Journal des soins infirmiers et des soins

Environmental Biodecontamination: When a Procedure Performed by the Nursing Staff has an Economic Impact in ICU Rooms

Abstract

Ragusa R*, Lombardo A, Bruno A, Sciacca A and Lupo L

Objective: The transmission of hospital-acquired infections most commonly occurs by means of healthcare workers coming into contact with contaminated surfaces or patients during routine care and the lack of or poor implementation of hygiene procedures. We present this study to assess the efficacy of a new environmental infection control system, managed by a nurse in charge of infection control, in terms of safety, clinical outcome and hospital/healthcare costs.

Methods: The following is an observational retrospective study performed at University Hospital of Catania; containing data on HAI infections from years 2013 and 2014, before and after a new disinfection procedure was introduced. The procedure used a no-touch technology for the indoor environment, using micronebulized hydrogen peroxide and silver cations. Cases of infections concerned adult inpatients with hospitalization time being greater than three days. The efficacy of the procedure was evaluated by comparing the decrease in number of infections, related deaths, and changes in antimicrobial load, whereas economic impact of the new procedure was assessed by a cost-effectiveness analysis. User satisfaction and environmental safety issue were also addressed.

Results: A total of 489 patients were hospitalized in the ICU between January 1, 2013 and December 31, 2014. The introduction of the procedure coincided with a significant decrease overall in infection-related deaths, as well as hospital days (16.95 ± 20.46 (mean ± SD) to 11.55 ± 10.03 (mean ± SD: p value <0.05). Bacterial load in samples from CVC and from broncho-alveolar lavage decreased, as well. The incremental cost-effective ratio resulted in € 807.80 to be added for each infection-related death avoided.

Conclusion: We demonstrated that HyperDRYMist technology with hydrogen peroxide and silver cations is effective, safe and cost-effective without evidence of safety risk. Biodecontamination performed by motivated and experienced nurses could be useful in reducing microbial load and nosocomial infections. The system can contribute to improving the ICU patient's final outcome.