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August 24. 2014 1:52AM

Robots deployed in ongoing battle against infection at Elliot Hospital


Patrica Heywood, supervisor of environmental services, programs Elliot Hospital's new germ zapping robot while giving a demonstration on Friday. (DAVID LANE/UNION LEADER)

MANCHESTER - Three of the toughest warriors in the ongoing battle against infection at the Elliot Hospital don't complain about their shifts or ask for time off.

Aurora, Violet and Twilight are killers and Chief Medical Officer Dr. Greg Baxter and Patient Safety Officer Martha Leighton couldn't be happier about it.


Xenex, Elliot Hospital's new germ zapping robot, pulses ultraviolight light killing potentially harmful single-cell organisms. (DAVID LANE/UNION LEADER)

The trio are the new disinfection robots by Xenex, who can kill any one-cell germ within seven feet in five minutes. The robots do their job with pulses of ultraviolet light, using a xenon bulb.

They have been on the job since June. In the months since they arrived and began their disinfection work, Leighton said: "We're half of where we were."


Patrica Heywood, supervisor of environmental services, wheels the Elliot Hospital's new germ zapping robot though the hallways while on her way to give a demonstration. (DAVID LANE/UNION LEADER)

Drug-resistant infections - MRSA (methicillin-resistant staphylococcus aureus), C. diff (Clostridium difficile) and VRE (vancomycin-resistant enterococci) - which can be hospital-acquired, threaten patients' lives and cost hospitals big bucks - billions nationally - because of extended patient stays or readmissions.

The Centers for Disease Control and Prevention say there were 772,000 healthcare-associated infections nationwide in 2011 and about 75,000 people with healthcare-associated infections died during hospitalization in 2011. The CDC says rates of healthcare-associated MRSA infections and C. diff infections are decreasing, but too slowly.

The CDC's latest figures, based on nationwide reporting, show the C. diff reduction was just 2 percent between 2011 and 2012 and the MRSA reduction was 4 percent in the same period. The U.S. Department's action plan for 2013 was to reduce both those infections by 30 and 25 percent respectively by the end of 2013, but those statistics are not yet published.

Baxter said the robots are not a substitute for best practices in cleaning by housekeeping and by medical personnel. But the robots can go beyond what humans can do.

Choosing the right robot

Leighton, a registered nurse, said she became aware of what the robots could do and gathered a group at the hospital to research and test various types of disinfecting robots.

One variety saturates the air in a sealed room with hydrogen peroxide mist, which disinfects and then converts to water vapor. A disadvantage is that ducts and other openings must be sealed to prevent toxic vapors from escaping.

Some of the ultraviolet light pulsing robots use mercury vapor lamps, but the winner at the Elliot was Xenex, which uses a xenon bulb to produce pulsed ultra violet light to kill germs that soap and water alone can't and even bleach can miss. Leighton explained that the light pulses destroy the DNA of a one-celled germ, preventing it from reproducing.

Baxter gives Leighton credit for the extensive research and demonstrations that led to the choice of the Xenex robots. It was about a six-month project from idea to robots in action. The first robot arrived in June and there are now three in operation.

The robots are used primarily in the higher risk areas, the Intensive Care Unit, the Newborn Intensive Care Unit, Pediatric intensive care and rooms for people who are on precautions. And, of course, "In operating and procedure rooms every night," said Leighton.

Baxter said even when humans have thoroughly cleaned a room, germs can still lurk in parts of the room that are often touched, like the beds. But no germs are safe from the robots. "The UV light finds its way in," he said, and damages their DNA beyond repair and replication.

UV-C rays are safe

Although the flashing light is obvious from a distance, due to all the glass on a hospital floor, Leighton said the light perceived from outside a room being treated won't hurt anyone.

The technical explanation: unlike UV-A and UV-B, the wavelengths in sunlight we are warned about, the robot's light is UV-C. The manufacturer says UV-C cannot penetrate through glass, plastic, clothing, or the top layer of your skin, although prolonged exposure to eyes can be harmful.

The manufacturer also says brief exposure to the light is not a health threat.

But Leighton said that wouldn't happen at the Elliot because there's no sneaking up on a working robot. The robot is always used in an unoccupied room and a built-in safety feature shuts down the robot when motion is detected in the room. There is also an emergency stop button that provides an immediate shutdown should anyone reenter the room.

Leighton said the pulsing light does not pose a problem for people with epilepsy. A small percentage of people with epilepsy have a photosensitivity and seizures can sometimes be triggered by flashing lights. Leighton said the robot's designers ensured the pulsing frequency is nowhere near a problem frequency.

The robots don't replace, or displace, members of the housekeeping staff. "Overwhelmingly, they are thrilled," said Leighton, because the robots help them do their job of making sure rooms are clean and patients protected.

Baxter said the goal at the Elliot is to bring the infection rate as close to zero as possible. So although the ultraviolet light disinfection robots are relatively new, the hospital chose to be an early adopter. Over time, he said, they enable the hospital to decrease contamination by going beyond regular cleaning. "To wait for Class A is to wait a little too long," he said.


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