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.

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Wednesday, December 24, 2014

A Year in Review

I remember my mom telling me as a teenager, the older you get the faster life goes....it seems that she was telling the truth!  It's hard to believe that another year is coming to an end and that Lee and I have managed to post 50 more blogs!
2014 was certainly the year of the outbreak with Porcine Endemic Virus  and  Ebolavirus  rearing their heads in North America, Enterovirus D68 infecting hundreds of children and vaccine preventable diseases such as Measles showing up in schools and Mumps hitting our beloved NHL teams this fall.
This past spring our team put together a marketing campaign to highlight the importance that there is more than just what a product kills to consider when choosing a disinfectant.  Affectionately referred to as the OMG! We have an HAI! campaign, we compiled many of our blogs that we had previously written and added some new ones to tell as story and even put them together in our first published Talk Clean To Me blog book!  Starting with The little devil or the little angel, we set the stage with the fact that at times the metrics used to choose a disinfectant (e.g. what it kills or what it costs) can at times be flawed making it very difficult for infection prevention or environmental services to make a business case for changing products.  The first chapter if you will focused on Premature Evaporation and the fact that many disinfectants dry on surfaces before their contact times as listed on the label is achieved which can have a direct impact on killing the bugs you were intending to kill!   Basically, if your disinfectant leaves you dry, your healthcare facility may be left unprotected against the spread of HAIs. Chapter two looked at Disinfection Dysfunction and the fact that we are frequently not achieving disinfection compliance with our One and Done mentality.  If we rely on a single wipe and walk away assuming disinfection has occurred we are not complying with the use instructions on our disinfectants and can leave ourselves vulnerable to being cited during our accreditation audits. Chapter three titled No Glove, No Love discussed one of my favorite topics around disinfectants - user safety!  Many of the disinfectants products we use pose a risk to our staff (EVS, Nursing or Clinical) and require the use of PPE.  In fact, among nursing professionals, workplace exposures to cleaning and disinfecting products increase the risk of occupational asthma.   Quats and Bleach being the leading chemicals contributing to not just occupational asthma, but neurological complains such as headaches or dizziness and eye and skin irritation.  We wrapped up the book with Gotta Be Wet to Disinfect providing a check list of how to assess and compare disinfectants to ensure you choose the best one for your facility.
This fall we spent some time dissecting Drs. Rutala and Weber's article Selection of the Disinfectant (ICHE July 2014).   Written over three weeks, I'll take Kill Claims for $200, Slippery When Wet, the Importance of Contact times and Over Easy, Why safety profiles and ease of use will improve disinfection this landmark article that embodies the attributes that anyone who is choosing a disinfectant should consider. 
Closing out the year, I spent a few weeks on apathy.   Please accept my condolences was a personal piece written after a friend lost her mother to C. diff.  You hope you do not have to attend a visitation due to such an unnecessary loss but it seems to the be the fact life.  A fact of life so prevalent, that I had ANOTHER friend lose a loved one.  Her mother passed from a Staph infection following a routine procedure.  The funeral was today.....two days before Christmas.
My hope is that 2015 will bring us wisdom, strength and courage.  Wisdom to realize that we cannot continue on with status quo.  Strength to fight for what we know is right and courage to not back down in the face of adversity and put our patients and their lives first.
Wishing everyone a Happy Holidays!  Thank you for reading our Talk Clean To Me blogs. 
Bugging Off for 2014!

Nicole

Friday, December 19, 2014

Mumps, Men and Moaning

If you're a hockey fan, you are probably well aware of the mumps outbreak going on in the NHL.  I'm a football fan....so I had no clue, not until Canada's beloved Sidney Crosby came down with the mumps this week.  That announcement hit my Facebook stream like a cross check from behind....

The outbreak seems to have started among the Anaheim Ducks in mid-October.  The Ducks played the Minnesota Wild, the Wild then played the St. Louis Blues, the Blues played the Rangers....and so forth and so on.  Apparently, the Ducks missed the alert sent from the local health unit that had been issued in September.  With the announcement of Crosby falling victim, the official tally of confirmed cases in the NHL is 13. 

As noted by the transmission within the NHL, mumps is a contagious infection that is caused by the mumps virus.  It spreads from person to person via droplets of saliva or mucus from the mouth, nose or throat of an infected person, usually when the person coughs, sneezes or talks, but I suppose spitting would work too!   The mumps virus can also be spread indirectly when someone with mumps touches items or surfaces without washing their hands and if someone else touches the same surface and rubs their mouth or nose. 

The incubation period of mumps can range from 12 - 25 days so the chances are highly likely that a few more NHL players will end up with mumps for Christmas and be wishing they got a lump of coal instead!   People with mumps are considered most infectious a few days before the onset of the characteristic swelling of the parotid glands to 5 days after their glands begin to swell.  As a vaccine preventable disease, mumps is generally rare in North America.  In 1964 there was an estimated 212,000 cases while in 2012 only 229 were reported.  While people who have had mumps in the past are considered to be protected for life, there are a few unlikely individuals who are infected again.

The best way to prevent the mumps is by being vaccinated.  Two doses of the vaccine provides a 88% effectiveness in prevention the disease.  Other means to prevent infection include minimizing close contact with infected individuals, ensuring those infected stay at home and limit contact with others, frequent hand hygiene, covering your mouth and nose with a tissue when coughing - or sneezing or coughing into your sleeve, refrain from sharing drinks or eating utensils and regularly clean surfaces that are frequently touched with a registered disinfectant.

Environmental hygiene is particularly important as the virus can live on contaminated surfaces (e.g. door knobs, faucet handles, light switches....locker room benches) or personal items (e.g. cups, utensils or water bottles) for hours or days.  These surfaces can help spread the virus to those who are not immune, especially if there is sharing of contaminated items or touching of contaminated surfaces and then touching your eyes, nose or mouth.  Perhaps the NHL needs to look at their cleaning and disinfection programs within the locker room and personal hygiene measures while sitting in close proximity on the bench.   An interesting thought (being a new hockey mom), since I know firsthand that covering your mouth while wearing a hockey helmet can prove to be difficult!

Bugging Off!


Nicole

Friday, December 12, 2014

#FF - Follow Friday

There are times when I think I have a great idea for a blog, but know that it is sometimes best to allow the idea to "percolate" to ensure that I temper the message.  The idea I had for my blog this week was based on a question from the field.  A question so outrageous that following the last three weeks' focus on Apathy,  the title that popped to mind was "From Apathy to Stupidity".....    I think I will need to "percolate" a little more as I think the title needs to be tempered..   I will say however, that there are times that the hoopla created by media, can make people take leave of their senses which leaves Infection Preventionists, the EXPERTS in understanding outbreak management, to be chasing after information that is distracting them from more important tasks.

So, as it's been awhile since I have written a #FF blog and I love being able to share and promote great blogs and great bloggers, here are some blogs and/or blog entries that I think you should check out!

Virology Down Under - VDU's Blog is a blog I was recently introduced to thanks to Twitter and @McKayIM.  Aside from having great blog topics, if you take the time to look at their website you will find a wealth of information on viruses.  Be sure to check it out!

Deb's Hand Hygiene, Infection Prevention and Food Safety blog is not new to our #FF list, but as we are closing out the year and the blog had a posting on the Top 10 Hand Hygiene Articles in 2014 I thought I would share as what better way to catch up on your reading then when someone has summarized it all for you!

Pathogen Perspectives, a new blog (e.g. launched in 2014) written by Heather Lander (@PathogenPhD) is dedicated to exploring the world of emerging infectious disease - and as one would expect, has focused much time and effort on Ebola.  I thought this was a perfect addition as my "question of the week" relates to Ebola.  I would definitely be checking this blog out in detail! 

I hope you'll check these blogs out!  Don't forget it's Friday so #FF and tweet!

Bugging Off!


Nicole

Friday, December 5, 2014

Hey! Hey! Ho! Ho! Apathy has got to go!

As mentioned last week, the original focus of my blog was going to be on the apathy of some or many (depending on your perception) toward the importance of cleaning and disinfection and the impact that choosing the right disinfectant can have on HAI rates or patient and employee safety.To some apathy may seem too strong or harsh a word to use in describing people's perceptions of cleaning and disinfection. Apathy implies a lack of interest, a lack of concern or a state of indifference. Certainly, there are many who, like me are wildly passionate about the importance of cleaning and disinfection and choosing the ideal disinfectant.  The truth remains, however, that there are just as many people who do not care. There are just as many people who believe they cannot effect change so do they nothing, and just as many people again that plainly think cleaning and disinfection is someone else's responsibility.

The event that started me down this discussion of apathy was a death.  A death that should not have happened. A death that could have been prevented with proper cleaning and disinfection and proper hand hygiene. It's ironic that more than 195 years ago Semmelweiss identified the importance of hand hygiene and the role that it can play in stopping the spread of infections. It was certainly a tenet that was taught to my mother in nursing school, yet one that we still struggle today with actually doing. We know we should, yet we too frequently make excuses for why we did not. 

When it comes to cleaning and disinfection we are no better.  In a study published in 2013, Donskey conducted a review of the literature to determine if we had sufficient evidence to prove that improved cleaning and disinfection could reduce HAIs.  Donskey concluded, "although the quality of much of the evidence remains suboptimal, a number of high-quality investigations now support environmental disinfection as a control strategy. Based on these data, current guidelines for pathogens such as C. difficile, MRSA, VRE, and norovirus emphasize the importance of environmental disinfection as a control measure."  It's not rocket science.  In fact I was in a facility today that has seen a reduction in their HAIs by changing to a more effective disinfectant and improving their cleaning practices. They understood the need to improve their cleaning and disinfection practices, empower their staff to take pride in their cleaning and disinfection and are now reaping the rewards of reduced HAIs.  Certainly a far cry from the facility who, "doesn't care what product is used because they're not the ones paying for it".

I wonder, would we still make excuses or still be apathetic if we were forced to apologize to the patient who is suffering from an HAI, or to a family member that lost a loved one as a result of our indifference toward hand hygiene or cleaning and disinfection? As parents we teach our children to own up to their mistakes and apologize for their bad behavior. Perhaps it's time we were made to own up and apologize for our bad behavior.

Just do it! Hand Hygiene works.  Cleaning and disinfection works. Let's stop being apathetic. Let's work together to effect change. 


Bugging Off!

Nicole


Thursday, November 27, 2014

Apathy: A Tale of Two Cows

My intent for this week's blog was to continue along the vein of apathy in our healthcare system when it comes to cleaning and disinfection, the use and choice of products and instilling compliance regarding their use to ensure positive patient outcomes.  Nothing spells apathy to me then hearing someone say "I don't care what disinfectant we use, you're the one who pays for it".... it was then that the narrative for the blog started forming.

And then I came across The Center for Disease Dynamics,Economics and Policy's blog titled "A tale of two cows: Why we have a cowmap and not a healthcare acquired infection map".  Now that I have sufficiently recovered my composure after reading the blog, I knew I had to share.  My discussion on apathy as it relates to cleaning and disinfection will have to wait until next week!

Drs. Saman and Kavanagh eloquently weave a satirical tale using the agriculture industry's ABILITY to account for EVERY cow in EVERY county in the US comparing it to the healthcare industry's INABILITY to agree on how to define or how to account for every HAI that occurs within their facilities.  The following is an excerpt that I hope will entice you to read the full blog:

"First there was intense disagreement on what a cow is.  Not everyone used the same definition.  Some farmers defined cows as black-haired mammals with at least four white spots, while others defined them as four-legged mammals with three black spots. Confusion certainly prevailed.  Some farmers asked whether cows in ponds are counted the same as cows eating grass.   It was then decided to only count cows standing in streams.  Called Cow Stream Infestations (CSIs) or cowteremia, this classification provided data that some praised and all could agree upon.  But the CSIs occurred so infrequently that meaningful comparison between farms could not be made."

Perhaps I found the comparison so vastly amusing because I grew up on a beef farm and knew how many cows we had, what breed (or crossbreed) they were, and what calf belonged to what cow going back three generations... 

Drs. Saman and Kavanagh summarized by stating "We believe our vision of cow counting utopia, applied to HAIs, can contribute to reducing unnecessary and mostly preventable infections and deaths.   This satire is not about public reporting, for that introduces another plethora of excuses of why it cannot be done.  The satire is about having the data for action, for community and federal response to a large and dangerous epidemic in our nation."

If we are to stop the spread of HAIs we need to work together to agree to black and white definitions.  The definition should not be defined in such a manner as to shed a "better" light on our facilities.  The definitions should be set to allow for clear classification, clear identification and clear means to create an action plan on how to improve.   Are we being apathetic towards the true concern of HAIs due to our inability to create clear definitions that everyone agrees to use?  What do you think?

Bugging Off!



Nicole

Thursday, November 20, 2014

Please accept my condolences

There are times when I hate knowing what I do about infection prevention. A few weeks ago a friend reached out to learn more about C.diff.  Her mother-in-law had gone to the hospital with an UTI and pneumonia and contracted C.diff.  We talked about transmission, proper cleaning and the need to ensure that proper hand hygiene was being followed - as in if you didn't see the nurse or doctor squirt some hand sanitizer into their hands, ask them to do so!  We were going to meet so I could give her some disinfectant wipes that the family could use in the room to clean the bedside rails and other high touch areas.

We never met so I could give her the wipes.  Instead last week I attended a visitation. Her mother-in-law at the age of 67 had died of an HAI and her sons, 4 and 6 were wondering what was going on and asking when Grandma was coming back. A life was lost, senselessly. There was a break in infection prevention. Another statistic can now be added to the growing number of deaths that occur each year due to HAIs.

I'm really not sure where to begin.  I think we all know what C. diff is.  Lee wrote a blog about C.diff back in 2011 that includes links to fact sheets and guidelines.  I think we all also know that cleaning and disinfection works to stop environmental transmission. In Sept of last year in a blog titled "Cleaning and Disinfection Works" we reviewed a study looking at just that. In fact, cleaning alone can remove sufficient spores from the surface to minimize transmission (refer to our blog "SOS- Spores on Surfaces"  that reviewed a paper by Rutala et al).

It's really not that difficult. 

  1. We need to wash our hands following the principles of the moments of hand hygiene: BEFORE touching a patient, BEFORE an aseptic procedure, AFTER body fluid exposure risk, AFTER touching a patient and AFTER touching the patient's environment.  
  2. We need to clean and disinfect the patient's environment thoroughly and frequently using elbow grease, taking enough time to do the job correctly and not cutting corners because the surface looks clean to the naked eye or because someone is pressuring the housekeeping staff to "hurry up".
  3.  We need to clean and disinfect shared patient care equipment every time after each use.
  4.  We need to practice judicious use of antibiotics.

Sometimes the loss of a single life can be the catalyst for change.   As expressed by Mary Elizabeth Frye in a poem in 1932 "Do not stand at my grave and cry; I am not there. I did not die."  Let's not accept loss of life from an HAI as the cost of doing business.  Let's not accept the fact that while there was a death due to an HAI the overall  facility's infection rates are below their standard baseline or lower than similar facilities in the area. Let's work together to target zero. Let's work together so that you do not have to attend a visitation for a friend or family member who was one of the unlucky ones.

Bugging Off,

Nicole


Friday, November 14, 2014

Keypad or Touchscreen: Which is the Lesser of Two Evils?

The fact that cellular phones and other mobile communication devices can become contaminated with potentially pathogenic organisms is not new. To my knowledge, the Brady article, “Is Your Phone Bugged”, from the American Journal of Infection Control was first to identify these devices as potential reservoirs for pathogens.  Even when cellular phones were banished from hospitals, Brady discovered that up to 25% of healthcare workers’ personal phones were contaminated with healthcare-associated microbes, including MRSA and VRE.  As concern about disturbance of electromagnetic fields diminishes - even airlines allow us to keep our phones and tablets on -  mobile phones and other such high-touch communication devices are making strong inroads to acute care settings. Their presence is generating new studies on the infection transmission risk associated with their use.

A group from University College London published an article in the Journal of Infection Prevention, comparing keypad phones to touch screen phones, particularly in an acute care hospital setting (“Keypad mobile phones are associated with a significant increased risk of microbial contamination compared to touch screen phones”,). The authors observed that the majority of healthcare professionals use the same mobile phone inside and outside the workplace, and thus risks contamination to other departments, hospitals, and the community. Many of the phones in use today have touch screens with a solitary smooth surface, as opposed to a keypad with separate buttons and numerous crevices. The authors postulated that, of the two styles of devices, bacterial contamination would be lower on touch screen phones.

Even in this rather small sampling, the results were telling.  Nine of the 67 samples grew either MRSA or VRE, all but one of those being from keypad phones. All of the “on-call” phones were keypad models, which might have skewed the results, since 40% of these phones showed MRSA or VRE contamination. Of the touch screen phones, 17 were iPhones, none of which were contaminated with potential pathogens.  To confirm their results the authors repeated the study in another hospital, and with a larger sampling of 126 touchscreen phones, and 47 keypad phones. This second facility had a lower baseline MRSA rate than in the first hospital. In this second attempt, 5 of the touchscreen phones (4%) were contaminated with MRSA. None of the keypad phones were contaminated with MRSA or VRE, but overall the bacterial colony counts were higher with keypad phones.

The authors concluded that touchscreen phones have lower bacterial colonization when compared to keypad phones. Keypad mobile phones were more likely to be contaminated with higher colony counts of bacteria, and the majority of drug-resistant bacteria were isolated from keypad phones. The keypad is the area in contact with the fingertips, and intermittent handling of mobile phones during and between patient consultations is a means for transmission and conceivably reduces the effectiveness of hand hygiene.

I suppose I should be "happy" that my iPhone and iPad, which are frequently played with by my 5-year son, would be expected to have fewer bugs than similar devices with keypads. That is, at least before he got his hands on them!  But moving outside of the hospital where the frequency of cleaning and disinfection does not occur with the same frequency, what level of contamination would we see?  I shudder at the thought of the level of contamination to be found on the keypads of debit machines.....how many times have you paid for groceries and then proceeded to have a snack on the way home without cleaning your hands first? To that I can answer....not anymore!


Bugging Off!
Nicole


Friday, November 7, 2014

Just Clean It!

I love writing, but admit there are times when I stare my computer screen watching my cursor flash on a blank page waiting and hoping for inspiration to hit. Last month I was in Tampa, FL at AHE's annual conference - Exchange 2014.  One of the sessions I was fortunate to attend was "Disney's Approach to Service and Culture" given by Patrick Jordan, a "cast member" (aka employee) at Disney. Part of the descriptor behind the session was, "It starts with extraordinary attention to detail in hiring and training, which ensures Disney on-boards people who fit the culture and consistently do what their roles ask of them.....you will gain insights to help you not only hire the right people, but also develop them into employees who are comfortable in their roles and know their purpose."

Wow.  Is this not the struggle all employers face daily regardless of the market they are in?  

From a cleaning and disinfection perspective in particular, nothing could be truer. We struggle daily with cleaning and disinfection of environmental surfaces and shared patient care equipment. Cleaning and disinfection is critical to reduce the risk associated with pathogens, and yet often times we find there are not clear roles and responsibilities as to who does what, when it needs to be done, and how to do it. Inevitably someone is breathing down someone's neck yelling "Just Clean It!" or "Why is it taking so long!"

We know there is strong evidence to demonstrate that daily cleaning and disinfection of surfaces in a patient’s room, such as bed rails, can significantly reduce the transmission of pathogens to healthcare workers' hands.  We also know that there is evidence to prove that a room previously occupied by a patient with a multiple drug resistant organism significantly increases the risk of the next patient to acquire an HAI. If we have proof to show that the investment of time for daily cleaning and disinfection of environmental surfaces and shared patient care equipment can decrease the risk for coming in contact with a pathogen and prevent the transmission of HAIs, why do we struggle so much to do it?

Could the answer be as simple as, "It’s not the magic that makes it work; it’s the way we work that makes it magic.”  Perhaps we need a paradigm shift in our thought process.  What if we stopped chasing after the silver bullet - that disinfectant that kills everything, that room decontamination device that we use as a fail-safe measure because we do not trust our staff to do the job they are supposed to do the first time? What if instead we focused on ensuring that we are hiring the right people?  Where we ensure that the people we have hired are comfortable in their roles, understand what they are expected to do, and know how important their job is and its impact on the health and well-being of the patients, colleagues, and other employees. 

What would HAI rates look like in a facility that had 100% compliance in cleaning and disinfection of environmental surfaces by housekeeping staff?  What would the HAI rates look like in a facility that had 100% compliance in cleaning of shared patient care equipment? 

Perhaps you'll join me next week on Wednesday November 12th for a webinar hosted by ICT as part of their Science Summit on Emerging Pathogens Disinfection Toward Perfection.  The webinar will address potential challenges faced in cleaning and disinfecting of healthcare surfaces and equipment, and strives to outline how these challenges can be overcome using evidence-based practice and thought leadership.

Personally, I think it's the work that makes it magic.  The magic of marrying people with products and processes!

Bugging Off!

Nicole

Wednesday, October 29, 2014

Have Wheels? Will travel....including invisible hitchhikers!

In recent years, there has been considerable focus around cleaning and disinfection by environmental services staff (EVS) as we become more in tuned with the risks associated by direct or indirect transmission mission due to a contaminated environment.  EVS have been audited, have received training and feedback and have I am certain been reprimanded for neglecting to clean and disinfect one, two or more high touch surfaces.   I know for fact, some of these surfaces get missed as a result of the pressure they get for trying to turn over rooms as fast as possible.  In the end, I think we would all agree that having a well trained staff, having an auditing and feedback process and a management team that genuinely appreciates the work EVS does as part of a facility's infection prevention program helps to ensure that EVS are doing the best job possible.

At the other end of the scale are the nursing and other clinical staff who utilize patient care equipment - particularly the portable kinds, on wheels, that can easily move from place to place.  While there have been outbreaks associated with contaminated patient care equipment, there has not been as much focus on who cleans said equipment with what frequency or how to audit to ensure that cleaning and disinfection is in fact occurring.  The best example I have of this, and one that I have used for years to highlight the importance of developing roles and responsibilities of who cleans what is what I will refer to as the "case of the poop splattered commode".

Imagine a facility, dealing with a C. diff outbreak, who utilized commodes in semi-private rooms as their way of maintaining private bathrooms.  This facility had an audit program in place using UV reflective markers and was in the process of conducting a clinical study.  In one room, for 5 days the underside of the commode seat was marked and the researcher noted there was fecal matter on the rim of the commode bowl.  For 5 days, the commode did not get cleaned.  There were 5 distinct UV marks that had not been removed or even smeared to show some form of wiping had occurred...  Long story short, when EVS and Nursing were brought together to determine what was going on, EVS stated "a commode is on wheels, therefore is a patient care device that should be cleaned by nursing" and nursing stated "a commode is a toilet, which is a surface that EVS should be cleaning".  Clearly, no one had thought to sit down and define who cleaned what.

It for this reason that Havill et al's study titled "Cleanliness of portable medical equipment disinfected by nursing staff" is so interesting.  This facility has taken the time to clearly define roles and responsibilities for what items need to be cleaned and disinfected between use by nursing and clinical staff.  The researchers sought to find out if they were to audit for cleaning compliance and provide feedback, if like the improvements they had found in their EVS staff could they improve the cleanliness of patient care equipment.

During unannounced visits, mobile medical equipment used for patient's vital signs were sampled using ATP (Adenosine Triphosphate Bioluminescence) as well as environmental cultures.  Sites tested included: the control button on the blood pressure unit, thermometer, BP Cuff, machine handle and pulse oximeter.  The results found that these pieces of patient care equipment were frequently contaminated with organic material as well as aerobic bacteria.  While VRE was not found on any of the sites sampled, MRSA was found on several surfaces.  The study showed there was a wide variation in cleaning compliance despite polices that clearly outlined who was responsible for cleaning and disinfection.  Similar to results found with EVS staff, implementing an auditing program and periodic education of nursing and clinical staff may be beneficial.

Which leads me back to the title of the blog - Have Wheels?  Will Travel.   Do you know the cleaning and disinfection compliance rates for patient care equipment at your facility?  Or better yet....are you confident that everyone knows who is responsible for cleaning and disinfecting what?  You never know where your "dirty commode" may turn up!



Bugging Off!

Nicole

Friday, October 24, 2014

Will you take the Infection Prevention Challenge?

For everyone who organized events for Infection Prevention Week, I hope you were able to educate, engage and enjoy in the fruits of your labors! I thought I would end the week with a little Infection Prevention Trivia  to get people to play along. The first person to respond back via the Talk Clean to Me blog, Twitter (@ViroxAHP and @nicolecronkenny), Facebook (the Virox Corporate page) and the Talk Clean To Me LinkedIn group we'll send you a Talk Clean To Me mug! Good Luck!

 1. True or False: If you wipe a surface and it does not stay wet for the contact time that has been indicated on the disinfectant product label, disinfection is NOT being achieved!

 2. True or False: The amount of liquid being released on a surface and the saturation level of a wipe can be different depending on the type of wipe substrate. 

 3. True or False: Ebolavirus is caused by a non-enveloped virus and is less susceptible to disinfectants. 

 4. What HAI am I Riddle: The main symptoms I show are wounds or sores. I've been a problem in healthcare for 20 years or more. I can live in the nose and reside on the skin. And I cannot be killed with methicillin.

 5. What HAI am I Riddle: I'm one of the worst of the GI infections. I cause diarrhea and vomiting projections. I'm a hard to kill virus found in healthcare and cruise. So you must be wary of the disinfectant you use.

 6. Guess the bug!






7. What's on the inside of a clean nose?


A heartfelt thank you to all of the Infection Preventionists for the work you do in keeping us safe!



Bugging Off!
Nicole


Monday, October 20, 2014

IIPW - A time to celebrate and educate!

The concept of Infection Prevention and Control week was first established in 1986 by President Ronald Reagan, with APIC spearheading the effort to highlight the importance of infection prevention among healthcare professionals, administrators, legislators, and consumers. In Canada, Infection Control Week originated in 1988 to highlight infection control efforts in Canadian hospitals, long-term care facilities and in the community.  Over the years, this week of recognition has vastly expanded to every corner of the globe, including Australia, the United Kingdom, the Middle East, and Southeast Asia.  As the reach of IIPW widens, more patients benefit from safer healthcare practices and reduced threat of healthcare-associated infections.

International Infection Prevention Week (IIPW) falls the third week in October and is an opportunity for infection control professionals to educate staff and the community about the importance of infection prevention and to promote the important work that was being done by infection control professionals in a visible and fun way.  Infection Prevention and Control programs are widely recognized as being both clinically effective and cost-effective in preventing and controlling the spread of infections in health care settings.  Infection Prevention and Control programs protect clients/ patients/ residents and staff alike by preventing infections before they occur. Such prevention results in better clinical outcomes, fewer healthcare associated infections, reduced length of hospital stay, and less antimicrobial resistance, resulting in important cost saving for the health care system.

In keeping with the theme of education the following are a handful of webinar, teleclasses, on-line or media-based events occurring this week or are available as recordings free of charge:
  • Topic:  Updated Ebola Infection Prevention and Control Guidance
    • Date / Time: October 21st, 11am EST
    • Link: http://webinars.apic.org/session.php?id=14754
  • Topic: Ebola Crisis 
    • Date/ Time: October 21st
    • Link: CBC is dedicating the day to Ebola with on-line, radio and television coverage throughout the day 
  • Topic:  Infection Prevention in Outpatient Oncology Settings 
    • Date/ Time: October 23rd, 1:30pm EST
    • Link:  http://www.webbertraining.com/schedulep1.php?command=viewClass&ID=1204 
  • Topic:  Cleaning and Infection Prevention Webinar

  • Topic: Free Webber Training Teleclasses  
    •  Date / Time: Pre-recorded  
    • Link:  https://webbertraining.com/recordingslibraryc4.php 
To get you in the mood for the week here are a couple of Infection Prevention word scrambles and brain teasers.  Are you up to the challenge?
 
 




In keeping with IIPW being a week of education we will be posting blogs on Wednesday and Friday as well.  Stay tuned as you have a chance to win a Talk Clean To Me mug!

Bugging Off!
Nicole

Tuesday, October 14, 2014

Over Easy: Why safety profiles and ease of use will improve disinfection

This week is the third and final installment of the dissection of Drs. Rutala and Weber's "Selection of the Ideal Disinfectant".  Before I get into the discussion of the last three sections "SAFETY, EASE OF USE and OTHER FACTORS", I hope that we can all agree that disinfection of non-critical environmental surfaces and patient care equipment is key to a successful infection prevention program.

From Burnt Bums and Occupational Asthma, to the Necessary Evil of PPE and Unintended Consequences of Improving Infection Prevention, the  Talk Clean To Me blog has hit on numerous topics around the health, safety and surface compatibility (or surface safety) of disinfectants.  As noted in the article "products should be nontoxic and should not cause harm to users, patients and visitors."  To meet this criteria, a facility should chose a product with the lowest toxicity rating, e.g. one that does not require PPE, one that can be used without restriction, one that is not flammable or combustible and one that will not cause temporary or permanent harm to staff. Further, we need to look at disinfectants from their compatibility perspective.  By this I do not mean that the product has to have the longest list of approved medical devices, because the truth is, not all medical device manufacturers are willing to invest in the time to validate newer, safer and more effective technologies. Instead look for a product that has been proven to be compatible with a wide range of materials that are commonly used in the manufacturing of medical devices and routinely used for the interior environmental surfaces such as plastics, stainless steel and other materials...like mattress pads.

While focusing on what a product kills is great - theoretically speaking the ugly truth is that it does not matter one iota what a product kills if staff cannot tolerate using it and patients complain of the smell. Never underestimate the odor profile of a product, something that smells like roses to one person may smell like pig poop to another! The easier the product is to use, the greater the chance that staff will use it as intended, ensuring compliance is met.  Compliance is the key to ensuring a successful environmental hygiene program.  For convenience sake as well it is easier to have a product that comes in various formats such as different sized wipes for the task at hand.  Of course in the "ease of use" perspective, products that have detergency properties to aid in cleaning and soil removal, are effective in the presence of a soil load, and have an extended shelf life once diluted and can be used with a number of different wipe substrates without interaction (e.g. no quat binding) are also areas to consider.

The last area to consider in choosing a disinfectant are some of the value added attributes if you will that may come with the product, such as what training programs the vender will provide. Although these are generally free, one thing for certain is that maintaining training programs is an area that all facilities struggle with.  Additionally, do the vendors provide the dilution systems or wall brackets for wipes free of charge and do they provide a maintenance program for the dilution systems once installed?  Remember, dilutions systems are like cars and need routine maintenance to ensure they work.  I have seen more than one facility attribute an outbreak due to poorly maintained dilution systems.  Then there are the questions such as what does the product cost, how many litres or gallons of product or how many wipes need to be used.  Those are the easy numbers.   As one IP recently told me "cost avoidance is not holding a lot of water" and certainly, determining the "soft" or "indirect" costs such as HAIs avoided or decrease in Occupational Health and Safety claims can be more difficult to prove, but if you can show how much a facility spent year over year on HAIs or Occupational Health and Safety issues..those numbers add up and those numbers are NEVER included in someone's budget!

In the end, the truth is that the perfect disinfectant does not exist.  However, by following the straight forward recommendations of Drs. Rutala and Weber and looking at the selection of a disinfectant from a holistic approach - finding the balance between efficacy and safety, you can be sure that you can find disinfectants in the market that can suit the needs of your facility and provide the level of kill you need from a daily infection prevention perspective while meeting the health and safety needs and concerns of staff to ensure they will use the product as you had intended, which will have a very real and directional impact on your HAI rates.


Bugging Off!
Nicole