Robo-UV use case in a hospital
Hospital-acquired infections are one of the leading causes of death worldwide. Prevention of hospital-acquired infections is even more crucial now as COVID-19 patients admitted to hospitals are more prone to co-infections and associated complications. Robo-UV, an autonomous disinfection robot, can be used for the effective sterilization of hospitals thus decreasing the rate of hospital-acquired infections in patients.
WHO defines “Hospital-acquired infection (HAI)” as An infection acquired in a hospital by a patient who was admitted for a reason other than that infection. HAIs are one of the leading causes of death and increased disease rates in hospitalized patients worldwide.
At any particular time, out of every 100 hospitalized patients,7 in developed and 10 in developing countries will acquire at least one HAI. According to WHO, such infections account for 37,000 in Europe and 99,000 deaths in the USA every year. HAIs not only affect human lives but also lead to significant financial losses to the health care system. Annual financial losses are estimated at about €7 billion in Europe, and approximately US$ 6.5 billion in the USA.
The percentage of hospital-acquired infections varies among countries of the world. Approximately 30% of ICU patients in high-income countries are affected at least once by HAI. Whereas, in low- and middle-income countries, the frequency of HAI in ICU patients is at least 2─3 times higher. (1).
Prevention of HAIs is of crucial importance in this current COVID-19 pandemic situation. COVID-19 patients admitted to hospitals are more prone to developing co-infections leading to severe complications, a longer ICU stay, and higher death rates. As reported by one study on critically ill COVID-19 patients in Spain, 40.7% of ICU-admitted COVID-19 patients developed hospital-acquired infections resulting in a 36% mortality rate (2). COVID-19 ICU patients are in an immunocompromised situation, which increases their susceptibility to HAIs.
Moreover, hospital-acquired COVID-19 infections also present a serious public health concern. According to a January 2021 study, the rate of hospital-acquired SARS-CoV-2 infection is 12–15%. (3).
Thus, the above-mentioned facts demonstrate the importance of proper sterilization of hospitals to prevent HAIs and hospital-acquired COVID-19 infections.
Most hospitals worldwide use manual sterilization processes. Manual sterilization with chemical agents is a time-consuming, inefficient, and labour-intensive process.
To make hospital sterilization faster, more efficient, and cost-effective, City Robotics has designed and developed the Robo-UV. City Robotics was born to provide help to our health care systems during this COVID-19 crisis by designing a robot for automatic disinfection of hospitals. While developing the idea, they realized that the lack of efficient central sterilization methods was a big challenge for hospitals that existed even before COVID-19.
The Robo-UV, an autonomous disinfection robot, uses the ultraviolet germicidal irradiation method to sterilize surfaces and can be used for large-scale sterilization in hospitals. The robot has 6 UV lamps installed which release UVC radiation 254 nm. UVC radiation works by breaking down the DNA, RNA, and proteins of the microorganism, which stops the microbe from multiplying and eventually kills it.
ROBO-UV picture
UVC lamps have been used for decades for sterilization purposes and have been known to be effective against both bacteria and viruses. UVC irradiation has been shown to be effective against many HAI-causing bacteria (4). It has also been shown to be successful in destroying members of the Coronavirus family. However, currently, there is limited published data on its effect on the SARS-CoV-2 virus, which causes COVID-19. (5)
The sterilization efficiency of the Robo-UV was tested in the laboratories of the University of Łódź, Poland. The tests conducted against common HAI-causing microorganisms presented astounding results. Direct exposure to the UV light caused 100% sterilization within 3 minutes whereas indirect exposure needed 10 minutes for 100% sterilization. Notably, only 35% UV efficiency (i,e 2 out of 6 UV lamps) was used for this experiment and definitive better results are expected under the full UV efficiency of the robot.
After the successful laboratory test, the Robo-UV was recently tested by a leading public hospital in Łódź, Poland for large-scale sterilization purposes. The hospital mainly used the Robo-UV for the sterilization of their surgical areas with highly positive results. As one of the most important and frequently used areas in hospitals, operation theatres pose the most risk for acquiring HAIs. Therefore, proper sterilization before and after an operation is of utmost importance to avoid spreading HAIs.
As seen in the above picture, an operation theatre has complex machinery, tools, and surfaces that would be very difficult to sterilize effectively by human hands. The operation theatre of the Łódź hospital, which requires at least one and half hours to sterilize manually, was reduced to only 15 minutes when the Robo-UV was used. The radiation was concentrated more in the high contact areas of the room, that is areas that are frequently touched by surgeons and nurses.
A UVC dosimeter card was used to check if the Robo-UV had delivered a sufficient dose of irradiation to kill all microorganisms on target surfaces. The centre of the card contains photo-chromatic ink that changes colour according to the dose of UV radiation received. The UVC dosimeter card helped to measure the target dose of the radiation and disinfection time needed.
Mostly in hospitals, the non-compliance with the sterilization protocols is due to human error, shortage of high-level disinfection equipment, lack of training in proper sterilization techniques, and absence of access to evidence. All these problems can be solved by using the Robo-UV. The advantages of automatic sterilization with Robo-UV are reliability, speed, task verification, and economic gain. The function of Robo-UV does not depend on any human effort, so it’s highly reliable. It works in almost one-fourth of the time needed for manual sterilization and the sterilization can be verified with the use of a dosimeter card. It is also more cost-effective as a single machine can cover larger areas and act faster than many human employees.
In fact, Robo- UV is the most affordable autonomous disinfection robot in the market in the present day.
Hence, the impact of HAIs has been seen to include longer hospital stays, increased antimicrobial resistance, excess deaths, and also creates additional suffering and high costs for patients and families. So, it is understood how HAIs are not only detrimental to human health but also a massive additional financial burden for health care systems.
Thus, any infection prevention and control measures will not only bring huge relief to patients but also lessen the burden on the health care systems. The use of Robo-UV is one such measure hospitals can use to effectively sterilize large areas in minimal time.
The introduction of Robo-UV to hospitals for large-scale sterilization procedures is, therefore, a big step in the right direction.
References-
1. https://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf
2. Bardi, T., Pintado, V., Gomez-Rojo, M., Escudero-Sanchez, R., Lopez, A. A., Diez-Remesal, Y., … & Pestaña, D. (2021). Nosocomial infections associated to COVID-19 in the intensive care unit: clinical characteristics and outcome. European Journal of Clinical Microbiology & Infectious Diseases, 40(3), 495–502.
3. Barranco, R., Vallega Bernucci Du Tremoul, L., & Ventura, F. (2021). Hospital-acquired SARS-Cov-2 infections in patients: inevitable conditions or medical malpractice? International Journal of Environmental Research and Public Health, 18(2), 489.
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7099662/
5.https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/uv-lights-and-lamps-ultraviolet-c-radiation-disinfection-and-coronavirus
6. https://insights.regencylighting.com/what-is-a-uvc-dosimeter
7. https://apps.who.int/iris/bitstream/handle/10665/80135/9789241501507_eng.pdf
