# The Surface of Hospitals Intensive Environmental Load Disinfection (SHIELD) Study

> **NIH AHRQ R01** · UNIVERSITY OF SOUTHERN CALIFORNIA · 2020 · $308,717

## Abstract

SUMMARY/ABSTRACT
Finding novel strategies to reduce healthcare-associated infections (HAIs), and Clostridium difficile infections
(CDI) specifically, is a primary focus of the US DHHS and AHRQ. Improved terminal cleaning of hospital
rooms is a critical imperative to interrupting transmission of HAIs. Unfortunately, the quality of terminal room
cleaning achieved with standard hospital protocols is highly variable and inadequate. More reliable, intense
disinfection has great potential to improve standard terminal room cleaning as a method to reduce HAIs.
 HyperDRYMist is a novel disinfectant device that creates a submicron, liquid particle mist of an EPA-
approved, sporicidal, hydrogen peroxide-based, silver ion-impregnated disinfectant, which is dispersed across
all air-exposed surfaces. After an EPA-compliant dwell period, the mist settles and the air in the room clears
below EPA standards for particle safety, leaving all impacted surfaces dry to the touch. The entire process
takes 20-30 minutes. In contrast, hydrogen-peroxide vapor technology, in which the active agent is in gaseous
form and is not a liquid particulate mist, requires 2-3 hours to safely turn around a room.
 No patient or staff safety concerns of the misting process were identified despite months of use at
multiple hospitals. Most importantly, in a 6 month, pilot, cross-over study, use of HyperDRYMist reduced the
incidence of CDI from 4.2% to 0.6%; after cessation, CDI rates rose back up to 4.7% (prelim data). Thus
HyperDRYMist has strong preliminary evidence. We propose to conduct a multi-centered trial to:
1. Define the impact of HyperDRYMist on HAI rates. Los Angeles County+University of Southern
 California, Harbor-UCLA, and Olive View Medical Centers are public hospitals in LA that provide care for
 AHRQ priority populations. A 12 month lead-in period will be used to establish baseline HAI rates and
 study infrastructure, and to ship, test, prepare, deploy and train personnel on the equipment. During the
 24-month, prospective, active-controlled intervention, single occupancy rooms in the hospitals will undergo
 normal terminal cleaning by EVS with (intervention) vs. without (control) the HyperDRYMist device. After
 the intervention, the relative change from baseline in the rate of facility-onset, CDC-defined CDI between
 intervention and control rooms will be the primary outcome measure; secondary outcome measures will
 evaluate other forms of MDRO infection; a direct medical cost-benefit analysis will also be conducted.
2. Define the impact of HyperDRYMist on microbiome ecology and densities in key areas of hospital
 rooms. Microbial ecology on high touch surfaces in hospital rooms will be compared between
 interventional vs. control rooms to determine the impact of HyperDRYMist disinfection.
 This study will determine the potential for a novel method to routinely, more effectively disinfect many
more surfaces in a hospital room than is achieved with standard cleaning. The...

## Key facts

- **NIH application ID:** 10013217
- **Project number:** 5R01HS025690-04
- **Recipient organization:** UNIVERSITY OF SOUTHERN CALIFORNIA
- **Principal Investigator:** BRAD J SPELLBERG
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2020
- **Award amount:** $308,717
- **Award type:** 5
- **Project period:** 2017-09-30 → 2021-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10013217

## Citation

> US National Institutes of Health, RePORTER application 10013217, The Surface of Hospitals Intensive Environmental Load Disinfection (SHIELD) Study (5R01HS025690-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10013217. Licensed CC0.

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