Washington Regional invests in robots to reduce infection risks

It’s no secret hospitals, which are places of healing, are also crawling with germs. They include superbugs, which are the most resistant to antibiotics. Washington Regional Medical Center in Fayetteville is one of only two healthcare providers in the state to invest in new robotic technology aimed at killing the bacteria associated with hospital-acquired infections (HAI) such as Clostridium difficile (C.diff) and the Methicillin-resistant Staphylococcus aureus known as MRSA.

Dr. James “Buddy” Newton, director of antibiotic stewardship at Washington Regional, said the hospital invested more than $240,000 to acquire two robots that sanitize areas of the hospital at the greatest risks for residual bacteria after the standard alcohol cleaning. The robots use ultraviolet rays to kill the DNA of the bacteria present on surfaces around the hospital. He said the UV light is not harmful to humans as it’s the broader spectrum rays UVC rays, not the UVA and UVB which are the more intense radiation waves associated with increased risks of skin cancer.

Newton said the hospital deployed the robots in February to track down and kill C.diff and MRSA bacteria, which are associated with hospital-acquired infections related to surface germs. Hospital administrators saw the robots at a conference last year. The bot is engineered by San Antonio, Texas-based Xenex. The company said roughly 400 U.S. hospitals are using the robot technology, including the Mayo Clinic in Minnesota.

The Center for Disease Control estimates roughly 1.7 million hospital-associated infections occur annually from bacteria and fungi that are resistant to antibiotics. Roughly 99,000 deaths are associated with HAIs annually in the U.S. A report from Castlight/Leapfrog Group earlier this year found one out of every 25 patients in U.S. hospitals contract an HAI each day. The report found the direct costs of HAIs to hospitals are estimated between $28 billion and $45 billion annually. These costs are passed along to insurers and employers and also impact patients financially in the form of higher out-of-pocket costs.

Newton said the costs of HAI are high, and now there is technology to do what humans have not been able to accomplish by themselves. He said the technology is new, but it lines up with Washington Regional’s commitment to antibiotic stewardship and reducing risks for HAIs.

Xenex is the first company to use non-mercury-based lighting in its robots which helped to seal the deal because of the environmental toxicity risks associated with mercury spills, should the bulbs break. Newton said Xenex uses xenon-based light bulbs that produce light by passing electricity through ionized xenon gas at high pressure.

“We weren’t the first hospital in the state to test these robots. Unity Hospital in Searcy acquired the Xenex robot first, but they are a smaller hospital with limited use cases. We are now using two of them and plan to acquire more,” Newton said.

The robot is wheeled in the room and plugged in the electrical outlet. The technician enters the room number into the dashboard computer on the side of the robot and then places the security barriers near the door before exiting the room. The robot has a neck that lifts up about a foot high and exposes light-emitting bulbs which begin to flash about 1,000 times per minute. To thoroughly sanitize a patient’s room it takes about 10 minutes. If the room door is opened and the barrier is crossed, the system will shut itself down, the neck rescinds into the canister. The only residual left behind after a Xenex robot cleaning is the faint smell of ozone which can linger for a minute or two before it dissipates.

He said in about 10 months of use, the hospital is starting to see meaningful data from the robots, which hospital staff has affectionally named Flash and Violet. Newton’s passion for the robots stems from his work in trying help hospitals reduce their risks for infections that are resistant to antibiotics. Newton said the bacteria are present in all hospitals and cleaning protocol does a good job at keeping them at bay, but the robots, when used after a routine cleaning, can totally eradicate any residual matter of DNA or its procurers RNA if present on surfaces in operating rooms, patient rooms in the intensive-care unit, the neonatal nursery and milk lab for mothers who pump breast milk and leave for their infants in the neonatal intensive care unit.

The hospital began using the robots to sanitize the ICU rooms after a patient was discharged and before a new patient enters. He said the C.diff rates were highest in these rooms. After three months of use, Newton said the hospital saw a 41% drop in C.diff infection rates compared to a year ago. He said C.diff typically prolongs a patient’s hospital stay and can cost an additional $25,000 per case. He said the dramatic drop in C.diff cases was a huge win for hospital and the patients who benefited from a better overall experience.

“We know these robots work well eradicating C.diff cells before they make our patients sick. In the rooms that did not get the robot sanitization, we saw cases increase,” Newton said. “Our MRSA (Staph) infection rates were already really low and these robots have not made any tremendous difference there. That said, the robots can very quickly eradicate MRSA DNA from any surface that comes in contact with the light beams.”

He said the usage in the operating rooms has also been positive. They started deploying the robot in the colon operating rooms where the surgical site infections were the highest. He said those numbers have come down since the robot began being used in the operating rooms five nights a week after the traditional cleaning. The robots were then deployed to the other operating rooms which also get cleaned by the robots five nights a week.

“We recently purchased a pod to use with our robots that allows us to sanitize equipment like baby isolettes, stethoscopes or even our cell phones. The light flash will clean but it won’t penetrate deep into surfaces, so fabrics are hard to sanitize using this light technology. The pod tent-like feature has foiled lined cloth drapes which reflect the light flashes emitted from the robot that shines down into the tent. Our neonatal ICU nurses can put the baby isolettes into the pod and totally sanitize every tiny part of it which can be very tedious to clean,” Newton said.

He said the hospital continues to find new use cases for the robots and ideally he would like to purchase more of them. At $120,000 each, he said hospital purchases would be a slow way to increase the fleet of robots.

“I am looking for other ways to get more robots purchased via community partnerships and grants,” Newton said. “I would love to be able to use these robots to clean our associated clinic exam rooms and also deploy them out to schools when there is a strong flu outbreak like last year. We are using our robots to sanitize rooms where there have been antibiotic-resistant infections present such as phenomena, meningitis, and influenza. Upon patient discharge, we will get the robot to the room for sanitizing if it’s not being used somewhere else.”