Pennsylvania's Lehigh Valley Health Network employs seven ultraviolet disinfection systems as
part of its ongoing fight against healthcare-associated infections.
Lehigh Valley Health Network includes three hospital facilities - two in Allentown and one in Bethlehem, Pa.; nine health centers caring for communities in four counties; and numerous primary and specialty care physician practices
throughout the region. Terry Burger, RN, the Director
of Infection Control and Prevention for Lehigh Valley
Health Network and an employee at the institution for
the past 35 years, recently spoke about the network’s
investment, implementation, and use of portable
ultraviolet disinfection systems. Since 2008, LVHN
has purchased seven TRU-D SmartUVC devices from
SP: Please offer a little background on
your facility and its infection control needs prior
to the purchase and implementation of the first
portable UV disinfection system, as well as the
thought process behind the investment.
Burger: Our hospital epidemiologist is an infectious disease specialist.
He and I often attend national conferences and take the time to investigate new technology. During one of those conferences, we saw this
particular piece of equipment on display.
We are always looking to see how we can maintain a safe environment
for our patients with the ultimate goal to prevent healthcare associated
infections. We were intrigued with the UV-C disinfection technology but were hesitant to be an an early adopter. We wanted to do our
homework and find out the costs and benefits of this new technology.
We have a template for evaluating new equipment. It is a set of guidelines. We look at factors such as effectiveness, published evidence about
(equipment), ease of use, costs, environmental impact, as well as patient
and staff preferences. Also, one factor we are always considering is
patient and employee safety. In addition to exploring the ultraviolet-C-emitting device, we also looked at some fogging technology with hydrogen peroxide vapor. After looking at all of those factors and performing
some testing, we selected the UVC disinfection machine, TRU-D. The
decision to utilize this technology was made with the understanding
that it did not replace our day-to-day manual disinfection of the hospital
rooms. This was to be used in addition to our routine environmental
Our expectations were realistic. We knew it was not going to eradicate
every infection. We developed criteria to use TRU-D. We decided to
use it for terminal disinfection on discharge for rooms of patients that
had been identified with Clostridium difficile. Eventually
we expanded the use of TRU-D to include the Burn
Center and our operating rooms on a rotational basis.
As we purchased more, we continued to expand the use
when we had a cluster outbreak in a certain unit.
The technology is particularly useful when responding to a a cluster outbreak, whether in an intensive care
unit, a burn unit, or on a medical surgical floor. When
two or three cases of the same organism are observed, the
machine is deployed to supplement routine disinfection
methods. We bring in TRU-D and use it on the entire
floor as the patients are discharged. In every circumstance
it has helped to mitigate the outbreak.
SP: Why did you feel this was the right
type of technology to act as a complement to your
Burger: Number one, it had the most published evidence. That was
very important to us. It also offered the most patient and employee
safety features. It can measure the amount of UV-C that is delivered and
has different time settings to choose based on what type of organism
you are trying to eradicate. The device is controlled remotely and has
an automatic shut off safety feature in the event someone inadvertently
attempts to enter the room while the machine is in operation.
SP: This is something you use in conjunction with
other disinfection methods. Has it altered those
other methods in any way?
Burger: We did have to develop some modifications in our work processes, because this does add time to clean the room. It can additional
time dependent upon the settings and the room size and configuration.
Adjustments were made to minimize the turnover time that included
enhanced communication, and deployment guidelines. A multi-disciplinary taskforce was convened to develop an implementation process.
We have come along way since 2008. We did have some hurdles, and
it did modify some of our work processes.
SP: What made you decide to invest in more devices?
Burger: We recognized more opportunities to use the technology in
other inpatient and ambulatory location. We needed more of them to
achieve our goals.
Director of Infection
Control & Prevention,