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tamination by 81%, according to Lou Ann Bruno-Murtha, DO, medical director of
infection prevention and division chief of infectious diseases for the Cambridge
(Mass.) Health Alliance.
Although bleach is used in her ORs, it requires 10 minutes of drying time for
adequate sporicidal effect, says Dr. Bruno-Murtha. "UV light is able to penetrate
spores that are quite hardy," she adds. "If a surface is missed, or not wiped proper-
ly with chlorine bleach, UV provides another level of security."
UV light travels in straight lines, so there's reduced efficacy in areas that are
out of the unit's direct line of sight. That's partially mitigated by shooting from
multiple locations throughout the room to triangulate targeted surfaces, points
out Dr. Otter, but, he says, UV systems still might result in less than uniform effi-
cacy compared with the vapor systems. However, UV systems are easier to use,
don't require rooms to be sealed off and run relatively shorter cycles. That said,
having to position a single unit in multiple areas to target several surfaces could
add to disinfection times.
Assessing the need
Staff charged with manually cleaning OR surfaces have a lot to consider, accord-
ing to Dr. Otter's study: Ensuring adequate amounts of the active cleaning agent
reach target surfaces and remain for the intended contact time; maintaining a sys-
tematic approach and constant compliance with facility protocols; ensuring the
correct formulation of disinfectant is used; allowing enough time between cases
to do the job properly; and monitoring the overall efficacy of the surface cleaning.
There are no microorganisms these systems attack that proper manual
cleaning would not, says Dr. Otter. "If manual cleaning were done properly all
the time, you wouldn't need an automated system," he continues.
The problem with manual cleaning is not the efficacy or the agents used — it's
about ensuring adequate formulation, distribution and contact time occur repeatedly
in a busy healthcare environment.
There are limitations to no-touch decontamination, too, says Dr. Otter: You have
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