inoculation and culturing were then repeated. Results: Prior to UV implementation, the DNA tracer disseminated to 10.1% of tested surfaces in non-inoculated rooms at 48 hours. Post UV light deployment, only 1.2% of surfaces tested positive for the DNA tracer after 48 hours. Conclusion: UV decontamination significantly retarded the spread of the virus DNA, with a relative reduction in 90% at 48-hours from 10.10% of surfaces pre-UV to 1.20% of surfaces post-UV (p < 0.0001). UV decontamination holds the potential to confer protection to patients by reducing the number of surfaces that can serve as a nidus for transmission.

scholarly journals Evaluation of a Continuous Decontamination Technology in an Intensive Care Unit

2020 ◽  
Vol 41 (S1) ◽  
pp. s519-s519
Author(s):  
Tami Inman BSN ◽  
David Chansolme
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Urban Hospital ◽  
Patient Room ◽  
Colony Forming Units ◽  
Prevention Interventions ◽  
Continuous Application ◽  
Low Levels ◽  
Healthcare Associated ◽  
Cleaning And Disinfection

Background: The scientific literature increasingly indicates the need for the development of continuous disinfection to address the persistent contamination and recontamination that occurs in the patient rooms despite routine cleaning and disinfection. Methods: To determine a baseline microbial burden level on patient room surfaces in the intensive care unit (ICU) of a large urban hospital, 50 locations were swabbed for total colony-forming units (CFU) and the prevalence of methicillin-resistant Staphylococcus aureus (MRSA). Once the baseline in ICU patient rooms was established, 5 novel decontamination devices were installed in the HVAC ducts near these patient rooms. The devices provide a continuous low-level application of oxidizing molecules, predominately hydrogen peroxide. These molecules exit the duct and circulate in the patient room through normal convection, landing on all surfaces. After activation, environmental sampling was conducted every 4 weeks for 4 months. The effect from continuous low levels of oxidizing molecules on the intrinsic microbial burden and the prevalence of MRSA were analyzed. In addition to external laboratory reports, the facility tracked healthcare-associated infections (HAIs) in the unit. HAI data were averaged by month and were compared to the preactivation average in the same unit. Results: The preactivation average microbial burden found on the 50 locations were 179,000 CFU per 100 in2. The prevalence of MRSA was 71% with an average of 81 CFU per 100 in2. After activation of the devices, levels of microbial burden, prevalence of MRSA, and average monthly HAI rates were all significantly lower on average: 95% reduction in average microbial burden (8,206 CFU per 100 in2); 81% reduction in the prevalence of MRSA (13% vs 71%); 54% reduction in the average of healthcare-onset HAIs. All data were obtained from the averages of sampling data for 4 weeks during the 4-month trial period. Conclusions: The continuous application of low levels of oxidizing molecules throughout the patient rooms of an ICU demonstrated 3 outcomes: reduced overall surface microbial burden, lowered the incidence of MRSA, and significantly decreased the monthly average HAI rate. Please note, the ICU ran other infection prevention interventions at this time, including standard cleaning, as well as and their standard disinfecting techniques.Funding: This study was supported by the CASPR Group.Disclosures: None

Limited Impact of Sustained Simple Feedback Based on Soap and Paper Towel Consumption on the Frequency of Hand Washing in an Adult Intensive Care Unit

2002 ◽  
Vol 23 (3) ◽  
pp. 120-126 ◽  
Author(s):  
Marvin J. Bittner ◽  
Eugene C. Rich ◽  
Paul D. Turner ◽  
William H. Arnold
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prospective Trial ◽  
Hand Washing ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Surgical Intensive Care ◽  
Adult Intensive Care Unit ◽  
Paper Towel

Objective:To determine whether hand washing would increase with sustained feedback based on measurements of soap and paper towel consumption.Design:Prospective trial with a nonequivalent control group.Setting:Open multibed rooms in the Omaha Veterans Affairs Medical Center's Surgical Intensive Care Unit (SICU) and Medical Intensive Care Unit (MICU).Subjects:Unit staff.Intervention:Every weekday from May 26 through December 8,1998, we recorded daytime soap and paper towel consumption, nurse staffing, and occupied beds in the SICU (intervention unit) and the MICU (control unit) and used these data to calculate estimated hand washing episodes (EHWEs), EHWEs per occupied bed per hour, and patient-to-nurse ratios. In addition, from May 26 through June 26 (baseline period) and from November 2 through December 8 (follow-up period), live observers stationed daily for random 4-hour intervals in the MICU and the SICU counted actual hand washing episodes (CHWEs). The intervention consisted of posting in the SICU, but not in the MICU, a graph showing the weekly EHWEs per occupied bed per hour for the preceding 5 weeks.Results:Directly counted hand washing fell in the SICU from a baseline of 2.68 ± 0.72 (mean ± standard deviation) episodes per occupied bed per hour to 1.92 ± 1.35 in the follow-up period. In the MICU, episodes fell from 2.58 ± 0.95 (baseline) to 1.74 ± 0.69. In the MICU, the withdrawal of live observers was associated with a decrease in estimated episodes from 1.36 ± 0.49 at baseline to 1.01 ± 0.36, with a return to 1.16 ± 0.50 when the observers returned. In the SICU, a similar decrease did not persist throughout a period of feedback. Estimated hand washing correlated negatively with the patient-to-nurse ratio (r= -0.35 for the MICU,r= -0.46 for the SICU).Conclusions:Sustained feedback on hand washing failed to produce a sustained improvement. Live observers were associated with increased hand washing, even when they did not offer feedback. Hand washing decreased when the patient-to-nurse ratio increased.

Prospective Trial of House Staff Time to Response and Intervention in a Surgical Intensive Care Unit: Pager vs. Smartphone

2017 ◽  
Vol 74 (5) ◽  
pp. 851-856 ◽  
Author(s):  
James M. Tatum ◽  
Terris White ◽  
Christopher Kang ◽  
Eric J. Ley ◽  
Nicolas Melo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prospective Trial ◽  
House Staff ◽  
Surgical Intensive Care Unit ◽  
Staff Time ◽  
Surgical Intensive Care

Oximetry of the brain

2012 ◽  
Vol 19 (3) ◽  
pp. 176-179
Author(s):  
Alina Vilkė ◽  
Andrius Macas ◽  
Dalia Bieliauskaitė ◽  
Diana Bilskienė ◽  
Ilona Šuškevičienė ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Operating Room ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Prospective Trial ◽  
Cerebral Oximetry ◽  
Early Results

Background. Devices allowing direct assessment of brain tissue oxygenation have showed promising results in clinical studies. However, estimation of brain oximetry still has some challenges. The aim of our study was to estimate the feasibility to monitor cerebral oximetry for neurosurgery patients in the Operating Room and in the Neurosurgery Intensive Care Unit, possible basic disturbances for the study and early results. Materials and methods. The prospective trial took place in a tertiary university setting – the Neurosurgery Department of the Lithuanian University of Health Sciences Hospital (Kaunas Clinics). The monitoring was performed with an INVOS® Cerebral / Somatic Oximeter, which is based on near-infrared spectroscopy. The monitoring places were the Operating Room, later the Neurosurgery Intensive Care Unit and for some patients the regular Neurosurgery Ward. All patients had acute open or closed traumatic brain injury and had undergone neurosurgery. Results. 52 patients were included in the study, while 36 operations were performed after traumatic brain injury with successful monitoring. Preoperatively GCS ranged from 3 to 15 (average 10.2 ± 4.6), all patients had no hypotension ranged from 214 mmHg to 112 mmHg (average 148.0 ± 26.6), the mean arterial pressure ranged from 155 mmHg to 61 mmHg (average 106.0 ± 21.8), only two patients had hypoxia with SpO2 of 86% and 76%, other values averaged 96.7% ± 4.3% . Hemoglobin preoperatively ranged from 162 g/l to 82 g/l (average 133.7 ± 17.9). The va­ lues of cerebral oxygenation preoperatively in the Operating Room were 42–96% (average 74.8 ± 10.8), and one patient with cerebral oxy­ genation of 15% bilaterally before surgery died in 24 hours after the surgery (normal values vary from 58 to 82%). The values varied from to 15–95% in the period of the operation. The biggest difference of cerebral oxygenation between brain hemispheres was registered as 42% and 68% before the intubation, 60% (±8.8) and 76% (±4.0) during the operation, 64% (±4.9) and 80% (±5.3) in the Intensive Care Unit. 13 patients died, 17 were discharged with GCS of 13–15 and 6 patients with GCS of 8–12. Conclusions. Monitoring of regional cerebral oximetry for neurosurgery patients can be performed, despite of its limitations: surgery or application of the Mayfield holder in the frontal region of the head, intra­ operative transcranial Doppler monitoring

scholarly journals What Healthcare Workers Should Know about Environmental Bacterial Contamination in the Intensive Care Unit

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Vincenzo Russotto ◽  
Andrea Cortegiani ◽  
Teresa Fasciana ◽  
Pasquale Iozzo ◽  
Santi Maurizio Raineri ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Healthcare Workers ◽  
Uv Light ◽  
Bacterial Species ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Major Health Problem ◽  
Resistant Species ◽  
Increased Risk

Intensive care unit- (ICU-) acquired infections are a major health problem worldwide. Inanimate surfaces and equipment contamination may play a role in cross-transmission of pathogens and subsequent patient colonization or infection. Bacteria contaminate inanimate surfaces and equipment of the patient zone and healthcare area, generating a reservoir of potential pathogens, including multidrug resistant species. Traditional terminal cleaning methods have limitations. Indeed patients who receive a bed from prior patient carrying bacteria are exposed to an increased risk (odds ratio 2.13, 95% confidence intervals 1.62–2.81) of being colonized and potentially infected by the same bacterial species of the previous patient. Biofilm formation, even on dry surfaces, may play a role in reducing the efficacy of terminal cleaning procedures since it enables bacteria to survive in the environment for a long period and provides increased resistance to commonly used disinfectants. No-touch methods (e.g., UV-light, hydrogen peroxide vapour) are under investigation and further studies with patient-centred outcomes are needed, before considering them the standard of terminal cleaning in ICUs. Healthcare workers should be aware of the role of environmental contamination in the ICU and consider it in the broader perspective of infection control measures and stewardship initiatives.

Patient Room Considerations in the Intensive Care Unit

2014 ◽  
Vol 37 (1) ◽  
pp. 83-92 ◽  
Author(s):  
Jennie Evans ◽  
Evelyn Reyers
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Room
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