Enhancing Infection Control: The Role of UV Germicidal Irradiation in Combating Healthcare-Associated Infections

Each day, approximately one in 31 patients in the United States and one in 43 nursing home residents develop at least one healthcare-associated infection (HAI) 1. Surfaces are a recognized reservoir for pathogens in the healthcare environment, contributing to direct and indirect transmission opportunities for patients in those spaces to acquire these pathogens and potentially develop HAIs 2. The Centers for Disease Control and Prevention (CDC) recognizes the role of the physical environment in which patients are exposed to pathogens that cause HAIs. In its guidance for preventing HAIs, the CDC defines six core components of environmental cleaning and disinfection:

1. Integrate environmental services into hospital safety culture,
2. Educate and train all healthcare personnel responsible for cleaning and disinfecting patient care areas,
3. Select appropriate cleaning and disinfection technologies and products,
4. Standardize setting-specific cleaning and disinfection protocols,
5. Monitor effectiveness and adherence to cleaning and disinfection protocols,
6. Provide feedback on the adequacy and effectiveness of cleaning and disinfection to staff and stakeholders.

With the rise of UV germicidal irradiation as an adjunct technology in multi-faceted environmental cleaning and disinfection programs, many facilities utilize this technology and implement it with the recommendations of their UV-C device manufacturers. The advent of ultraviolet (UV) in disinfection is not new; in 1877, Downes and Blunt observed test tubes filled with bacteria-containing broth becoming sterile when exposed to sunlight. By using blue and violet end-of-the-spectrum color filters, in 1878, Downes and Blunt realized the inactivation of bacteria 3. In the nearly 150 years since these discoveries, UV germicidal irradiation has been harnessed as an adjunct in creating clean, safe environments for patients and clinicians. Consideration is given to where patient care items, furniture, and more are placed in the healthcare environment, sometimes even with mapping systems that allow devices to “learn” where the best placement for exposure will be based on furniture and item placement. However, as an invisible process, UV-C disinfection needs a visible method for validating placement that achieves correct exposure to the intended surfaces. As healthcare facilities seek processes that add value in providing safe environments for patients to be cared for and healthcare personnel to care for them, it is important for environmental services leaders, infection preventionists, and healthcare executives to recognize the importance of meeting the CDC’s six core components of environmental cleaning and disinfection and to understand the role UV germicidal irradiation can have in successfully meeting these core components.

UV-C dosimeters provide a visible way to validate invisible UV germicidal irradiation cycles. UV-C dosimeters change color when the correct dose of UV germicidal irradiation is delivered for the proper period of time and achieved at the surfaces intended for exposure. Whether to serve as a tool for educating and training healthcare personnel responsible for UV germicidal irradiation of proper device use and placement, helping to define the standard work for specific cleaning and disinfection protocols with UV germicidal irradiation, monitoring effective UV-C device placement and adherence to cleaning and disinfection protocols, or creating continuous process improvement systems for effective UV-C device operation, UV-C dosimeters provide the ability and assurance for environmental service professionals and leaders, infection preventionists, and healthcare executives to maximize the value of UV-technologies in their environmental cleaning and disinfection programs to prevent HAIs. 

Sources

1. Centers for Disease Control and Prevention. (2023). Current HAI progress report. Retrieved March 21, 2024 from https://www.cdc.gov/hai/data/portal/progress-report.html#:~:text=Each%20day%2C%20approximately%20one%20in,practices%20in%20U.S.%20healthcare%20facilities.
2. Centers for Disease Control and Prevention. (2020). Reduce risk from surfaces. Retrieved March 21, 2024 from https://www.cdc.gov/hai/prevent/environment/surfaces.html
3. Bolton, JR and Cotton, CA. (2008). The ultraviolet disinfection handbook: First edition. American Water Works Association. https://www.google.com/books/edition/The_Ultraviolet_Disinfection_Handbook/1-Aw1BVoJVgC?hl=en&gbpv=1&printsec=frontcover