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, October 21, 2016

Expend Energy to End Exposure

I hope you’ve enjoyed the blogs this week!   I’ll admit…I’ve had fun coming up with the alliterations! As Infection Control Week wraps up, I’ll end the week with one of my favorite topics when it comes to talking about chemicals.  In fact I’ve probably done at least one blog a year since inception that talks about the need to consider the safety aspects of cleaners and disinfectants.

Why am I so passionate?  I know the risks of chemical exposure.  It dates back to my childhood.  My brother, who was a particularly inquisitive (defined as hellion) child, was known to get into things.  One of those things was an aerosolized furniture polish that he sprayed in his mouth and inhaled, and ended up with chemical pneumonia.  He was 3 and he was lucky.  Before you think “how could he be allowed to grab it”, let me expand on the fact that it was on a highboy >5 feet off the floor.  To look at this piece of furniture you would not innately see or think there was a way to climb up it with the drawers closed.  As I said, he was “inquisitive”….nothing was safe with him.

I also know first-hand the impact that chemicals listed as carcinogens can have the health and well-being of people.  Those of you who have seen me speak may have heard the story of people I know who have died from cancer likely associated with the chemicals they worked with.  This is a topic I am passionate about.  This is a topic that some would say defines me as a zealot.  I’m okay with that.  I categorically believe there is NO reason to choose a product that can cause harm to those who are tasked to use it if there are safer options available.

I could repeat some of what I have already written, but I hope instead that you’ll indulge me and read or re-read the blogs I have already written.   The following are a few of my favorites:
  1. Safety Indifference Syndrome (which happens to link to several blogs on this topic)
  2. Burnt Buns Call for Ban on Disinfectants
  3. Mommy This Water Tastes Funny
  4. VOCs the Signs and Smells of Summer
  5. Of Frogs and Boys

If the safety of a product is still not enough for you to consider looking at safer alternatives, then I would recommend that you review the OSHA guidelines.   The General Duty Clause states: “Each employer shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.”  There is now a plethora of data to support hazards that some chemicals can have on our staff.  We are, by law, required to provide a safe working environment.  As some of you may know first-hand, OSHA Inspectors may interpret clauses in different ways.  I know one colleague who learned this the hard way.  He had an inspector that interpreted this clause to include the use of disinfectants in general and particularly when they are being sprayed.

Disinfectants are a key tool in our arsenal in the war on microbes.  But we need to ensure that we do not have blinders on and are only looking at products based on what they kill.  You may be looking at what HAI-causing pathogen you are most concerned with and not realize the impact (sometimes deadly) that the disinfectant you choose may have on your cleaning or nursing staff.

Bugging Off!


Thursday, October 20, 2016

Mucky Hands Wreak Havoc!

I’m not sure if there is much that I can say about hand hygiene that I haven’t already in past blogs and that everyone already knows.  When it comes to hand hygiene, I think Nike’s slogan sums it up perfectly: “JUST DO IT!”

Unfortunately, while we know what we should do and why we should do it, hand hygiene is one of those tasks that often gets put aside because we are busy or we forgot or we just don’t see the point.  A few of the favorite blogs I’ve done on hand hygiene include; “I TRIPLE DOG DARE you to wash your hands where I pondered what would happen if we changed our tact.  It’s been well published that doctors and nurses fail to wash their hands with alarming frequency.  In fact, this lack of hand hygiene contributes to 247 deaths each day by preventable hospital infections. What if a hand hygiene DARE was said out loud in front of your other peers?  Would your rise to the challenge?

I’m sure I needn’t say much more than Semmelweiss, and we can all fill in the blanks about the history of hand hygiene.  My “The Dissenter & Father of Hand Hygiene blog celebrated Semmelweiss’ 195th birthday with a little history lesson on how the importance of hand hygiene came to be known.  I would just like to say, I am SO thankful I was not alive during this time – particularly if I was with child!

Playing on the concept of dissenters or deviants in “A+ or F what’s your hand hygiene grade? I “dared” you to take a quiz and be positively deviant.  The objective of the quiz was to answer based on how NOT to follow hand hygiene best practices.   If you scored an A+ you without a doubt ensured that you were effective at spreading diseases. 

Where does that leave us now?  Well I hope you’ll “JUST DO IT!” after sneezing or coughing into your hands.  I hope you’ll “JUST DO IT!” after using the toilet.  I hope you’ll “JUST DO IT!” after handling raw meat or uncooked foods.  I hope you’ll “JUST DO IT!” after petting an animal.  I hope you’ll “JUST DO IT!” after helping a child or adult use the toilet or change a diaper or after helping someone blow their nose.  Last but not least, I hope you’ll “JUST DO IT!” before you enter a patient’s room to perform any form of care and/or after touching the patient’s environment.

Hand hygiene saves lives.  I know I want to protect the lives of my loved ones when they’re in a healthcare facility.  Don’t you want to protect their lives to?

Bugging Off!


Wednesday, October 19, 2016

Insufficient Information Inhibits Intellect

Okay, maybe I was stretching a bit to come up with alliteration for this title.  But I was given “insufficient information” as the topic to correlate to the “I” in “C.R.I.M.E.”  Regardless of the description, this comes down to what we do to ensure our staff are properly armed with the tools they need to do their jobs.  Whether you call it training, instructing or educating it all relates to the fact that we CANNOT expect our staff to know how to correctly use the products and tools to do their jobs unless we TEACH them how to use them. In fact, if we teach everyone the where’s, what’s, why’s and how’s to using disinfectants and cleaning chemicals, we won’t have any stories of how we have seen them used and abused, and should see an improvement in our HAIs and also our HCAHPS.

Since the inception of the Talk Clean To Me blog, there have been a number of different blogs talking to the importance of training to improve infection prevention outcomes.  “I Golf therefore I am a Golfer” talked to the 8 areas of training I believe should be included as part of a comprehensive training program that would provide EVS staff with the information they need to do their jobs safely.  “Effects of Education Efforts” looked at the definition of education “the act or process of imparting or acquiring general knowledge, developing the powers of reasoning and judgement and generally of preparing oneself or others intellectually for mature life” to expound on the virtues of training programs.

It’s interesting that in the work of medical device reprocessing, many regions are requiring certification in order to work in the Medical Device Reprocessing (MDR) Department due to the complexity of the job and implications to patient safety if devices are improperly cleaned, disinfected and/or sterilized.  I think there is sufficient evidence to support the fact that cleaning of environmental surfaces is also important in improving patient safety and saving lives.  Why then should there not be a certification program for environmental services staff?  If we agree that certification for MDR Technicians is important and we recognize them for the role they play in the smooth functioning of a facility, why then should we not do the same with EVS? 

Would an educated and certified environmental services technician not be viewed, paid, and treated as a knowledgeable professional?  EVS Technicians are members of our healthcare team, are they not? Certification or registration would highlight the level of knowledge and expertise they have to do their role effectively. Is it not time to elevate their importance and help them be proud of the profession they have chosen?  Is it not time to give them the respect they deserve?  

Bugging Off!


Tuesday, October 18, 2016

Recognize Rushing as Repugnant

I suppose if you were involved in a fraternity or sorority during university or college the title of today’s blog could have a different meaning….  For the purposes of Infection Control Week, I want to use “rushing” in its literal sense: to move with urgent haste.  Whether it’s at work or at home we’ve all experienced that feeling of being rushed.  There’s not enough time in the day to get your work done so you rush through projects without investing enough time to do as good of a job as you like.  At home, if you have kids you’re probably like me, rushing (aka speeding while driving) to basketball practice, swimming lessons, hockey or trying to squeeze in time to get homework done (aka doing more than you probably should).

The fact that rushing leads to cutting corners is nothing new.  It is this fact however, that unwittingly puts our facilities or our staff on the road to catastrophe.  One example of this is cutting staffing rates in an attempt to maintain profitability.  The unintended consequences of this is people taking on additional responsibilities for which they were not trained or people start omitting tasks they perceive as non-critical just to keep up with their overburdened workload.  From an infection control perspective this will lead to the breakdown in our programs and will ultimately increase the likelihood of HAIs or outbreaks.
Many IP’s are tasked with or are part of a team that works together to choose what disinfectants will be used.  This task can be daunting.  There are literally hundreds of products to choose from, and how do you decide what characteristics (safety, speed, efficacy etc.) you are looking for in a disinfectant?  To take some of your stress away, I had written a blog Disinfectant Selection Made Easy.  The premise of this blog being that the selection of a disinfectant really can be made as simple as tabling out the desired traits of a disinfectant and adding any criteria that is specific to the needs of your facility.  You can in turn develop a rating system that allows you to more objectively look at the overall picture and how the product answers your needs. Developing a matrix such as the one we developed can help reduce the anxiety over picking a product. 

From a staffing perspective for housekeeping, we must keep in mind that cleaning takes time.  Cutting time, cutting staff and/or cutting training programs can and will lead to disaster.  We need to invest the time in looking at the ROI of effective cleaning and disinfection.  Have you considered what impact cutting staff would have on errors, on customer retention, on longevity of equipment, on employee retention or on lost time due to grievances from ineffective supervision?  If you spend the time, you’ll find that it leads to more efficient practices, reduced HAIs and reduced employee absenteeism.  Spending time looking at how to improve cleaning and disinfection, be it through compliance monitoring, training programs or new methods of cleaning (e.g. use of disposable wipes), may in fact save you money in the long run.  Not only will you save money, but you’ll likely avoid outbreaks or other medical errors that land you on the front page of your local newspaper or the headline for the evening news.
It’s easy to slash 10% from a budget.  We know the cost of our staffing budgets, our chemical budgets etc., however, being short-sighted and focusing only on cutting costs can mean we do not protect our interests and are putting ourselves at risk to mistakes happening which can and will result in phenomenally high and unpredictable "unknown costs."   
Since no one wants to have to justify why we went over budget, look at the practice of choosing disinfectants in your facility.  Do you have a formal procedure?  Look at the number of staff and your cleaning compliance rates.  If you do not have a formal procedure for choosing products and your cleaning compliance is low or your HAIs have increased, it may have nothing to do with apathy of your cleaning staff or the products you are using.  Recognize that it may have to do with rushing. 
Bugging Off!


Monday, October 17, 2016

Cleaning Compliance Confines Contagions

Welcome to Infection Control Week!  Like us, many of you are probably launching a series of events to highlight this important time of the year.  The theme for our company is Disinfection Delinquents: Crimes against Infection Prevention.  The “CRIMEs” we will be focusing on are Compliance, Rushing, Insufficient Information, Mucky Hands and Exposure.

I’m pretty sure you’ve guessed based on the awesomely alliterated title where I’m going with the topic of this blog!  I think we can all agree that reducing the incidence of HAIs requires proper environmental cleaning and disinfection of frequently touched objects in healthcare facilities.  A quick PubMed search looking for “cleaning compliance” provided hundreds of studies that are looking into the impact that monitoring cleaning compliance can have on improved patient safety through reduction of HAIs.  I think we could all say that we’ve likely read more than 1 study that has looked at testing patient rooms pre and post-cleaning showing poor compliance.  Many studies look at the level and/or type of training provided to staff about proper cleaning.  I would hazard a guess that the percentage of cleaned surfaces improved showing that repeat training favorably changes behavior in the staff.

But how is compliance measured?  It depends on the outcome you are looking for and the time and budget that you have.  Many facilities are utilizing the various UV reflective kits that are available on the market.  These UV reflective kits can be an effective way of covertly monitoring what surfaces have been cleaned and have certainly been used by a number of journalists who have gone “undercover” to see how well hospitals clean.  Many facilities who use UV reflective kits as their monitoring tools have found that when the staff achieves 80% or greater cleaning compliance of high touch surfaces, HAI rates are dramatically reduced.  The downside of these kits is that some staff will go out and buy their own black light to find the spots…..

ATP Meters are another method that has been gaining interest as tool for monitoring cleaning compliance.  ATP is present in many types of organic material including food, microbes, body fluids and other natural substances.  An enzymatic reaction with the ATP in bioburden results in bioluminescence (biological production and emission of light) and the intensity generated is proportional to the amount of organic material present on the surface tested.  The luminescence is expressed in "relative light units" (RLU), providing a quantitative measurement. 

ATP has been used for many years in the food industry.  While I agree that ATP has its use, there are several limitations to the use of ATP within healthcare facilities.  First, the absence of standardization of the ATP technology from various manufacturers and RLU readings for use within healthcare makes cross-comparisons of readings and benchmarking problematic.  Second, the lack of documented correlation between ATP readings and levels of microbial contamination on environmental surfaces makes meaningful interpretation of the data difficult and distinction between pathogenic and non-pathogenic microbes on the sampled surface virtually impossible. Also, ATP kits cannot detect or measure viral contamination because viruses do not possess ATP.  Third, and perhaps most important, many surface disinfectant chemistries and cleaning tools interfere with ATP measurements.   Therefore, the use of ATP as a tool to determine the effectiveness of different cleaning practices or to compare the effectiveness of different cleaning and disinfectant chemistries remains a challenge. 

Regardless of the method you use to measure compliance, the key is to develop a program that can provide meaningful results for you.  This should include a validation study to set a baseline by which to measure yourself against so you can show improvements or lapses in cleaning.  It should also include a training program to ensure that everyone tasked with measuring compliance is doing it in the same way so that the results you are recording can provide direction for where improvements need to be made.  Either way, it is important that these programs are introduced in a positive and not punitive manner.  Our housekeeping staff are the backbone of our cleaning and disinfection programs.  We need them to work with us, not against us and we need to let them know how important their jobs are to the safety of our patients.

Bugging Off!


PS – don’t forget to develop an equivalent program for our clinical staff.  Shared patient care equipment is just as important as environmental surfaces! 

Friday, October 14, 2016

The quest for the silver bullet

Monty Python’s The Quest for the Holy Grail was the first Monty Python movie I watched, but from that point on I was hooked!  If you’ve not had the pleasure of watching, one of my favorite scenes is when King Arthur and his squire, Patsy, who travel throughout England in search of men to join the Knights of the Round Table, encounter the Black Knight.  The Black Knight, however, will not let them pass without a fight. A sword fight ensues with Arthur gaining the upper hand, but the Black Knight continues fighting despite having his arms and legs severed.  The Black Knight assures King Arthur that the injuries are nothing but a scratch and after losing both his legs explains that he’ll bite King Arthur’s legs off.   Somehow, in the end the battle is declared a draw…..  The movie continues with Arthur and his Knights of the Round Table going in search of the Holy Grail.

What does Monty Python have in common with infection prevention?  Well, until I read an article on a new invention that claims to kill MRSA on surfaces in 5 minutes I did not realize how far we have gone in the quest for the elusive silver bullet in our fight against germs.   If we look back in history, routine disinfection of frequently touched environmental surfaces and floors has been a controversial issue due to the fact that the exact extent of the impact of contaminated surfaces on the rate of infections is difficult to establish.  As the prevalence of antimicrobial resistant organisms continues to rise, more attention has been paid to environmental disinfection and its importance in an effective infection prevention program. We would now agree that there is sufficient evidence for the possibility of cross-contamination from surfaces to patients and staff, and vice-versa, to make surface disinfection essential.   However, effective disinfection is dependent on the choice of products, on suitable application methods, on staff training and lastly, on evaluation and monitoring of processes to ensure that disinfection is in fact occurring.  Effective cleaning and disinfection is also dependent on having the appropriate amount of time to ensure that ALL surfaces are addressed.

Back to King Arthur and the Black Knight - in our quest to stop the spread of diseases are we King Arthur who is willing to travel wherever he must to find the grail – even if it means fighting a killer rabbit?  In our quest to kill germs are we willing to try anything and everything in the hopes that something will safeguard us against our apathy of following methods we know work?  Cleaning and disinfection works.  We know this. But because of the human factor, we cannot trust people to do their jobs correctly.  Have we inadvertently made cleaning staff out to be the Black Knight in a futile fight due to the fact that staffing has been cut and we expect more with less?  Cutting staff and not allowing for an appropriate time to clean a room leads to cutting corners.  Have we effectively cut their arms and legs off?

Don’t get me wrong, I am all for innovation.  I am all for looking at ways we can improve patient safety.  I am all for looking at the use of newer products that are safer for the environment and those who have to use them.  What I am against, is the use of Silver Bullets like doorknobs, handrails or what have you made out of salt when we have not addressed the fact that hand hygiene rates continue to be dismal and are linked to transmission of pathogens.  What I am against is the amount of money we are willing to invest in the search of the Silver Bullet when if we added staff to our housekeeping and nursing departments that we would not have people struggling with too many rooms to clean or too many patients to care, encouraging the mindset that we need to cut corners and skip cleaning of all surfaces in a patient’s room or all shared patient equipment in order to get to them all.

Bugging Off!


PS – Salt dissolves in a liquid does it not?  How the heck are these surfaces going to be cleaned?  

Friday, October 7, 2016

Don’t let your lab experiment go awry!

Even if you do not consider yourself a scientist in the true sense of the word, I’m sure that we can all admit to at least one science experiment going awry.  I can think of a few situations that I may have gotten into during my high school science classes.  While not a science experiment per say I do recall the eyeball of the frog I was dissecting launching itself halfway across the room, and another situation where (much to the dismay of my chemistry teacher) my science partner and I learned the hard way how to properly mix acids and water.  Let’s just say there was an incident…but the classroom did not have to be evacuated. 

If you cannot recall fond memories of high school, college or university classes, then at the very least I think we can all attest to having forgotten some leftovers or other food items stuffed at the back of the fridge only to find weeks or month later that you’ve unwittingly created a science experiment.  It happens at work all the time. So much so that we get emails every month asking us to check the fridges for any food we may have forgotten to eat or take home.  I won’t name names, but there are some repeat offenders.  They know who they are and now they know I know……

But what happens when accidents happen in the “real” world, meaning in actual laboratories?  I think many of us can recall a couple of news stories where biosecurity breaches or lapses occurred.  If not, let me remind you.  Do you recall the case in Atlanta when several vials of smallpox were left unattended in an unused storage room?  How about the time that there was a temporary closure of laboratories (also in Atlanta) due to potentially infectious live anthrax samples being exported to labs that were not equipped to handle them? Better yet, the accidental contamination of a relatively benign flu sample with the dangerous H5N1 bird flu strain???

The truth is mistakes happen.  Unfortunately the ones that I’ve highlight above could have had very dire consequences.  This highlights the importance of following biosecurity guidelines when handling specimens and also understanding how to properly decontaminate the areas after potential exposure during a breach in biosecurity.  Most importantly, it highlights the need how to properly manage a lab environment on a day to day basis.  Certainly we hear of the scary stories that can be sensationalized in the news cycle, but every day there are lab technicians working with samples (human or animal) helping to identify a disease or the cause of an illness.  Everyday there are people working in environments such as cancer clinics compounding chemotherapy agents that also need to be handled with care.

To highlight the importance of biosecurity and cleaning and disinfection within the lab setting our monthly education campaign “What’s Growing in Your Lab?” focuses specifically on everything you need to know to keep a safe and clean environment.   I hope you’ll check it out! 

Bugging Off!