Implementation and impact of ultraviolet environmental disinfection in an acute care setting.
BACKGROUND
Multiple-drug-resistant organisms (MDROs) and Clostridium difficile (CD) are significant problems in health care. Evidence suggests that these organisms are transmitted to patients by the contaminated environment.


METHODS
This is a retrospective study of the implementation of ultraviolet environmental disinfection (UVD) following discharge cleaning of contact precautions rooms and other high-risk areas at Westchester Medical Center, a 643-bed tertiary care academic medical center. Incidence rates of hospital-acquired MDROs plus CD before and during the UVD use were evaluated using rate ratios and piecewise regression.


RESULTS
The average time per UVD was 51 minutes, and machines were in use 30% of available time. UVD was used 11,389 times; 3,833 (34%) of uses were for contact precautions discharges. UVD was completed for 76% of contact precautions discharges. There was a significant 20% decrease in hospital-acquired MDRO plus CD rates during the 22-month UVD period compared with the 30-month pre-UVD period (2.14 cases/1,000 patient-days vs 2.67 cases per 1,000 patient-days, respectively; rate ratio, 0.80; 95% confidence interval: 0.73-0.88, P < .001).


CONCLUSIONS
During the time period UVD was in use, there was a significant decrease in overall hospital-acquired MDRO plus CD in spite of missing 24% of opportunities to disinfect contact precautions rooms. This technology was feasible to use in our acute care setting and appeared to have a beneficial effect.
Westchester Medical Center Department of Infection Prevention and Control, Valhalla, NY; Department of Medicine, New York Medical College, Valhalla, NY. Electronic address: haasj@wcmc.com.
Janet P
JP
Haas
Westchester Medical Center Department of Performance Management, Valhalla, NY.
Jonathan
J
Menz
Department of Epidemiology and Community Health, New York Medical College, Valhalla, NY.
Stephen
S
Dusza
Westchester Medical Center Department of Infection Prevention and Control, Valhalla, NY; Department of Medicine, New York Medical College, Valhalla, NY.
Marisa A
MA
Montecalvo
D000046:Academic Medical Centers / Q000706:statistics & numerical data; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control*; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control*; D004203:Disinfection / Q000379:methods* / Q000706:statistics & numerical data*; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D010362:Patients' Rooms; D012189:Retrospective Studies; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D013997:Time Factors; D014466:Ultraviolet Rays
Clostridium difficile; Multiple-drug-resistant organisms