Hygienic devices: Our task force fighting hospital germs

Surface specialist Martin Seifert collaborates with an interdisciplinary team of experts to develop hygienic product solutions for medical devices – supporting hospitals in their fight against hospital-acquired infections (HAI).
Katja Gäbelein
Published on March 4, 2024

Going to hospital for treatment of a serious illness only then to "catch" another serious infection while there, is a nightmare for patients. 
Yet, unfortunately, it's not uncommon.

<p>A few years ago, Martin Seifert's cousin – a man in his 30s at the time – experienced the problem first-hand. When suffering from a severe case of pneumonia, he was put on a ventilator in the hospital. In the process, he contracted a pulmonary pathogen – and was lucky to survive this additional infection, recounts Seifert, our Senior Key Expert for Surface Technology, in a grave tone: "What happened to my cousin back then is definitely one reason why the issue of hygiene is so close to my heart."</p>
Nosocomial infections are common: According to a 2022 report by the World Health Organization (WHO), out of every 100 patients in acute care hospitals, seven in high-income countries and 15 in low- and middle-income countries develop at least one nosocomial infection (also known as a hospital-acquired or healthcare-associated infection – HAI for short) during their hospital stay.
<p>On average, one in ten patients affected by HAIs dies from the infection. And where multi-resistant pathogens are involved in the infection, the death rate is even higher<sup>1</sup>. Nosocomial infections are also a financial burden on the healthcare system: because prolonged hospital stays cost money. What's more, the COVID-19 pandemic has shown just how key the issue of hygiene is in healthcare facilities.&nbsp;<br><br>"Our clinical partners do everything in their power to provide patients with a safe environment, and invest a lot of time and money in hygiene and infection prevention," Seifert emphasizes.</p>
<p>The WHO report also states that infections in the healthcare sector could be reduced by some 70 percent if efficient <a href="IPC">IPC</a> programs were in place, meaning if recommended hygiene regulations were consistently and rigorously implemented.</p>
IPC stands for "infection prevention and control". These are scientific approaches and practical solutions to prevent infections and their spread within healthcare facilities.
In the picture, we see an orange, smooth surface. The focus is on water droplets, which can be seen on the surface. Towards the back, the image becomes blurred.
Every hospital has specially trained staff and carefully designed hygiene plans. Yet, when the team of experts that Seifert helped co-found at Siemens Healthineers began to delve in-depth into the topic of hygienic product solutions in 2019, it quickly became clear that such hygiene plans are often difficult to implement in everyday hospital life.
<p>Seifert and his colleagues surveyed international clinical staff – in total over 70 radiation therapists, surgical technical assistants, laboratory technicians, hygiene officers and decision-makers from hospital management – to find out more about their hygiene challenges. And they learned a lot about a reality defined by staff shortages, economic constraints and time pressures. <br><br>The respondents described, for example, how cleaning the bores of MRI and CT scanners is such a challenge. The area is difficult to access, and the lengthy cleaning process causes unwanted downtime for such highly utilized equipment. Overall, the responses were dominated by the desire for robust surfaces, quick and easy cleaning, and clearly defined and signposted disinfection procedures, says Seifert.</p>

In the picture we see Martin Seifert tracing the surface of a device with his finger. The device has a round, open circle through which Martin is photographed.

<p>So, where's the best place to start to ensure particularly hygienic medical devices? "The topic of hygiene is very complex and multi-layered," explains Seifert: "Each individual device has a different function and is integrated into a different clinical process. Not every surface material and every surface disinfection technology is suitable for every device and every process. There are many statutory standards and regulations that we have to observe. And most of the time we have to combine multiple measures to achieve good end results."<br><br>Precisely because the topic is so complex, a whole <a href="team">team</a> of experts are needed to contribute their specialized knowledge – their "super skills", so to speak.</p>
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In addition to regular co-creation sessions with clinical partners, the team is in close contact with colleagues from all product lines and business units at Siemens Healthineers, sharing information and ideas. This enables the team to get involved right from the early phases of developing future medical devices.
<p>A hygienic product needs a specialized design. Under the leadership of Tim Richter, who heads the <a href="Industrial%20Design%20Team">Industrial Design Team</a> at Siemens Healthineers, the initiative has worked in collaboration with product designers and colleagues from research and development to develop around 60 principles for hygienic design which, during the design process, are then integrated into the respective products.</p>
Humanizing medical technology – that is the core task of our User Experience (UX) Team and industrial designers.
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<p>The goal is to design devices to make their cleaning process as easy and efficient as possible for clinical staff with the goal of impeding germ transmission and preventing the formation of <a href="biofilms">biofilms</a>.</p>
A biofilm is a collection of microorganisms that attach themselves to a surface and are connected to each other by a layer of mucus. It consists of bacteria and fungi, for example, and can promote the spread of infections.
Close-up: in a graphic line, we see design color samples of medical device surfaces in shades of gray, white and orange.

Simplify. Smoothen. Automate.

For example, developers and product designers are integrating as many wireless solutions as possible as well as touchscreens instead of control buttons. These are easier to wipe and disinfect. Overall, they have optimized the designs of components in such a way that there are as few hygiene-critical areas as possible, such as edges and gaps where germs could collect and multiply.
Surface Technology is Seifert's specialty. Over time, collaborating with suppliers and colleagues, he has put together a standardized "construction set" with state-of-the-art surface materials and layer structures. This kit can be used for medical devices: It covers regulatory requirements and can be individually adapted to the specific hygiene requirements of the given device.
<p>"In our selection testing, we examine, for example, whether the surfaces can be processed using the hygiene procedures and techniques commonly used in the clinical environment, and whether they're resistant to the cleaning agents and disinfectants commonly used in clinical applications. And we test them for <a href="biocompatibility">biocompatibility</a>," explains Seifert.</p>
Biocompatibility is the ability of a material to interact with biological systems without causing harmful effects. It is an important factor in the development of medical devices, as they are often in direct contact with body tissues.

For medical devices that are used in operating theaters and therefore have to meet the highest hygienic standards, partly functionalized coating materials are used to support the cleaning and disinfection efforts.
<p>The third main area of focus that the team is concentrating on is the validated processing, in other words the cleaning and disinfection of relevant medical device surfaces. This set of topics includes the sub-aspects of hygiene technology, hygienic workflows and hygiene testing. In the field of hygiene technology, Seifert is constantly on the lookout for new or existing technologies that can be adapted to the medical sector. In doing so, he researches numerous different approaches, for example to make the surfaces of medical devices even more robust, to simplify and automate the hygienic processing of surfaces, or to make contamination easier to recognize. <br><br>With their hygiene analyses, for instance, the team ensures that our devices meet hygiene standards for cleaning and disinfection. Seifert works closely in this area with Daniel Mach, an expert in statutory standards, hygiene directives and guidelines, and materials testing.</p>
Based on the findings from their surveys and research results, the team put together a hygienic design study that takes a look into the future of human-centered industrial design. While we unfortunately can't reveal any details here, this much can be said: Today, with artificial intelligence making more and more automation and robotics elements in devices possible, and with the growing need for automation and robotics due to the shortage of skilled workers, components that clean themselves automatically are becoming the focus of development.
Finding hygienic product solutions is time-consuming. There is no one-size-fits-all solution for all devices and areas of application, says Seifert. But it's worth the effort: "Every single person who falls ill with a nosocomial infection is one too many." And hygienically sophisticated devices can better protect not only patients, but also the clinical staff who operate them.

There's one last question we'd like to ask: Do you actually become a bit of a "cleanliness fanatic" in your private life when you deal so intensively with all kinds of creepy germs in your professional life? Seifert laughs: "My family would probably indeed say that I pay a lot of attention to hygiene. For example, it's important to me that my children wash their hands when they come home from school, and that they don't eat anything that has fallen on a dirty floor." Yet, despite this, he's adamant that his children – two boys, aged seven and nine – can and should play unrestrained outdoors in the dirt: "It's good for the immune system."

By Katja Gäbelein
Katja Gäbelein is a digital editor and content creator for multimedia content at Siemens Healthineers. She specializes in technology and innovation.