Preventing and controlling infection is the cornerstone of great healthcare, yet nurses, doctors and clinicians struggle to keep up with ever-mutating pathogens, which are constantly adapting and adjusting to their environment. The impact of these ‘superbugs’ has been addressed by the World Health Organisation and country leaders alike, yet we struggle on, using age-old protocols to clear up these modern bugs, in what has been referred to as the ‘challenge of our time’.
‘Our most recent report, issued this past April, was the most alarming yet. Drugs that were once lifesavers are now worthless. Hospitals have become hotbeds for the transmission of highly resistant superbugs, increasing the risk that hospitals kill rather than heal. For a growing number of serious infections, doctors are empty-handed. The rise of resistance has vastly outpaced the development of replacement drugs.’ Dr Margaret Chan, Director-General, WHO.
The Review on Antibacterial Resistance commissioned in 2014 and published in 2016 concluded that by 2050, resistance to antibiotics will be the main cause of death. That would equate to the loss of US$ 100 trillion in world GDP by 2050 due to infections.
Pathogens need to survive; thus, they constantly adapt to achieve this. Our job in the wider healthcare community is to introduce strategies and protocols that minimise or eradicate the pathogen’s adaption and reproduction. Indeed, it is recognised that protocols are the drivers of improvement, and with reviews showing how closely we have adhered to these protocols, we have scope to adapt our own practices, allowing further improvement.
It is expected that chemicals will kill these pathogens, but with constantly changing criteria, how do we keep up? We could employ the use of increasingly potent chemicals and compounds, but we run the risk of destroying the fabric of our healthcare establishments, which could cost us millions of pounds to repair and replace. Additionally, wrongly diluted chemicals can actually build chemically resistant pathogens; and as such the Food and Drugs Administration are currently reviewing the safety and efficacy of their use in such environments.
Is there one single silver bullet; a single answer; a panacea? The short answer is no. We have no choice but to augment our protocols with technology.
It is essential that our current method protocols are reviewed, and that we engage and embrace new technologies with proven track records. Our methods must be fast, effective and repeatable. They have to be proactively deployable within a protocolled environment, thereby preventing infections by continuously reducing the bio-burden.
The irony of some older methods of decontamination is that they are so time-consuming that they are the first things to be neglected when the patient and workflow pressures increase.
The combination of the current infection toll in deaths, human suffering and budget restraints provides the basis for a ‘burning platform’ that is urgently in need of improvement. Prospects for the future of current practices do not bode well, with growing numbers of elderly patients with weaker immune systems, increasing pathogen virulence, and resistance to antibiotics and chemicals.
A key point to keep in mind is that great healthcare has to begin with the cleanest environment possible.
Millions of pounds have been spent on developing an efficient adjunct to current practices. Let’s look at how technology, in this case UltraViolet C (UVC), can be implemented in a key area of the hospital: the operating theatre.
UltraViolet C (UVC) is on the light spectrum, as is Gamma (a regular sterilisation method for instruments and prosthesis) and X-Ray. All are very familiar, safe uses of penetrative light wavelengths. UVC is not penetrative and is therefore containable and deployable with little or no preparation. Why aren’t we utilising this technology more, when it busts the DNA/RNA of most pathogens – including MRSA, CRE, VRE, Coronavirus, C-Difficile, Ebola, bacteria, fungi, and spores – killing them and ceasing their ability to reproduce?
The operating room is the engine room of any healthcare facility. It has the highest ‘real estate’ value in the hospital (cost per minute), and is a key area in which lives are saved, where healthcare is delivered in a tangible form and money is generated. Having a clean and decontaminated operating room is of paramount and increasing importance due to ‘Never Events’ and CMS/Department of Health penalties. Workflow pressures result in decontamination being moved down the list of priorities and focus, with deep cleaning often suspended; sometimes for years; particularly as some methods which utilise gas and chemicals result in several operating rooms being out of use at the same time.
A quick, easy, environmentally and operationally friendly high-level germicidal dose of UVC delivered proactively on a daily basis has many benefits. Not least, it ensures a decontaminated operating room, continually reduced bio-burden, healthier patients, better surgical outcomes and fewer penalties for the hospital/surgery centre. In turn, these factors result in higher retained revenue to buy other products/services, including private sector/US marketing, as well as increased time to see more patients. All rooms in which invasive procedures are performed, or anywhere in which a patient or other person has cause to go, can benefit from disinfection diligence.
Increasing transparency with regards to decontamination issues within our healthcare environments, alongside new penalties, are contributing to rendering this current situation unsustainable; for example, many US medical insurers have stopped reimbursement for the incremental costs associated with healthcare acquired infections, which are now classed as ‘Never Events’.
From 2015, US hospitals have been financially penalised if they have fallen in the lower 25 per cent for Healthcare Associated Conditions (HAC), with infections being the major contributing factor. The human and financial toll is enormous, and will remain unabated unless new technologies and strategies, such as incorporating UVC room decontamination treatment into hospital protocols, are adopted.
For UV disinfection equipment, the global market has the potential to reach $2.8 billion by 2020, registering a CAGR of 15.3 per cent during 2014 – 2020. (2 – World UV Disinfection Equipment Market – Opportunities and Forecasts, 2013 – 2020; Allied Market Research, Report Code: SE 14253).
Finsen is specifically focused in the high-growth segment of surface disinfection and rapid equipment disinfection. Persistent high infection rates and costs, combined with studies that show traditional surface cleaning methods as being flawed and incomplete, have made surface disinfection an attractive target for improvement. Engineering advances with ultraviolet (UV) systems now make it possible for automation to correct the fundamental human errors, which cause gaps and mistakes when implementing traditional decontamination methods.
The targeted ultraviolet surface disinfection segment is sometimes referred to as the UV Robot segment. The market for UV disinfection robots is the highest growth segment.
While doctors, nurses, clinicians are deliverers of healthcare and companies such as Finsen Technologies are suppliers to healthcare, there is one thing that is certain; we and our families are, or will be, consumers of healthcare at one or many points in our lives. It is incumbent on us all to make this healthcare the absolute best it can be, every day.
Recommendations on how we should use AI, genomics and medtech in the NHS – click here for 98 pages to guide us to the future. ‘The greatest challenge is the culture shift in learning and innovation, with a willingness to embrace technology for system-wide improvement. An ambitious drive “towards the NHS becoming the world’s largest learning organisation”’.
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