FLuorescent Imaging of Critical Cleanliness Areas – FLICCA

新冠肺炎大流行期间发生的一个主要问题是全球个人防护装备(PPE)短缺。这在很大程度上是因为疫情爆发的突发性和迅速发展到大流行状态，再加上供应链准备好适应工业和医疗保健的要求，而不是大规模的公众恐慌性购买。未来有几个解决全球个人防护用品短缺的方法：增加供应链，但这必须是可持续的，为大众市场生产不同的产品，或者更好地利用现有的个人防护装备，无论是通过重复使用还是更好地了解个人防护装备需要更换的频率。后者还通过减少浪费和鼓励更多的重复使用来帮助应对另一个全球威胁-气候变化。虽然一线医护人员显然需要适当的个人防护装备来确保自己和患者的安全，但准确评估某些个人防护装备的状态可能会对整体供应产生重大影响。虽然密切接触的个人防护设备，如手套，显然必须极端定期地更换，但对于其他形式的个人防护设备，如面罩或可重复使用的呼吸器，指南较少被禁止。这里的建议是明确的，但只是定性的(例如，损坏、污染、难以使用)。如果能够快速、可靠地评估在用个人防护设备的状态，就可以减少浪费，进一步将污染降至最低。美国疾病控制与预防中心目前的指导方针规定，在PPE的生命周期之后使用PPE比不使用PPE更可取。同样，简单的清洁程序可能足以继续使用以前被丢弃的个人防护设备。我们建议评估基于荧光成像的简单设备的可行性，以测量使用中的个人防护设备和可以在医疗保健环境中进行简单清洁过程后的个人防护设备的状态。我们进一步建议，同样的技术可用于评估去污后现场设备/设施(例如监视器、病床)的清洁度。这种设备还可以应用于食品生产行业，以确保食品制备区和包装不会通过食品供应链产生进一步的污染。随着我们项目的进展，随着大流行的卷土重来，对可持续个人防护设备的需求也增加了。然而，尽管正在开发可持续的个人防护装备，但由于缺乏质量控制技术来确认再加工的个人防护装备的适用性，使用它的能力受到了影响。FLICCA将扩展到调查该技术是否适合于质量控制，方法是参与NHS的改进，以针对一些拟议的后处理概念来指定和测试FLICCA。NHS在该项目期间提出的第二个问题是调查擦拭清洁。最初的项目是寻找表面的污染物，并通过擦拭确认它们的去除，但扩展将通过寻找擦拭残留物的荧光来检查擦拭覆盖率。这可能是确定给定表面是否已完全擦拭(并因此清洁和消毒)或是否需要进一步清洁的合适量具，类似于已使用的培训系统，但可部署在活动场所。这两个新途径将为NHS提供至关重要的功能，但也将为这项技术带来显著的额外收入来源。

A major issue occurring during the COVID-19 pandemic is a global shortage in Personal Protection Equipment (PPE). This has mostly been due to the sudden nature of the onset and rapid progression to pandemic status, coupled with a supply chain prepared to accommodate the requirements for industry and healthcare, rather than mass public panic buying. There are several solutions to this global shortage going forwards; increase the supply chain, but this must be sustainable, produce different products for the mass market or make better use of the available PPE, either through re-use or better understanding of how often PPE needs replacing. The latter also helps combat another global threat, climate change, by reducing waste and encouraging increased re-use.Whilst front line healthcare professionals obviously require appropriate PPE to ensure their own and their patient's safety, accurately assessing the state of certain PPE could make a substantial difference to the availability as a whole. Whilst close contact PPE, such as gloves, must obviously be changed with extreme regularity, the guidance is less proscribed for other forms of PPE, such as face shields or reusable respirators. Here the advice is clear, but only qualitative (e.g. damaged, soiled, difficult to use). If the state of in-use PPE could be assessed quickly and reliably, waste could be reduced and contamination further minimised. Current CDC guidelines state it is preferable to use PPE beyond its lifetime rather than go without. Similarly, simple cleaning procedures may be sufficient to allow continued use of PPE that would previously have been discarded.We propose to assess the feasibility of producing a simple device based on fluorescent imaging to measure the state of in-use PPE and PPE after simple cleaning processes that could be carried out in a healthcare setting. We further propose that the same technology could be used to assess the cleanliness of in-situ equipment/facilities after decontamination (e.g. monitors, beds). This device could also have applications in the food production industry to ensure that food preparation areas and packaging produces no onward contamination through the food supply chain.As our project progresses the need for sustainable PPE has risen with the resurgence of the pandemic. However, even though sustainable PPE is being developed, the ability to use it is compromised by the lack of quality control technologies to confirm the suitability of reprocessed PPE. FLICCA will be extended to investigate if the technology is suitable for quality control by engaging with NHS Improvement to specify and test FLICCA against some of the proposed reprocessing concepts. A second issue, proposed by the NHS during the project, is to investigate wipe cleaning. The original project is looking for contamination on surfaces and confirmation of their removal through wiping, but the extension will examine wipe coverage by looking for fluorescence of the wipe residue. This may be a suitable gauge to ascertain if a given surface has been fully wiped (and thus cleaned and disinfected) or if further cleaning is required, similar to the training systems already used, but deployable in active sites. These two new avenues will provide vital functionality to the NHS but also significant additional revenue streams for the technology.