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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Friday, November 17, 2017

Ban the Bad Blowers!

As I’ve mentioned in previous blogs, I like to get my geek on.  Thankfully I was alone in my office when I squealed in delight after reading a Letter to the Editor in the October Special Edition of the Journal of Hospital Infection.  The letter talked about a pilot study comparing the level of microbial contamination found in hospital washrooms when paper towel or hand dryers were used.

I HATE hand dryers.  While I try darn hard to be environmentally conscious and sit on our company’s Green Team, when it comes to drying my hands I have no qualms about the number of trees needed to be cut down to make paper towels.  Why? Because there is enough evidence to show that hand dryers impede hand hygiene and as this study shows when looking at microbial contamination washrooms (restrooms) with hand dryers had higher levels of microbial contamination than washrooms that used paper towel.

Some may be questioning my comment about hand dryers impeding hand hygiene, but back in 2012 guest author Prof. Todd from Michigan State University discussed a survey where researchers found that hand dryers, because they can only accommodate a person at a time and can take up to >1 minute to adequately dry hands, can lead to avoidance of their use, incomplete drying of the hands or worse, wiping clean hands on clothes…..  I will admit there has been more than one occasion where along my travels I have encountered either a line up to get to a hand dryer or gave up on getting my hands dried due to insufficient air flow and/or heat.

In this particular study, the researchers sampled 2 washrooms within one hospital over a period of 3 months.  Their sampling regime included air sampling, environmental sampling of 5 locations and collecting dust samples.  In reviewing the data, significant differences and trends were seen.  In the washroom that utilized paper towels lower microbial levels were found whereas in the washroom that employed the hand dryer the microbial contamination was higher, had a greater range of bacteria and in general the floor, the hand dryer and the dust samples were more heavily contaminated.

I knew there was a reason I had such a loathing for hand dryers….this study simply continues to build upon my bias towards the need to ban their use.  The fact that WHO advocates to dry hands thoroughly on a single use towel strengthens my resolve to avoid the use of hand dryers at all costs!

Bugging Off!
Nicole


PS – I know more investigation is needed, but for me the proof is in the 
pudding - blowers are bad!

Friday, November 10, 2017

Under the weather...

This week I’ve been off site at an amazing Executive Leadership Program.  It’s been insightful, a little humbling and very eye opening.  It has also been a bit sickening…..and by that I mean 5 of the 12 people in our group came down with tummy issues and as we found out last night talking to another group at our facility, 7 of the 30 in their group came down with something as well.

That something...was definitely food-borne, we just can’t decide if it was the Asian coleslaw, the cod or the avocado salad….or maybe all 3!  Needless to say, I have managed to survive enough to complete my course, but all good intentions in writing my blog this week went down the drain (pun intended).

The upside I suppose, is this is a great reminder that where ever we go, bugs will be there!


Bugging Off!


Nicole

Friday, November 3, 2017

Restrooms, You and the Flu!

There are times that my self-control amazes me.  Perhaps not when it comes to chocolate, candy, chips and dip or really good cheese, but upon occasion, like my ability to not work out is truly impressive.  The fact that we have hit November and this is the first blog of the fall to talk about Flu Season is a great example of my self-control.

You may be wondering why I think I’m so impressed with myself, well…..have you be following the Flu Season in Australia and the Southern Hemisphere?  Australia has had a particularly bad flu season with >93,000 lab confirmed cases as of August 18th which happens to be 2.5 times more infections than the previous year.  The deaths and hospitalizations associated with the flu have also almost doubled when comparing recorded numbers year over year.

So what does that mean for North America? Well, if we use Australia and Hong Kong as indicators, and we know they have grappled with one of the worst flu seasons on record, then it’s safe to say that we may follow suit.  One of the reasons is because H3N2 is one of the most predominant strains circulating and it happens to be the strain that wreaked havoc a couple of years ago when our vaccine was a mismatch…  So, with the arrival of November we can and should expect the flu to start showing up.  If we keep on track to when we typically see spikes, we can expect the first  hit sometime in December, about the time that kids return home from school. Then a second hit in late January into February when we start seeing the true colour of Jack Frost and his blustery frigid temperatures.

Which leads me to restrooms and the flu.  “Spring Cleaning” is a well-known phenomenon with its intention to get rid of the dirt and grime that accumulates over the winter after we lock ourselves inside to avoid the cold.  Perhaps we should develop a new phenomenon – Fall Extermination.  We know that germs can be anywhere and we know that germs start “accumulating” in the fall when Cold and Flu seasons hits so maybe if we look at implementing a few key prevention tips we can help reduce the risk of transmission:

  1. Schedule seasonal deep cleaning at the beginning, middle and end of cold and flu season to keep the germs at bay.
  2. Increase the number of hand sanitizers you have on hand and make sure your bathroom is well stocked with soap in order to facilitate hand hygiene.
  3. Have disinfectant wipes readily accessible and encourage employees to disinfect their work areas, telephones, keyboards, door handles etc.
  4. Can you move to hands free options?  The less we touch, the less our hands will pick up and the lower the chance we have to spread things to ourselves.
  5. Just because cold and flu season happens every year, doesn’t mean everyone remembers how to differentiate between the two and how to try and stop from getting sick.  EDUCATE!
  6. Encourage sick employees to head home and recover.  A sick employee is not a productive employee and they’ll just make others sick.
  7. Promote Flu shots; and if you can, hold a flu shot clinic.


As we enter flu season, I hope you implement a few of these things both at work and at home because there’s nothing worse than working with sick grouchy people only to have to head home to a husband with a man-cold……


Bugging Off!


Nicole

Friday, October 27, 2017

Acquired Infections vs Acquired Illness

It’s relatively hard to go a day without seeing some form of media article about hospital acquired infections (HAIs).  Hospitals and Infection Preventionists are being pushed to prevent HAIs so as not to lose out on funding (and of course not to harm patients).  At virtually every tradeshow or conference I attend and speak with Infection Preventionists, I hear “Do you kill X or Y?”  or “How fast is the contact time?” over and over…..ad nauseam.

Depending on the person or the conversation, I have been known to challenge the concept of focusing only on efficacy or speed.  In fact one of my favorite lines is “I don’t care what the product says it will kill or how fast it will kill it, if the staff don’t like using it (or are scared of using it), you can be guaranteed they won’t.” It’s the truth.  I’ve seen it.  I’ve talked with staff who are concerned for their health due to the perception they have of the disinfectant product that has been chosen and they feel forced to use.

The truth is, in the race to ensure we rid every surface of as much as we can in order to minimize the spread of HAIs we have forgotten one important thing.   We have forgotten to consider the balance between efficacy and safety.   It’s relatively easy to go online and find a recipe to make a “safe” disinfectant.  From a chemical engineering perspective it’s also pretty easy to create a disinfectant that will kill everything….assuming we’re not concerned with occupational safety or materials compatibility.  Finding the balance and creating a product that has a pretty broad-spectrum efficacy along with a great safety profile is another thing altogether. 

A recent study published in AJIC investigated health problems associated with disinfectant product exposure and concluded that the PAA-based disinfectant chosen because of its product label effectiveness to reduce C. difficile was directly associated with mucous membrane and respiratory health effects.   The results were based on a survey completed by healthcare workers as well as air monitoring in units that utilized the disinfectant in question.  It was found that there was a higher prevalence of work-related wheeze and watery eyes among users of the disinfectant product.  It was also found that in one unit where the highest level of chemicals was found in the air that there was a higher prevalence of health effects among both product users and non-users.  The researchers also compared the prevalence of asthma among the healthcare workers in the hospital to reported values for the US adult population and found that the prevalence was significantly higher.  The recommendations of the study were to ensure that healthcare workers concerns about occupational illness are taken seriously and to implement controls to reduce exposure to cleaners and disinfectants in order to provide a safe working environment while still protecting patients from HAIs.

The long and the short is that everything we do in life needs to be balanced and that many of our choices will require a trade-off.  In the case of choosing disinfectants, the difficulty being you may be choosing between the health and well-being of a patient over a healthcare worker or vice versa.  When looking at our disinfection needs remember it’s not just about what a product kills or how fast it kills.  We need to consider the safety of the staff that have to use it.  If there is a potential health concern, then what controls need to be put in place such as additional PPE such as respirators or only cleaning 1 or 2 rooms per shift with the product in question.   Alternatively are there changes in cleaning protocols that can be used such as twice daily cleaning (e.g. morning and afternoon) to help keep the pathogen load in the environment lower?  

As I learned today, perhaps we need to use a “Beginner’s Mind” when trying to come up with solutions to the problems we have.  We often look to the experts to come up with a solution, but according to Zen Master Shunryu Suzuki “In the Beginner's Mind there are many possibilities. In the expert's mind there are few." 


Bugging Off!

Nicole


Friday, October 20, 2017

Sword fighting with baseball bats

If you think about growing up, there seems to be kids who naturally are more reserved and less adventurous, and then there are the ones who often act before thinking and have no fear.  You might even wonder if there really is a “dare devil gene”.  I was and still am a dare devil.  I can honestly say that if I or my brother thought of something, we rarely ever failed to follow through on execution.  From building the best hay forts with booby traps to climbing trees to see who could swing the top over the farthest, we did it.  We also successfully built a bike out of wood which steered, but lacked brakes, and were professionals at making swords, spears and may have been known to dabble in making things that could go “boom”.  I’m happy to say that neither of us ever broke anything that required casts, but there may have been the occasional set of stitches and an eye patch, and by the time I was 6, we knew I was allergic to almost every adhesive used in band aids.

I was 5 the first time I had stitches, although surgery was required before the stitches could be put in.  My brother was only 3 at the time so was not involved in this scheme, but the boys down the road sure were!  The collective “we” decided that sword fighting with baseball bats was a reasonable thing to do, and for a while it worked. If I recall, I was holding my own…. that was until my pinkie (check out the picture) got caught between the 2 wooden baseball bats.  I’m not really sure how it happened, but I suspect I went in for a thrust and the neighbour swung to fend me off.  Let’s just say, my pinkie didn’t stand a chance against 2 baseball bats.  That said, I was lucky.  The bone did not break, but the skin from my first knuckle up sure popped off!  In fact it was hanging by a thread and let’s just say, while running around in circles, there was a lot of blood.

The surgeon was able to piece my finger back together, but during the healing process the beginnings of infection set in.  Luckily my mom was a nurse so nothing got out of hand, but I do remember having to soak my finger in a bath every day to draw out the infection to avoid losing more of the finger than I did.  I was lucky.  I kept my pinkie, I grew back a finger nail and best of all when we were learning right from left at school, I never had a problem because I only ever had to look at my pinkie to know which hand was which!

In the stories I shared this week, the HAIs were all associated with adults and several of them older adults with poor immune systems or underlying diseases that would have increased their odds of getting an infection.   I’ll admit, while the infection was in the site of a surgical incision, the original “incision” was not made with a sterile scalpel, so it’s entirely plausible that my foray into sword fighting contaminated the area which made it easier for infection to set in.  The reason I’m sharing my story is because we need to keep in mind that the transmission of pathogens can happen almost everywhere and to anyone.  While I focused on HAIs this week, we see infectious diseases transmitted in schools, at work, on cruise ships, at restaurants, at spas and even other healthcare settings like dental offices. 

The long and the short is that we need to be mindful.  We need to take a pause and if sick, stay home.  We ALL need to wash our hands.  As highlighted in the obituary I shared yesterday, dirty hands can lead to HAIs.  In healthcare settings, we need to support the cleaning staff and allow them the time they need to clean rooms properly and not push them to finish faster in order to get a new patient in the bed.  If we rush, we cut corners and those corners can be deadly. 

As we come to the end of International Infection Prevention Week, I would like to give a shout out to the great jobs done by the housekeepers who work hard to keep facilities clean, to the nurses and doctors who work hard to keep us healthy and the Infection Preventionists who work tirelessly educating and helping to reduce HAIs!


Bugging Off!


Nicole 

Thursday, October 19, 2017

Farewell dear husband, father and friend

I started with Virox in March of 2003.  Shortly after I started, I was introduced to someone who I would now call a dear friend.  Paul Webber, who some of you may know as one of the founders of the Webber Training Teleclass program, took me under his wing. He introduced me to some of the greatest and most influential minds around the world in infection prevention, he helped build my love of infection prevention and the myriad of opportunities there are to educate, and he has spent more than a decade correcting my grammar any chance he gets!

You’ve likely guessed from the title, this story does not have a happy ending.  It’s the story of Paul’s father-in-law and how he lost his life due to a HAI.  Paul wrote about the unfortunate set of circumstances in his father-in-law’s obituary that I am sharing in full.  It’s poignant.  It’s heartfelt and I could not do it justice by trying to create an abridged version.

“On October 30, 2005 David Williamson Milne passed away at Kingston General Hospital after a battle with hospital-acquired infections.  He was loved and is deeply missed by many.

David Milne was the kind of person that you got to know, and like, quickly.  His friends were among society’s small and society’s great, and he treated each with equal respect and appreciation. His Scottish humour and laugh were infectious. Even in the last days he could make us laugh.

His family was the joy of his life and sustained him throughout. As the youngest of a large Manitoba farm family, he was his mother’s joy and primary recipient of her loving largess. He wedded his first love and childhood sweetheart, Catherine, who followed him from posting to posting, with one and then two children, Catherine Jr. and Jacqueline.

As a long-service pilot in the Canadian Armed Forces David Milne’s life was not without risk, but risk balanced in an equation with skill.  His heart surgery was a risk, but it was balanced against the outstanding skill of Dr. Hamilton at Kingston General Hospital.  The surgery was successful and Dave’s recovery was proceeding well, thanks to the care of KGH staff. Unfortunately, a series of hospital-acquired infections set back his progress and ultimately caused is premature passing.

Every year hospital-acquired infections cause or contribute to the death of more people than breast cancers, heart disease, and car accidents combined. Most of these infections are initiated by otherwise caring healthcare workers who forget or neglect to clean their hands. And for each of those who, like our friend David, succumb to one of these unnecessary infections there are many more who ache for their loss. These are not numbers on month-end reports. These are our fathers, our mothers, our children and our dear friends who are dying prematurely because of unclean hands. The little bit extra time that it takes for healthcare workers to wash or to use and alcohol sanitizer is pittance compared to the waste of so many productive, loved and loving lives.

In honour and memory of David Williamson Milne a donation will be made in his name to the Community and Hospital Infection Control Association of Canada.  His family and extended group of friends openly urge those at Kingston General Hospital as well as healthcare workers everywhere to clean their hands before and after every patient contact.  It is absolutely a matter of life and death.

Farewell to a dear husband, father and friend.”

Thank you Paul and Jacquie for letting me share your story.  There is nothing additional that I can add.  I agree completely that cleaning, be it hands or environmental surfaces or medical devices, saves lives.


Bugging Off!


Nicole

Wednesday, October 18, 2017

Cars, Hearts and HAIs

In the story I’m sharing today, one may wonder how cars, hearts and HAIs go together.  In fact when Rob, our Director of Production shared his family’s story I did what I often do when writing a blog – I started Googling.

Rob’s story goes like this.  “In 1996 my father-in-law was in Lewiston, New York and got in a car accident. While sitting in the back of a police car, he had a heart attack and thankfully paramedics who happened to be at the scene of another accident about a mile down the road were able to bring him back to life.  Unfortunately, while in the hospital in New York he contracted MRSA.  After being flown back to Canada, he was put in an isolation ward for 3 months, this is 3 months of wearing gowns, gloves and masks every day we went to see him….  In the end after a quadruple bi-pass you couldn’t slow him down, at least for another 12 years or so…”


Did you know that stress-induced cardiomyopathy is not uncommon?  In fact, it’s known as Takotsubo Syndrome and according to research it’s a temporary and sudden weakening of heart muscles, often triggered by emotional stress or constant anxiety. The sudden emotional stress can cause abnormal contractions of heart muscles and while contractions usually disappeared one to four weeks after the “stress that caused them,” they can sometimes persist which can lead to more serious complications and even death.  If you’ve ever been in a car crash, without a doubt it can put you on an emotional roller-coaster that depending on the severity can take weeks, months or even years for a victim to emotionally recover from the accident.


As Rob mentioned, his father-in-law contracted MRSA while in the hospital.  MRSA is usually spread by direct contact with an infected wound or from contaminated hands, usually those of healthcare providers.  From a risk of contracting MRSA there are 3 key factors; being hospitalized, having an invasive medical device, and residing in a long-term care facility.  Considering Rob’s father-in-law had 2 of the 3 risk factors since he was in a hospital with a weakened immune system and he had intravenous lines and urinary catheters, he was the perfect host for MRSA to travel directly into his body. 


The ending of Rob’s story is a happy one.  Certainly, it was a long road back to recovery, but his father-in-law was able to recover from the ordeal, and I hope like every good father-in-law he gave Rob a hard time for the next decade of his life!

Bugging Off!


Nicole