A systematic review of the germicidal effectiveness of ultraviolet disinfection across high-touch surfaces in the immediate patient environment.

Background: There is not yet a consensus regarding the in-use effectiveness of ultraviolet irradiation (UV-C) as a supplementary tool for terminal room disinfection. Aims and Objectives: To summarize and evaluate literature detailing the germicidal effectiveness of UV-C disinfection on high-touch surfaces in the patient environment. Methods: A literature search was carried out utilizing PRISMA guidelines. Studies were included if intervention included UV-C after standard room disinfection in hospital rooms evaluated microbiologically by surface type. Findings/Results: Twelve records met our criteria for inclusion. Studies predominantly focused on terminal disinfection of patient rooms, including five reports carried out in isolation rooms and three studies including operating room (OR) surfaces. Bedrails, remote controls, phones, tray tables, assist rails, floors, and toilets were the most commonly reported surfaces. Across study designs, surfaces, and room types, flat surfaces tended to showcase UV-C effectiveness best, particularly isolation room floors. In contrast, handheld surfaces (i.e., bed controls and assist bars) tended to show reduced efficacies (81-93%). In the OR, complex surfaces similarly demonstrated reduced UV-C effectiveness. Bathroom surfaces demonstrated 83% UV-C effectiveness overall, with surface characteristics uniquely impacted depending on the room type. Isolation room studies tended to include effectiveness comparison with standard treatment, reporting UV-C superiority most of the time. Discussion: This review highlights the enhanced effectiveness of UV-C surface disinfection over standard protocols across various study designs and surfaces. However, surface and room characteristics do appear to play a role in the level of bacterial reduction.

Effect of SARs-CoV-2 pandemic on infection prevention behaviors and bacterial burden of high touch surfaces in a medical/surgical setting.

This study aimed to determine the longitudinal efficacy of ultraviolet germicidal disinfection (UV-C) in a non-terminal disinfection context. Moreover, factors influencing enhanced infection prevention behaviors during the SARS-CoV-2 pandemic were evaluated. Sixty nursing staff from three medical/surgical wards in a large military hospital were recruited for a survey and microbiological sampling of high-touch surfaces (stethoscope, personal electronic device, common access card, and hospital ID badge) and portable medical equipment (wheelchairs and mobile commodes). Surveys included hand hygiene estimates, frequency/method of cleaning items of interest, perception of UV-C, and factors influencing the use of enhanced disinfection tools. Surveys and microbiological samples were performed prior to and after the installation of a rapid, automated ultraviolet disinfection enclosure for staff use. Both time points preceded the SARS-CoV-2 pandemic in the United States. A final survey/sampling time point was carried out eight months after the declaration of the COVID-19 pandemic. Participants' hand hygiene frequency did not increase throughout the study, with > 80% reporting a minimum of 4 hand hygiene events per patient hour. The cleaning frequency of high-touch surfaces (non-clinical) but not portable medical equipment increased after installation of a UV-C disinfection tool and was sustained eight months into the COVID-19 pandemic. While a modest decrease in bacterial burden was observed after UV-C intervention, a more significant reduction was observed across all surfaces during pandemic time sampling, though no detectable decrease in pathogenic contamination was observed at either time point. Motivators of UV-C use included fear of SARS-CoV-2 contamination and transmission, ease of device use, and access to rapid, automated disinfection tools while deterrents reported included technical concerns, lack of time, and preference for other disinfection methods. Automated, rapid-cycle UV-C disinfection can be efficacious for high-touch surfaces not currently governed by infection prevention and control guidelines. The introduction of enhanced disinfection tools like UV-C can enhance the overall cleaning frequency and is correlated with mild decreases in bacterial burden of high-touch surfaces, this is enhanced during periods of heightened infection threat. Evidence from this study offers insights into the factors which prompt healthcare workers to internalize/dismiss enhanced infection prevention procedures.

IMPACT-ICU: A Relevant Sustainable Program for Military Institutions.

The IMPACT-ICU program provides staff with tools that make difficult palliative conversations easier; introduces the "3 conversations," incorporates role-play activities, and provides for continued coaching. This program is highly relevant to the military health system, which typically lacks a specialized palliative care service. It is easily transferable to any environment to include austere locations as well as other disparate health care institutions. Although titled IMPACT-ICU, it uses communication skills that are appropriate for any difficult conversation in any situation, which makes it appropriate for empowering all multidisciplinary team members in any work area.

Limited impact of an ultraviolet disinfection intervention on hygienic behaviors of nursing staff in a military hospital.

Ultraviolet disinfection (UV-C), though effective, has not been thoroughly evaluated at the level of the clinical end user. We assessed behavioral outcomes related to environmental hygiene among 60 nursing staff in a medical-surgical section after introduction of a UV-C tool aimed at disinfecting 4 high-touch surfaces, and we noted limited changes.

Bedsharing: toward a more holistic approach in research and practice.

On October 10, 2005, the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome made the recommendation that babies should not sleep in the same bed as adults. The purpose of this article is to present a more holistic approach to bedsharing based on the current research.

Omega-3 fatty acid supplementation in perinatal settings.

The purpose of this article is (a) to explain the role of omega-3 fatty acids in human health, specifically in fetal/neonatal development, (b) to summarize the recent research behind the innovations in infant formula manufacturing and advertisement of omega-3 fatty acid supplementation for pregnant and lactating mothers, and (c) to relate the research findings to clinical practice. Omega-3 fatty acid supplementation in perinatal settings is discussed here from three vantage points: (a) supplementation of the third-trimester pregnant woman to enhance fetal development, (b) supplementation of the lactating mother to enhance development of the breastfeeding infant, and (c) supplementation of infant formulas to enhance development of the bottle-feeding infant. Supplementation can occur by increasing one's intake of foods high in omega-3 fatty acids or by ingesting fatty acid nutritional supplements. The challenge of supplementation for vegan and vegetarian women is also addressed.