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Concord Hospital first in New Hampshire to deploy UV light in fight against infections

  • Joe Duncan, an environmental services specialist at Concord Hospital, watches Rosie the robot pulse its UV light 450 times in five minutes to help disinfect the Cath Lab Prep and Recovery Room at Concord Hospital during a demonstration on April 23, 2014. <br/><br/>(ANDREA MORALES / Monitor staff)

    Joe Duncan, an environmental services specialist at Concord Hospital, watches Rosie the robot pulse its UV light 450 times in five minutes to help disinfect the Cath Lab Prep and Recovery Room at Concord Hospital during a demonstration on April 23, 2014.

    (ANDREA MORALES / Monitor staff) Purchase photo reprints at PhotoExtra »

  • Lynda Caine, the infection prevention specialist at Concord Hospital, held a contest to name the new robots that were brought in to kill medication-resistant bacteria with UV light. She then insisted that they have name tags, like Rosie's here.<br/>(ANDREA MORALES / Monitor staff)

    Lynda Caine, the infection prevention specialist at Concord Hospital, held a contest to name the new robots that were brought in to kill medication-resistant bacteria with UV light. She then insisted that they have name tags, like Rosie's here.
    (ANDREA MORALES / Monitor staff) Purchase photo reprints at PhotoExtra »

  • Joe Duncan, an environmental services specialist at the hospital, sets up Rosie the Robot, a portable UV disinfectant that Concord Hospital uses, during a demonstration on Wednesday afternoon, April 23, 2014 at the hospital. <br/><br/>(ANDREA MORALES / Monitor staff)

    Joe Duncan, an environmental services specialist at the hospital, sets up Rosie the Robot, a portable UV disinfectant that Concord Hospital uses, during a demonstration on Wednesday afternoon, April 23, 2014 at the hospital.

    (ANDREA MORALES / Monitor staff) Purchase photo reprints at PhotoExtra »

  • Rosie the robot pulses its UV light 450 times in five minutes to help disinfect the Cath Lab Prep and Recovery Room at Concord Hospital during a demonstration on April 23, 2014. <br/>(ANDREA MORALES / Monitor staff)

    Rosie the robot pulses its UV light 450 times in five minutes to help disinfect the Cath Lab Prep and Recovery Room at Concord Hospital during a demonstration on April 23, 2014.
    (ANDREA MORALES / Monitor staff) Purchase photo reprints at PhotoExtra »

  • Joe Duncan, an environmental services specialist at Concord Hospital, watches Rosie the robot pulse its UV light 450 times in five minutes to help disinfect the Cath Lab Prep and Recovery Room at Concord Hospital during a demonstration on April 23, 2014. <br/><br/>(ANDREA MORALES / Monitor staff)
  • Lynda Caine, the infection prevention specialist at Concord Hospital, held a contest to name the new robots that were brought in to kill medication-resistant bacteria with UV light. She then insisted that they have name tags, like Rosie's here.<br/>(ANDREA MORALES / Monitor staff)
  • Joe Duncan, an environmental services specialist at the hospital, sets up Rosie the Robot, a portable UV disinfectant that Concord Hospital uses, during a demonstration on Wednesday afternoon, April 23, 2014 at the hospital. <br/><br/>(ANDREA MORALES / Monitor staff)
  • Rosie the robot pulses its UV light 450 times in five minutes to help disinfect the Cath Lab Prep and Recovery Room at Concord Hospital during a demonstration on April 23, 2014. <br/>(ANDREA MORALES / Monitor staff)

There’s a new member on the cleaning crew at Concord Hospital who never turns up her nose at a mess. She’s never squeamish, never sick, and hasn’t missed a day of work since starting last April.

Rosie, a 3-foot-tall robot, cleans about 30 rooms every day with a pulsing purple light, killing stubborn bacteria that cause drug-resistant infections. It’s the first in the state, and it was joined last month by an identical new friend, Wally, who cleans the surgical suite.

Hospital staff use the robots in rooms after their regular cleaning routine. The UV light penetrates bacteria cell walls and disrupts their DNA. The light also kills spores of a notorious bacteria that are difficult to kill in other ways, and can survive months outside the body, waiting to infect a new host.

“You can clean and disinfect the room and get rid of all the germs, if you take the time and clean everything you need to

clean, using the liquids with the appropriate kill time, and that’s 10 minutes in some cases,” said Lynda Caine, infection prevention officer for the hospital.

“But the germs are invisible, so how do you know? Other things kill the germs, but this is just, we know for sure that we’ve killed them.”

An estimated 1 in 20 patients picks up infections in a hospital or nursing home, infections linked to an estimated 100,000 deaths and as much as $30 billion in medical costs each year.

More than 2 million worst-case scenarios play out each year for people infected by bacteria immune to common antibiotics. More than 10 percent of those infected die, according to the Centers for Disease Control and Prevention.

Two of the most common are caused by the germs Clostridium difficile, called C. diff., which causes 14,000 deaths a year in the U.S., and methicillin-resistant Staphylococcus aureus, called MRSA, which causes about 5,500 deaths a year in the U.S.

Most people infected by these bugs pick them up in the general community, but most of the fatal infections begin in health care settings such as hospitals and nursing homes, according to the CDC.

C. diff. and MRSA infections aren’t tracked here in New Hampshire, but certain types of other health care-associated infections are.

In 2012, the most recent year for which data is available, 198 health care-associated infections were reported in New Hampshire – fewer than would be expected based on national data, according to the Department of Health and Human Services – “but we want to get to zero,” Caine said.

In the past year since they started using Rosie, seasonally adjusted cases of C. diff. have fallen, she said.

If a patient shows symptoms of a C. diff. infection, such as diarrhea, the hospital will perform a stool sample test. If it’s positive, Rosie will disinfect the bathroom in that patient’s room right away. When they’re discharged, the robot will disinfect the rest of the room after staff have done the standard cleaning they normally would have done.

Without Rosie, C. diff. spores might linger in the room, infecting the next patient or getting picked up by a doctor or nurse and brought to another patient. Treating a case of C. diff. that starts in the hospital can cost the organization $25,000, so preventing three cases makes each robot’s $75,000 price tag worth it, said Joe Lally, director of the hospital’s environmental services department.

New, nonchemical cleaning methods like UV light are one weapon in the arsenal against medication-resistent bacteria, but can’t be the only one, public health officials said.

“What’s really driving the antibiotic resistance is what CDC is targeting efforts around: prescribing practices, consumer knowledge and farming industry consumption of antibiotics,” said Beth Daly, chief of the infectious disease surveillance section at New Hampshire’s Division of Public Health.

Many patients expect to walk out of a doctor’s appointment with a prescription, even without a positive test for a bacterial infection. Overusing antibiotics can throw the body’s natural bacterial balance out of whack and leave someone vulnerable to an infection like C. diff.

“It’s one thing to focus on making sure we’re doing everything right in the hospitals, but I think we’ve never done as good a job as we should with engaging the patient,” said Anne Diefendorf, vice president for quality and patient safety at the Foundation for Healthy Communities.

She is one of the New Hampshire coordinators for the Partnership for Patients, a nationwide public-private collaboration sponsored by the federal Department of Health and Human Services to keep patients from being harmed while in the hospital and help them heal without complication once they are discharged.

The partnership has been tracking 11 areas of concern, including four infections and preventable readmissions.

Since first measuring data in 2011, the state’s hospitals have improved in all areas, Diefendorf said.

“There’s a lot of innovative things in environmental approaches, and it’s beneficial the more people can try them and see whether or not it helps with a reduction of organisms,” she said.

“But it also still comes down to the very basics of hand hygiene, making sure employees wash their hands. But everybody should wash their hands. Hand hygiene is the No. 1 effort that can reduce the transmission of disease.”

And despite her enthusiasm over Rosie, Wally and the as-yet-unnamed third UV light robot due to arrive later this year, Caine, Concord Hospital’s infection specialist, agreed.

Quite simply, “C. difficile is acquired by ingesting the spores and can be reduced if people wash their hands before they eat,” she said.

The hospital has recently expanded its “Clean Hands, Clean Things” campaign. It started by reminding staff to clean their hands before and after patient contact and after contact with the environment, and cleaning equipment. Now, the posters remind patients and visitors to wash up, too.

(Sarah Palermo can be reached at 369-3322 or spalermo@cmonitor.com or on Twitter @SPalermoNews.)

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