OPERATING ROOM
company,” Auer added. “The last two years have really been a push trying to help and pro- vide as many solutions for as many people/ environments as possible and we asked a lot of our team, the admin or ‘front of the house’, engineering, production, sales, and all con- tinuously work hard to deliver solutions. They put in the extra time knowing how important their work is, to help to keep people safe.” R-Zero is a biosafety technology company
that provides smart, sustainable disinfection to improve productivity, reduce sick days and enable better health through “clinically clean” shared spaces. As Natalie Quinn, Director of Brand and Content describes, R-Zero is devoted to enabling better outcomes for patients and providers: “R-Zero takes a holistic approach to indoor environmental health by understanding the risk factors of a given hospital or health system’s spaces and then identifying how our technology can mitigate that risk while improving indoor air quality (IAQ) and elimi- nating pathogenic threats. We believe clini- cally clean shared spaces are achievable with less waste and less use of harmful chemicals, and we are deeply committed to enabling a new normal where elevated indoor health is the status quo.”
R-Zero’s Arc UV system enables hospital-
grade efficacy while emitting more light at a lower cost than competitors. With Arc’s powerful lighting array and overall design, the device can disinfect the air and surfaces in a , square foot room in ust seven minutes. Arc also has LTE-M connectivity to R-Zero Connect, the company’s dashboard that allows users to track disinfection cycles, thereby making the traditionally unseen dis- infection process visible and auditable.
R-Zero’s Arc UV system
of solutions will enable you to fight COVID today and HAIs or any other emergent threats tomorrow.”
Quality in water and steam
The Joint Commission has made water quality a priority, as evidenced by its New Water Management Requirements issued March , . Under the new requirements, a hos- pital must have a water management program that addresses Legionella and other waterborne pathogens, and an individual or team respon- sible for the oversight and implementation of the program, including but not limited to, development, management and maintenance activities.6
•
Water quality is a key consideration for the CS/SPD department in the processing of instruments for re-use, from water used in decontamination sinks for pre-cleaning and rinsing, to the water used to generate steam for sterilization.
“When maintaining purity of water for
CS/SPD departments, most of the challenges center around particles, minerals, bacteria and endotoxin,” said Marissa Khoukaz, Medical Prefiltration Product Manager, Pall. “These contaminants can impact the lifes- pan of equipment or the sterilizing cycles themselves. Bacteria and endotoxin are of particular concern since infection and inam- mation can result when levels are too high. If the water purity is not well maintained, there is a greater risk of equipment downtime and a greater patient infection risk.” Steven Autiello, Regional Manager, Barclay Water Management, explains how the main- tenance of water treatment equipment and monitoring of water quality presents several challenges to healthcare orga- nizations and their CS/SPD departments.
“Rinse water used in sterile processing should be pre- treated with a de-ionized (DI) or reverse osmosis (RO) treatment system to remove organics and inorganics from reaching instruments.
“Simply put, we kill COVID - and a host of other common microbial threats,” Quinn commented. “R-Zero’s disinfection ecosys- tem enables safer indoor environments by destroying . of pathogens (including coronavirus, E. coli, the common cold, and the u). s our products disinfect spaces in mere minutes, they eliminate the need to use harmful chemicals - all while creating a clear record of disinfection activity via our software dashboard. Implementing R-Zero’s suite
Normally SPD departments handle the opera- tion of this equipment, or it is done by a third party. Steam purity is typically at the mercy of the hospital’s central steam system, which would originate from a central steam plant in the hospital over which SPD has no control.”
Monitoring and measuring water and steam quality “Checking bacteria and endotoxin levels are the best way to measure and monitor
Pall Kleenpak capsule filters for small-batch sterile filtration of aqueous pharmaceutical solutions
to understand the water quality,” said Khoukaz. “Other measurements to consider are pH, conductivity and water hardness. The first step for water purity concerns would be to assemble a team and do swab and water testing to establish current levels. If levels of water contaminants are higher than acceptable levels, various types of filtration can be used to address different problems.”
To overcome the challenges of water treatment and steam generation performed outside of the CS/SPD department, Autiello has seen hospitals install dedicated equip- ment for the pre-treatment of rinse water and steam generators specifically for ster- ilization within the sterile processing area. “Properly maintained air, water and
steam is nothing new to the industry so there are no silver bullets, though diligence in maintaining the installed pretreatment equipment is crucial,” said Autiello. “Try to identify the issue (air, water or steam) based on evidence or perceived issue. Work with facilities to correct or third-party vendor, if applicable.” HPN
References
1. Mold found in baby’s heart after surgery; family suing Seattle Children’s hospital, Seattle Times, April 14, 2020, https://www.
seattletimes.com/seattle-news/health/after-mold-infects-babys- heart-another-family-sues-seattle-childrens-hospital-over-ongoing- aspergillus-problems/
2. Sick Building Syndrome, EPA,
https://search.epa.gov/epasear ch/?querytext=sick+building+syndrome&areaname=&areaconta cts=&areasearchurl=&typeofsearch=epa&result_template=#/
3. Healthcare-Associated Infections (HAIs), CDC, https://www.
cdc.gov/winnablebattles/report/hais.html
4. UV Lights and Lamps: Ultraviolet-C Radiation, Disinfection, and Coronavirus, FDA, February 1, 2021, https://www.fda. gov/medical-devices/coronavirus-covid-19-and-medical-devices/ uv-lights-and-lamps-ultraviolet-c-radiation-disinfection-and- coronavirus
5. Behind the Update: ASHRAE Handbook Chapters on UV-C to Include Updated Best Practices, Guidance, ASHRAE, https://
www.ashrae.org/news/ashraejournal/behind-the-update-ashrae- handbook-chapters-on-uv-c-to-include-updated-best-practices- guidance
6. The Joint Commission, New Water Management Require- ments, March 19, 2021,
https://www.jointcommission.org/-/ media/tjc/documents/standards/prepublications/water_man- agement_prepub_hap.pdf
7. Lee, L. (2017). Surface and air: What impact does UV-C at the room level have on airborne and surface bacteria? CJIC, Vol 32, Issue 2, p.108-111.
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