Providence Holy Cross Medical Center, Mission Hills, CA.
Clean Sweep Group Inc, Los Angeles, CA.
Am J Infect Control. 2018 Nov;46(11):1224-1229. doi: 10.1016/j.ajic.2018.05.012. Epub 2018 Jun 19.
Hospital-acquired infections (HAIs) are a significant contributor to adverse patient outcomes and excess cost of inpatient care. Adjunct ultraviolet-C (UV-C) disinfection may be a viable strategy for reducing HAIs. This study aimed to measure the clinical, operational, and financial impact of a UV-C terminal disinfection intervention in a community hospital setting.
Using a pre-post study design, we compared the HAI rates of 5 multidrug-resistant bacteria (Acinetobacter baumannii, Klebsiella pneumoniae, methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Pseudomonas aeruginosa) from 6 culture sites before and after a 12-month facility-wide UV-C intervention. To measure impact of UV-C disinfection on hospital operations, mean inpatient emergency room wait time was calculated. Finally, we conducted a cost saving analysis to evaluate the financial benefits of the intervention.
Overall, 245 HAIs among 13,177 inpatients were observed during a 12-month intervention period, with an incidence rate of 3.94 per 1,000 patient days. This observed HAIs incidence was 19.2% lower than the preintervention period (4.87 vs 3.94 per 1,000 patient days; P = .006). The intervention did not adversely impact emergency department admissions (297.9 vs 296.2 minutes; P = .18) and generated a direct cost savings of $1,219,878 over a 12-month period.
The UV-C disinfection intervention was associated with a statistically significant facility-wide reduction of multidrug-resistant HAIs and generated substantial direct cost savings without adversely impacting hospital operations.
医院获得性感染（HAI）是导致患者不良预后和住院患者医疗费用增加的重要原因。辅助紫外线-C（UV-C）消毒可能是降低 HAI 的可行策略。本研究旨在衡量社区医院环境中 UV-C 末端消毒干预的临床、运营和财务影响。
使用前后研究设计，我们比较了在为期 12 个月的设施范围 UV-C 干预前后 6 个培养部位的 5 种多药耐药菌（鲍曼不动杆菌、肺炎克雷伯菌、耐甲氧西林金黄色葡萄球菌、万古霉素耐药肠球菌和铜绿假单胞菌）的 HAI 率。为了衡量 UV-C 消毒对医院运营的影响，计算了平均住院急诊等待时间。最后，我们进行了成本节约分析，以评估干预的财务效益。
在 12 个月的干预期间，共有 13177 名住院患者中观察到 245 例 HAI，发病率为每 1000 患者日 3.94 例。与干预前相比，这一观察到的 HAI 发病率降低了 19.2%（4.87 比 3.94 每 1000 患者日；P=0.006）。干预并未对急诊科入院产生不利影响（297.9 与 296.2 分钟；P=0.18），在 12 个月内产生了 1219878 美元的直接成本节约。
UV-C 消毒干预与多药耐药 HAI 的全设施范围显著降低相关，并在不影响医院运营的情况下产生了大量的直接成本节约。
