The presence of an effective disinfection process is the cornerstone of optimal infection control that protects patients and healthcare providers from disease-causing pathogens in healthcare or hospital settings.
Different medical devices carry varying degrees of contamination depending on their level of exposure or contact with blood or internal tissues.
Hence, the Spaulding Classification serves as the standard in infection control for classifying medical devices based on their infection transmission risk. This framework guides healthcare professionals on the appropriate disinfection or sterilization method for medical device disinfection.
High-level disinfection aligns with the Spaulding classification of medical devices for disinfecting semi-critical devices like endoscopes and probes.
This article discusses Spaulding classification and the role of UV-C technology in achieving high-level disinfection of medical devices.
Understanding the Spaulding Classification
The Spaulding classification¹ categorizes medical devices based on their infection risk.
Dr. Earle Spaulding developed this classification system in 1968, which guides healthcare professionals on the appropriate disinfection or sterilization techniques for medical device disinfection.
It categorizes medical instruments into three risk-based groups:
1)Critical devices: These are medical devices that come in contact with blood or sterile tissues in the body. Examples include surgical instruments and implants. They require sterilization to eliminate all forms of microorganisms, including bacterial spores.
2)Semi-critical devices: Medical devices under this category require high-level disinfection because they come in contact with mucous membranes or non-intact skin. The high-level disinfection process eradicates pre-existing microbes except for spores. Examples are endoscopes and respiratory therapy instruments.
3)Noncritical devices: These medical devices (like blood pressure cuffs) make contact with intact skin and, hence, require low- or intermediate-level disinfection to destroy some microbes.
The Spaulding classification enhances understanding on patient safety and reduces the spread of microbes that cause hospital-acquired infections.
How UV-C Achieves High-Level Disinfection
UV-C technology has the capacity to achieve high-level disinfection that aligns with the Spaulding classification for semi-critical devices.
UV-C technology possesses germicidal properties at wavelengths between 200 to 320nm.
At this wavelength, UV light produces electromagnetic energy that eliminates disease-causing organisms by triggering cell death and inhibiting replication. UV light causes a photochemical reaction in the DNA/RNA² (nucleic acids) of microbes that forms abnormal bonds called pyrimidine dimers, which distort the normal structure and function of microbes' nucleic acids. The disrupted cellular DNA/RNA prompts a series of biochemical cellular changes that result in microbial cell death.
Even though UV-C technology does not achieve sterilization, it can achieve high-level disinfection, which destroys all forms of microbial organisms in semi-critical devices except for their spores. Following the Spaulding classification, high-level disinfection is suitable for Spaulding-classified semi-critical devices. Researchers at the Department of Hospital Epidemiology, University of North Carolina, found that UV-C technology³ achieved high-level disinfection of semi-critical medical devices, such as endocavitary probes.
High-level disinfection is necessary for optimal infection control for semi-critical medical devices, and UV-C technology can achieve high-level disinfection more efficiently than alternatives like chemical disinfectants.
Applications in Semi-Critical Devices
UV-C disinfection of semi-critical devices such as endoscopes and probes has enormous benefits in healthcare settings. It not only achieves high-level disinfection of these medical devices but also accomplishes it in very short periods of time, like 60 seconds for the UV Smart D60. This provides a huge advantage in densely populated clinic settings that require rapid disinfection of endoscopes or probes after each use.
In addition, UV-C disinfection has the following benefits:
- consumes less energy
- non-chemical
- harmless to medical equipment
- no consumables required
Great examples of Innovative health solutions for achieving UV-C high-level disinfection include the UV Smarts D45 and the UV Smart D60. The D45 device is designed to disinfect ultrasound probes, while the D60 device is for ENT endoscopes and TEE probes.
These devices are created to provide automated UV-C disinfection that meets the stringent high-level disinfection standards required in healthcare settings. The D60 is clinically validated to be effective against a broad spectrum of infectious organisms, such as bacteria, fungi, and viruses. Researchers from the Eurofins Scientific Laboratories found that D60 met the criteria for high-level disinfection standards for the full spectrum of microorganisms.⁴
In addition to its infection control capacity, these devices ensure consistent and reliable results with reduced risk of human error in the reprocessing workflow.
Hence, UV-C-based disinfection systems have the potential to significantly impact the burden of healthcare-associated infections.
Conclusion
UV-C technology's antimicrobial properties eradicate various forms of infectious organisms, which helps with infection control in high-risk healthcare settings. Though it does not sterilize medical devices, its ability to kill pathogens without damaging them makes it an ideal choice for disinfecting them.
UV-C light can kill² a wide variety of infectious organisms:
- Bacteria: Staphylococcus aureus, E. coli, Salmonella, etc.
- Fungi: Candida, Aspergillus, etc.
- Protozoa: Giardia, Cryptosporidium, etc
- Viruses: Influenza, SARS-CoV-2, etc.
For semi-critical devices, which demand rigorous reprocessing due to their contact with mucous membranes or non-intact skin, UV-C's non-thermal, non-toxic nature and non-chemical approach make it an optimal choice for high-level disinfection.
Research findings⁵ from Scientists from Cornell University in the United States revealed that UV-C technology can achieve bacterial reductions of up to 6.9 log CFU within a few minutes.
This study further supports how UV-C technology is an indispensable tool for ensuring infection control that meets regulatory standards in healthcare environments.
Final Thoughts
UV-C light has a broad germicidal capacity, destroying various forms of bacteria, viruses, fungi, and protozoa. It can achieve high-level disinfection that meets the Spaulding classification framework.
Medical workers can achieve high-level disinfection using UV technology products like UV Smart D60 without chemicals or consumables. UV Smart’s UV-C devices can safely and efficiently disinfect semi-critical medical devices without damaging them.
Check out UV Smart's products to learn how to reliably and efficiently disinfect your medical devices.
References
²https://www.mdpi.com/2673-8007/1/3/35
⁴ This article can be requested at info@uvsmart.nl
⁵https://www.frontiersin.org/journals/food-science-and-technology/articles/10.3389/frfst.2023.1223829/full
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