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As part of the development and testing of an innovative technology for tracking disinfection of portable medical equipment, end-user feedback was obtained during an initial trial on two acute care hospital units. The disinfection tracking device was installed on the computers-on-wheels and vital signs machines. Each device had the capability of detecting a cleaning event, reporting the event to an online database, and displaying the time since last cleaning event on a visual display. End-user feedback regarding functionality, usefulness of information provided, and impact on workflow was obtained by survey and facilitated group discussions. Seventeen frontline nurses completed the anonymous survey, and 22 participated in the facilitated group discussions. End users found the system functionally easy to use and the information about time since last cleaning useful and reported minimum disruption of workflow. Functionality of the system was confirmed by consistency between recorded and self-reported cleaning patterns. Managers found the data on cleaning of portable medical equipment helpful in validating compliance with hospital equipment cleaning policy. Frontline staff expressed appreciation for technology that helps them and improves outcomes but also discussed concerns about the potential for technology that creates extra work and disruption in the busy frontline nursing care delivery environment. Nurses were appreciative of opportunities to provide feedback and input into efforts to develop and introduce technology. Recorded cleaning events coincided with self-reported equipment cleaning patterns and illustrated that the device efficiently collects information deemed useful by the end user.

Background Ultraviolet (UV) light disinfection following a manual terminal cleaning process for hospital rooms has been proposed as an additional method to reduce the bacterial burden on surfaces. The impact of UV light disinfection and the level of interdependence between the modalities remains unclear. Methods Samples were collected from 5 high touch surfaces from 10 patients room following discharge prior to manual disinfection, following manual disinfection, and following pulsed xenon UV disinfection using Rodac contact plates (total 150 samples). Colonies were identified using MALDI-TOF mass spectrometry. The bacterial colony counts were recorded and analyzed as pathogenic or commensal organisms (based on CDC criteria) to assess the efficacy of the disinfection process. Results Average colony counts for the rooms prior to disinfection, post disinfection, and post UV light were 185.8 CFU +/- SD 280, 43 CFU +/- 121, and 20 CFU +/- 36.7 respectively. The average drop in colony-forming units of the five high touch areas in patient’s rooms can be seen in table 1. Twelve commensal bacterial species were isolated: Bacillus species (sp.), Corynebacterium sp., Enhydrobacter sp., Kocuria sp., Lysinibacillus sp., Macrococcus sp., Micrococcus sp., Paenibacillus sp., Pantoea sp., Psychrobacter sp., Siccibacter sp., Coagulase negative staphylococcus. Seven pathogenic bacteria were isolated: Acinetobacter sp., Brucella sp., Proteus sp., Staphylococcus aureus, Escherichia sp., Enterococcus, and Pseudomonas aeruginosa. Reductions in the predominant bacterial species following disinfection modality are noted in table 2. Table 1: Colony forming units (CFUs) average Pre-disinfection (Pre-Dis), Post Disinfection (Post-Dis), and Post PX-UV Light (PX-UV). Table 2: Sub-analysis of commensal and pathogen isolation Pre-Disinfection (Pre-Dis), Post-Disinfection (Post-Dis), and Post PX-UV light (PX-UV). Conclusion A combination of manual disinfection and UV has shown a notable additional reduction in overall bacterial contamination of the patient rooms, including the majority of high touch areas as compared with manual disinfection alone. No additional reduction in commensal bacteria isolates was noted after UV light, however a further decrease in pathogenic bacteria (Acinetobacter and Enterococcus) was noted. UV light may be considered as an additional room disinfection method to reduce overall bacterial burden and pathogenic bacterial contamination of rooms as a comprehensive strategy to reduce nosocomial infections. Disclosures Mark Stibich, n/a, Xenex Germ-Zapping Robots (Board Member, Grant/Research Support) Chetan Jinadatha, MD, MPH, AHRQ (Research Grant or Support)Department of Veterans Affairs (Other Financial or Material Support, Owner: Department of Veterans Affairs. Licensed to: Xenex Disinfection System, San Antonio, TX)Inventor (Other Financial or Material Support, Methods for organizing the disinfection of one or more items contaminated with biological agents)NiH/NINR (Research Grant or Support)NSF (Research Grant or Support)Xenex Healthcare Services (Research Grant or Support)

Background Tracking of disinfection of portable medical equipment (PME) and demonstration of compliance with PME disinfection policies can be difficult to demonstrate. A Disinfection Tracking System (DTS) was implemented in our hospital to assess the impact of such a system on the disinfection events of PME and its ability to capture disinfection events. The DTS system improved the total disinfection events as well as disinfection events on commonly used items such as Computer-on-wheels (COWs) and vitals machine (VM) (Figures 1 & 2). Here we present a summary of healthcare workers’ (HCWs) opinions about the implementation of the DTS system in their routine work flow. Image of DTS Mounted on a Computer-on-Wheel Image of a DTS Mounted on a Vitals Machine Methods The study was conducted on two medical-surgical acute care units in Temple, TX Veterans Affairs hospital. The DTS devices were equipped with sensors to detect moisture events corresponding to disinfection. A display on the device indicated the last time the PME was disinfected. Opinions were obtained after the 10-week study period through a survey and facilitated group discussions between frontline HCWs and managers who had encountered the DTS during their daily work routine. The survey measured level of agreement with 13 items on a Likert-type scale system ranging from one (least agreement) to ten (most agreement). Disinfection Tracking System with Screen Displaying Time Since Last Disinfection Results A total of 17 surveys were completed. The lowest mean agreement score was 5.1 for the statement - the DTS system display corresponds to a real disinfection of the equipment and the highest mean agreement scores included - the DTS system was easy to understand and follow and the DTS system can easily be adopted in my routine workflow. Lastly, - the DTS system helped improve the disinfection of my COW and the DTS system will improve patient outcomes corresponded to agreement score means of 8.1 and 7.9, respectively. In the group discussions, all the involved groups of healthcare workers expressed agreement in the ease of use of the system and minimal disruption in workflow. Conclusion Our survey and interview results indicate that most of the HCWs who interacted with the device had a positive interaction with the device. They stated the DTS system helped serve as an indicator about the last disinfection event. They also noted the system integrated well into their workflow without any disruption or additional workload. Disclosures Sarah Simmons, DrPH, Xenex Disinfection Services (Employee, Shareholder) Mark Stibich, PhD MHS, Xenex Disinfection Services, Inc (Board Member, Employee) Chetan Jinadatha, MD, MPH, AHRQ (Research Grant or Support)Department of Veterans Affairs (Other Financial or Material Support, Owner: Department of Veterans Affairs. Licensed to: Xenex Disinfection System, San Antonio, TX)Inventor (Other Financial or Material Support, Methods for organizing the disinfection of one or more items contaminated with biological agents)NiH/NINR (Research Grant or Support)NSF (Research Grant or Support)Xenex Healthcare Services (Research Grant or Support)

Background Portable Medical Equipment (PME) can play a vital role in transmission of multidrug-resistant organisms. Cleaning PME is challenging and protocols vary by institution. Tracking of PME cleaning events is usually performed manually and demonstration of compliance with protocols is difficult. We studied a Disinfection Tracking Systems (DTS) to understand its potential role in tracking disinfection events of PME and whether its implementation led to improvement in the number of cleaning events. The DTS device was designed to automatically register several types of disinfection events and could be set to display time since last disinfected on the screen. Methods For a 25-day period, a single acute care unit received a DTS device with the display screen off but with the ability to detect and log disinfection events in a database from a disinfectant wipe. After the 25-day screen-off period the DTS units screen was turned on to display the number of hours since the last recorded disinfection event (Figure 1) for a 42-day period. DTS devices were placed on 10 computer-on-wheels (COW) and 5 vitals machine (VM). An interrupted time series analysis, using a Bayesian model compared the number of events in the display screen-off to the screen-on period. Disinfection Tracking System with Screen-off and Screen-on Results During the 25-day screen-off period, there were a total of 345 events captured with 61 events on VM and 284 on COWs averaging 0.49 and 1.26 cleaning events for VM and COWs respectively per day. During the 42-day screen-on period, there were 845 total disinfection events with 104 events on VM and 741 events on COWs with 0.50 and 1.76 mean events for VM and COWs respectively per day. The mean events per device per day in the screen-on period for COW’s were 1.32 (1.10 – 1.57) times greater than those in the screen-off Period. The mean events per device per day in the screen-on period for VM devices was 1.37 (0.89 – 2.01) times greater than those in the screen-off period. Conclusion Disinfection events for COWs and VMs were found to be above the local policy requirements. Implementation of a DTS device was able to increase the rate of disinfection events for COWs potentially due to the prompt on the screen. Additionally, it captured disinfection events successfully on the database demonstrating its effective to be a tool for demonstration of compliance. Disclosures Mark Stibich, PhD MHS, Xenex Disinfection Services, Inc (Board Member, Employee) Sarah Simmons, DrPH, Xenex Disinfection Services (Employee, Shareholder) Chetan Jinadatha, MD, MPH, AHRQ (Research Grant or Support)Department of Veterans Affairs (Other Financial or Material Support, Owner: Department of Veterans Affairs. Licensed to: Xenex Disinfection System, San Antonio, TX)Inventor (Other Financial or Material Support, Methods for organizing the disinfection of one or more items contaminated with biological agents)NiH/NINR (Research Grant or Support)NSF (Research Grant or Support)Xenex Healthcare Services (Research Grant or Support)

Background Portable Medical Equipment (PME) are routinely used by healthcare workers (HCWs). Transmission of healthcare-acquired infections has been attributed to PME. Our institution policy requires at least once daily PME disinfection. Automated tracking of disinfection events by Disinfection Tracking System (DTS) makes routine monitoring possible. We tested the device to see if it could provide accurate information about disinfection practices and patterns, as well as be used to accurately monitor compliance with policy. Methods Data obtained from DTS devices on PME from 2 acute care wards over a 25-day period was obtained. DTS devices record disinfection events and are automatically stored for monitoring. DTS was placed on 10 computer-on-wheels (COWs) and 5 vitals machine (VMs) on both the wards. One ward received DTS with “Screen-on” feedback displaying the time since last disinfection event, and one unit had no display on the screen (screen-off). The number of recorded events was summed over the 25-day period and sorted by time of day to determine the pattern of events over a typical 24-hour period. Minute “0” indicates start of each monitoring period in a 24-hour cycle and corresponds to 12 midnight (Figure 1). Results A total of 421 moisture events were recorded for the screen-on and 345 for the screen-off, during the 25-day implementation period. The highest number of events occurred between 6am and 7am, with 69 moisture events recorded in the screen-on group and 75 events were recorded for the screen-off group. Further, 37 events were recorded in the screen-on group and 43 events in the screen-off group between 2pm and 3pm. Between 6pm and 7pm the screen-on group showed 52 moisture events and 32 events for the screen-off group. Figures 1 shows the three peaks corresponding with a spike in disinfection events. Conclusion The pattern of disinfection events over 24 hours demonstrate that most events occurred regularly at certain times in the day. These time points correspond with higher volumes of disinfection happening at the beginning of shift changes for nursing. It also demonstrated that disinfection rates were higher than the policy recommended once a day PME disinfection. DTS has the potential to continuously record & report data related of disinfection events on PME in healthcare settings. Disclosures Chetan Jinadatha, MD, MPH, AHRQ (Research Grant or Support)Department of Veterans Affairs (Other Financial or Material Support, Owner: Department of Veterans Affairs. Licensed to: Xenex Disinfection System, San Antonio, TX)Inventor (Other Financial or Material Support, Methods for organizing the disinfection of one or more items contaminated with biological agents)NiH/NINR (Research Grant or Support)NSF (Research Grant or Support)Xenex Healthcare Services (Research Grant or Support) Mark Stibich, PhD MHS, Xenex Disinfection Services, Inc (Board Member, Employee) Sarah Simmons, DrPH, Xenex Disinfection Services (Employee, Shareholder)