Welcome to Professional and Technical Services (PTS) – experts in chemical disinfection for infection prevention. Our goal is to educate and provide you the latest resources related to cleaning and disinfection of environmental surfaces, medical devices and hands. As specialists in disinfectant chemistries, microbiology, environmental cleaning and disinfection, facility assessments and policy and procedure creation we are dedicated to helping any person or facility who uses chemical disinfectants.

Our expertise is utilized by Infection Preventionists, Public Health Experts, First Responders, Dentists, Physicians, Nurses, Veterinarians, Aestheticians, Environmental Services professionals and janitorial product distributors to develop more sustainable cleaning and disinfection practices in North America.

Our commitment to providing chemical disinfectant education is more than business, it is a passion.

Thursday, June 27, 2013

Safe, Safer, Safely, Safest - Who knew they were "Bathroom" words!


Knowing that I am likely to be mocked by my colleagues for using my son in yet another blog, I think those of you with children will appreciate this analogy. Kids are sieves.  They soak up everything you say and in particular EVERYTHING you don't want them to repeat.  In our house, these are deemed "Bathroom" words.  Aside from the obvious "bad" words, I did not realize the list of unobvious words that have now become taboo in my vocabulary such as stupid, idiot, butt or butthead, nerd or loser. I am really running out of descriptive words to use when on the verge of road rage because the IDIOT in front of me has braked for no apparent reason.  Inevitably from the back seat I hear "MOM - that's a BATHROOM word!"



From a manufacturer's perspective, EPA registration of disinfectants is a long and windy road often filled with potholes, U-turns and the occasional dead end.  It's true, there are defined test methods that a manufacturer must use to prove product disinfectant efficacy, toxicity profiles and chemistry profiles etc.  There are also a number of supporting documents that the EPA has published such as the EPA Label Review Manual and Code of Federal Regulations -  Labeling Requirements to "help" ensure that disinfectant product labels, marketing materials, advertisements, websites and even tradeshow booth graphics use "approved" language and avoid the use of "inappropriate" language.

Safe, Safely, Safer, Safest, Green, Non-Toxic, Harmless... etc, etc are wonderfully simple yet descriptive words that clearly impart in plain English a meaning that the general population can understand. These words can easily be found in the Merriam or Webster dictionary, however, in the EPA's Dictionary of Approved Words that CAN be used on Disinfectant Product Labels or Marketing Materials they do not exist. They are banned, they are taboo, they are to be avoided at all costs and if used....there can be hefty repercussions.

Unfortunately, from a consumer perspective there is no class that can be taken to learn what can and cannot, should and should not be included on disinfectant product labels or marketing materials.  "Policing" of disinfectant marketing materials, advertisement etc is primarily left to industry to monitor their competitors. Most reputable manufacturers follow the rules and ensure that they do not use words or phrases that are considered false or misleading, however, there are those unscrupulous companies that know the general consumer does not understand what can be said by law on their marketing materials and also know that "simple" words such as Safe or Harmless will resonate with the consumer looking to choose a product.  They have no qualms pulling the wool over your eyes to sell more product or position their product against similar competitive products to gain a competitive edge so to speak and make another buck.

To become a "Pro" at reading and interpreting disinfectant labels and marketing materials you certainly can use the EPA Label Review Manual or CFR Labeling Requirements regulation, but having read them myself, save yourself the trouble.  Instead when reviewing new disinfectant products ask yourself the following:

1. Do these claims seem too good to be true?  If they do, ask to see the data used to make the claims.

2. Is the wool being pulled over my eyes? Do these claims or statements seem misleading?  If so, investigate further and ask lots of questions and gather the data to support the claims.

3. Are they using "Bathroom" words?  If they are, you should question the accuracy and appropriateness of such claims.

As a consumer if you are uncertain as to the appropriateness of claims or statements made on disinfectant products and their associated marketing materials you can submit an inquiry to the EPA or just call or email me...I'd be happy to provide clarification for you!



Bugging Off!


Nicole


Monday, June 24, 2013

ATTENTION PLEASE!! ATP CANNOT be used to compare different disinfectant chemistries!

Being a Clean Freak, I'm passionate about building the science behind cleaning and disinfection.  The infection prevention guidelines we follow are built around science-based evidence so I certainly agree that the more we study, investigate, hypothesize, pontificate the more we will learn and improve upon our current practices.  However, we need to understand the limitations of some of the methods we use to build the science. 

The use of ATP meters is certainly gaining popularity and don't get me wrong, I think there is a place for their use, but in designing studies to help further the science behind cleaning and disinfection we MUST understand the limitations of some of the methods we are using. In October of last year, we posted a blog on ATP (ATP – a microbiologist’s square peg) the impetus of which was based on the realization that Environmental Service Managers and Infection Preventionists believed that ATP can be used to compare cleaning and disinfection efficacy between different disinfectants.

Truth is ATP CANNOT be used to compare the cleaning and disinfection efficacy between different disinfectant chemistries.  If you talk to suppliers of ATP meters - they agree.  This is not the intended use and such use could lead you down a slippery slope of unintended consequences.  Since October of last year our research team has worked with several of the leading companies who supply ATP meters and at the CHICA-Canada conference held at the beginning of this month presented our findings with a research poster "Evaluating market leading ATP meters for the reliability of their test results as measurement tools for surface cleanness in Healthcare applications".  The following summarizes the findings:

ATP can be used as an indicator to determine cleanliness of a surface, however there are a number of limitations with its use:

1. The measurement of ATP is not standardized:
  1. Each ATP meter has different detection limits therefore a statistical   analysis must be done to ensure that consistent results can be achieved. 

  2. No ATP meter is the same.

  3. Each ATP meter has its own minimum detection limit – if the contamination of a surface is below a certain level the ATP meter may not be able to detect it. This means that a surface can have significant contamination and have an ATP reading of zero!

2. Chemical interference from residual cleaners and disinfectants has an effect on the ATP readings:
  1. Disinfectant and cleaning chemistries can either quench – causing false low readings as seen with bleach or enhance – causing false high readings as seen with quats and anionic surfactants (detergents).

  2. There are two possible explanations for quenching:
  a. The disinfectant ingredients are breaking the ATP molecules and    thus they are no longer active/detectible;
  b. The disinfectant ingredients enter into the enzymatic reaction from the swab and interfere with the enzymatic pathways for luminescence production.

  3. The level of quenching (providing false low readings) with sodium hypochlorite (bleach) increases as the concentration of bleach increases.

  4. These chemical interferences can give misleading results that can have significant implications on interpretation of data.

3. There is conflicting evidence to support a correlation between RLUs and the bacteria left on a surface (the amount of bacteria is determined by Colony Forming Units or CFUs):
  1. Some studies show a correlation between RLUs and CFUs, other studies show a loose correlation while other studies have not examined the correlation between the two.

I completely stand behind the fact that ATP can be used to assess the effectiveness of a cleaning program but if used for quality control measures the results should be cautiously interpreted and at least periodically checked with plate counting methods.  As illustrated in our study, depending on the sensitivity of the ATP meter, even high levels of contamination on the surface may not be detected.  This can lead to a false confidence in the cleaning program.   Most importantly, ATP CANNOT AND SHOULD NOT  be used to compare cleaning or disinfection effectiveness between difference chemistries.    Different chemistries have distinctive quenching or enhancing effects on ATP readings making meaningful and accurate evaluations between cleaning/disinfectant chemistries  unreliable as the RLU readings do not account for such differences.

If you're looking to change cleaning and disinfecting products and are looking at the use of ATP to determine which product works better I hope you'll think twice!




Bugging Off!
Nicole


Friday, June 14, 2013

I survived Hurricane Andrea!

The 40th Annual APIC (Association for Professionals in Infection Prevention and Epidemiology) Conference was held in Fort Lauderdale, Florida this past weekend.   One of the privileges of my job is the ability to attend Infection Prevention conferences around the globe, the downside of course being the travel - which to some may seem glamorous and fun, but trust me, being on a plane landing as one of the cells of Hurricane Andrea is hitting the coast of Florida is far from fun. 

On second thought, I take that back, I LOVE roller coasters and actually happen to love being on a plane when we hit turbulence.  The torrential rain I could do without!

If you have never been APIC is an amazing conference that offers a wide scope of educational tracks.  I think even a non-Infection Preventionist could find a session they would be interested in!  This year, the opening ceremonies kicked off with a celebration of APIC's 40th anniversary by looking back through the years to see how Infection Prevention has evolved.  Founded in 1972 (yet another thing younger than me..) by a group of pioneering Infection Preventionists (IP), the review of how infection control evolved through the '70's, '80's, '90's and '00's was insightful and entertaining.  In the 1970's, infection control was controversial to the point that one IP was told "the only surveillance you're going to do in the future is in the checkout lane at a grocery store".  Today, every healthcare facility has a surveillance program in place with many countries around the world having laws for mandatory reporting for hospital associated infections.

The 1980's saw the birth of what we now know as Routine or Standard Precautions.  Originally introduced as Body Substance Isolation or BSI.  Nurses did not wear gloves because of the psychosocial belief taught during nursing school that gloves would make patients uncomfortable.  BSI became the risk assessment tool used to help limit exposure to body substances and limit the risk of contracting an infectious disease through contact with body substances.

As society continued to develop and use "state of the art" devices (think portable cell phones), so too did healthcare facilities. With technological advancements, new ways of transmitting diseases were brought to light.  The 1990's ushered in the era of device-associated outbreaks.  One of the first published studies in a medical journal included the review of an outbreak caused by a medical device and the understanding that investigations need to also include where corners are being cut whether it be by the device manufacture, the medical personnel reprocessing the devices or the use of single-use devices.

With the arrival of the millennium and of course SARS, infection prevention in the 2000's finally saw national awareness that HAI's were preventable and UNACCEPTABLE.  We are now in an era where we are not just looking at evidence-based guidelines to improve patient outcomes and prevent disease transmission, but focusing on implementation science to ensure that the "evidence" can be put into practice by healthcare workers for every patient.   IPs are also now understanding that their role is not only about stopping HAIs, but helping the C-suite to understand that investing in infection prevention programs, can in fact save money for a facility.

In the end, I was among 4000 delegates from around the world and 295 vendors attending APIC  not just to learn, but to share our experiences to further infection prevention. 



Bugging Off!


Nicole




Thursday, June 6, 2013

Gamification of Talk Clean to Me a CHICA-Canada hit!

For many of our readers, today is likely your first day back from the annual CHICA-Canada conference (Canada's National Infection Prevention and Control Association).   The speaker line up and breadth of topics was impressive.  Opening the conference was Dr. Martin Wale from Vancouver, BC with in inspiring talk on "Thinking Differently About IPAC: A More Strategic Approach".  The closing session was given by Sir Liam Donaldson from the United Kingdom talking about "Global Patient Safety".

The Clean Freaks "gamified" Talk Clean To Me by creating a "It's Time to Get Social" game. Each delegate was given a Talk Clean To Me button with a unique number and challenged to talk to other delegates through whatever means necessary to find their match (e.g. another delegate who had the same number on their button).  As the days progressed we had people during question period following the seminars introducing themselves and their number, we had presenters add their Talk Clean To Me number at the end of their presentations, many tweeted using the #CHICACanada2013 hashtag and one delegate used her Outbreak Management sleuthing skills to track down her match literally by following up with "contacts".  She knew the facility the person was from and quite literally tracked her down amongst the 500 plus delegates!
   

Alexis Silverman (Top Centre) found her match with me winning the grand prize of an iPad Mini.  Shirley MacDonald and Camilla Levers (bottom left) and Nancy Todd-Giordano and Barbara Catt (bottom right) found their matches and will receive free registration to the Virox Cleaning, Disinfection and Sterilization Symposium Pre-Conference Day at the 2014 CHICA-Canada conference in Halifax, NS.

Thanks to everyone who played along with us!  If you are in Fort Lauderdale this weekend for the APIC Conference be sure to drop by our booth to get your Talk Clean To Me mug and Webber Training Infection Control Posters!



Bugging off!


Nicole