Contamination Inspection and Disinfection for Incident and Cleanliness Management in Long Term Care Facilities

摘要 虽然美国的养老院居民比其他任何国家都多，但家庭已经不愿把 他们的老年人由于害怕猖獗的感染而被送往长期护理机构(LTCFs)。这些设施需要提高 通过改进他们的清洁方法并提供令人放心的证据来增强客户的信心 家人相信他们的长辈会很安全。在LTCFs中的有效清洁包括监测清洁的效果 使用的方法。LTCFs中的清洁程序正日益走向更标准化的方法， 而清洁效果的监测通常基于目测评估。一些设施开始 采取目视评估以外的措施，如拭子三磷酸腺苷(ATP) 生物发光，但这些昂贵和耗时的棉签测试并未被广泛采用。研究表明，大多数 长期合作伙伴将受益于标准化工具，如核对表、更频繁的工作人员教育，包括 产品使用培训。该项目的主要目标是将一种新的审计系统引入长期护理 提供即时污染检测、对隐形污染进行快速表面消毒的设施(例如 可携带病原体的体液、唾液和呼吸道飞沫)，并记录清洁证明。我们 相信我们的污染、卫生检查和消毒(CSI-D)技术将会改变 清洁度监测标准，允许用户实时查看污染情况，以便立即进行补救。 CSI-D系统不打算作为主要的消毒或清洁工具；相反，它充当清洁后工具 与其他清洁后审计工具(ATP、FT-IR等)互补的审计解决方案，以及提供 洁净度文件。该系统的消毒能力仅用于提供现场消毒 在审核或事件应对期间，不作为大面积消毒方法(如喷雾)使用。 此第一阶段SBIR将验证CSI-D作为清洁后审核系统的可用性，以检测、消毒 并记录残留污染，并应用风险映射算法来改进当前的管理 LTCFs的清洁度。这个项目是与该大学的人工智能和机器学习研究人员合作的 住在新泽西州大福克斯的北达科他州和硅谷老年人，以及新泽西州法戈的Edgewood Healthcare，谁将 为设计过程提供重要投入，并为试点研究提供长期护理设施。目标1将 包括为长期护理机构建立CSI-D软件，包括制定软件规范， 数据管理软件，以及污染检测算法。目标2将包括以下地点的试行测试 LTCFs，包括制定审计检查程序(任务清单)，比较CSI-D与 目测评估和ATP生物发光检测，以及动态风险分析算法的开发。 未来方向：第二阶段将包括更广泛的纵向研究，多达20名·埃奇伍德 使用CSI-D技术作为审计工具的医疗设施为期一年，此后 SafetySpect清洁度监测计划将与其余地点的感染控制结果进行比较。

ABSTRACT While the U.S. has more nursing-home residents than any other country, families have become reluctant to send their elders to long term care facilities (LTCFs) due to fear of rampant infection. These facilities need to raise the confidence of their clients by revamping their approaches to cleanliness and providing reassuring proof to families that their elders will be safe. Effective cleaning in LTCFs involves monitoring the efficacy of the cleaning methods used. Cleaning procedures in LTCFs are increasingly moving towards more standardized methods, while monitoring of cleaning efficacy is generally based on visual assessment. Some facilities are beginning to adopt measures beyond visual assessment such as swab-based Adenosine Triphosphate (ATP) bioluminescence, but these costly and time-consuming swab tests are not widely adopted. Studies show most LTCFs would benefit from standardized tools such as checklists, more frequent staff education including specific product use training. The main objective of this project is to bring a new auditing system to long-term care facilities that provides instant contamination detection, rapid surface disinfection of invisible contamination (e.g. body fluids, saliva and respiratory droplets that can host pathogens) and documents proof of cleanliness. We believe our Contamination, Sanitization Inspection and Disinfection (CSI-D) technology will change cleanliness monitoring standards by allowing users to see contamination, in real time, for immediate remediation. The CSI-D system is not intended to be a primary disinfection or cleaning tool; instead, it acts as a post-cleaning audit solution complementary to other post-cleaning auditing tools (ATP, FT-IR, etc.), as well as providing documentation of cleanliness. The system’s disinfection capability is intended to provide spot disinfection only during audits or incident response and not employed as a large area disinfection method (e.g. fogging). This Phase I SBIR will validate the usability of the CSI-D as a post cleaning auditing system to detect, disinfect and document residual contamination, and apply risk-mapping algorithms to improve the current management of cleanliness in LTCFs. This project is a collaboration with AI and Machine learning researchers at the University of North Dakota and Valley Senior Living in Grand Forks, ND, and Edgewood Healthcare in Fargo, ND who will provide important input to the design process and access to long term care facilities for pilot studies. Aim 1 will include building the CSI-D software for long term care facilities, including developing the software specification, software for data management, and the contamination detection algorithm. Aim 2 will include the pilot test at LTCFs, including the development of the audit inspection procedure (task list), comparing efficacy of CSI-D with visual assessment and ATP bioluminescence detection, and development of the dynamic risk analysis algorithm. Future directions: Phase II will include more extensive longitudinal studies, with up to 20 of 64 Edgewood Healthcare facilities using the CSI-D technology as an auditing tool for one year, and thereafter the facilities with SafetySpect cleanliness monitoring program will be compared with remaining sites on infection control outcomes.