Impact of UV powder surveillances on environmental cleaning at 8 intensive care units

Background: The hospital healthcare environment is considered a reservoir for bacterial pathogens. To prevent horizontal transmission of multidrug resistant organisms, appropriate environmental disinfection is of paramount importance.

Objective: To evaluate the impact of UV light surveillance with periodic reporting to environmental services and healthcare providers on environmental cleaning rates at a major teaching hospital.

Methods: Eleven weekly surveillances were performed within 8 intensive care units (ICUs) located in a 1,500 bed major metropolitan hospital from August 14, 2009 until October 30, 2009. UV powder (GlitterBug®, Brevis Co) was applied weekly to high-touch areas (tables, bed-rails, bed controls, call buttons, IV pumps, IV poles, mechanical ventilator's panels, computer keyboards, and chairs) in ICU patient rooms. Using UV lamps, powder was inspected at 48 hours from initial application. We calculated the percentage of surfaces with remaining UV powder per ICU (# of surfaces with UV powder remaining/total number of surfaces applied x 100). Given that the powder can be difficult to remove from porous surfaces, a surface with evidence of any effort of wiping was considered “clean”. Weekly results were emailed to hospital administrators and ICU Medical and Nursing Directors. We include ICU rankings and past performance curves of all ICUs based on the amount of UV powder found. Starting week 5, most 48 hr readings were done by the Infection Preventionists in conjunction with the units' environmental services personnel. Statistical analysis was done comparing grouped results of weeks 1-3, 5-8, and 9-11 by 2-way ANOVA (time-ICU).

Results: 8 ICUs (142-bed capacity) were evaluated, which included trauma, surgical, medical, burn, and pediatric units. On week 1, UV powder was found at 48-hr in 75% of observations (range: 10%-100%). By week 11, UV powder at 48-hr decreased to 40% (range: 5%-88%) in all surfaces tested. The removal of UV powder observed over the study period was significant (R2:0.30; p<0.0001).

Conclusions: Environmental cleaning surveillance coupled with feedback to the originating ICUs was successful in improving environmental cleaning. The impact of this program on the transmission of multidrug resistant organisms awaits determination.