Technological advancements are beginning to revolutionize the way infection preventionists fight hospital-acquired infections (HAIs). We take a look at emerging technology and the way it is facilitating measurement and compliance with everything from hand hygiene to environmental cleaning and instrument decontamination and tracking.
ATP
Adenosine triphosphate (ATP) applications in healthcare are beginning to take off. ATP is the universal energy molecule found in all animal, plant, bacterial, yeast and mold cells. And because large amounts of ATP can be found in bioburden and contaminants left behind by hands, it makes for an efficacious test technology. While the use of a fluorescent product to evaluate hand hygiene, such as GloGerm, has been in the market for a very long time, researchers have developed a new method using an invisible fluorescent marker to target high-touch surfaces in hospital rooms to determine cleaning efficacy. Carling, et al. (2006) describe how a nontoxic target solution, which intensely fluoresces with a black light, was formulated to be inconspicuous yet readily removed by disinfectants used by hospital housekeeping staff. Small volumes of material were applied to 12 target sites in patient rooms in three hospitals following terminal cleaning. The targets were reevaluated following terminal cleaning after several patients had occupied the room. The researchers evaluated 157 rooms in which 1,404 targets were placed, and found that in the three hospitals only 45 percent, 42 percent, and 56 percent of targets were removed by routine terminal cleaning/disinfecting activities. The frequency with which various individual sites were cleaned varied widely but was similar in all hospitals. The researchers concluded that the use of a novel target compound to evaluate housekeeping practices confirmed high rates of cleaning of traditional sites but poor cleaning of many sites that have significant potential for harboring and transmitting microbial pathogens.
ATP also is the technology at the heart of a new system to measure decontamination of the inside channels of flexible and rigid scopes. The Ruhof ATP Complete Contamination Monitoring System is a rapid method for verifying the cleaning process of all scopes and cannulated instruments. An absorbent swab on a flexible wand is fed into the internal channels to test for the presence of bioburden; when ATP is picked up by the tip of the swab and the swab makes contact with a reagent in the swab tube, light is emitted by the handheld unit in direct proportion to the amount of ATP present in just 15 seconds. The handheld device can be synced to a computer and the reading downloaded to the provided software program. The data can then be used to produce detailed reports and used to monitor cleaning history.
