No-Touch Technology Manufacturers Share Perspectives on Key Issues

Weber, et al. (2016)  concur with a number of studies that indicate the value of "no-touch" methods for disinfection of the contaminated healthcare environments, including technologies such as  ultraviolet (UV) light devices, hydrogen peroxide systems, and other devices that employ vaporized/misting and electrostatic technologies. As Weber, et al. (2016) note, "Many studies have demonstrated that terminal cleaning and disinfection with germicides is often inadequate and leaves environmental surfaces contaminated with important nosocomial pathogens. 'No touch' methods of room decontamination have been demonstrated to reduce key nosocomial pathogens on inoculated test surfaces and on environmental surfaces in actual patient rooms. Further UV devices and hydrogen peroxide systems have been demonstrated to reduce HAI. A validated 'no touch' device or system should be used for terminal room disinfection following discharge of patients on contact precautions."
Reference: Weber DJ, Kanamori H, Rutala WA. 'No touch' technologies for environmental decontamination: focus on ultraviolet devices and hydrogen peroxide systems. Curr Opin Infect Dis. 2016 Aug;29(4):424-31.

ICT invited manufacturers of various types of UV light technology to provide their perspectives on a number of pertinent issues.

UV Light

ICT: How do you believe that UV disinfection technology is contributing to and enhancing to manual cleaning practices?

While manual cleaning and disinfection is a critical step to limiting the spread of pathogens, studies have demonstrated that less than 50 per-cent of hospital room surfaces are adequately cleaned and disinfected – leaving facilities and patients vulnerable to pathogens. UV disinfection technology should supplement manual surface cleaning by killing persistent pathogens, including Clostridium difficile (C. difficile), carbapenem-resistant enterobacteriaceae (CRE) and Methicillin-resistant Staphylococcus aureus (MRSA), for optimum infection prevention. UV-C technology improves patient safety by offering an extra layer of protection and killing microorganisms in high-risk settings or areas of the healthcare environment that may otherwise be missed or insufficiently addressed by manual cleaning practices.
-- Ross Mitchell, senior product manager, Clorox Healthcare

UV is a non-chemical light that kills microorganisms by disrupting its DNA and does not cause genetic changes or create superbugs. UV germicidal light will lower the overall pathogenic load contributing an active layer of defense not addressed by current manual cleaning methods or products. UV germicidal light disinfection is a safe, highly effective 24/7, clinically proven and tested technology, that when implemented, enhances and creates a more successful infection control program than just using current protocols to achieve the highest standard of care.
-- Chris Griffith, executive vice president, sales, marketing and research, HealthySole LLC

Healthcare facilities that adopt UV disinfection should not alter their manual cleaning process. Manual cleaning of rooms must still be completed and EVS staff have a difficult job and are under constant time restraints. Expecting staff to thoroughly clean all of the surfaces in a room while allowing sufficient contact time of disinfectants is a nearly impossible task. Utilizing UVC as an adjunct or enhancement to manual cleaning reduces or eliminates potential pathogens on surfaces and provides that extra level of protection for patients as staff.
-- Adam Buchaklian, PhD, director of clinical research, Surfacide, LLC

Over the past decade much has been learned about the role of the environment in infection prevention. Carling, et al.1 concluded that manual disinfection is inadequate for terminal room disinfection. Rutala,2 Boyce3 and Donskey4 concluded that a UV device with measured dos-ing capability could in fact disinfect all room surfaces (direct and shadowed surfaces) from a single placement in the room. Anderson, et al.5 demonstrated extremely significant reduction of pathogens with no manual cleaning processes at all. Very recently in a presentation at IDWeek 2016, Microbial Load on Environmental Surfaces: The Relationship Between Reduced Environmental Contamination and Reduction of Healthcare-Associated Infections, researchers proved that a combination of manual cleaning and Tru-D’s measured dose UV light energy can lead to a reduction of 94 percent of MDROs and a 35 percent decrease in infection rates. Further, the only clinical trial on UV disinfection, the Benefits of Enhanced Terminal Room Disinfection (BETR-D) study, which will soon be published in The Lancet, proved that enhanced terminal room cleaning protocols decreased the risk of acquisition of infection by 10 percent to 30 percent for patients admitted to a room that was previously occupied by a patient infected with a MDRO, and the largest decreases were seen when Tru-D was added to the standard cleaning protocols. Additionally, the BETR-D study concluded an 11 percent reduced risk of infection for every patient who walked through a hospital’s doors when a focus was placed on UV disinfection on isolation discharge rooms.
References:
1. Carling PC, Parry MF, Von Beheren SM. Healthcare environmental hygiene study group. Identifying opportunities to enhance environmen-tal cleaning in 23 acute care hospitals. Infection Control and Hospital Epidemiology 2008; 29; 1-7
2. Rutala, et al. Room Decontamination with UV Radiation. Infection Control and Hospital Epidemiology. October 2010, vol. 31, no. 10
3. Boyce, et al. Terminal Decontamination of Patient Rooms Using An Automated Mobile UV Light Unit. Infection Control and Hospital Epide-miology. August 2011, Vol. 32, No. 8.
4. Donskey, et al. Evaluation of an automated ultraviolet radiation device for decontamination of Clostridium difficile and other healthcare-associated pathogens in hospital rooms. Infectious Diseases. 2010, Vol. 10, No. 197.
5. Anderson, et al. Decontamination of Targeted Pathogens from Patient Rooms Using an Automated Ultraviolet-C-Emitting Device. Infection Control and Hospital Epideiology. May 2013, Vol. 34, No. 5.
-- Chuck Dunn, president and CEO, Tru-D SmartUVC, LLC

There is ample evidence to prove that even the most thorough manual cleaning is insufficient when it comes to removing the pathogens that can cause infections. No touch disinfection with a Xenex LightStrike robot eliminates the human error factor. Hospitals have repeatedly report-ed dramatic decreases of 50 percent to 100 percent in their infection rates when they added Xenex LightStrike pulsed xenon UV disinfection technology to their manual cleaning regimen.
-- Sarah Simmons, DrPH, CIC, FAPIC, science director, Xenex Disinfection Services

ICT: What do you believe are the remaining gaps in the science related to UV disinfection technology efficacy?

There is a growing body of evidence demonstrating the efficacy of UV disinfection, but because the technology is still relatively new, incon-sistencies in testing methods are common and can make comparing device efficacy difficult. For example, a study published in Infection Control & Hospital Epidemiology last year described how different test methods impact the performance of different UV-C decontamination systems (in that case the Clorox Healthcare® Optimum-UV® System and Tru-D Smart UVC). In addition to finding both devices equally effective at killing MRSA and C. difficile spores, the study showed that variations in testing methods, such as spreading of the inoculum, orientation relative to the device and type of organic load, can impact measured reduction in pathogens by UV-C devices during experimental testing.1 As the market for UV-C devices continues to grow, more standardized laboratory testing methods could help ensure that healthcare facilities can make informed decisions when purchasing UV devices.
Reference: 1. Cadnum JL, et al. Infect Control Hosp Epidemiol 2016;37:555–560.
-- Ross Mitchell, senior product manager, Clorox Healthcare

The direct result of UV technology has proven to lower the numbers of HAIs in healthcare facilities. UV has specifically proven to be a highly effective breakthrough healthcare disinfection technology that has grown rapidly in a relatively short period of time. Science and research con-tinues to validate the efficacy of UV disinfection technology as a highly effective pathogen decontamination process. The gap is not in the sci-ence, it is more an issue of lack of education regarding the proven, clinical efficacy and use of UV technology.
-- Chris Griffith, executive vice president, sales, marketing and research, HealthySole LLC

UV-C energy is very well documented in its ability to kill microorganisms both in the laboratory and the clinical setting. However, testing and documentation that identifies the amount of UV-C energy that is necessary to kill different microorganism is not well described or defined. Of-ten, UV disinfection devices have focused on time but not efficacy. While time is much easier to present in a sales setting, exactly how effica-cious that device is in that time is often not well defined. 
-- Adam Buchaklian, PhD, director of clinical research, Surfacide, LLC
 
To date, no large scale, well-controlled study has demonstrated conclusively that UV disinfection of the operating suite has a direct effect on the reduction of SSIs.  More data is needed on which UV disinfection protocols provide the most impact on infection reduction in long-term acute care facilities. The soon-to-be-published Benefits of Enhanced Terminal Room Disinfection (BETR-D) study is the most comprehensive study on UV disinfection to date. The cluster randomized, multicenter crossover study with 2x2 factorial design evaluates the impact of enhanced terminal room disinfection on acquisition and infection caused by MDROs.
-- Chuck Dunn, president and CEO, Tru-D SmartUVC, LLC

There is a fast-growing body of evidence about the efficacy of pulsed xenon UV disinfection technology on reducing hospital infection rates. There are 50-plus companies that manufacture mercury UV devices and none of them have had multiple hospitals publish infection reduction studies in peer-reviewed journals. The continuous mercury UV companies may claim that all UV light is the same -- but it's not. Pulsed xenon UV is scientifically different, and as a result, numerous hospitals using pulsed xenon UV have successfully brought down their infection rates and shared their results in peer reviewed published studies so that other hospitals can learn from them. Other gaps in the science related to UV disin-fection are infection reduction studies published by nursing homes, long-term acute care and rehabilitation facilities.
-- Sarah Simmons, DrPH, CIC, FAPIC, science director, Xenex Disinfection Services
 

ICT: The UV device marketplace is a crowded one; how are you differentiating your technology?

There are numerous automated device options available for facilities to choose from, which is why it’s important for facilities to do their re-search to find the device that will be the best fit for their specific infection control needs. Key considerations for selecting an automated disinfection system include kill claims for relevant healthcare pathogens, relatively short cycle times, safety features, data tracking, ease of use, and affordability. The Clorox Healthcare® Optimum-UV Enlight® System provides the optimal balance of strong performance, quality, user-friendly design and affordability. Real-time smart data reporting software tracks where, when and how the system is working, assuring facilities that they’re maximizing their investment, getting the efficacy they’re counting on, and protecting their patients and staff. In addition, Clorox Healthcare uniquely offers a full portfolio of proven manual surface disinfectants and UV technology, enabling comprehensive environmental pathogen management.
-- Ross Mitchell, senior product manager, Clorox Healthcare

HealthySole® Plus is the first and only 24/7, chemical free, no-touch system that disinfects the soles of shoes and booties, which carry un-addressed millions of dangerous pathogens that cause HAI’s. HealthySole® Plus unlike other UV devices, is safe while operating in the presence of staff members and patients. Shoe soles have one of the highest identified bio-burdens of infectious pathogens of any vector. These pathogens are spread throughout the hospital floors, and through aerosolization contaminate the environment and patients. HealthySole® Plus is a revolutionary new, clinically proven and tested system that prevents the spread of infectious pathogens throughout healthcare facilities and as a result lowers HAI’s.
-- Chris Griffith, executive vice president, sales, marketing and research, HealthySole LLC

Surfacide has several features that differentiate it from other UV devices. The first and most obvious is the use of the triple emitter system. The use of three emitters minimizes shadows and places the emitters closer to all surfaces thereby allowing them to deliver more energy in less time.  In addition, Surfacide uses a laser mapping feature to measure the overall dimensions of the disinfection space and identify objects within the space. Once the system gathers these measurements the optimum disinfection time for each space is calculated thereby eliminating any guess work by the operator.
-- Adam Buchaklian, PhD, director of clinical research, Surfacide, LLC

The pioneer in the UV disinfection industry, Tru-D placed the first UV robot in a health care facility in 2007.  Our commitment to differentiate has not wavered in providing a validated UV device that guarantees total room disinfection from a single position in the room. Using patented Sensor360 technology, Tru-D compensates for room variables such as size, shape and geometry to deliver the precise, lethal dose of UV needed to completely disinfect the entire room. Tru-D’s Sensor360 technology provides a consistent baseline of disinfection and completely eliminates human error in the disinfection process, which is why it was the device of choice for the CDC-funded Benefits of Enhanced Terminal Room Disin-fection (BETR-D) randomized clinical trial.
-- Chuck Dunn, president and CEO, Tru-D SmartUVC, LLC

Xenex is the only company that uses pulsed xenon (a noble gas) to make germicidal UV light. There are 50-plus companies that manufacture continuous mercury UV devices and none of them have had multiple hospitals publish infection reduction studies in peer-reviewed journals. They may claim that all UV light is the same -- but it's not. Pulsed xenon UV’s high intensity and broad spectrum light is scientifically different, and as a result, hospitals using pulsed xenon UV are successfully bringing down their infection rates. Our differentiator is infection reduction results. We now have nine peer-reviewed studies showing infection rate reductions at hospitals using LightStrike Germ-Zapping Robots to disinfect rooms. Another differentiator is materials damage. Many hospitals are reporting materials damage as a result of exposure to continuous mercury UV light. Because the Xenex device uses a pulsing technology (not continuous exposure) to create UV light and destroy pathogens, no hospitals have reported materials/equipment damage as a result of using Xenex devices.
-- Sarah Simmons, DrPH, CIC, FAPIC, science director, Xenex Disinfection Services

 
ICT: How do you address factors such as cost, turnaround time, shadowed areas, and other factors that healthcare decision-makers identify as barriers?

The Clorox Healthcare® Optimum-UV Enlight® System is designed to deliver high performance at a lower cost, which is an increasingly important consideration in today’s market. Clorox Healthcare offers leasing, financing, and bundled discounts to enhance affordability. The system emits UV-C energy in a full 360 degrees, utilizing “line-of-sight” pathogen reduction technology to target surfaces. We work closely with our customers to integrate UV technology into their existing cleaning protocol and workflows. For example, we offer a comprehensive Workflow Guide and access to comparable customers who have been successful implementing the Optimum-UV Enlight® System. In a recent study published in Infection Control and Hospital Epidemiology, researchers at the Hospital of the University of Pennsylvania found that deploying the Clorox Healthcare® Optimum-UV® System in hematology/oncology units helped reduce C. difficile infection rates by 25 percent, saving approximately $350,000 to $1.5 million in direct medical costs, all without impacting room turn-over times.2
  Reference: 2. Pegues, DA, et al. Infect Control Hosp Epidemiol 2016;1–6. https://doi.org/10.1017/ice.2016.222.
-- Ross Mitchell, senior product manager, Clorox Healthcare

The return on investment (ROI) and life-saving results of the HealthySole® Plus system is a must for any healthcare environment. The HealthySole® Plus is an affordably priced cost effective breakthrough technology that decreases the bio-burden on the soles of shoes that lead to HAIs. HealthySole® Plus does not affect patient or room turnaround time as it is safe to use in the presence of staff and patients. With a disinfection time of only 8 seconds and a 97 percent-plus shoe sole surface UV light exposure, HealthySole® Plus achieves up to a 99.9 percent disinfection rate of infectious pathogens with insignificant shadowing.
-- Chris Griffith, executive vice president, sales, marketing and research, HealthySole LLC
 
Surfacide was designed to overcome the limitations of single emitter first generation UV disinfection devices.  The use of multiple emitters maximizes energy delivery, minimizes shadows, decreases labor, and reduces turnaround time.
-- Adam Buchaklian, PhD, director of clinical research, Surfacide, LLC

The direct medical cost of HAIs to health care facilities exceeds $30 billion dollars annually, and each HAI case can cost a hospital more than $15,000. Tru-D lowers the risk of patients developing unnecessary and preventable infections transmitted by room surfaces contaminated with epidemiologically-import pathogens during their treatment. Tru-D offers impressive return-on-investment backed by the only device-specific, CDC-funded, well-controlled, large scale randomized clinical trial. There are significant labor costs associated with devices that require multiple room placements and constant monitoring by EVS staff.  Many offerings recommend hiring additional full-time employees whose only job is to operate a UV device. Tru-D’s single placement method leaves operators free to complete other tasks during the disinfection process, thus mini-mally impacting productivity and room turnover time. Disinfection of shadowed areas from a single room placement is the premise behind Tru-D’s claim of total room ultraviolet disinfection. Sensor360 technology compensates for room variables, disinfecting the entire space with one cycle of UV energy. Due to its Sensor360 technology, Tru-D is able to disinfect in direct and shadowed areas, guaranteeing total room disinfec-tion.
-- Chuck Dunn, president and CEO, Tru-D SmartUVC, LLC

The cost of a UV disinfection device is offset by preventing three to four infections. Hospitals using pulsed xenon UV disinfection devices have reported a Return on Investment (ROI) in as early as 30 days as a result of fewer infections. UV light is poorly reflective and using only one posi-tion in a room generates a large number of surfaces that will be inadequately disinfected because of shadowed areas. Xenex recommends running multiple positions in a room to increase direct line of sight to high-touch surfaces and ensure that the room has been properly disinfect-ed. The Xenex LightStrike Germ-Zapping Robot runs in 4- or 5-minute cycles (depending on robot model) and doesn't require any warm-up or cool-down time, so there is little effect on room turnover time. Furthermore, hospitals must consider the cost of replacement of materials dam-aged by continuous mercury UV light as well as the extra time needed to disinfect a room – up to 53 minutes per position to run a mercury UV device and the additional time required for a mercury UV device to cool down.
-- Sarah Simmons, DrPH, CIC, FAPIC, science director, Xenex Disinfection Services

ICT: How should individuals best evaluate/trial UV disinfection technology in their institutions?

Facilities should evaluate UV technology based on their needs, capacity, pathogens of concern and the areas of the facility they are looking to treat. When choosing a UV room device, look for a partner that has a deep commitment to patient safety and product quality. Clorox Healthcare offers best-in-class pre-and-post sale customer support, ranging from in-person trainings, implementation and workflow support, to marketing and ongoing technical support. In addition, comprehensive training videos and instructional documents enable facilities to maximize their trial periods. 
-- Ross Mitchell, senior product manager, Clorox Healthcare

Individuals should evaluate UV disinfection technologies by considering its application, staffing costs, down time, return on investment (ROI) and proven efficacy in reducing pathogens from target vectors that lead to infection. Effective UV technology should be afforded the same importance as hand hygiene to overall infection control programs. To decrease the potential for infections and improve the highest standard of care, implementing the benefits of UV’s unique 24/7, chemical free, safe and easy to use technology will achieve benefits that outweigh any added protocol implementation.
-- Chris Griffith, executive vice president, sales, marketing and research, HealthySole LLC
 
If conducting a trial or evaluation of UV disinfection devices don’t expect to see immediate reductions in HAIs. Seasonal and monthly varia-tions in infection rates can be misleading. Be sure that the system works well in your facility and is easy to use.  Confirm that the system provides tracking and reporting information for your team to track and verify system usage.
-- Adam Buchaklian, PhD, director of clinical research, Surfacide, LLC

Infection preventionists and infection prevention committees must discard marketing and look very closely at device-specific, evidenced-based research.  If a published study or whitepaper contains conflict of interest disclosures or company shareholder authorship, it should be dis-counted. If a published study or whitepaper does not have controls that eliminate other infection prevention modalities (monitored handwashing and manual disinfection compliance) it should be discounted as well as these other strategies affect outcomes and claims. Tru-D SmartUVC takes pride in its leadership in providing the gold standard in science and research behind its product. With a dozen independent studies on Tru-D including the only randomized, clinical trial on UVC disinfection, Tru-D’s claims for total room disinfection and the resulting reduction in HAIs are backed by science from leading experts on best practice in environmental disinfection.
-- Chuck Dunn, president and CEO, Tru-D SmartUVC, LLC
 
Hospital decision-makers need to ask some tough questions when it comes to evaluating UV technologies. The gold standard for assessing new technologies is evaluating the peer-reviewed literature. Ask the UV vendor to show you peer-reviewed studies from hospitals that saw a reduction in infection rates when the UV device was used at that facility. If they don't have peer-reviewed and published outcome studies, then the technology is inadequate and has not met the standard for evidence-based medicine. As health professionals are analyzing UV technologies, they need to look at the peer-reviewed literature supporting the device's claims with regards to reducing infection rates at hospitals. For example, the CDC-funded BETR-D study was presented at the IDWeek conference. In his presentation, Dr. Anderson, the lead researcher in the CDC study, stated that there was no decrease in C. diff infections and no statistically significant difference in MRSA infections resulting from their use of mercury UV disinfection devices. They averaged disinfecting two rooms per day and cycle times ranged from 31 minutes to 52 minutes (per cycle). But if you look at advertising information provided by that mercury UV vendor, they report that infection rates decreased 30 percent for infections where Dr. Anderson specifically disclaimed efficacy.
-- Sarah Simmons, DrPH, CIC, FAPIC, science director, Xenex Disinfection Services

Electrostatic/Vaporized/Misting Technology

ICT: How do you believe that your technology is contributing to and enhancing to manual cleaning practices?

Obviously, with more than 100,000 people dying each year as a result of HAIs in the U.S. alone, technology solutions are needed. Unfortunately, hydrogen peroxide can be toxic and is limited by space, cost, mobility, healthcare room turn rates, as well as repeatable log kill rates. However, other innovative tech such as the E-Mist Electrostatic System and Touch Point Healthy Process are beginning to gain support as an effective, systematic and cost effective approach to IPC.
-- Doug Morrell, chief marketing officer, E-Mist Innovations, Inc.

SteraMist™ BIT™ is an Activated Ionized Hydrogen Peroxide (AIHP) technology that goes above, beyond, under, and around disinfecting sprays and wipes to achieve a more thorough disinfection in hard to reach areas. AIHP is quicker, with no wipe no rinse, and our efficacy is not based on an antiquated nebulized vaporized technology.
-- Aaron D Loveland, vice president of marketing and public affairs, TOMI Environmental Solutions, Inc.
 

ICT: What do you believe are the remaining gaps in the science related to technology efficacy?

Standardized cleaning and disinfecting processes are infrequent. Novel technologies such as hydrogen peroxide vapor, though costly and limited, appear to have a place where high-risk patients are present. On the other hand, founded on a legacy of electrostatic science and technology, the E-Mist Infection Control System eliminates traditional disinfectant methods by providing a mobile, touchless, safer, and more cost-effective approach to environmental surface disinfection. E-Mist helps hospitals and other healthcare institutions break the chain of pathogen mobility.
-- Doug Morrell, chief marketing officer, E-Mist Innovations, Inc.

There are no remaining gaps in the science of vaporized technologies because vaporized applications only nebulizes highly caustic percent-ages of hydrogen peroxide. SteraMist’s AIHP application is a real science that alters the molecule of hydrogen peroxide in which it allows its derivative, a reactive oxygen species, mostly hydroxyl radicals, to react with pathogens resulting in a 99.9999 percent kill of spores including C. diff spores.
-- Aaron D Loveland, vice president of marketing and public affairs, TOMI Environmental Solutions, Inc.
 
 
ICT: The marketplace is a crowded one; how are you differentiating your technology?

Environmental cleaning and disinfection play important roles in the prevention and control of healthcare-associated infections. Though prevalent and widely used since the 1960s in other industries, electrostatic technology is now being adopted in the application of disinfectants. The E-Mist electrostatic disinfection application system is an effective alternative to existing facility disinfection methods. The system is patented, providing a unique positive charge to liquids.
-- Doug Morrell, chief marketing officer, E-Mist Innovations, Inc.

UV is an unregistered science/technology thus results in a crowded marketplace. UV is also hard to achieve consistent data from and are cumbersome to use. We all know that it is an only a matter of time until the regulatory officials mandate UV to undergo the same efficacy studies that hydrogen peroxide based fogging technologies under go. With UV being line of sight radiation and such short distance kill results, efficacy in a total room may be hard to pass. The SteraMist™ platform starts with a low concentration (7.8 percent) H2O2 solution and is converted to Reactive Oxygen Species, specifically the Hydroxyl Radical by passing though High Energy Atmospheric Cold Plasma activation.  This breaks the double bonds of the H2O2 creating the highly effective OH radical. This process called Binary Ionization Technology® is the first EPA Registered Solution + Equipment combination that provides the unique technology of hydrogen peroxide ionization for hospital/healthcare disinfecting.
-- Aaron D Loveland, vice president of marketing and public affairs, TOMI Environmental Solutions, Inc.
 

ICT: How do you address factors such as cost, turnaround time, shadowed areas, and other factors that healthcare decision-makers identify as barriers to adoption?

The E-Mist disinfectant application system can be used in various healthcare settings including, but not limited to patient rooms, common ar-eas, operating rooms, triage areas, patient transport vehicles, nurse’s stations, emergency rooms, hallways, therapy areas, restrooms, scrub-in areas, etc. The System is used after an area is effectively cleaned. Once the application is complete the room can be used in as little as 10 minutes. Customers who use the E-Mist disinfectant application system realize anywhere between 25 percent to 45 percent labor savings, and between 35 percent to 50 percent chemical savings.
-- Doug Morrell, chief marketing officer, E-Mist Innovations, Inc.

SteraMist™ BIT™ is economical, non-corrosive, easy to apply, and requires no wipe, no rinse, leaves no residues. Due to the gas-like proper-ties of the SteraMist™ BIT™ fog/mist it is not affected by shadows and can reach all crevices and hard to reach areas often missed by manual spray and wipe and UV light technologies. It does not contain any other additives that leave a residual or offensive smell such as PAA. Stera-Mist™ also does not use silver (Ag+) ions leaving environmental concerns, and the hand-held SteraMist™ Surface Unit has a quick turn-around time of 12-20 minutes depending on size of room compared to 1-2 hours for most other fogging systems.
-- Aaron D Loveland, vice president of marketing and public affairs, TOMI Environmental Solutions, Inc.
 

ICT: How should individuals best evaluate/trial fog/mist/vaporized technology in their institutions?

Those involved in the prevention and control of preventable infections require a balanced approach of cost and quality to improve outcomes. Existing healthcare disinfection methods including hand-wiping, vaporized tech, fogging, and UV lighting are ineffective or expensive. As environmental surface contamination and healthcare-acquired infections have become more defined, the E-Mist electrostatic disinfection application system presents an effective, approved, and cost effective alternative to healthcare facility disinfection procedures.
-- Doug Morrell, chief marketing officer, E-Mist Innovations, Inc.

Facilities must make sure that the product being used is adequate to perform the disinfection necessary for the area being treated. Infection preventionist must evaluate what products are being used, what areas need to be treated. Does the product pose harm to the delicate medical equipment and/or inanimate objects? SteraMist does not. Is the product being used in the NICU, the OR, or throughout the facility in all common areas? SteraMist is easy to use in these areas. Does the staff know how to apply it per the label directions? How will the staff be trained and how will results be evaluated?  Key to the success of environmental cleaning and disinfection is knowledge, consistency, and evaluation of end results. TOMI offers trial programs and ongoing training and education of its SteraMist™ BIT™ platform to the hospital’s staff and service providers to ensure optimal implementation across the facility.
-- Aaron D Loveland, vice president of marketing and public affairs, TOMI Environmental Solutions, Inc.