Hospital floors, yet another source of Hospital-Acquired Infections

The list of potential areas of contamination in hospitals seems to keep growing, leading us to identify more sources of hospital-acquired infections (HAIs) and making hospital cleaning continuously more complicated. To add to this, researchers are now finding that hospital floors are a significant source of hospital-acquired infections. Every day, hospital and clinic floors are flooded by thousands of people. Shoes soles, wheels from equipment, such as monitors or stretchers and bodily fluids all contribute to the contamination of hospital floors.

It seems so obvious; floors are dirty in general. Hospital floors must be even dirtier. However, as Koganti, et. al. (2016) describes,

“… hospital floors are often heavily contaminated but are not considered an important source for pathogen dissemination because they are rarely touched. However, floors are frequently contacted by objects that are subsequently touched by hands (e.g., shoes, socks, slippers). In addition, it is not uncommon for high-touch objects such as call buttons and blood pressure cuffs to be in contact with the floor.”

(Koganti, et. al. (2016).

In addition to this, shoe soles and wheels on equipment also frequently touch hospital floors. Shoes of healthcare professionals can lead to the spread of infection since these workers are visiting many different patient rooms. Similarly, equipment such as monitors, stretchers or infusion pumps all have wheels which touch the floors of multiple hospital rooms.

Now you might be thinking, ‘but surely hospital floors are routinely cleaned?’ While that is true, researchers are now finding that much of the floor cleaning that is done is relatively ineffective since the bacteria is able to reproduce so quickly. So, what can be done to help reduce the risk of hospital floor contamination?

A good hygiene program for hospital floors, to reduce the risk of contamination

The cleaning and the disinfection of floors are essential elements of an effective hygiene program for hospitals. Regular floor maintenance implies the systematic elimination of hidden bacterias, which can be achieved by using vacuums, mopping and other elimination processes.

A good floor disinfection program consists of using effective disinfectants/detergents and procedures that are notable for reducing the risk of contamination. It is also important that cleaning equipment be properly cleaned and maintained, so that bacteria doesn’t spread when cleaning.

Cleaning hospital floors seems like a daunting task, especially since bacteria has been able to reproduce and spread itself so quickly. Healthcare facilities will need to become more exigent with their floor cleaning programs, if they are going to seriously tackle the threat of hospital-acquired infections.

Source : 
https://www.infectioncontroltoday.com/environmental-hygiene/shoe-sole-and-floor-contamination-new-consideration-environmental-hygiene

How to Prevent Cross-Contamination

Our last post discussed how janitors may contribute to the cross-contamination of different environments. As a follow up, this post will discuss different methods for preventing cross-contamination.

Cross-contamination can happen so easily that many people do not even realize it. A simple example would be that a janitor cleans a toilet with a wipe, and then uses that same wipe to clean the bathroom sink. Whichever viruses were present on that toilet have now been transmitted to the sink. This is why it is crucial that organizations develop cleaning programs that will prevent cross-contamination from happening.

Source: Flickr

Steps for preventing cross-contamination

Cleaning and Maintenance Management (CMM) makes three simple recommendations for the prevention of cross-contamination: (1) color code and categorize, (2) upgrade your tools, (3) clean from top to bottom. (2017).

The first recommendation is to color code and categorize. Organization is crucial in preventing cross-contamination. CMM recommends the use of a color-coded system, more specifically, the use of microfibre cloths and mop heads which come in a minimum of four colors: red, green, blue and yellow.
The British Institute of Cleaning Science recommends the following color chart for the cleaning of specific items and rooms:

  • Red: sanitary appliances, restroom floors, toilets, urinals
  • Yellow: restroom surfaces – sinks, towel dispensers, hand dryers, soap dispensers
  • Green: general food and bar cleanup in non-preparatory food areas, such as lunchrooms
  • Blue: areas of low-risk of contamination, such as hallways, offices and classrooms

Furthermore, it is recommended that cleaning tools are kept separate within the janitor’s closet. This is because if these items touch each other in the closet, then it defeats the purpose of having different colors for different areas and does not solve cross-contamination.

The second recommendation is to upgrade your tools. Having the best tools for cleaning will ensure that most of the bacteria is removed. Microfibre cloths and mops are highly recommended, since they are the best material for trapping dirt and bacteria. Once the dirt and bacteria are trapped in the microfibre, the particles will remain trapped in the material.

The third recommendation is to clean from top to bottom. Cleaning from top to bottom allows the cleaner to avoid missing any areas. By starting from the top, any dust or dirt that may fall to the bottom, or the floor, will be picked up afterwards, since the cleaner will then move on to the lower areas.

CMM provides the following methodological approach for top to bottom cleaning:

  • Wipe Down surfaces first. Make sure to wipe down surfaces before applying products.
  • Disinfect second. Spray disinfectant on areas that have been wiped down and let sit for 5-10 minutes before wiping it off.
  • Tackle the floor last. Mopping or vacuuming the floors last will ensure that anything that may have fallen onto it will be picked up.

Preventing cross-contamination may seem like a daunting task, but the steps recommended by CMM definitely help simplify it!

As you have read on this post, microfibre is one of the best cleaning tools that you can use because it has the ability to trap dust and dirt particles, and does not release them. Having microfibre cleaning products will provide you with optimal results in cleaning. Here at Lalema Inc, we offer all types of microfibre products. Feel free to consult our website for more details 🙂

http://www.lalema.com/search?q=microfiber

Source:
https://www.cmmonline.com/articles/preventing-cross-contamination-is-as-easy-as-1-2-3?utm_medium=email&utm_source=cmm&utm_campaign=CM+e-News+Daily&omid=


How Janitors contribute to cross-contamination

Source: Wikimedia Commons

Janitors are responsible for the cleanliness and maintenance of many types of establishments, including hospitals, schools and restaurants. In most places, there are procedures and regulations to be followed in order to achieve optimal cleanliness and, ultimately, prevent the spread of harmful bacteria.

But did you know that janitors can also spread infection through cross-contamination, if there aren’t proper cleaning protocols in place?

According to Infection Control Today (2019),

“Cross-contamination is defined as the spread of germs from one surface or object to another and frequently occurs when performing janitorial tasks.”

Robert Shor, Infection Control Today, 2019

Infection Control Today describes several possible causes of janitorial cross-contamination, which include mop heads, towels, and gloves. While it is known that these sources are associated with the spread of infection, there is one which is often overlooked: the gloves worn by the janitor. While cleaning many different rooms, and even different buildings, the janitor usually keeps the same gloves for the duration of the cleaning. When changing rooms and buildings, he is spreading the bacteria that are on his gloves.

Infection Control Today suggests the following protocol for janitors’ use of gloves:

  • Don gloves before performing cleaning tasks (use gloves that are appropriate for the task being performed).
  • Change gloves in the following situations:
    • When they become soiled, torn or punctured
    • After cleaning areas with high concentrations of germs (restrooms)
    • When going from building to building or floor to floor
    • After cleaning each classroom (room), restrooms, kitchen areas
  • Avoid contaminating your hands when removing gloves by following CDC guidelines.
  • Wash hands and/or use hand sanitizers after janitorial tasks are completed.

Janitors play a very important role when it comes to keeping establishments sanitary and safe. That is why it is crucial to develop protocols to ensure the highest quality of cleaning.

Source: Infection Control Today, Vol. 23, No. 3, March 2019

Cellphones: One of the dirtiest things that you touch every day

You have probably already heard that cellphones are some of the dirtiest things that you can touch. What you probably don’t know is just how bad they are. According to Patrick Boshell (2013), cellphones carry about 25,000 germs per square inch or, in other words, 10 times more bacteria than a toilet seat.

Source: Pexels

Cellphones come with us wherever we go, even the bathroom! So it’s no surprise that it is one of the dirtiest objects to come into contact with. Although a lot of the bacteria found on your phone won’t make you sick, studies have found that some pretty dangerous pathogens can be found on your phone, such as MRSA or E. Coli.

So, what can you do to protect yourself against the potentially harmful bacteria on your phone?

How to keep your cellphone clean

The following is a list of recommendations to help keep your cellphone bacteria-free (or as close to it as possible):

  1. Wash your hands frequently and properly. It may seem obvious, but many people don’t pay attention to hand-washing guidelines, which results in hands that were not washed properly carrying bacterias that will touch and contaminate your phone. Hand-washing is probably the most important thing you can do to keep your phone clean, since the majority of the bacteria is transferred from your hands.
  2. Keep your phone out of the bathroom. Bathrooms are some of the dirtiest places that you go to. Using your phone while you’re in the bathroom exposes it to the bacteria lurking in stalls.
  3. Wipe down your phone. Time magazine recommends two options for cleaning your cellphones: (1) wipe the phone with a microfibre cloth or (2) for a deeper clean, combine water and alcohol and dip a cloth in the mix and wipe down your screen.

For more information, take a look at this video below:

Source:
https://info.debgroup.com/blog/bid/290652/your-mobile-phone-is-dirtier-than-you-think

http://time.com/4908654/cell-phone-bacteria/

Handwashing really is important…

February 2019. We have all learned time and time again about the importance of handwashing, and how it can reduce the risk for harmful infections and, ultimately, save lives. Then, along comes Pete Hegseth, co-host of Fox & Friends, with the statement that he has not washed his hands in 10 years. He stated the reason for this as being “germs are not a real thing – I can’t see them, therefore they’re not real.” Whether he was joking or not is still under debate, but one thing is for sure, his statement is far from being correct.

Hegseth’s statement no doubt created a lot of publicity, but many are now concerned that people will be influenced by him in not washing their hands. And they have every right to be.

The Guardian (2019) quotes Professor Val Curtis, from the London School of Hygiene and Tropical Medicine, where she states that:

“Hands are the most important vector of infectious diseases.”

Val Curtis, 2019. Retrieved from the Guardian

She adds to this that not washing your hands or improper handwashing puts everyone at risk, and that it is a moral issue above all. If, for example, you go to the washroom and don’t wash your hands, everything you touch afterwards will be contaminated. Everyone who touches the same surfaces that you did will be touching the bacteria that you have spread, putting them at high risk for infection.

Even though the risks are significant from improper handwashing, many people rarely put in the extra little effort needed in order to reduce these risks. According to Sandoz (2019), 1 in 20 people fail to wash their hands properly after using the washroom. Also, the average time that people take to wash their hands is 7 seconds, which is far below the recommended 20 seconds (Sandoz, 2019).

How to properly wash your hands

So what is considered proper handwashing and how can we achieve it in order to prevent infection? The Centre for Disease Control and Prevention (CDC) provides us with detailed steps in order to maintain ultimate hand hygiene. The steps are as follows:

  1. Wet your hands with clean, running water (warm or cold), turn off the tap and apply soap.
  2. Lather your hands by rubbing them together with soap. Be sure to lather the backs of your hands, between your fingers and under your nails.
  3. Scrub your hands for at least 20 seconds.
  4. Rinse your hands well, under clean, running water.
  5. Dry your hands using a clean towel or air dry them

Proper handwashing is necessary to prevent the spread of infection and to ultimately save lives. It doesn’t take a lot of time or effort to do, and it can make all the difference. So do your part for yourself and society; wash your hands 🙂

Sources:

https://www.theguardian.com/lifeandstyle/shortcuts/2019/feb/12/hands-hadnt-washed-10-years-peter-hegseth

https://www.sandoz.com/stories/access-medical-information/washing-hands-saving-lives-surprising-health-benefits-clean-hands

https://www.thestar.com/entertainment/television/opinion/2019/02/11/fox-news-host-pete-hegseth-shouldve-kept-his-dirty-secret-to-himself.html

https://www.cdc.gov/handwashing/index.html

Candida auris : A new threat ?

Candida auris

After the coming of hospital’s contracted diseases such as C. difficile or MRSA (Methicilin-Resistant Staphylococcus Aureus), another difficult to treat bug seems to emerge. This time, it is a fungus: Candida auris.

This fungus or more precisely this yeast, has first been discovered by scientists in 1996. Then, a first infected human case has been reported in Japan in 2009. 1,2 To this date, Candida auris has been detected in hospitals of more than 20 countries such as the United States of America, England and many Europe countries. The first case in Canada has been reported in 20173.

Candida auris poses a specific threat because of the following characteristics4:

  • Infections by this microorganism have a high mortality rate.
  • The microorganism resists antifungal agents.
  • The microorganism is difficult to identify in clinical microbiology laboratories which results in wrong diagnostic. The identification is important in the choice of antifungal treatment.
  • The microorganism is known for its virulence.
  • The microorganism colonizes surfaces such as catheters used for healthcare.

Among recommended precautions by American and Canadian governments, disinfection of surfaces plays an important part. However, specific disinfectants are to avoid: this is notably the case for quaternary ammonium-based disinfectants which are ineffective5. The following procedure is rather recommended:

« Healthcare facilities that have patients with C. auris infection or colonization should ensure thorough daily and terminal cleaning and disinfection of these patient’s rooms with hospital-grade disinfectant effective against Clostridium difficile spores. »6

Sporicidal sodium hypochlorite-based disinfectant against C. difficile are for example great disinfectants to prevent and control contact transmission of Candida auris. In other words, scientists are only starting to understand and study this recently discovered microorganism. More studies will allow the discovery of effective treatment.

Until that time,in need of sporicidal products against C. Difficile to face Candidaauris new threat? Get our products right now!

References:

 1) Lee WG, Shin JH, Uh Y, Kang MG, Kim SH, Park KH, et al., (2011), First three reported cases of nosocomial fungemia caused by Candida auris. J Clin Microbiol, 49:3139-3142.

2) Satoh K,Makimura K, Hasumi Y, Nishiyama Y, Uchida K, Yamaguchi H., (2009), Candida auris sp. nov., a novel ascomycetous yeast isolated from the external ear canalof an inpatient in a Japanese hospital. Microbiol Immunol., 53:41-44.

3) Schwartz IS, Hammond GW., (2017), Premier cas de Candida auris multirésistant au Canada. Relevé des maladies transmissibles au Canada., 43(7/8):168-72.

4) Anuradha Chowdhary, Cheshta Sharma et Jacques F. Meis., (2017), Candida auris : A rapidly emerging cause of hospital-acquired multidrug-resistant fungal infections globally, PLoSPathogens, 13(5):e1006290

5) Institut National de Santé Publique du Québec, (Janvier 2018), Mesures de prévention et de contrôle dans les milieux se soins, Comité sur les infections nosocomiales du Québec, 2377 :1-11

6) Relevé des maladies transmissibles au Canada, (juillet 2017), Premier cas de Candida auris déclaré au Canada, Agence de santé publique du Canada, 43-7/8

Will “good” viruses replace antibiotics in the future?

A major health concern for the future

Antibiotics have been around for almost 100 years now, and have proven to be very effective against fighting harmful bacterias. However, during this time, these bacteria had time to evolve and many of them are now becoming “drug-resistant”, meaning that these bacteria have developed a resistance to antibiotics. There are even some bacteria, known as “superbugs”, that have become resistant to nearly every existing antibiotic. If a person is infected with a “superbug”, this means they cannot seek treatment from antibiotics and will have to rely solely on their immune system to fight the disease. This could result in death by diseases that were once treatable. According to the United Nations World Health Organization, “By 2050, estimates indicate that more people could die from antibiotic resistant infections than those who currently die from cancer” (2016), making drug-resistant bacteria one of the most serious health concerns that we face. 

Source: Wikimedia Commons

So if antibiotics are becoming ineffective, then what can be done? Researchers are now turning towards a “good virus” called a “bacteriophage”, or simply phage, that kills bacteria, which was previously overlooked by researchers and scientists.

Phages: The Virus that kills drug-resistant superbugs

First of all, what is a phage? Simply put, phages are viruses that infect specific bacteria (Motherboard, Vice). This means that bacteriophages do not infect human or animal cells. There are more phages on earth than any other living specimen, and they can be found almost anywhere. There are also many different kinds of phages, and each phage does not fight the same bacteria.

Phages kill bacteria by binding themselves to the membrane of the bacteria when they come in contact with it and then releasing an enzyme that drills a hole in the bacteria cell. The phage then injects its own DNA into the cell and reproduces more phages inside of it. This causes the bacteria cell to explode (Motherboard, Vice). Phages can therefore be used as a natural alternative to antibiotics, and may prove to be even more effective.

 

Source: Wikimedia Commons

 

In the early 1900s, phages were studied by many researchers and scientists all over the world, however, after the invention of antibiotics, Western countries became less interested in phages and any research about the viruses were put to a halt. The Soviet Union, on the other hand, kept investing in phage research and Russia, Georgia and Poland are among the only countries that use phage therapy today as a bacteria-fighting technique. Research scientist Benjamin Chan (Yale University) explains that the United States has been “hesitant to use bacteriophages because they’re a virus.” However, he goes on to explain that there are many types of viruses and virus does not always mean that there is a disease involved.

Will phages replace antibiotics in the future?

Maybe. It will take some time, as much research still needs to be done by Western countries. Many science researchers believe that they will begin to be used out of desperation. One thing is for sure though: our current antibiotics will no longer be a sustainable option and we need to find another alternative and fast!

For more information on the subject, watch the video below by Vice:

 

SOURCES:

https://motherboard.vice.com/en_us/article/9kdbqa/bacteriophages-phage-therapy-antibiotic-resistant-bacteria?utm_source=mbfb

http://www.lemonde.fr/sciences/article/2012/06/14/les-phages-des-virus-guerisseurs_1718745_1650684.html

https://en.wikipedia.org/wiki/Antibiotics

http://www.un.org/apps/news/story.asp?NewsID=54928#.WnikApM-cWo

Will Quebec experience a higher than usual number of influenza cases again this year?

From December 2017 to February 2018, across all types of healthcare facilities in Quebec, the number of Influenza cases was much higher than anticipated. While the number of cases were high all across Canada, Quebec seems to have experienced the greatest number of flu cases. In Canada, in the week from Feb. 4 – Feb. 10, the overall percentage of positive tests for the flu went from 31% to 34%!

Source: PxHere

Influenza A and influenza B were the two types of flu viruses in circulation in Quebec. For A, the most common flu type in Quebec was A(H3N2), which made up about 95% of flu cases. As for B, the virus B/Phuket was the dominant one. While there were reported cases of both influenza A and B, the more shocking of the two was the elevated numbers of influenza B, which usually only starts to see an increase in cases during the month of March. This increase in B during the months of December to February is primarily responsible for the higher numbers of flu cases.

The former Quebec Minister of Health and Social services stresses that the number of flu cases are still very high. It is recommended by the government that people get the flu vaccine, especially if they have a weakened immune system.

In addition to this, we’d like to offer you some further advice on how to prevent the flu:

  1. Frequently wash your hands with an antibacterial soap.
  2. If you do not have soap or water, use an antibacterial wipe to clean your hands.
  3. Disinfect high-touch surfaces with a disinfectant.
  4. Finally, avoid touching your face if possible; apparently we touch our faces about 5000 times per day, which is not only gross, but can make us sick!

Source: http://publications.msss.gouv.qc.ca/msss/document-001973/ (Volume 8, numĂ©ro 3).

Are hospitals disappearing?

Hospitals have always had ups and downs, according to the New York Times (2018). During the 19th century, wealthier people preferred being treated by doctors in their homes and hospitals were seen as a place for poorer people. Hospitals were not known for having good conditions. However, research led hospitals to learn some of the best practices and new technologies, such as anesthesia, which allowed hospitals to give better treatment than at home.

These new pratices and technologies caused more people to start going to hospitals. But now, people are once again shifting towards medical assistance at home or choosing to go to small clinics rather than going to hospitals. Why are these changes happening and what has been the implications for healthcare facilities?

hospitals

Source: Wikimedia Commons

Why are hospitals shutting down?

According to the New York Times (2018), the maximum number of hospitalizations in the US was over 39 million, in 1981. Even though the population has increased, hospitalizations have decreased by 10 percent! (New York Times, 2018). There are many different reasons explaining these numbers.

Aside from less patient admissions, the number of days a patient spends in a hospital is much shorter than before. Previously, a patient who had surgery could spend a week or longer in the hospital. However, now patients who have surgery sometimes stay only one day! This is one of the reasons for the reduction of hospital beds. According to Modern Healthcare (2015), new technologies and better medications can either reduce the length of the stay of a patient, or receive the necessary treatment outside of a hospital.

Second, one of the biggest problems that hospitals face today are hospital-acquired infections and trying to control the spread of infection. Hospital-acquired infections are becoming an increasingly serious problem, especially with the rise of drug-resistant suberbugs.

According to the Center for Disease Control and Prevention, in 2002, there were 1.7 million cases of HAIs, and that number has only been increasing. Controlling the spread of bacteria in hospitals has become increasingly challenging and, as you have seen on this blog, researchers are constantly finding new sources of infection. As people are becoming more aware of this risk, they are opting for either smaller healthcare facilities with less risk or at-home care.

One of the biggest causes for hospital closures is lack of funding; some hospitals simply cannot sustain themselves. In the US especially, this is in part due to patients being unable to pay hospital fees or having complications with insurance companies and, therefore, postponing their treatments. Hospitals are now scrambling to cut costs, however, this does not always work and has led to many closures.

The costs of shutting down hospitals

The majority of hospitals being shut down are in rural and small town areas, where people are far from cities. These closures can lead to many problems for these people. Doctors may lose their jobs or have to relocate to other cities to practice. Similarly, patients no longer have the option of having a regular, family doctor and need to relocate themselves in order to seek medical attention. They will also incur higher costs to reach the hospital, since they have to travel to hospitals. They lose time travelling, which may even be deadly in some cases. Finally, in the video example below, we see that the loss of jobs from a hospital closure can be detrimental to a small town’s economy, leading to the closure of other companies.

What does the future for hospitals look like?

So what is going to happen to hospitals? Will they eventually all disappear? Although a total disappearance is highly unlikely, it seems that hospital closures are becoming unavoidable, due to the risks associated with hospital-acquired infections, changing consumer preferences and lack of funds to maintain hospitals. There has already been a signifcant number that have been closed since 1981; in 1981, the US had 6933 hospitals and by 2017 this number had dropped to 5534 (New York Times, 2018). And this trend is expected to continue in Western countries. We’ll just have to wait and see what the outcome will be…

Sources:

http://www.huffingtonpost.ca/michelle-cohen/ontario-rural-hospitals_b_16290384.html

http://www.modernhealthcare.com/article/20150221/MAGAZINE/302219988

Water, a source of hospital-acquired infections?

Hospital-acquired infections are a serious threat in healthcare facilities today and researchers keep finding new sources of these infections. We know that sources of HAIs include surfaces, high-touch objects, hands and medical devices, but did you know that these infections can also occur due to the water and plumbing systems in healthcare facilities?

Source: Public Domain Pictures

According to Infection Control Today (2018), “Potable and utility water systems in healthcare settings are reservoirs and vectors of Hospital-acquired infections, resulting in pneumonias, bacteremias, skin infections, surgical site infections, eye infections and others.”

Hospitals are major users of potable water, whether it be for drinking, bathing, hand-washing or rinsing medical devices. It is therefore important that healthcare facilities realize that the water entering their facilities is not considered sterile.

Why is the water in plumbing systems infected? The design of and water use patterns in premise plumbing creates biofilms, which provide shelter and food for harmful bacterias. According to Infection Control Today (2018), “Biofilms in premise plumbing systems are complex ecosystems, and it is within these biofilms that bacteria, fungi and amoeba find the food, water and shelter they need.” Many bacteria develop in the biofilms, such as Legionella, Ancinetobacter aumanniii, Aspergillus flavus, etc.

Legionella – what is it and how does it affect patients in a healthcare setting?

Legionella colonies

Hospital-acquired infections

       Source: Wikimedia Commons

Legionella is one example of a bacteria that is found naturally in water. This bacteria is known for causing Legionnaires’ disease: a severe form of pneumonia. This disease is one of the most significant waterborne infections. Legionnaires normally has a mortality rate of only 10%, however, if acquired in a hospital, this rate goes up to anywhere between 25-50% (Infection Control Today, 2018)! Hospitals experience the highest number of outbreaks of Legionnaires disease (compared to other types of buildings) due to having a large number of patients with weakened immune systems or that have chronic diseases. It is important to note that the majority of Legionnaires cases in hospitals are due to the drinking water system.

How to reduce the risk of wHAIs: education and water management programs

So now that we are aware of waterborne hospital acquired infections (wHAIs), is there a way to reduce the risk that potable water poses to healthcare facilities? Infection Control Today (2018) suggests both education and water management programs as possible solutions to reducing the wHAI risk. Firstly, through education, it is important that healthcare workers know that potable water does carry bacteria and does cause an increase in HAIs. Second, once this idea of water carrying bacteria is understood, it will be important to implement water management programs. There can be no standardized water management programs, as all facilities differ in factors such as age of establishment and system, overall design of plumbing system, populations served, etc. Some hospitals have already tried different methods of water disinfection. Examples of these methods used to reduce risk include the use of sterile water in high-risk patient areas, engineering controls and point-of-use water filters.

To summarize, healthcare facilities must realize the risk that water and plumbing systems pose to their patients and employees. Hospital-acquired infections are one of the leading causes of death in North America and it is therefore crucial that hospitals take action against any source that could spread these infections. Education and water management programs are the best ways to help reduce the risk of wHAIs, according to Infection Control Today (2018).

Learn more about Hospital-acquired infections in this free webinar

Source: Infection Control Today. Vol. 22. No. 2. February 2018. 

Medical hygiene monitoring badges: how new technology is helping to prevent the spread of microorganisms

Hygiene and cleanliness are already monitored closely in hospitals and healthcare facilities. Hand sanitation is a crucial hygiene practice for both medical professionals’ well-being, as well as their patients. However, according to TrendHunter (2014), hand hygiene compliance in US hospitals is only achieved 50% of the time. And this is only an example of hand hygiene in the US. Studies would probably show similar, if not worse, percentages in countries across the globe. That is why Biovigil invented a medical hygiene monitoring badge.

Source: Pixabay

The Biovigil monitoring badge is specifically made for hand sanitation. The badge can be clipped on to a scrub or lab coat. It reminds healthcare workers to clean their hands when they leave or enter a patient’s room. It also works by telling either healthcare professionals or patients if their hands have been properly sanitized by turning green when the worker places their hand over the monitor. The badge also collects data on hand sanitation and sends it to be analyzed. While these badges are not heavily used yet, they could prove to be very efficient in eliminating the spread of hospital-aqcuired infections.

It is not, then, unreasonable to ask what other sort of technology could be developed in order to better monitor hygiene and sanitation in healthcare facilities. With the technological resources we have today, it is highly possible to create new products such as this. For now, most hygiene monitoring technologies revolve around hand sanitation. But as we’ve seen in other posts, there are way more sources of contamination and spread of bacteria than just hands; hospital bed mattresses, marked medical instruments, surface damages on medical equipment, etc. Why not create a technology that monitors the hygiene of these things as well? Similarly to the hand sanitation monitor, there could be monitors for other medical equipments that alert healthcare cleaners to check if they are clean and safe to use.

 

Source: https://www.trendhunter.com/trends/biovigil

Global Market for antiseptics and disinfectants: Rapid Growth Expected

With the number of hospitals and healthcare facilities on the rise around the globe, more institutions and individuals are realizing the importance of antiseptics and disinfectants. According to Zion Market Research’s forecast, the global antiseptic and disinfectant market is expected to reach USD 8.1 billion by 2021 (market value of 5.55 billion in 2015), and is expected a rapid growth rate of about 6.7% yearly between 2016 and 2021.

WHAT IS THE DIFFERENCE BETWEEN ANTISEPTICS AND DISINFECTANTS?

Antiseptics and disinfectants are both fundamentally used for the same purpose: eliminating disease-causing organisms. How they differ, however, is based on the surface they are used on. Antiseptics are used to kill microorganisms on or in the skin. Disinfectants are used to get rid of microorganisms on the surface of objects or surfaces. (Livestrong, 2014).

WHY ARE THEY SO IMPORTANT?

Antiseptics and disinfectants are essential to preventing infection. Hospital acquired infections, caused by the spread of microorganisms, is one of the leading causes of death worldwide and is the fourth leading cause of death in Canada. Antiseptics and disinfectants are especially necessary in a healthcare setting, as preventing hospital-acquired infections can save lives, reduce a patient’s hospital stay time and save hospitals a lot of costs associated with these infections. With an increase in advanced healthcare facilities and medical professionals/researchers worldwide, antiseptics and disinfectants are increasingly in demand. It is also important to note that, as developing countries are modernizing their healthcare facilities, demand is increasingly high in these regions. Institutions make up the biggest segment of the demand for these products (50% of market), hospitals and schools being major consumers.

To conclude, increase in advanced technologies, research and healthcare facilities has contributed to a higher awareness (both institutionally and domestically) of the danger that bacteria poses if left on skin or surfaces. This increase in awareness is what is driving the market for antiseptics and disinfectants and leading to its rapid growth, which is expected to continue.

 

SOURCE: https://www.zionmarketresearch.com/news/global-antiseptics-and-disinfectants-market

https://www.livestrong.com/article/291472-antiseptic-vs-disinfectant/

Is Nipah Virus the Next Epidemic Crisis?

Nipah-Virus-Grey-Headed-Flying-Fox-Size

According to the CBC:

A rare virus spread by fruit bats, which can cause flu-like symptoms and brain damage, has killed 10 people in southern India, health officials said on Tuesday, with at least two more cases being monitored.

The virus was first detected in Malaysia in 1998, and India’s eastern state of West Bengal has suffered two outbreaks in the last decade, killing 50 people, the WHO has said.

There has been a another preivous outbreak in Bengladesh in 2004. It would be the third outbreak if confirmed.

Is there any risks in Canada?

The risk to Canadians is considered to be low as there are no species of fruit bats in Canada. However, people working with swine in Southeast Asia should be aware of the risk.

Mode of transmission of Nipah Virus

nipah virus

Public Health Canada states that:

The mechanism for the transmission of the virus from fruit-bats to animals is unknown, but may involve consumption of fruit contaminated with urine or saliva from infected bats. Transmission from animals to humans appears to occur by direct contact with contaminated tissues/body fluids of infected animals, especially pigs. Other infected animals, such as cats and dogs, may also be involved in spreading the virus. Human to human transmission is likely to occur by direct exposure to an infectious inoculum shed in the respiratory secretions of the infected individual, as well as by close physical interaction and frequent contact with the infected individual’s saliva.

Human-to-human transmission has been documented in several of the more recent outbreaks in Bangladesh, before which human-to-human transmission was considered to be a rare event

 

Sources:

Special Thanks: Remi Charlebois

http://www.cbc.ca/news/health/india-nipah-virus-death-toll-1.4672446

http://www.who.int/csr/disease/nipah/en/

http://www.inspection.gc.ca/animals/terrestrial-animals/diseases/immediately-notifiable/nipah-virus/fact-sheet/eng/1303439340158/1306100144027

https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/nipah-virus.html

Mystery virus Nipah virus identified in Kerala, 9 dead, Central team on way

Grey-Headed Flying Fox

How certain medical instrument marking methods can enable the growth of microorganisms – and what to do about it

In order to make it easier to identify a medical instrument, many doctors use different marking systems.The methods in which medical instruments can be marked are quite strict, in order to prevent the spread of bacteria. For example, instruments cannot be engraved because bacteria can get stuck in the small holes and grow. The article “Instrument Marking Methods Must be Maintained Properly”, by Nancy Chobin, describes three different methods of marking medical instruments and how these methods still have disadvantages and need to be maintained.

medical instrument

Source: Wikimedia Commons

First method for marking a medical instrument

Firstly, instruments are often marked by different colored tapes, however, many healthcare professionals fail to realize that the tape on the instruments can harbour bacteria and must be very carefully maintained. The tape should be replaced as soon as it begins to chip, as those small tears in the tape could allow for microorganisms to grow. According to Chobin “All tape and adhesive residues should be completely removed and the instrument washed before it is re-taped.” It is also stressed that a sharp object should not be used to remove tape, as this could simply create small fissures on the instrument where bacteria could grow.

Two other methods for marking a medical instrument

There are two other methods for marking instruments that are considered “acceptable”; chemical etching and color-bonding. These methods also come with some disadvantages, such as color-bonded instruments also chipping sometimes, however, seem to be more “sanitary” than using tape.

Why is this important? The general goal of healthcare facilities is to improve the health of its patients, while at the same time controlling and preventing the spread of infections and contamination. This means that healthcare facilities should aim to prevent, at all costs, the growth of bacteria. In order to be able to do so effectively, healthcare workers must know where all sources of bacteria may come from.

Source: Infection Control Today. Vol. 21. No. 12. December 2017.

Infection control in schools

Every parent knows it: when kids are in school, they are way more likely to get sick than when they are not. From sharing toys, chairs, desks, computer keyboards, water fountains and door handles, kids are the most prone to getting sick. Elementary and preschool students are the most prone to getting sick at school, mostly because their immune system is not fully developed yet. On average, elementary students will have 12 colds per year (yikes!). And let’s not forget that many school staff also end up getting sick from their students. So what can be done to help stop the spread of infection among students and staff?

Source: Pixabay

Sure, you can remind kids to wash their hands, cover their mouths when they cough, etc, but how effective will it really be? Schools must play a very important role in the cleaning and disinfection within their buildings in order to protect both employees and students. The primary person responsible for the upkeep of the school building is the custodian, and, as such, he should be trained in infection control methods.

The Centers for Disease Control and Prevention (CDC) makes the following recommendations on how to properly clean and disinfect schools and what procedures to follow:

  1. Knowing the difference between cleaning, disinfecting and sanitizing
    The CDC stresses the difference between the three methods of “cleaning”. While cleaning involves the removal of dirt and germs, it does not necessarily kill the bacteria. Disinfection, on the other hand, uses chemicals to kill bacterias, and does not focus on a clean surface, but rather a bacteria-free one. Finally, sanitization is the process of lowering the number of bacteria to a safe level.
  2. Clean and disinfect surfaces that are touched often
    This point speaks for itself; many schools already have a specific procedure regarding what should be cleaned more often, such as desks, compared to something that does not have to be cleaned often.
  3. Do routine cleaning and disinfecting.
  4. Clean and disinfect correctly.
    It’s simple to say, however, many people and institutions are not trained to know exactly what “correctly” means. It is important to pay close attention to the detailed instructions provided on the label of product.
  5. Use products safely.
    Pay attention to warnings and hazards on the label of product. Make sure that proper equipment (gloves, masks, etc.) are used when necessary.
  6. Handle waste properly.
    Avoid touching tissues/napkins when emptying waste baskets. Wear gloves, if possible. Wash hands after handling waste.
  7. Learn more.
    CDC provides more follow up information on their website about disinfection and cleaning for schools.

Let’s prevent staff and students from getting unnecessary illnesses and work together for a more clean and safe learning environment!


SOURCES: https://www.cdc.gov/flu/school/cleaning.htm

http://www.standard.net/Health/2015/09/24/Everyone-gets-sick-when-school-starts

Surface Damage and its implications for healthcare facilities

Preventing and controlling the spread of contamination and infection is of very high importance for healthcare facilities, and it is safe to say that many measures have already been taken in order to reach these goals. However, like many things, there is still much room for improvement moreover when it is about surface damage.

medical equipment surface damage

Source: Shaw Air Force Base

Evidently healthcare facilities use a wide variety of equipment, from monitors to surgical instruments to cleaning tools, and over time, this equipment wears down. Sometimes, equipment will break completely and be unusable, however sometimes there will only be a few scratches or other small damage.  But what happens when these scratches or other forms of damage become shelters and areas of growth for microorganisms? This is an example of how surface damage may not only impede the prevention of bacteria growth, but also provide the microorganisms with a place to grow.

What is surface damage?

According to Infection Control Today, surface damage is defined as:

a quantifiable physical or chemical change from the original manufactured state of an object (surface or device).

While it is recognized that surface damage of medical equipment poses a potential threat in the spread of bacteria in healthcare facilities, there is no standardized method for healthcare workers to determine what is considered surface damage, and at what point the damage is likely to cause the spread of bacteria. In a later blog post, I will discuss the ideal surface damage testing protocol, proposed by Peter Teska et al. in “Infection Control Today.” In this article, the authors discuss ideal methods of avoiding the problems that surface damage presents.

Are your surfaces damaged?

At Lalema, when we talk about hygiene and cleanliness, we offer a wide range of technical and consulting services. Find out more.

You can also read this article about The complete guide for hospital cleanliness.

Source: Infection Control Today. Vol. 21. No. 12. January 2018.

Hospital bed mattresses: An overlooked healthcare hazard (Follow up)

As a follow-up to my previous blog post about the problem of hospital bed mattresses being contaminated, I would like to go into further detail the recommendations provided by the Food and Drug Administration (FDA). As previously mentioned, the FDA recommends that healthcare facilities take preventative measures against contamination of hospital bed mattresses in four simple steps: inspection, removal and replacement, maintenance and the development of an inspection plan.

Hospital bed matressesSource: Flickr

Inspection involves routinely checking the bed mattress cover for any signs of damage, stains or tears, as well as checking if the bed mattress cover is past its expiry date (Yes – bed covers do have a limited lifespan). It is also important to frequently remove the cover and check the inside surface, as well the mattress itself for these same conditions.

Next, it is important to replace any mattress covers with visible signs of damage or stains. Also, mattresses with damage or visible stains should be removed immediately.

For maintenance, it is important to clean and disinfect undamaged bed mattress covers. This can be done according to the bed cover cleaning guidelines given by the manufacturer.

Finally, FDA suggests that healthcare facilities develop an inspection plan that can be applied for all medical bed mattresses and covers. It is important to check the expected life of the bed mattress, as well as the cover.

 

Source: Infection Control Today. Vol. 22. No. 1. January 2018.

Hospital bed mattresses: An overlooked healthcare hazard

Hospital beds are composed of many different parts: the bed frame, which includes the bed side rails, as well as a mattress and a mattress cover. Once a patient is discharged from the hospital, normally, the room will go through a substantial amount of cleaning, including the bed. The rails and bed frame will be wiped down and the bed cover will be changed in order to prepare for the next patient. However, one factor is often dismissed: the hospital bed mattress.

hospital-bed-matresses

📷 pixabay.com

According to the ECRI Institute:

Bed and stretcher mattresses can remain contaminated after cleaning, putting patients and staff at risk of exposure to body fluids or microbiological contaminants. Reported incidents include patients lying on an apparently clean bed or stretcher when blood from a previous patient oozed out of the support surface onto the patient.

While hospital bed covers are changed regularly, many health care facilities fail to examine these bed covers for damages, heavy stains or tears. It is also important to note that mattress covers have an expected lifespan, and will become ineffective after this duration of time. All of these factors can lead to blood or any other body fluids leaking onto the hospital bed mattress, therefore leaving it contaminated.

The FDA (Food and Drug Administration) makes several recommendations in order to overcome this healthcare hazard:

  • Inspect
  • Remove and Replace
  • Maintain
  • Develop an Inspection Plan

While companies who sell the mattress covers have the responsibility in properly explaining to healthcare facilities how to properly disinfect, clean and dispose of bed covers, it is crucial for healthcare facilities to use the necessary materials and procedures in order to clean and disinfect. Healthcare facilities must also regularly inspect both mattress covers and mattresses in order to prevent infection as much as possible.

Reference:

Infection Control Today. Vol. 22. No. 1. January 2018

Towards a universal vaccine against flu

Influenza is a stubborn virus. Moreover, every year, the virus is changing and it’s another race against time to produce a new vaccine, often composed of several strains, which will be able to protect the most vulnerable population such as young children, the elderly and sick people.

inlfuenza

AN ENCOURAGING RESEARCH on INFLUENZA

According to the article by Radio-Canada:

At Laval University, Gary Kobinger’s team is testing a new influenza vaccine, which could provide better protection and long-term immunization. The formula incorporates much of the circulating influenza strains over the last 20 years.

A first clinical trial to test the safety of the vaccine ended a few months ago. According to the researchers, it shows that the product does not cause significant side effects.

The effectiveness of vaccines against influenza (the flu) is also limited especially when we guess wrong the strain that will be the most virulent that year!

THE IMPORTANCE OF HAND WASH

We are all at one point exposed to the flu virus. A good way of individual prevention is to put on your hat on and tie your coat. I am joking. On the other hand, regular hand washing before meals, after the toilet and even just when arriving at work or at home is really an effective way against the spread of the virus.

Regular hand soaps like Utopia or antibacterial soap like Utopia AB do the trick.

Did you know that our soaps do not contain any: methyisothiazolinone?

THE IMPORTANCE OF SURFACE DISINFECTION

Cleaning worker also plays a very important role in the winter period when it comes to disinfecting surfaces. Specialty products such as the Ali-Flex line of product offers many benefits:

 

DOWNLOAD MY FREE TRAINING ON INFLUENZA EPIDEMICS

I can give it in person at your workplace. Contact me glanthier@lalema.com

Source: http://ici.radio-canada.ca/nouvelle/1065664/vaccin-universel-grippe-influenza-guerir-personnes-agees-annee-h1n1-une-fois

Would we be ready to face an epidemic of bubonic plague?

Would we be ready to face an epidemic of bubonic plague?

In Madagascar, the government has recently imposed two days ago new emergency measures to stop a plague epidemic. It has been declared 24 dead since 1 month1.

black_death

What is the bubonic plague?

The plague is a bacterium Yersinia pestis, present in rodents as rats are often passed to humans by infected fleas.

According to Health Canada:

The incubation period of the plague varies from one to ten days.

Whatever the form, the illness always starts with flu-like symptoms (fever, chills, muscle aches, weakness and headaches) and can also cause nausea, vomiting, diarrhea and abdominal pain.

If left untreated, the mortality rate can reach 50%.

Bubonic plague smear demonstrating the presence of yersinia pest

SURFACES DISINFECTIONS

According to Health Canada2, in the event of a spill or contaminated surfaces:

Let the aerosols fall; wear protective clothing, carefully cover the spilled material with paper towels and apply 1% sodium hypochlorite from the periphery to the center; allow to act for a sufficient period (30 minutes) before cleaning

Plague is affected by many types of surface disinfectants such as:

MATERIAL SAFETY DATA SHEET: PATHOGENIC AGENTS, AND RISK ASSESSMENT

You are dealing with a bacterium, virus or other pathogen and you want to know more about it. Health Canada has launched an application and a website:

LAST CASE REPORTED IN CANADA

Cases of plague in humans are very rare in Canada; the last case was reported in 1939.

 

References:

1 http://www.lapresse.ca/international/afrique/201709/30/01-5138249-madagascar-durence-measures-to-tenter-delight-pidemic-epidemia.php

2 https://www.canada.ca/en/public_health/services/biosururity-biosurete-laboratory/technical-sheets-health-security-agents-pathogenes-risk-assessment/yers-in-the-health-technical-files -Security-ftss.html

How often should I clean this or that?

I develop maintenance program for my clients and the question that comes up most often is:
“How often should I clean this or that?”

clean

How often should I clean this?

Here is a non-exhaustive list of 16 surfaces to clean regularly at home.

Item Frequency Tips
1. Cellular phone

Daily Wipe with a microfiber glass cloth to remove any greasy substances and germs
2. Kitchen Counter

Daily Use a mild all purpose cleaner. When using a disinfectant cleaner, rinse the surface.
3. Dishwasher

Monthly Use specially designed capsules or a little bit of baking soda and vinegar and the trick is done.
4. Refrigerator

Quarterly To avoid the appearance of mold and other undesirable contents, empty and clean the shelves and containers.
5. Kitchen floor

Weekly Use a broom after each meal and a good damp mopping every week.
6. Carpets

Weekly Vacuuming carpets every week will even reduce allergies. Remove the dog and the baby before to do so!
7. Furniture

Monthly Vacuum furniture and fabrics every month and steam clean annually
8. Remote control or joystick

Weekly Remove the batteries, clean the remote control surface by rubbing the buttons and gaps.
9. Ceiling fans

Quarterly With an all purpose cleaner, wipe the blades. Do not forget to turn off the fan!
10. Window blinds

Quarterly Dust and clean batten by batten with soapy water and a soft cloth.
11. Toilet

Daily Brush daily and thoroughly clean once a week.
12. Towels

After some use After the shower or the bath, hang to dry and use a few times (3 or 4 times), then machine wash. Note: If you have teenagers, this thing may not work!
13. Shower curtain

Monthly Spray a bathroom cleaner to remove residual accumulated soaps and limescale.
14. Bed linen

Weekly Wash in warm water to remove bacteria and mites. Avoid eating in your bed!
15. Mattress

Biannual Vacuum the mattress twice a year to remove dead skin cells and mites.
16. Air filter

Monthly Changing air filters every month or as recommended by the manufacturer contributes to a healthy environment.

We have the tools to clean

At Lalema, we serve a large industrial and institutional clientele with an online catalog of more than 18000 products ! Come and have a look!

www.lalema.com

 

Source :

inspired from http://www.webmd.com/a-to-z-guides/ss/slideshow-how-often-clean-this.

Photos are owned by me or from various talended photographs via unsplash.com

How to reduce the phenomenon of antibiotic resistance?

As you know, improper and inappropriate use of antibiotics has resulted in bacteria developing resistance mechanisms. In general, we observe a decrease in the effectiveness of antibiotics in fighting multiresistant bacteria. In fact, the antibiotics that were developed between 1940 and 1980 generally had a very specific target, which facilitated the acquisition of resistance mechanisms by bacteria. In addition, the new antibiotics that are marketed are generally similar to existing antibiotics, making resistance acquisition even easier for bacteria. Thus, all the preceding facts suggest the importance of developing new antibiotics displaying novel mechanisms of action.

One of the alternatives is to develop antibiotics targeting the cell membrane of bacteria. Among others, we find the natural antimicrobial peptides that are a class of molecules participating in the immune response of several organisms such as bacteria, plants and mammals [1]. These peptides have the ability to form pores or to induce defects in the cell membrane, which will lead to a disturbance of the electrochemical gradient across the membrane, thus causing cell death (FIG. 1) .

antibiotic-resistance

Figure 1: Illustration of the main mechanisms of cationic antimicrobial peptides [3].

Inspired by these natural peptides, many researchers are attempting to develop synthetic antimicrobial peptides that will be both less toxic and pharmacologically viable. On the market, we find daptomycin (Cubicin®) which acts by a mechanism similar to natural antimicrobial peptides [4]. This antibiotic from the lipopeptide family is used for the treatment of infections involving methicillin-resistant Staphylococcus aureus (MRSA). It is interesting to note that, like natural antimicrobial peptides, quaternary ammoniums, which are commonly used in disinfection operations, also destroy bacteria because of their membrane activity [5]. At Lalema, a wide range of quaternary ammonium-based disinfectants are available to meet your needs.

The ever-growing problem of antibiotic resistance is a major health issue and a heavy tax burden on governments. The use of an adequate antibiotic management system, the advent of new technology and better control of the transmission of pathogens (disinfection) are essential tools to reverse the current trend.

 

References

[1] Jenssen, H., Hamill, P., and Hancock, R.E. W. 2006 Clin. Microbiol. Rev. 19, 491-511.

[2] Zasloff, M. 2002 Nature, 415, 390-395.

[3] Chan, D. I., Prenner, E. J., and Vogel, H. J. 2006 Biochim. Biophys. Acta. 1758, 1184-1202.

[4] Taylor, S. D., and Palmer, M. 2016 Bioorg. Med. Chem., 24, 6253-6268.

[5] Ioannou, C.J., Hanlon, G. W., and Denyer, S. P. 2007 Antimicrob. Chemother Agents, 51, 296-306.

The complete guide to hospital cleaning

hospital-cleaning

For a long time, cleaning has been all about the look; fresh smell and the absence of stains or dirt were the criteria to determine that a place is clean. Today, these criteria are still generally accepted in environments such as offices and classrooms.

It’s common knowledge, however, that microbes (bacteria or viruses) invisible to the human eye represent a risk for spreading infections. Take the example of the influenza virus: it can survive for up to 48 hours on a hard surface!

Without cleaning and disinfection procedures or a quality check procedure, microbes can survive in hospital environments.

Three key elements have to be considered in order to perform an infective risk analysis:

  • Is the patient carrying a disease agent? Disease agents are classified based on their spreading capacity and their virulence. The choice of a disinfectant will be based on this.
  • Do the functional activities of a sector represent a risk of spreading infections from the environment? E.g.: food service, offices, Intensive Care, etc.
  • The intensity of contact is related to the traffic and the surfaces that are more likely to be touched. E.g.: bathroom fittings.

Infective Risk Analysis

Cleaning in hospitals allows reducing risks of infection among patients. This is not the only factor, of course: good personal hygiene habits such as washing hands and the use of protective equipment such as overalls, gloves, masks, or protective glasses are also important elements.

For this reason, interventions must be well coordinated in order to have a good surface maintenance plan. The manager of hygiene and cleanliness should therefore take into account:

  • The type of place associated to the level of risk
  • The tasks to perform
  • The required cleaning frequency

If well applied, a detailed estimate allows validating the cleaning performance.

The global approach is going to be determined by type of place:

  • Regular eradication (e.g.: operating rooms)
  • Keeping environmental effects as light as possible (e.g.: low infection risk such as individual office spaces)
  • Balance of microorganisms. This approach is based on the competition between good and bad microbes. The presence of good microbes guarantees less space for bad microbes to grow (e.g.: living environments)
  • Green cleaning. Approach that uses less toxic products
  • Review and improve arrangements and/or surfaces (during conception or renovation)

The Cleaning Staff: key to success

The hygiene and cleanliness staff represents a key element in the fight against infections in hospital environments. Often little valued, their role in the global strategy of surface cleaning is extremely important.

The hygiene that comes from the work of the cleaning staff requires a high performance level. In order to reach that, the executing staff and the managers need to master all the different elements representing this profession.

Cleaning products and equipment are undeniably crucial in order to ensure performance during the environment asepsis of any establishment. Therefore, it is important to associate the day-to-day actions of the cleaning staff with a range of products and equipment that favor the quality of their performance.

Since several years, partly due to the devotion and the involvement of many members in the healthcare system, we take into consideration new factors:

  • Provincial training
  • Establishment of an AEP hygiene and cleanliness in healthcare environments of 630 hours now offered by many school boards
  • Provincial day of hygiene and cleanliness
  • Etc.

Having said this, the hygiene and cleanliness staff deserves our deepest gratitude. Thank you so much!

Work Organization

How can proper work organization contribute to the cleanliness of a hospital? How to be in the right place with the right equipment? Here are the questions we are going to answer in this post of the Cleaning in Hospitals series.

Evaluation of production needs

First, we need to assess the needs in hygiene and cleanliness. In order to do this, a standard evaluation is preferable but it needs to be adjusted based on the type of place, units, and traffic.

It is during the evaluation of needs that the hygiene and cleanliness estimate (see Cleaning in Hospitals part 2) is going to be determined. All daily, weekly, monthly, and annual tasks have to be considered.

Usually, the results are presented by production yields (square meters/hour) or FTE (Full Time Equivalent).

How to reduce time waste

How to measure productivity in a context where an important aspect of the task is moving? Actually, hygiene and cleanliness departments are almost always in the basement, whereas most of their work happens on the floors!

We increase productivity by reducing traveling.

It is for this reason that the cleaning cart needs to be as complete as possible and the water sources or janitor’s closets well stocked with supplies (i.e.: paper products or waste bags), equipment, and sanitary products.

Moreover, it is important to remember that a good entrance carpet can greatly reduce dirt.

Have a successful day!

Here are a few hints on how to have a successful day:

  • Establish a sequence of actions to perform in a day/week/month
  • Define a sequential order of rooms
  • Integrate linked and periodical tasks (monthly)
  • Make sure to have time gaps to focus on periodical tasks (dusting of high surfaces, polishing, etc.)
  • Minimize traveling
  • Work by space and not by task
  • Distribute tasks equitably
  • One look is worth a thousand words: choose a colorful plan together with some graphics instead of a list of tasks on a word file!

Want to know more?

Look this free webinar from my collegue Remi:

Need help?

Don’t hesitate to call 514.645.2753 or subscribe to one of our training seminars. I really hope that you liked this post!

An enzyme to destroy biofilms

One can not stop the progress. The discovery of an enzyme capable of preventing the production of a biofilm, this polymeric protective layer produced by bacteria that prevents antibiotics and surface disinfectants from functioning well, could ultimately revolutionize the fight against nosocomial infections.

perturbation-biofilm

The team at the McGill University Health Center, which includes Dr. Donald C. Sheppard, has published a study in the journal Proceedings of the National Academy of Sciences (PNAS). Their hope is that this technology will be the subject of human clinical trials in Canada within 5 years and be used in hospitals within 10 years.

From the abstract:

We demonstrate that glycoside hydrolases derived from the opportunistic fungus Aspergillus fumigatus and Gram-negative bacterium Pseudomonas aeruginosa can be exploited to disrupt preformed fungal biofilms and reduce virulence.

What is a biofilm?

My colleague RĂ©mi Charlebois described biofilms as follows:

Biofilms found on surfaces are often derived from a complex colony of microorganisms producing polymers that allow them to adhere better to the surface and facilitate colony life. In short, a biofilm is like a city for microbes. Man has learned to tame these biofilms and can use them to treat wastewater or produce certain molecules such as natural plastics. However, the presence of unwanted biofilms could be harmful and can lead to infections.

Biofilms are also found on the skin and medical devices. Thus, according to the article of Le Devoir:

Biofilms, a highly sticky matrix of proteins and sugar polymers made by bacteria to protect themselves, are attached to the skin, mucous membranes or the surface of biomedical materials, including catheters, tubing, heart valves and other prostheses Which become preferred entry points for infection.

In the same article, Dr. Sheppard quotes:

Biofilms are produced by molecules that defend against our immune system or against antibiotics with this shell that is 1000 times more resistant than the organisms that produce and proliferate in these biofilms.

An enzyme that acts as a “destructive machine” for biofilms

In short, the enzyme discovered was modified to destroy the biofilms instead of forming them. This is a new strategy that can reduce nosocomial infections in healthcare centers.

Watch this video about biofilms (25 minutes, french)

Sources:

http://www.ledevoir.com/societe/sante/501939/des-chercheurs-percent-le-secret-de-la-resistance-de-certaines-bacteries

http://www.lapresse.ca/sciences/medecine/201706/27/01-5111114-avancee-majeure-contre-les-infections-dans-les-hopitaux.php

What about Surface Disinfection against Poliovirus

Recently, my friend RĂ©mi wrote on Twitter: “Why is it so long to get rid of Polio in the world? “, Did you know that there are barely 30 cases per year in the world! Only 3 countries in the world still have Polio cases. One of these 3 countries, Nigeria is on track to succeed with no cases reported since 1 year.

Credit CNN

Should we worry about the anti-vaccine movement?

In the report on CNN twitted by RĂ©mi, the specialist mentions that the number of children not vaccinated in the United States is growing continuously. Will we have to wait for another epidemic?

Surface disinfection against poliovirus type 1

According to Health Canada, in its guideline – Safety and Efficacy Requirements for Disinfectants Assimilated to Hard Surface Drugs, a broad spectrum virus is defined as:

Broad-Spectrum Virucide: A disinfectant that is shown to be effective against a representative, envelope-free and hard-to-kill virus, which is also intended to inactivate other enveloped and envelope-free viruses (ie a product of which A “broad spectrum virucide” efficacy has been demonstrated).

Also according to Health Canada:

The incidence of poliomyelitis in Canada declined following the creation of vaccination programs in the 1950s. The last indigenous case of wild poliovirus infection in Canada dates back to 1977. In 1994, the World Health Organization Officially declared Canada free from wild poliovirus. The cases of paralytic poliomyelitis that have occurred in Canada since then have been associated with imported cases of wild poliovirus infection and the use of OPV.

According to the MSSS, in its guide “Disinfectants and disinfection in hygiene and sanitation: fundamental principles”

Among the viruses are those that are enveloped by a lipid layer and those that are not. These are called naked viruses. Paradoxically, this lipid-rich envelope is easily altered by chemicals, making wrapped viruses vulnerable. In contrast, naked viruses are “accustomed” to coping with outdoor conditions and are more resistant to disinfectants. Generally, if a disinfectant is active against naked viruses, such as polio, it is likely to be active against enveloped viruses, such as AIDS (HIV).

Quaternary or sodium hypochlorite disinfectants

Quaternary or sodium hypochlorite disinfectants with the “broad-spectrum virucidal” claim are effective against naked viruses such as polio.

Good Practices in Waste Management

Waste management can be a real headache especially if you work in a hospital or university! In Quebec, the legal and regulatory framework has evolved for more than 50 years and in 2017, several municipal, provincial and federal laws and regulations are in force. Let’s see how we can classify and demystify the different types of waste.

Waste Management

Credit photo Joseph Barrientos via unsplash

Good practices in waste management

To properly manage waste, it is imperative on one hand to be well aware of the characterization of your waste and on the other hand to know the regulations that apply to your situation.

Safe Handling

The safe handling of waste, whether at the time of its production, handling, storage or disposal, must be accomplished with appropriate protective measures for your own safety, safety of of others and protection of the environment.

Communication

Each department must also be informed of the way in which they dispose of the waste they produce in a safely manner. That’s why a good communication plan is also important!

Reduction at source

Take action by initiating gradual changes in how you manage your residual materials on the basis of the 3RV-E principle that promotes source reduction, reuse, recycling and valorise until residual materials must be eliminated.

  • Reducing at source is the fundamental principle of management to decrease the quantity of goods consumed, which necessarily decreases the amount of natural resources consumed.
  • Reuse is to give a second life to objects and use what others do not need anymore.
  • Recycling is the process of converting a residual material into a raw material for the manufacture of a new product
  • Valorisation is to give a second life to the products but in different ways, usually this is done by the biological way for example compost or energy like biofuels
  • Elimination when all efforts have been made in the 3RV and waste is finally disposed of.

Classification of waste by category

In industrial and institutional environments, waste is generally grouped into 7 categories:

  • General Waste
    • Non-recyclable waste with no reuse or recovery potential
  • Biomedical waste
    • Human anatomical waste
    • Animal anatomical wastes
    • Non-anatomical waste
      • Piercing, sharp or breakable objects that have been in contact with blood
      • A liquid or a biological tissue
      • Biological tissues, cell cultures, cultures of micro-organisms;
      • Live strain vaccines;
      • Containers of blood and blood-soaked equipment, etc.
  • Pharmaceutical waste
    • Hazardous pharmaceutical waste
      • Drug residues
      • Toxic expired drugs
      • Cytotoxic drugs
    • Non-hazardous pharmaceutical waste
      • Other drug residues
      • Non-hazardous expired drugs
  • Chemical waste
    • Chemicals from laboratories
      • Laboratory reagents
      • Laboratory solvents
    • Pressurized containers
  • Radioactive waste
    • Residues containing radioactive isotopes above standard
    • Syringes, reactors, lead cylinders (nuclear medicine)
  • Electronic waste (or with heavy metals)
    • Hardware
      • Computers
      • Screens
    • Cell phones
    • Battery
    • Articles containing mercury
      • Thermometers
      • Fluorescent or compact fluorescent bulbs
  • Recyclable waste
    • Paper
    • Cardboard
    • Plastic
    • Glass
    • Metal
    • Food and compostable residues
    • Organic waste
    • Construction debris
      • Brick
      • Concrete
      • Unpainted gypsum board
      • Metal
      • Wood

Legislative and regulatory framework for waste management in Quebec

  • Loi sur la qualitĂ© de l’environnement (chapitre Q-2)
  • Règlement sur l’enfouissement et l’incinĂ©ration des matières rĂ©siduelles (c. Q-2, r. 19)
  • Règlement sur la santĂ© et la sĂ©curitĂ© du travail (chapitre S-2.1,r. 13)
  • Code de sĂ©curitĂ© pour les travaux de construction (chapitre S-2.1,r. 4)
  • Règlement sur les dĂ©chets biomĂ©dicaux (c. Q-2, r. 12)
  • Code de la sĂ©curitĂ© routière (chapitre C-24.2)
  • Règlement sur le transport des matières dangereuses (c. C-24.2, r. 43)
  • Règlement sur les matières dangereuses (c. Q-2, r. 32)
  • Règlement sur la rĂ©cupĂ©ration et la valorisation de produits par les entreprises (c. Q-2, r. 40.1)
  • Code de sĂ©curitĂ© pour les travaux de construction – amiante (chapitre S-2.1, r. 4)
  • Loi sur la sĂ»retĂ© et la rĂ©glementation nuclĂ©aires (L.C. 1997, ch. 9)
  • Règlement gĂ©nĂ©ral sur la sĂ»retĂ© et la rĂ©glementation nuclĂ©aires (DORS/2000-202)
  • Règlement sur la radioprotection (DORS/2000-203)
  • Règlement sur l’emballage et le transport des substances nuclĂ©aires (DORS/2000-208)
  • Règlement sur les substances nuclĂ©aires et les appareils Ă  rayonnement (DORS/2000-207)

Learning, Understanding, Implementing, Enhancing

Have you enjoyed this post and would like to learn about this topic or about hygiene and sanitation in general? Great! Why not check out our training and consulting catalog now?

Source: Guide de gestion des déchets du réseau de la santé et des services sociaux

Inside an anthill near you

Several tasks accomplished by ants are similar to those of human professions such as farmer or breeder. Swiss researchers recently added a surprising task to this list: chemist!

david-higgins-10165-fourmi-1024x683

Credit David Higgins, Unsplash

Community life

We all know that anthills are full of ants. A population of a colony can easily reach several millions. Although they may be insects, food supply, waste management and infection control are, believe it or not, a major concern for the queen of an anthill.

The chemist ant

By mixing coniferous resin with formic acid (a venom secreted by ants to combat their enemies), the mixture doubles the antifungal efficacy of the resin alone. These ants are capable of improving the resistance of the colony to pathogens. This is the first time that we have observed, apart from humans, a species mixing different compounds in order to improve their effects.

Hard surface Disinfection in the human world

At Lalema, conifer resin and formic acid are not used to make our disinfectants. On the other hand, our formulas are developed and validated by real chemists in addition to being registered with the appropriate governmental bodies.

Our exclusive Certiklör technology allows our sodium hypochlorite products such as Ali-Flex RTU to have the following advantages over the competitor’s products :

  • Hypochlorite stabilized in solution (vs. Bleach)
  • Low odor (vs. Bleach at the same concentration)
  • Low corrosive potential (vs. Bleach at the same concentration)

Discover our Certiklör product line now or call our customer service at 514.645.2753 for more information.

Source: http://ici.radio-canada.ca/news/1024037/fourmis-chimie-infection-bacterie-antibiotique-etude

Thanks to my cousin Thierry L-D for finding the article about the ants!

How to make cleaning safer in 7 steps

According to ASSTSAS, falls and slips account for 18% of workers’ compensation costs in the province of Quebec. This is the third leading cause of workplace accidents in the health and social services sector and it includes all types of jobs.

Causes of workplace accidents

There are many other causes of workplace related accidents :

  • Fall and slide accidents
  • Muscle problems related to lift and flexion
  • Eye and skin lesions, often related to the handling of chemicals
  • Respiratory problems, often the result of working with chemicals and equipment
  • Accidental exposure to electrical hazards or biological hazards

Seven ways to make cleaning work safer

  1. Ensure periodic review of working methods and procedures
  2. Identify and evaluate “at risk” situations including load lifting, repetitive movements, exposure to chemicals, air quality, work organization
  3. Determine tasks requiring personal protective equipment such as gloves, goggles, masks, protective sleeves, etc.
  4. Wear non-slip shoes when stripping or laying floor finish
  5. Install “wet floor” safety panels when washing floors. Remove the panels when the floors are dry.
  6. Inspect the electrical wiring of your equipment regularly. Never pull the wire to disconnect a device.
  7. Consider the presence of any body fluid or blood as a real biological hazard and clean up only if you have received the proper training.

Sources:

https://asstsas.qc.ca/sites/default/files/publications/documents/Fiches/FT13_chutes_WEB.pdf

http://www.cleanlink.com/news/article/Seven-Ways-To-Make-Cleaning-Work-Safer–20393 (via Kim B., thanks!)

Free Webinar: Fighting Healthcare Associated Infection with Environmental Hygiene

Fighting Healthcare Associated Infection with Environmental Hygiene.


The main objective of this webinar is to review the basics of cleaning and disinfection:

  • The updated burden of HAI’s in Canada
  • Why do we disinfect
  • Best practices in cleaning and disinfection
  • Using the right product
  • Validation technique

This 40 minutes long webinar was originally broadcast on December 15th, 2016. Watch it now on replay for a limited time!

Invitation Free Webinar: Fighting Healthcare Associated Infection with Environmental Hygiene

webinar-topfree-webinar-left2

I would like to invite you to a free webinar on


Fighting Healthcare Associated Infection with Environmental Hygiene.


I will present this webinar on December 15th, 2016 at 12:00 PM EST. (45 minutes long)

The main objective of this webinar will be to review the basics of cleaning and disinfection :

  • The updated burden of HAI’s in Canada
  • Why do we disinfect
  • Best practices in cleaning and disinfection
  • Using the right product
  • Validation technique

Practical information:

  • The webinar will take place on Thursday, December 15th, 2016 at 12:00 PM EST (Toronto Time)
  • Make sure you have a computer accessible with an internet connection
  • The webinar is 100% free without any engagement
  • We will take question after the webinar

SUBSCRIBE NOW

Biofilms: What you should know.

Biofilms are everywhere

Well hidden or sometimes visible, always disgusting, biofilms, as so well described by my colleague RĂ©mi Charlebois, are defined as follows:

Biofilm is an aggregation of microbial cells, surrounded by a protective layer of extracellular polymeric matrix, which attaches itself to any surface found in the hospital environment and becomes a source of contamination. Formation of complex, multicellular communities by microorganisms is a natural phenomenon which helps bacteria or fungi to survive environmental stress such as cleaning and disinfection.

Warning: Graphic Content Ahead

A Biofilm looks like this:

Kitchen Drain

biofilms-drain-cuisine

Source: http://www.biofilm.montana.edu/content/household-biofilms

Sink strainer

biofilm-bouchon-evier

Source: http://www.biofilm.montana.edu/content/household-biofilms

Showerhead

biofilm-pommeau-douche

Source: http://www.biofilm.montana.edu/content/household-biofilms

Toilet Bowl

biofilm-cuve-toilette

Source: http://www.biofilm.montana.edu/content/household-biofilms

How to remove biofilms

Here are 3 methods to eliminate biofilm:

Replace equipment

This mehode is somewhat drastic, probably very expensive certainly mostly impractical. Some industries still proceed that way in 2016. I must say that in some cases it may be the only and best solution. For example pipe sections, filters, etc.

Strong acids and bases

Hydrochloric or Peracetic acids or strong bases such as caustic are sometimes used alternatively. However, corrosivity and danger of these chemicals can damage surfaces, individual protection equipment, storage and handling can also be a challenge . Furthermore, there is always the workplace hazards.

Safe hand soap: a primer

hand soapHandwashing is the single most important action to break down the transmission of infection. Anyone working in the food industry, in a lab or in healthcare environment will tell you how often they have to wash their hands. So many products are available, however, it is clear that not all product were created equal. Multiple claims are often written on the bottle confusing users and buyers. A lack of regulation is seen. However, recently the American FDA (Food and Drug Administration) and Health Canada seems to be going toward new regulation in order to increase the safety of hand soaps.

FDA bans Triclosan

The American FDA (Food and Drug Administration) banned the use of Triclosan and 18 other chemicals in consumer hand soap. The decision was based on the lack of information regarding the effectiveness of this product compare to regular handwashing. Also, serious doubt concerning the safety of this product was crucial in the decision process. The debate has been going on for a while before the decision was made.

Health Canada identified risk regarding Methylisothiazolinone

According to Health Canada, the repeated exposure to this substance and its derivatives can generate multiple symptoms including:

  • a red rash or bumps;
  • itching;
  • swelling, burning, or tenderness of the skin;
  • dry, cracked or scaly skin;
  • blisters.

These symptoms may occur each time someone uses a product containing Methylisothiazolinone and its derivatives and may become more severe with repeated use.

Multiple solutions exist

Hopefully, many suppliers offer products without triclosan, paraben, methylisothiazolinone, benzalkonium chloride, polyacrylamide, dioxane, nonylphenol ethoxylated alcohol or any chemicals of concern. Ask you supplier what are the options regarding safe hand soap, it might save you a lot of trouble.

 

Reference:

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm378393.htm

http://canadiensensante.gc.ca/recall-alert-rappel-avis/hc-sc/2016/58290a-fra.php

6 reasons why staff should be more involved

staff

When selecting or standardizing cleaning products, the involvement and participation of your staff  is essential. It is important to set up a participatory structure (mandatory user committee) for the acquisition of products and equipment. This would not only lead to a greater accountability from the users, but it will also bring a higher degree of satisfaction.

This structure would allow managers :

  1. To listen to users and to promote their full autonomy;
  2. To establish internal standards for any product. Such standards should truly reflect the needs of users;
  3. To review product stock to ensure they remain relevant;
  4. To specify, with users, technical specifications of products for purchasing according to the standards of the institution;
  5. To educate stakeholders on the content of standards and their use;
  6. To enhance internal resources in terms of products and equipment.

Participatory approach for the staff with the managers

Managers and users must be trained to properly select products and their many uses to avoid handling errors, improper dilution and to grab the security concepts associated. This is an essential prerequisite which is part of a participatory process that will generate a consensus from the janitors about the choice of cleaning products and initiate actions and training of new practices.

3 useful definitions in cleaning and disinfection

When it comes to cleanliness, some people are mixing technical terms leading to ambiguity. It is like mixing chemicals together: That is not a good idea! To keep it simple, we’ll just give three useful definitions.

Deteriorated surfaces

A deteriorated surface shows wear off sign often caused by time or misuse.

Deterioration is one of three elements of impairment of property, the others being functional obsolescence (or obsolescence) and economic obsolescence.

surfaces-vetustes

Safe surfaces

Safe surface means that it is safe to health. Such surface is healthy or good for health often because of risk management. In the food industry, this is why we often refer to it as food safety.
Safe is also synonymous to hygienic !

corridor-hopital-lalema

Disinfected surfaces

Disinfection is a voluntary momentary removal operation of certain bacteria (if it comes to “all germs” we refer more to sterilization), so as to stop or prevent infection or the risk of infection or superinfection by pathogenic or undesirable microorganisms or viruses.

For example:

  • To sanitize a surface eliminates 99.9% of microorganisms (This is a 1,000 X reduction)
  • To disinfect a surface removes 99.999% of microorganisms (This is a 100,000 X reduction)
  • To sterilize a surface or instrument removes 99.9999% of microorganisms (This is a 1,000,000 X reduction)

Obviously, “momentarily” is a key fator because the surface will be contaminated again as soon a a contaminant will enter in contact with the it. That’s why some disinfectants have a residual effect that prolongs the action of disinfectant for a certain time.

biofilm-1024x767

Sources: Larousse, Wikipedia, Linternaute