Cleaner than humanly possible

If you approach an employee at Oroville Hospital and ask for “Trudy,” you’ll get a smile or laugh in reply.

Anyone can point out “Trudy 1” and “Trudy 2”—also known as “Cooper’s girls,” in honor of Cooper Cunningham, the administrator who recently brought them on board to bolster hygienic housekeeping. Some staff members even do “Trudy” impersonations, mimicking their distinctive phrases and tones.

The reason they’re so memorable is they’re robots.

“Trudy” is the homonym for the devices’ abbreviated name, Tru-D, which stands for total room ultraviolet disinfection. Designed to kill microorganisms that cause infections, Tru-D scans a room with eight eye-like sensors and bathes every exposed surface with UV radiation from 28 bulbs arranged in two ringed tiers.

“Our [hospital-acquired infection] rates are among the lowest around, and that’s because we do a really great job at cleaning those rooms,” said Cunningham, director of environmental services. “To have this come in and add that extra layer, to know that we’re going to bring [rates] down lower than what we’re at, there’s a lot of pride in that.”

In the most recent state report on Clostridium difficile, or C. diff—a bacterial infection that causes diarrhea and can be life-threatening—Oroville Hospital had the lowest incidence among Butte County medical centers. C. diff is one of the bugs Tru-D neutralizes.

Roy Shannon, a hospital-based physician who chairs the facility’s infection control committee, said he and his colleagues reviewed copious research before signing off on the technology. Among the myriad studies conducted on UV hygiene, one exemplified the impact. Over a 12-month period ending January 2015, the 789-bed Hospital of the University of Pennsylvania experienced a 25 percent decrease in acquired cases of C. diff in treated rooms versus a 16 percent increase in untreated rooms.

Since Oroville Hospital has utilized its Tru-D units for only one month, it’s too early to chart any meaningful data, Shannon said. Besides, he continued, “anecdotal experience from a small scale isn’t too valuable. What is valuable is looking at the literature [on] large studies from major universities, going with that sort of data, and we know from there that this [technology] is valuable.”

The medical staff evaluated UV disinfection for around eight years. Back then, a unit cost around a half-million dollars. Now, a Tru-D runs about $90,000.

Two companies make similar devices. Oroville Hospital chose Tru-D—from Tru-D SmartUVC, LLC—because it does not treat all rooms as equal. Rather than clean for a predetermined period of time, Tru-D scans each room for size, contours and surface textures, then calibrates its cycle accordingly.

“It has built-in feedback to where it very accurately determines how long you need to keep this going in a room,” Shannon explained. “The others, you just set them for a certain amount of time and guess that it was enough, or not too much. This is much more accurate.”

The machine runs anywhere from 20 to 40 minutes.

Oroville Hospital uses the Tru-D units to disinfect isolation rooms throughout the day. At night, barring an emergency surgery, the staff puts Tru-D to work in operating and procedure rooms.

“What this offers us that we don’t have now [with human housekeeping alone] is just that additional layer that covers the entire room,” said Kim Basham, a nurse who serves as director of infection control. “When you talk about people manually scrubbing walls and scrubbing items in a room, there’s always that possibility of areas getting overlooked or missed—and cracks that it is not possible for them to go through and clean.

“By putting this device in the room, you’re going to kill off all the bacteria, spores or viruses that are in that room. So, it immensely helps us, just doing that final sanitation.”

Tru-D consists of a conical pillar mounted on a rectangular base with rails and four wheels. Roughly 5 feet tall, it plugs into a wall socket. The operator controls it with an iPad.

Once plugged in and switched on, Tru-D plays an audio greeting advising the operator to prepare the room—a polite way of saying, “Get out!” The UV radiation isn’t just harmful to microbes; it’ll deliver a nasty burn to exposed skin. Window glass offers requisite protection, so the operator can stand safely in the hall and monitor progress through a door pane.

Tru-D’s two plastic outer guards come off and serve as barricades with signs warning passersby not to enter. When active, the UV bulbs glow light blue.

“Everyone is so excited to have it here,” Basham said. “The staff, they’re very excited, and I’ve had people outside of the hospital comment about it.”

Added Cunningham: “Right now, it’s hard to even run it, because everyone wants to see it. You pull it up and say, “All right, let’s get started,’ but [you hear], ‘I’ve got so many questions!’ They want to watch you. It’s like, ‘OK, don’t talk, just let us get it going; we’ll go from there.’”

“And they get really excited over the voice,” Basham injected.

“‘It talks to you?!?’” Cunningham relayed.

Just a simple series of prompts—“It’s not Siri,” he said with a chuckle.

Tru-D has added a gee-whiz factor to Oroville Hospital, but staff anticipates clinical benefits. That’s why the administration finally placed an order. Cunningham couldn’t be more pleased: “It’s a fantastic tool that we now have in our arsenal.”