A year-long study at Methodist University Hospital (MUH) shows how hospital staff integrated mobile Tru-D SmartUVC disinfection technology into hospital cleaning protocols to reduce C. difficile infections by over 45 percent. MUH is a 661-bed urban facility located in Memphis, Tenn., and serves as an academic campus for the University of Tennessee Health Science Center. Clostridium difficile (C. diff) rates at MUH remained substantially below national averages until the first quarter of 2010, when administrators noticed an increase in the occurrence of healthcare-associated CDAD.
During the first six months of 2012, MUH administrators logged 128 new cases, or an average of 21.3 new cases per month. Historically, Clostridium difficile rates at MUH tracked well below national averages. C. diff infection rates were not only tracked and reported by number of infections, but also by the 'number of new cases per 10,000 patient days' to remove variables from reported results. The 128 new cases equated to a C. diff infection rate of 21.3 cases per month, or 19.2 cases per 10,000 patient days.
A number of additional internal efforts and protocols had been implemented to control and reduce C. diff rates, including greater enforcement of handwashing, additional PPE, more restrictive patient isolation, additional EVS training, implementation of more stringent terminal cleaning standards, and greater use of bleach and chemical disinfectants. Despite these increased efforts, C. diff rates remained constant; from 20 new cases reported in January, to 21 new cases in June.
HAI cost data published by Emory University (1) cited an average cost of $13,973 per incidence of infection. Using this data, MUH administrators calculated that the direct C. diff cost over the first two quarters of 2010 totaled over $1,788,000, or an average of $298,000 per month (21.3 infections x $13,973 / infection). Any reduction in new C. diff infections would result in a substantial bottom-line financial gain and a better and more desirable outcome for patients.
While researching options regarding reduction of C. diff spores, Hospital administrators noted a Cleveland VAMC(2) study that confirmed significant reduction of C-diff spores using a portable, automated Ultraviolet Germicidal Disinfection Instrument, Tru-D SmartUVC(TM).
Bryan Simmons, MD, Methodist's infectious disease specialist, researched several emerging disinfection technologies: "We looked at a number of methodologies. Tru-D was supported by multiple, independent peer-reviewed studies that gave us the confidence to invest in an advanced level of environmental disinfection."
Methodist engaged Tru-D SmartUVC in July of 2010 to determine if the environmental contamination of isolation rooms caused by patient-shed C. diff spores could be significantly reduced. All C. diff patient discharge rooms were treated with Tru-D before being occupied by a newly admitted patient.
In the month following the intervention, reported C. diff cases decreased by more than 45 percent and remained stable at the lower rate. By the end of November, MUH reported new C. diff infections averaged 11.6 per month, a 45.5 percent reduction. Infection rates per 10,000 patient days also dropped by 44%, averaging 10.8 cases per month.
Cost savings associated with the reduction in reported cases (from 21.3 / month to 11.6 / month), and directly attributed by management to the use of the portable Ultraviolet disinfection instrument, totaled $677,000 from July to November, or more than $135,000 per month.
Automated portable UV germicidal technology (Tru-D) had an immediate, positive impact in our commitment to excellence, with improved patient outcomes and a reduction in hospital stays," says Chuck Lane, CFO. Based on those findings, additional Tru-D units are being deployed into Methodist Le Bonheur Healthcare facilities.
1. "Prevention of Cross Transmission of Microorganisms Is Essential to Preventing Outbreaks of Hospital-Acquired Infections" David Schwegman, MD, Emory University
2. "Decontamination with Ultraviolet Radiation to Prevent Recurrent Clostridium difficile Infection in 2 Roommates in a Long-Term Care Facility" Infection Control and Hospital Epidemiology May 20, 2012 Vol 33, No 5. Brett Sitzlar; Ravy K. Vajravelu; Lucy Jury; Curtis J. Donskey; Robin L. P. Jump.