A growing body of research shines light on the need to augment existing disinfection protocols with no-touch and chemical-free methods, such as Instant UV.
Infectious disease specialists will agree: controlling the spread of pathogens continues to be a daunting task and this is especially true within healthcare facilities such as hospitals. The US Centers for Disease Control and Prevention (CDC) estimates that, on any given day, one in 31 patients in hospitals across the US will have at least one hospital-acquired infection (HAI). In 2015, 10.5% of patients with HAIs died while hospitalised1. The total economic burden of HAIs on the US healthcare system is upwards of $45bn annually and this startling statistic shows that the uncontained spread of pathogens in healthcare facilities remains to be a massive challenge that severely undermines the quality of patient care2-4.
Staff and patients alike serve as effective carriers, populating the facility with a diverse range of microbes; and HAI-causing microbes are exceptionally threatening because they have been shown to survive in the hospital environment for prolonged periods of time5. Studies also show that high-touch surfaces in medical facilities present the highest risk to patients of coming into contact with these pathogens and therefore acquiring HAIs6,7.
The COVID-19 pandemic has prompted an extremely urgent need to address the spread of pathogens. The rampant transmission of the SARS-CoV-2 virus, particularly in medical facilities, has become a global concern. Healthcare workers are at a significantly higher risk of acquiring COVID-198 and the incidence of nosocomial COVID-19 infection (acquired in hospital by a patient who was admitted for non-COVID-related conditions) continues to be a problem9,10.
Fighting the ‘invisible enemy’ of HAIs still relies primarily on basic hygiene methods like handwashing and approved disinfection protocols such as chemical wipes and sprays, as well as newer technologies including ultraviolet (UV) disinfection. However, these existing protocols recommended by the CDC are still insufficient in arresting the spread of infections which affect patient care.
UV technologies used in disinfection and top misconceptions
UV radiation is highly effective in eliminating infection-causing microbes, and has long been used to disinfect water, surfaces, and even air. It inactivates pathogens by penetrating the cell walls and damaging the DNA, rendering it unviable and unable to reproduce11. UV disinfection is also significantly more sustainable than its chemical-based counterparts. With the growing use of chemical-based disinfectants, healthcare environmental teams are beginning to actively reduce the number of chemical variants used in their workflows due to environmental and health concerns12 and damage to sensitive equipment13.
UV towers and ‘upper air’ systems are two commonly used UV technologies deployed in hospitals and patient care facilities currently. Upper air UV systems are installed on walls or ceilings to disinfect circulating air. This system has been shown to reduce the concentration of airborne bacteria by 46% to 90%14. However, eradicating only airborne pathogens is insufficient in preventing the overall spread of pathogens.
UV towers are also become increasingly integrated in patient room/terminal cleaning protocols; primarily to disinfect the entire patient room after patients are discharged, by emitting UV light throughout the room. While UV towers are efficient at disinfecting a confined space, there are several limitations:
- UV towers are typically brought in after a patient is discharged (patients’ hospital stays last an average of five to six days)15. During the patient’s stay, the bioburden within their room accumulates and spreads, increasing the risk of HAIs;
- Due to line-of-sight issues, shadowing of surfaces can prevent effective disinfection; and
- Due to the ‘canyon wall effect’, the effectiveness of UV towers is further limited by textured surfaces often found in healthcare facilities16.
What is Instant UV?
Recent advances in UV technology have paved the way for a new category in disinfection: Instant UV, a portable, hospital-grade UV device that is designed to facilitate frequent and routine disinfection, all with just a wave of the hand. Instant UV with NuvaWave™ has been subjected to rigorous third-party lab testing and shown to be effective in eliminating more than 99.9% of common and harmful pathogens including SARS-CoV-2 within one second17, making it the most efficient hospital-grade portable UV disinfection device available on the market to date. It is the first product to introduce targeted UV light with a patent-pending intelligent system, instantly disinfecting high-touch surfaces by simply depressing a trigger.
NuvaWave can work on a variety of surfaces such as metal, plastic, glass, and more. Due to the ease of use and portable nature of the device, NuvaWave can be used routinely to disinfect objects and surfaces, effectively controlling the unwanted spread of infection-causing pathogens.
The limitations of existing disinfection protocols
Experts recognise that the disinfection protocols and practices currently in place in medical facilities are sub-standard. A study has shown that only 40% to 50% of hospital surfaces that need to be sterilised are in fact manually wiped by environmental service (EVS) personnel18. This is further exacerbated by the shortages in EVS staff experienced by more than 50% of hospitals; and the lack of standardised employee training reduces the efficacy with which medical facilities are disinfected, contributing to subpar containment of pathogen spread19.
Additionally, chemical wipes are not recommended for use on sensitive medical equipment, computers and other electronic devices. This is concerning because research shows that portable medical equipment, such as computers on wheels and IV pumps, are among the most frequently touched items during patient care. Even with proper hand sanitisation and personal protective equipment, the inadequate disinfection of frequently used equipment can serve as vectors to help spread pathogens20.
UV towers have made headway in delivering a high standard of terminal cleaning. However, the primary function and value of UV towers come after the patient room is vacant; and are not commonly used at other hotspots in the healthcare facility with high traffic flow. Their utility does not serve for frequent and routine disinfection of highly patronised spaces, and therefore have limited capacity to prevent the spread of pathogens and reduce the risk of HAIs. In addition, UV towers are not designed to perform targeted disinfection; and while they are mobile, their sheer size requires time and effort to be transported around and used. They also carry a high price tag, ranging between $50,000 and $125,000 per unit, which makes it cost-prohibitive for healthcare facilities to purchase towers at the scale needed to effectively disinfect patient rooms parallel to the pace of room turnover.
Finding a standardised and automated solution which can enable easier and faster disinfection workflows can significantly increase the efficacy and quality of disinfection routines. Given the many challenges in achieving optimal levels of disinfection in the fight to combat HAIs, adoption of modern technologies has to supplement conventional methods15.
How does Instant UV work to close the disinfection gap?
Instant UV was not intended to be a one-stop-shop solution for pathogenic disinfection, nor is it intended to override existing disinfection and cleaning protocols. It serves to bridge the gap between the first and last steps of existing disinfection protocols.
Chemical wipes and sprays are effective at killing pathogens, but the inadequate or improper use of wipes can still result in poor disinfecting of surfaces and even promote further spreading of pathogens between surfaces15. As mentioned earlier, the lack of standardisation in using chemical wipes and spray reduces the overall effectiveness of this method. Unless cleaning personnel can adhere to the ‘one wipe, one surface, one direction, dispose’ policy, recontamination will occur up to 35% of the time21. As described above, chemical disinfectants can damage medical equipment and devices; and fabrics and linens, where pathogens collate, are also less frequently exposed to chemical-based disinfectants due to fears of damage and staining.
Meanwhile, UV towers used during terminal cleaning are designed to disinfect an enclosed space at the end of a patient’s stay or use. Therefore, there is a distinct disinfection gap between the use of chemical wipes and UV towers that Instant UV can fulfil. Instant UV devices like NuvaWave strategically close the gap between the first line of defence – chemical wipes and sprays – and larger UV systems such as upper air UV systems and UV towers, which serve as ‘end point’ disinfection.
The engineering behind Instant UV
The ongoing fight against HAIs warrants the implementation of a new technology, designed with user safety and seamless integration within standard workflows in mind.
With over 25 years of experience in light technology development and more than 200 US patents for medical devices, electronic materials and LED products, the inventors of NuvaWave have designed a novel product which revolutionises light technology. They leveraged the use of mercury-free lighting, as well as software innovations, to harness the power of UV light in a safe, portable handheld device. The cordless, battery-operated device lasts for up to three hours per charge and weighs only 0.7kg. NuvaWave is well-equipped with advanced safety features and can be carried around on a utility belt, bringing about convenience and ease.
The most critical feature of Instant UV with NuvaWave is its speed and effectiveness in killing pathogens like staph infection-causing methicillin-resistant Staphylococcus aureus (MRSA), harmful bacteria such as Escherichia coli, and Enterococci faecalis, as well as the SARS-CoV-2 virus.
Innovating current disinfection protocols for enhanced staff and patient safety
Despite current protocols and technologies, infection-causing pathogens are still spreading; hospitals and healthcare facilities need innovative solutions to mitigate risk of HAIs19. The COVID-19 pandemic has amplified this need, but the fundamental problem will not be solved with a vaccine. World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus has warned that the coronavirus crisis will not be the last pandemic. The ‘New Normal’ demands a new disinfection paradigm as part of the global effort to mitigate the spread of bacteria and viruses. Touch-free methods, such as Instant UV devices, should be considered as an adjunct to chemical and terminal disinfection – especially on high-touch surfaces22.
Chemical wipes and spray should still remain as the first wave of pathogenic eradication, but Instant UV such as NuvaWave could be added as part of the standard operation procedures (SOP). NuvaWave can be integrated into current disinfection workflows and be continuously and consistently applied to surfaces, fabric, electronics and equipment throughout the day. Other UV technologies such as UV towers should still be utilised in terminal cleaning but can be supplemented with NuvaWave – particularly when disinfecting hard-to-reach spots, electronic equipment or textured surfaces. Instant UV technology addresses the gaps in current technology and protocols, helping to close the disinfection gap.
There is an imperative need for frequent, non-disruptive disinfection, especially on high-touch surfaces in healthcare facilities. Instant UV with NuvaWave is a novel tool that has been scientifically proven to safely eliminate harmful pathogens and presents itself as a solution to reinforce the positive impact of disinfection in order to create clean, safe and healthy environments that deliver high quality patient care.
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