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.

Friday, September 27, 2013

Porous versus Non-Porous: Who wins the trophy for most effective transmission?

The truth of the matter is any surface or fomite has the potential to transmit pathogenic bacteria, viruses or fungi.  However, the effectiveness of transmission and likelihood any surface in particular could be directly linked to transmission and ultimately lead to infection are two entirely different things.   Equate transmission to transportation.  A bicycle will get you to from point A to point B faster than walking, but the 2014 Porsche 911 Turbo which can go from 0 - 60 in 3.2 seconds is the obvious winner in terms of speed of getting you from point A to point B.

Similar to the differences in effectiveness of transportation between bicycles and sports cars, there are distinct differences in the effectiveness of transmission between hard, non-porous surfaces such as glass, laminates or smooth plastics and porous, soft surfaces such as privacy curtains, lab coats and bed linens.

There is evidence to support the fact that hard, non-porous surfaces such as tables, door handles or toilets are far more effective in transferring germs from their surfaces to the hands of healthcare workers (HCWs) than  soft, porous surfaces like fabrics.  Just using a little common sense can see how this would be true.  Fabrics, sponges and other porous, soft surfaces by their very nature have crevices, pits or divots.  What better place for germs to hide.  Have you ever used a sponge to paint or stamp?  When you apply paint to the sponge and then press it to a surface does the paint spread uniformly?  No.  There are pockets of the surface that the colour did not transfer.  The reason?  The paint was hiding in the crevices.  Similarly, these crevices decrease the effectiveness of germs transferring to hands of HCWs. 

Now picture a hard, non-porous surface such as a table or plastic touch screen.   Such surfaces do not offer the same crevices for germs to hide.  If you were to use a plastic square to stamp what would happen?  The paint would cover the surface uniformly and when you then pressed that plastic square to a surface you would get a nice, uniform square of colour.  From an infection transmission perspective a hard non-porous surface provides a far more effective transfer of germs to hands.

A 2001 study by Sattar et al. investigated how bacteria is transferred from fabrics to hands and then to other fabrics again.  I particularly like this study because the research team applied a quantitative protocol for assessing the transfer of bacteria from fabrics of 100 percent cotton and a 50-50 cotton/polyester blend to fingerpads or other pieces of fabric.  Transfer from fabric to fabric was performed by direct contact using moist and dry fabrics. Transfers from fabrics to fingerpads of adult volunteers were tested using moist, dry and re-moistened pieces of the fabrics, with or without friction during the contact. Bacterial transfer from fabrics to moistened fingerpads was also studied.  Sattar and his team concluded that bacterial transfer from moist donor fabrics using recipients with moisture was always higher than that to and from dry ones.  Further, friction increased the level of transfer from fabrics to fingerpads by as much as fivefold. Bacterial transfer from poly/cotton was consistently higher when compared with that from all-cotton material.

What does this all mean?  Well, we know that germs are able to be survive on soft surfaces such as fabrics, and certainly there is evidence that they can be transferred from fabric to hand or fabric to fabric.  But, transfer was most successful when fabric or hands were wet.  How often to HCWs touch patients with wet hands/gloves?  Are soft surfaces a true concern for infection prevention or are we simply hypothesizing that based on findings from a few studies that have show germs can live and survive on soft surfaces that such surfaces MUST then be the reservoir for all the transmission we see in hospitals?  Personally, I think not.  Hard, non-porous surfaces are still by far the most efficient in transferring and thereby transmitting disease.  I think we need to take a harder look at all of those pieces of shared patient care equipment and really investigating who is cleaning them (if in fact they are being cleaned) and how they are contributing to the spread of HAIs.

Stay tuned for next week's blog...... A New Claim on the Block!  Can you guess where I'm going with this?


Bugging Off!


Nicole


Tuesday, September 17, 2013

Cleaning and Disinfection Works!

The fall tradeshow and conference season is in full swing.  As I write this blog I am waiting for the opening ceremonies of Exchange 2013 (Association for the Healthcare Environment's (AHE) annual conference).  Could there be a better place to learn about cleaning and disinfection than a convention with delegates whose day to day responsibility is environmental hygiene?

I am not certain what I find more concerning at tradeshows; delegates running from booth to booth in search of a knight in shining armour (aka the next silver bullet) or the noise permeating from vendors as to why their product is the answer to every facilities  problems.  I wonder sometimes if in today's society where we see technological advancements as the answer to everything if we forget that sometimes getting back to basics can in fact improve outcomes as much (OR BETTER) than trying to implement some new fangled gizmo.

For that I would like to applaud Curtis Donskey and his research team for the study they published in ICHE titled "An Environmental Disinfection Odyssey: Evaluation of Sequential Interventions to Improve Disinfection of Clostridium difficile Isolation Rooms".

The research team conducted a prospective study that included three interventions: 1) the use of fluorescent markers applied to high-touch surfaces in patient rooms to provide monitoring and feedback on thoroughness of cleaning; 2) utilization of an automated ultraviolet (UV) radiation device as a complementary disinfection strategy used after cleaning; and 3) an enhanced disinfection process composed of a dedicated daily disinfection team and a process requiring supervisory assessment and clearance of terminally-cleaned C. difficile infected rooms. The study was designed in such a fashion that each strategy built on the previous one. 

In order to determine the effectiveness of the interventions, environmental cultures were obtained from rooms contaminated with C. difficile after cleaning and disinfection.  The first intervention using  fluorescent markers saw modest improvement in the disinfection of high-touch surfaces over traditional cleaning practices (57 percent versus 67 percent).  When UV devices were introduced in the second intervention there was a further reduction in the percentage of positive cultures, but C. difficile still was present in 35 percent of rooms.  However, the impact from implementing an enhanced cleaning and disinfection team dramatically improved the outcome by reducing positive cultures to 7 percent!

What?!  Did I just read that improving cleaning worked better than implementing a new fangled gizmo that we were hoping would be the answer to all of our environmental hygiene problems? 

Yup!  As the study concluded "Ultimately, disinfection was dramatically improved through formation of a dedicated daily disinfection team and implementation of a standardized process for clearing CDI rooms."

I still look forward to walking the AHE Exhibitor hall and picking up the materials on all of the latest and greatest products, but I will certainly make sure I take the time to wade through the noise of what I heard from the sales reps to make my own informed decision on what I think is the latest and greatest advancement to environmental hygiene.   I hope for those of you reading this blog, you'll go back and take a look at what your environmental services team is doing.  Perhaps you already have your knight in shining armour, he may need some polishing but perhaps you've had the answer to your environmental hygiene problems under your roof the entire time.   Let's go back to basics and remember that cleaning and disinfection does and can work.  We just need to support our environmental services staff and promote them for the heroes they really are!


Bugging Off!

Nicole


Thursday, September 12, 2013

#FF - Follow Friday!



One of the joys of travelling is never truly knowing if you're going to get home when you hope to.  Yesterday, was one such day.  Rush hour traffic was in my favour, I made it from New Haven, CT to Hartford in about an hour and even had time to enjoy a relatively "nice" dinner and glass of red wine.  Then Mother Nature hit leaving me stranded in the Bradley International Airport in Hartford, CT yesterday for 4 hours due to weather conditions - apparently it's a health hazard to have ground crew servicing planes during thunder and lightning storms.  For anyone travelling via Hartford, I would like to point out that the stores and restaurants close by 8pm!!! so, if there is even the REMOTEST chance you're plan may delayed and you may get hungry or thirsty later - stock up, even if you do not think you'll need it! 

The upside of sitting around in airports is that you get the opportunity to catch up on your reading and yesterday I had the perfect opportunity to peruse some of the blogs I loyally follow.  As introduced back in January, one of the ways we want to educate is through sharing of blogs that we think are noteworthy and worth following.  Social Media whether through blogging or tweeting or any other forum is about having a conversation on topic that is of interest to you!  The Talk Clean To Me we focus on topics related to the use of Chemical Disinfectants and Infection Prevention – this is the stuff we know and know well.  This week I’m taking the concept of #FF to the Blog-Sphere and want to introduce to a couple of blogs that I think are worth following!

CDC's Safe Healthcare where "opinions expressed are those of its authors and may not represent the official positions of the Centers for Disease Control and Prevention or the Department of Health and Human Services" shares experiences from the trenches covering virtually any topic an IP may be interested in.  You never know, you may find the answer to your current infection prevention dilemma! 

Controversies in Hospital Infection Prevention  is written by ID Docs or Hospital Epidemiologists Eli, Mike and Dan.  Touch on current topics  or newly published in Infection Prevention,  and share articles by other authors that they are worth reading.  They also include useful reference links, presentations and an extensive list of other noteworthy blogs!  Did you know that the Jumbo Squirting Bowtie was an IP's Dream attire?

Hand Hygiene, Infection Prevention and Food Safety Blog by the DEB Group, a leading company in hand hygiene and skin care products, leverages their relationships with experts around the world to provide weekly blogs on topics pertaining to hand hygiene, infection prevention and food safety.  You may recognize the blog they posted this week if you read the Talk Clean To Me blog we posted a few weeks back on School Absenteeism!
 
That’s it for this #FF!  I hope you turn on your inner geek and check out some of these blogs!



Bugging Off!

Nicole



Thursday, September 5, 2013

It’s getting harder and harder to breathe!

When I first started collecting my thoughts for this week’s blog post on Occupational Asthma and the potential contributing role played by cleaning and disinfectant products, the final lyrics from the chorus of Maroon 5’s 2002 hit “Harder to Breathe” rang clearly in my head, “it’s getting harder and harder to breathe!”.  For many professionals in the cleaning industry, this statement has the potential to ring true over the span of their careers. 

In the USA, several states conduct work related asthma surveillance as part of the Sentinel Event Notification System for Occupational Risks (SENSOR).  The surveillance system in California showed that custodians and cleaners had the highest incidence of work related asthma.  Furthermore, Rosenman et al reported that a cleaning product was 1 or more of the 3 suspected agents identified in 12% of the confirmed cases that they reviewed.  The fact that bleach was the most frequently identified product should not be all that surprising considering that bleach was recently designated an asthma-causing agent by the Association of Occupational and Environmental Clinics (Sastre 2011). 

Quaternary ammonium compounds (Quats or QACs) also tend to be frequently identified as potential asthma causing agents due to their prevalence in numerous cleaning and disinfectant products.  Michigan’s SENSOR program published a detailed report on the link between asthma and quats in their 2008-2009 newsletter (http://www.oem.msu.edu/userfiles/file/News/v20n1.pdf).  The newsletter includes several case reports and a review of several peer reviewed studies completed on the subject. 

This past summer, Massachusetts’ Dept. of Health issued an Occupational Lung Disease Bulletin as part of their SENSOR program (http://www.mass.gov/eohhs/docs/dph/occupational-health/sensor-lung-disease-bulletins/summer2013.pdf).  This bulletin further detailed the potential link between the use of certain cleaning and disinfectant products and work-related asthma but also included valuable recommendations related to the correct use of cleaning products and the consideration of safer disinfectant chemistries.  The bulletin states that “The prevention goal is to balance the two needs—to reduce infectious disease transmission without causing chemical related disease”.  Ensuring that disinfectants are not overused, unnecessarily aerosolized or misted into the air, and employed at the correct concentration are important points to consider.  The bulletin also includes reference to the consideration of safer disinfectants: “EPA’s Design for the Environment (http://www.epa.gov/dfe/) has begun promoting use of safer disinfectants that pose lower risks of adverse human effects and environmental degradation. To date, the active ingredients approved as safer include citric acid, lactic acid and hydrogen peroxide”.

In summary, where the use of disinfectants are necessary, steps should be taken to reduce the potential exposure to harmful and potentially asthma causing chemicals by considering safer cleaning and disinfectant options or by employing practices and protocols that will reduce a user’s direct contact and risk.


Hasta la vista!


The Germinator - Lee