Evaluation: Surfacide Helios UV Room Disinfection Device

• The Surfacide Helios system is used to disinfect a room after cleaning, with the goal of reducing healthcare-associated infections (HAIs).
• Major device components:
  • Mobile wheeled tower
    • Dimensions (L × W × H): 43 × 43 × 196 cm (17 × 17 × 77 in), single-emitter; 147 × 43 × 196 cm (58 × 17 × 77 in), triple-emitter
    • The manufacturer recommends the triple-emitter approach: a single-site, multiple-device approach in which the units remain in one location throughout the cycle. Alternatively, facilities may use the single-emitter approach: a pause-and-reposition approach employing one device (one cycle is completed, the unit is moved, then another cycle is completed).
    • Multiple towers can be linked to treat any size room; the configuration can be mixed and matched to include anywhere between one and five towers. Multiple units are recommended to treat patient rooms, as they reduce shadowing and increase the intensity of UV exposure—which can translate to shorter treatment times as compared to a single tower in a single location. One tablet controller is used for all linked devices, including motion sensors (described farther down).
    • Each Helios tower uses three low-pressure mercury amalgam UVC lamps. Parabolic mirrors shield the lamps and direct the UVC light in one direction at a time (approximately 60° field of view). The tower rotates slowly to emit UV light in 360°.
      • Each tower is equipped with a laser-mapping system. When the mapping mode ("Calculated Cycle") is selected, the towers slowly rotate (no UV light is emitted), using the lasers to determine the size and shape of the room. The towers then perform a second rotation, with the lasers angled downward to detect the presence of objects, like beds, chairs, and workspaces, which the system considers to be high-touch. During the disinfection cycle, the system then adjusts the rotation speed of the towers in order to deliver higher doses of UV light to these high-touch objects.
      • If a "Fixed Cycle" is selected, the system does not map the room. The user selects the desired treatment time, and the towers rotate at a steady pace.
      • Scrub feature. This capability allows users to select objects or areas for concentrated exposure to UV light. For example, light can be focused on a patient bed, work area, or OR table for rapid disinfection. Alternatively, equipment (e.g., wheelchairs) can be lined up in a storage area for UV disinfection. In Scrub mode, only the defined area (not the entire room) is disinfected by UV light. Even though the UV light can be focused in a particular direction, users and patients should vacate the room during Scrub mode, as they would during a 360° treatment.
    • Power requirements: 120 or 240 VAC, 4 A (per tower), 50 or 60 Hz
    • UVC intensity (per tower):
      • Scrub mode: Approximately 1,700 µW/cm2 at a distance of five feet
      • Averaged around 360° of exposure: Approximately 300 µW/cm2 at a distance of five feet
  • Control tablet with a touchscreen interface (see Figure 2)
    • Using a Surfacide application, the user accesses the control portal by entering a user name and password. The user selects a treatment room, then allows the tablet to search for nearby devices. They select the desired towers and motion sensors for use (up to seven devices total), and then initiate the desired cycle control approach—either calculated or fixed time.
    • The control tablet can be used to initiate or terminate cycles and monitor cycle progress from outside the room, up to about 30 feet away. Surfacide recommends placing the tablet in a "joiner" stand (described below) outside the treatment room as an indication that UV disinfection is in progress and to display the remaining time in the cycle.

c) "Joiners," which serve multiple purposes:
- Physically linking multiple towers together for transport
- Functioning as caution signs outside the treatment room (see Figure 2)
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- Automatically synchronizes treatment data from tablet controller, using either Wi-Fi or the Verizon cellular network

• Typical locations where the device is used:
  • Patient rooms--Manufacturer-recommended positions include three locations around the patient bed; alternatively, if a patient bathroom is present, users may place one tower in the entrance to the bathroom, and one tower on either side of the patient bed.
  • Bathrooms—For disinfection of the bathroom independent from the patient room, Surfacide recommends that one tower be placed in the bathroom; this can be done while the patient room is occupied.
  • Operating rooms—Manufacturer-recommended positions include three locations around the surgical table.
• Configuration tested:
  • Single-emitter approach: One Helios tower was set to run three fixed-time cycles of seven minutes. The tower was located on the left side of the bed, then the foot of the bed, and finally the right side of the bed.
  • Triple-emitter approach: Three Helios towers were set to run calculated (mapped) cycles simultaneously. The towers were located on both sides of the bed and at the foot of the bed.
  • For all cycles, the Surfacide application was set as described below. When used in a facility, these settings may vary depending on the target organisms and room size. Surfacide provides individual recommendations based on the facility's rooms and device configurations.
    • Default Energy Level (reflects the desired UV dose, which may vary by the needs of the care area or by the types of organisms that are targeted): Low
    • Default Threshold (reflects the expected radius of effective disinfection around each tower): Five feet
  • For portal testing, we accessed a...