The Prevention of Waterborne Hospital-Acquired Infections

Source: Flickr

On this blog, we have already learned that healthcare-associated infections can be spread through the water and plumbing systems of hospitals. There are many possible reservoirs for the growth and spread of harmful pathogens; including potable water, sinks, faucets, showers, bathtubs, toilets, etc. It is therefore crucial that healthcare facilities develop water-management programs, in order to reduce the risk of infection.

In a recent article from Infection Control Today 2019, it is stated that:

“facilities must develop and adhere to policies and procedures that inhibit microbial growth in building water systems that reduce the risk of growth and the spread of Legionella and other opportunistic pathogens in water.”

Kelly M. Pyrek, Infection Control Today, 2019

Infection Control Today (2019) discusses many different policies that should be adopted by healthcare facilities.

In terms of potable tap water and hospital water systems, recommendations include:

  • Hot water temperatures at the outlet should be at the highest temperature allowable, preferably >51C.
  • In the case of water disruptions, signs should be posted and the drinking of tap water should be prohibited.
  • Standards for potable water must be maintained (<1 coliform bacterium/100 mL).
  • Equipment should be rinsed first with either sterile water, filtered water or tap water and an alcohol rinse should follow.
  • Periodic monitoring of water samples should be done in order to test for Legionella growth.

In terms of sinks in hospitals, recommendations include:

  • The use of separate sinks for handwashing and disposal of contaminated fluids.
  • The decontamination or elimination of sinks if epidemic spread of gram-negative bacteria via sinks is suspected.

In terms of showers in hospitals, recommendations include:

  • Prohibit the use of showers in neutropenic patients.
  • Control Legionella colonization of potable water.

The article discusses many more recommendations for other water-related reservoirs that are potential sources of infection. For more information on these other reservoirs, please refer to Infection Control Today’s website.

In addition to this, it is recommended by Tim Keane, a consultant with Philadelphia-based Legionella Risk Management Inc, that healthcare facilities hire engineers that are “building water system expert(s) who specialize in risk management for building water systems” (Infection Control, 2019). This will provide healthcare facilities with the expertise needed to develop a concise water-management program.

Preventing the spread of infection is no easy task, especially when there are constantly new sources of HAIs in healthcare facilities. That being said, with the help of very specific programs and procedures, such as the recommendations described above, it is possible to reduce the risk of infection and the spread of bacteria.

Source:

Infection Control Today. Vol. 23. No. 3. March 2019.

Hospital Staff Cuts and its impact on hospital cleaning

Source: Pixabay

Healthcare-associated infections (HAIs) are one of the biggest risks in healthcare today and Canada is no exception to this. In fact, Canada has one of the highest occurrences of HAIs out of all developed nations, with 200,000 cases per year and consequently, 8000 deaths (Statistics Canada, 2016). The spread of HAIs can be prevented, as we have seen on this blog, with proper handwashing techniques as well as proper disinfection protocols for equipment and patient rooms. The problem is that hospitals need A LOT of staff in order to properly disinfect, and control and prevent infection. And yet, Canada, as well as other countries, are seeing cuts in hospital staff.

According to a report prepared by Venrock (2018), one of the predictions for trends in healthcare for 2018 was the continuation of cutting and hiring less hospital staff. This is mostly due to hospitals working to balance their budgets. But at what costs does this balancing of budgets come at?

Although not a recent report, CBC’s Marketplace investigation of hospital cleanliness from 2012 does a good job at showing the consequences of hospital staff cuts (see video below). They interviewed nurses, doctors and hospital cleaners to find out more about staff cuts and its relation to infection control.

One hospital cleaner described the following:

“They’ve really cut staff, and we don’t have a lot of time to actually get done what we’re supposed to get done in a day. We used to have one person to one wing of the hospital to clean, but now we have three floors to clean.”

Anonymous, Hospital Cleaner (2012)

According to the report, in order to sufficiently clean a hospital room, it would take just over an hour. However, with the staff cuts being made, hospital cleaners are only getting on average 15 minutes for each room. This leads to a lot of uncleaned surfaces, leaving harmful pathogens in patient rooms. Furthermore, sometimes the harmful bacteria will even be spread from one room to another, since cleaners either don’t have the time to change cleaning materials or there aren’t enough cleaning materials. One example given in the report is that a cleaner will mop a patient’s room and then continue mopping into another room with the same water, simply because they don’t have the time to change the water.

Hospital staff cuts may save hospitals money, however, the potential risks that result from staff cuts are very significant and should not be overlooked. Leaving surfaces infected by pathogens can be detrimental to both patients and staff, and that is why it is essential to have an adequate number of educated staff to control the spread of infection.

To learn more about the consequences of hospital staff cuts, refer to this CBC Marketplace video:

Sources:

https://www.youtube.com/watch?v=UIOHKrfzJzI

https://www.cnbc.com/2017/11/27/venrocks-health-investors-make-predictions-for-2018.html

https://www.cbc.ca/news/canada/sudbury/health-sciences-north-funding-meeting-1.4902836

Is Ultraviolet disinfection the new technology for reducing the risk of hospital-acquired infections?

According to a study published in the American Journal of Infection Control, the use of ultraviolet (UV) disinfection technology in an operating room eliminated up to 97.7% of pathogens (infectious agent), which otherwise could have caused hospital-acquired infections. The UV light technology that was used is by PurpleSun, a New York based company. PurpleSun’s UV technology can reach and clean multiple surfaces in several seconds, compared to traditional disinfecting methods which use chemicals and does not eliminate bacteria as well. Traditional methods also take longer, since it is normally humans cleaning with a disinfectant.

Source: Wikimedia Commons

What is ultraviolet disinfection?

Ultraviolet disinfection is the use of UV light to disinfect. UV light is absorbed by the DNA and RNA of microorganisms, which in turn causes changes in the structure of the DNA and RNA. This makes the microorganisms incapable of replicating. According to Bolton (2008), “because they cannot multiply, they cannot cause disease, even though technically they are still metabolically alive.” Ultraviolet disinfection is more commonly used for the disinfection of water, however, it may soon become an effective method to eliminate bacteria causing hospital-acquired infections.

PurpleSun: pioneer in ultraviolet disinfection technologies?

PurpleSun is a New York based company, and is set to be the first company to launch ultraviolet-based technology as a disinfectant. Their mission, as stated on their website, is to reduce hospital-acquired infections, in order to save lives, reduce costs, and enhance safety in healthcare facilities.

On their website, they have identified 3 limitations with hospitals’ current disinfection process:
1) Everything is done by hand
2) There are thousands of surfaces, and not enough time to clean them all
3) There is no room for human error

PurpleSun’s light disinfectant will allow rooms to be cleaned within seconds, disinfect all the surfaces in the room and has been proven to be very effective in eliminating harmful pathogens.

Is ultraviolet technology the next step that healthcare facilities must take to reduce the risk of HAIs?

Light technology as a disinfectant is still in the process of experimentation in healthcare facilities. That being said, the study conducted produced highly favorable results. PurpleSun as a company has also been doing extremely well on a global scale, being named one of the 50 most promising companies in the world. Furthermore, many firms and organizations have been investing in and partnering with the company, demonstrating that the company has a lot of potential. The effectiveness of ultraviolet light as a disinfectant is undeniable, but for now, we will just have to wait and see what the future holds for it in healthcare facilities.

Sources:

https://www.infectioncontroltoday.com/environmental-hygiene/study-says-ultraviolet-disinfection-977-effective-eliminating-pathogens

https://purplesun.com/

Bolton, James R. Cotton, Christine A.. (2008). Ultraviolet Disinfection Handbook (1st Edition). American Water Works Association (AWWA) . Retrieved from:
https://app.knovel.com/hotlink/toc/id:kpUDHE0001/ultraviolet-disinfection/ultraviolet-disinfection


One-wipe cleaning system in hospitals proven to be effective

Source: Flickr

According to Infection Control Today (2018), a recent study carried out in a hospital in the UK has determined that a “one wipe” cleaning system was proven to be more effective than the traditional “two wipes” system in reducing the risk of MRSA in hospitals. Between 2013-2016, the hospital had been using a “two wipe” system, which consisted of first using a detergent wipe and then using an alcohol wipe as a disinfectant. In May 2016, a universal cleaning and disinfection wipe was introduced to the healthcare facility, and it made a significant difference.

According to Infection Control Today (2018),

“Using a Poisson model the researchers demonstrated that the average hospital acquisition rate of MRSA/100,000 patient bed days reduced by 6.3 percent per month after the introduction of the new universal wipe.”

Infection Control Today (2018)

These results were significant, and led to a big change in how this UK healthcare facility cleans its equipment. Not only did the universal disinfectant wipes lead to higher efficacy, but they also led to higher efficiency, since healthcare workers now only have to go over the equipment once and are assured that it will be clean.

Keeping this in mind, there are many different types of disinfectant wipes to choose from. If you would like to learn more about different types of disinfectant wipes, and how each of them work, feel free to visit our official website, and view our product offerings, or contact us directly by phone or email.

Click on the link below to view our product offerings for disinfectant wipes.

http://www.lalema.com/catalog/disinfecting-wipers-101

Source:

https://www.infectioncontroltoday.com/environmental-hygiene/simple-one-wipe-system-cleaning-nurses-effective-strategy-researchers-say

https://www.healthcarefacilitiestoday.com/posts/Study-says-one-wipe-cleaning-system-for-nurses-is-effective–20336

Hospital Privacy Curtains: A Harbour for Infectious Agents

Source: Wikimedia Commons

On this blog, we have already reviewed many of the sources of a major health problem: hospital-acquired infections (HAIs). And yet, every day, researchers seem to discover new sources of HAIs. One of the latest discoveries is that hospital privacy curtains in hospital rooms are extremely contaminated with pathogens. A study conducted in Winnipeg, Canada, revealed that freshly hung hospital curtains with minimal contamination became more contaminated each day that they hung in the hospital rooms. Furthermore, after 14 days of being in the room, 87.5% of the curtains were tested positive for methicillin-resistant Staphylococcus aureus (MRSA).

Kevin Shek (Bsc), the leader of the study on hospital privacy curtains carrying pathogens, writes,

“We know that privacy curtains pose a high risk for cross-contamination because they are frequently touched but infrequently changed.”

Kevin Shek (2018)

Healthcare facilities have been placing a great amount of effort in reducing the risk of HAIs in terms of hand-washing and the cleaning of equipment and high-touch surfaces, however, other things such as curtains, mattresses, and bedsheets have often been overlooked. A survey that was conducted to determine how hospital privacy curtains are cleaned/changed revealed frightening results. Only about half of the hospitals had a written policy which specified how often the curtains needed to be changed. 37% of respondents answered that hospital curtains were changed only when visibly soiled. 13% of respondents answered that the curtains were changed only once per year. Considering the results obtained from the Winnipeg hospital study, where curtains became increasingly more contaminated with each day that they remain in a patient’s room, the responses from the survey are alarming.

In terms of controlling the spread of infection, hospitals really need to consider that almost anything in the facility could be contaminated. Hospital cleaning is becoming increasingly complicated, as there are so many places where harmful pathogens can be found. It will be increasingly important that healthcare facilities develop new protocols and policies to prevent HAIs.

Sources:

https://www.infectioncontroltoday.com/transmission-prevention/new-study-says-hospital-privacy-curtains-may-harbor-infectious-pathogens

https://www.infectioncontroltoday.com/transmission-prevention/hospital-privacy-curtains-and-bed-sheets-soft-surface-contamination-and

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

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

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

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.

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

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!

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 qualité de l’environnement (chapitre Q-2)
  • Règlement sur l’enfouissement et l’incinération des matières résiduelles (c. Q-2, r. 19)
  • Règlement sur la santé et la sécurité du travail (chapitre S-2.1,r. 13)
  • Code de sécurité pour les travaux de construction (chapitre S-2.1,r. 4)
  • Règlement sur les déchets biomédicaux (c. Q-2, r. 12)
  • Code de la sécurité 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 récupération et la valorisation de produits par les entreprises (c. Q-2, r. 40.1)
  • Code de sécurité pour les travaux de construction – amiante (chapitre S-2.1, r. 4)
  • Loi sur la sûreté et la réglementation nucléaires (L.C. 1997, ch. 9)
  • Règlement général sur la sûreté et la réglementation nucléaires (DORS/2000-202)
  • Règlement sur la radioprotection (DORS/2000-203)
  • Règlement sur l’emballage et le transport des substances nucléaires (DORS/2000-208)
  • Règlement sur les substances nucléaires et les appareils à 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

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

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

How to obtain a more effective disinfection with Certiklör?

disinfection

How to obtain a more effective disinfection with Certiklör?

What is Certiklör? The name of a new chemical? A new government certification?

None of the above! Simply put, Certiklör technology is the insurance for you, your patients and all Canadians to achieve a better, more efficient and high quality disinfection. Certiklör is a proprietary technology developed by Lalema for you. This technology ensures that you have in the bottle, an effective stabilized hypochlorite, and here to stay!

Stabilized hypochlorite?

Yes, yes! Let me explain. The hypochlorite that is found in bleach for example, flies away usually at a fast rate of more than 1% per month. This means that after 12 months, there will remain only small amounts of the active ingredient: the hypochlorite found in bleach! Imagine how fast this bleach goes away when it’s on the surface to be disinfected in the open air when it does so quickly when, in a closed container!

The difference with our Certiklör stabilized hypochlorite?

The name says it all: stabilized hypochlorite!

Our multidisciplinary team of skilled scientists took 2 years to stabilize the hypochlorite solution. What is the secret? I’m afraid that’s like a little like the Caramilk’s secret! All I can say is that the ingredients that uses this technology have been carefully selected and expertly designed to give hypochlorite increased stability.
And who says stabilized hypochlorite, says better disinfection, less smell and increased cleaning!

How to know if a product uses Certiklör stabilized hypochloritetechnology?

Now, how can you determine which Lalema products use this technology ? Easy! Look at the product label! For now, look at Ali-Flex RTU and Ali-Flex LF.
So if you care about your health, life quality and efficiency at work, think Certiklör stabilized hypochlorite!

Biofilm: The Next Big Thing in Disinfection

biofilm

The Next Big Thing in Disinfection: Biofilm

Have you ever wondered what are the main factors affecting the efficacy of disinfection and sterilization in the healthcare facility? U.S. Centers for Disease Control and Prevention lists seven major causes of microbiological persistence on surfaces:

  1. Number of microorganisms
  2. Microbial resistance to biocides
  3. Concentration and Potency of Disinfectants
  4. Duration of Exposure
  5. Chemical and Physical Factors
  6. Presence of Organic or Inorganic Matter
  7. Biofilms

For many experienced healthcare professionals, these factors are well known and often well dealt with. However, did you know the difference between soil (organic and inorganic matter) and biofilm? They both can significantly lower the efficacy of disinfection, but the biofilm is much harder to remove and control.

What is biofilm and how does it form?

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.

Many pathogens require a presence of conditioning layer made from organic soil to settle and start extracellular matrix synthesis. But there are bacteria which don’t really need much help to start a biofilm community. When pathogens settle down and surround themselves in an extracellular polymeric substance (EPS), they are much harder to kill.

It has been reported that bacteria found in biofilm can be up to 1,000 times more resistant to biocides than their planktonic counterparts.

How to outsmart and fight biofilm?

Despite biofilms’ rigid structure and resistance mechanisms, biofilm cells can still be outsmarted. Since EPS is the ultimate protective barrier and communication route for pathogens, the control of biofilm should start with disruption of the EPS itself, followed by an application of a biocide.

Why choose a Ready-to-use Bleach based Cleaner-Disinfectant?

ready-to-use-cleaner-disinfectant-nursing

In the actual market, you can find many cleaner-disinfectants. When it comes to consumer products, you’ll find a lot of brand, most of them are ready to use. It means you do not have to dilute the product and use it as is to disinfect. For industrial and institutionnal use, most of cleaner-disinfectants are concentrated if not ultra-concentrated. In that case, why choose a ready-to-use Bleach based Cleaner-Disinfectant for institutionnal use?

Main benefit of a low-foam concentrated product

Let’s talk about a product like Ali-Flex LF, a product like this one offers a high concentration for general disinfection in hospitals. On a day to day basis, with the right dilution system, the surfactants contained in ALI-FLEX LF increase the wetting power of this chlorinated disinfectant and contribute to degrease and remove dirt from hard non porous surfaces such as countertops, walls, floors, toilets, commode chairs, etc.

Main benefit of a ready-to-use chlorinated disinfectant cleaner

When it comes to infection control, one important aspect is to reduce the risk. We know that dilution systems can sometimes be flawed and not consistant with delivery concentration. Therefore, it is crucial to obtain a consistant known concentration. That is exactly what Ali-Flex RTU can provide: a factory consistant concentration of 6000 PPM (when packaged) with a validated shelf-life.

Of course it may generate more plastic in the environnement. Recycling may then be on option to consider. At the same time, when patient’s lifes are at risk, all factors that can reduce the risk is of important value.

What are you using in your facility?

Tell us what kind of product you are using. Are you in control? Are you facing problems when it comes to stop eclosion? Surely we can help you! Let’s talk!

FIFO: First In, First Out also applies to disinfectant!

fifo

First In, First Out (FIFO): also applies to disinfectant!

Some of you may be familiar with the FIFO concept. FIFO is a method for organizing and manipulating goods such as food, it is also used in computer science to organize data. In the food industry, FIFO is essential in order to ensure freshness, preventing foodborne illness and controlling costs.

Can a cleaning product expire?

When it comes to disinfectant the same goes, a fresher or let’s say a newer product is better. I sometimes hear people saying that soap doesn’t expire. Even though the shelf life of soap is way greater than most food items, soaps and other cleaning products do expire. Same goes for disinfectant the active ingredient of a disinfectant whether it is quats, chlorine or peroxide will diminish over time. Hence to ensure a proper disinfection it is important to use product that are not expired. A good way to achieve this is by implementing a FIFO rotation system. By always using the oldest disinfectant that you have in inventory first, you make sure that you won’t get stuck with old and maybe expired stuff!

How to know if a cleaning product is expired?

This is a broad question… For disinfectant it is pretty easy, Health Canada and the EPA requires that all disinfectant have an expiration date on their label. Most cleaning product however does not have an expiration date and the shelf life varies greatly among them. But some signs won’t get you wrong. If the color, the odor, the consistency of the product is changed or if you see a deposit in the product it might be a good sign that the product is expired. In case of doubt, call the manufacturer, with the lot number every good manufacturer will be able to tell you if the product is expired.

A brief history of the Influenza

Emergency_hospital_during_Influenza_epidemic_Camp_Funston_Kansas_-_NCP_1603

Historical picture of the 1918 Spanish flu at Camp Funston, Kansas, showing the many ill patients. Source: WikiCommon

 

I would like to talk to you about the Influenza. My mother always told me: “Son, a small flu lasts a week and a big one lasts 7 days.” and she was right. Influenza is a respiratory infection that also spreads very easily. It is caused by the influenza virus.

The origin of the flu

Influenza hit human beings in China as early as around -2500 B.C. With birds, the virus goes back more than 8000 years ago.

Hippocrates had clearly described Influenza

In -2400, the writings of Hippocrates clearly describe the symptoms of the flu. And since then, history is full of influenza pandemics description. However, before 1850, the data are sometimes difficult to analyze because the symptoms of flu are similar to other diseases such as diphtheria, bubonic plague, typhoid fever and others.

Major known influenza pandemics

Major known flu pandemics
Pandemic Date Death Subtype involved Severity Index
Asian Flu (Russia) 1889–1890 1 million H2N2 ? ?
Spanish Flu 1918–1920 30 à 100 millions H1N1 5
Asian Flu 1957–1958 1 à 1,5 millions H2N2 2
Hong Kong Flu 1968–1969 0,75 à 1 million H3N2 2
A (H1N1) Flu 2009–2010 18 138 H1N1

Discovery of the virus

It was long thought that influenza was caused by bacteria. In 1931, the virus was identified in pigs and two years later, in 1933, humans from levy on the throat of a researcher contaminated with the flu.

Discovery of the vaccine

In 1935, we managed to “grow” the virus in embryonated chicken eggs. The first clinical trials between 1936 and 1938 are inconclusive. In 1944, with support from the US Army, we obtained the first effective vaccine based on influenza virus. Research has continued since.

The vaccine in Quebec for 2014-2015 is available since November

The injectable vaccine against influenza 2014-2015 offered in the program framework contains the following three strains:

  • A / California / 7/2009 (H1N1)
  • A / Texas / 50/2012 (H3N2)
  • B / Massachusetts / 2/2012
  • The intranasal vaccine contains four strains or B / Brisbane / 60/2008 in addition to the same three strains contained in the vaccine injection.

Even if you have been vaccinated against the flu last year, you still need to receive it this year. Indeed, antibody levels fall about 6 months after vaccination against influenza, particularly in people whose immune system is weakened.

The index of influenza activity in Quebec for the week of 7 to 13 December 2014 (CDC 14-50) is HIGH tends UPWARD.

f23239b08c69e43c4a2aa6999e06ee5a

Preventive measure against the flu

If we can not escape it, there is still prevention methods:

  • It maintains a proper hygiene program (particularly hand washing).
  • It is vaccinated.
  • This ensures clean and disinfect surfaces regularly.

For more info on how to fight a flu epidemic (or pandemic if it degenerates there), see this presentation (in french):

sources:
http://fr.wikipedia.org/wiki/Grippe
http://www.msss.gouv.qc.ca/sujets/prob_sante/influenza/index.php?accueil

Hospitals, here and there

Hospitals here and there around the world

The saying goes, the grass is always greener on the other side of the fence. Let’s see what’s going on on the other side!

Sierra Leone

sierra-leone

Maternity hospital in Sierra Leone. Since 2010, more and more women are choosing to give birth in hospitals.

Source: http://www.theglobeandmail.com/news/world/in-west-africa-the-birth-of-a-notion/article4105570/

Taiwan

taiwan

Colors & Hospital seems to be an international concept!

Source: http://www.theglobeandmail.com/news/world/in-west-africa-the-birth-of-a-notion/article4105570/

Sudan

soudan-du-sud

Sometimes budgets do not include beds …

Source: http://www.theglobeandmail.com/news/world/in-west-africa-the-birth-of-a-notion/article4105570/

Russia

russie

Some Russian hospitals beyond the Urals are still waiting for post-Soviet modernization.

Source: http://www.viralnova.com/awful-russian-hospital/

Poland

pologne

Poland is modernizing its hospitals to override the memories of Soviet rule.

Source: http://polandpoland.com/polish_hospitals.html

United Arab Emirates

dubai

Modern hospitals in Dubai, nothing too good!

Source: http://www.arabianbusiness.com/saudi-german-eyes-q1-launch-for-dubai-hospital-361565.html

US

etats-unis-1024x768

If you have the means, the US private hospitals offer great luxury!

Source: http://imatter.silvercross.org/uncategorized/room-view-2

Quebec

hospitals-quebec-1024x768

Although hospitals are not all young or renovated, we can be proud of the quality of care in our hospitals!

Source: http://imatter.silvercross.org/uncategorized/room-view-2

Hospitals Cleaning Supplies

We have those! www.lalema.com

Don’t be afraid to go micro

microfiber-cloth

Today it’s undeniable that microfibers are superior to cotton fibers. Although the official recommendation of the Ministry of Health and Social Services privileges the use of microfibers, cotton fibers are still pretty common in disinfecting procedures.

What are the differences between cotton and microfibers?

The difference between microfibers and normal fibers are the size of filaments as well as their structure. You can see their superior effectiveness in the image.
It is in fact for this reason that the Ministry of Health and Social Services recommends the use of microfibers for cleaning in hospitals, as their mechanic cleaning ability is greatly increased.* Up to 90% of microorganisms can be removed from a surface by simply rubbing it with a microfiber cloth.

It is also important to keep in mind that natural fibers such as cotton can decrease the effectiveness of the disinfectant. In fact, quaternary ammoniums may permanently bond with the natural fibers and lose their ability to react on the surface. Although quats of the 4th and 5th generation are much less sensitive to the type of fiber used, it’s still recommended to use synthetic fibers. The same holds for peroxide and oxidant based products such as chlorine; these products may interact with natural fibers. If you don’t have access to synthetic fibers, we strongly suggest not soaking your cotton cloths in the disinfecting solution for too long.

Quality of your microfiber cloth!

Beware of microfibers imitations, certain low quality products won’t have the same mechanical effect on surfaces. Also, low quality microfibers often shrink after washing and are more sensitive to hot water and oxidants. At Lalema, our microfiber cloths are all supplied by first choice suppliers. Although a little bit more expensive, these microfiber cloths are more durable and represent the best choice for quality cleaning.

To learn more about microfibers

Visit the Microfiber section of Lalema’s online catalog
* MESURES D’HYGIÈNE ET DE SALUBRITÉ AU REGARD DU CLOSTRIDIUM DIFFICILE Lignes directrices. MSSS, 2008.

Wipe out gastroenteritis!

ebola-disinfect-surface

Standard disinfectants are not as effective when facing viruses that cause gastroenteritis.

Approximately 40% of commercial disinfectants that are used to clean surfaces are little or no effective in destroying the norovirus, the virus that causes gastroenteritis. This is what Dr Julie Jean, of the Université de Laval, has found in her recent study.* Her research has demonstrated that bleach-based disinfectants are the most effective in reducing the norovirus from surfaces.

The virus that is responsible of gastroenteritis

The norovirus is the main cause for viral gastro-enteritis in health centers. Moreover, it’s responsible of half of gastro-enteritis breaks originating from food. This virus spreads mainly through direct contact with the infected people, or indirectly through objects, food, or dirty surfaces.

The effectiveness of disinfectants used for cleaning surfaces is therefore crucial to limit the spread of viruses.

The best strategy to prevent gastroenteritis

As a conclusion, the research suggests that the best strategy to limit the spread of the norovirus is to use a disinfectant containing bleach and leave it in contact with the surface for at least five minutes, ideally ten.

Clorox bleach wipes destroy C. difficile in five minutes!

 

2013-01-29-CloroxBot

10% of admitted patient will contract an HAI

The ministry of Health and Social Services estimates that in Quebec, between 80 000 and 90 000 hospitalized patients will present a nosocomial infection, which represents 10% of admitted patients. In addition to the measures suggested in the action plan on prevention and control of nosocomial infections 2010-2015, healthcare centers can count on an effective cleaning product: Clorox bleach disinfecting wipes.

Clorox Bleach Wipes are pre-humidified

Since March 2011, Clorox bleach wipes are effective for killing the spores of C. difficile after a contact time of 5 minutes. The wipes are pre-humidified with a stable solution of sodium hypochlorite diluted at 1:10, that is the recommended concentration by the American Centers of Disease Control and Prevention (CDC). They are also homologated for the destruction of 31 other pathogen agents in one minute.

clorox-bleach-disinfecting-wipes

UV disinfection how does it works?

r2d2 UV disinfection

Since 1877, scientists know the microorganisms can be eliminated by UV rays. Nearly 50 years later, however, they discovered the specific type of frequency that was the most damaging.

In the 1950s, researchers knew that UV rays penetrate cells and damage the nucleic acids or deoxyribonucleic acid (DNA) and ribonucleic acid (RNA). This led to the commercial development of multiple UV disinfection devices, primarily with mercury vapor, which produces UV having the most effective frequency for the destruction of microorganisms. Today, UV disinfection devices use xenon UV rays.

UV disinfection is used in many hospitals

UV disinfection devices are used in hospitals such the ones in Vancouver and Hamilton. It is the natural evolution of the UV disinfection, to which are added the cleaning and disinfecting surface and a good dose of prevention.

Combined with touchless systems for bathrooms and public spaces, hospitals are able to reduce the number of surfaces to be disinfected to prevent nosocomial infections.

In any case, these robots do not replace the housekeeping staff but add a small sector futuristic air … don’t you see a family resemblance with this R2-D2 designed by Agent-Spiff?

We have UV solutions for you

Not to disinfect but to perform quality control. Visit our web site to find out more about it

Ebola, how does it spread?

top-2014-ebola-virus

The Ebola Virus

Ebola is a virus. There is currently no vaccine or treatment. It causes severe disease, causing serious symptoms including vomiting and bleeding. The mortality rate can reach 90%. Primary infection comes from a contact with an infected animal and it can spread quickly.

How can you get infected by Ebola?

By coming into contact with following bodily fluids such as blood, urine, feces and vomit. Of by one of the following means: by contact with a dead victim, by ingestion of infected animal meat or by having sexual intercourse with an infected person.

What are the symptoms of Ebola?

The symptoms of Ebola are fever, headache, nausea and fatigue. It may also include bleeding from nose, mouth or eyes, coughing, diarrhea or vomiting with the possible presence of blood.

How to prevent ebola transmission

The risk of transmission of the Ebola virus in Canada is very low. However, certain precautions must be taken. The Public Health Agency of Canada also recommends that travelers avoid all nonessential travel to Guinea, Liberia and Sierra Leone.

There is a risk only if you have been in contact with sick people. In such case, if you experience symptoms, call 8-1-1 (Quebec) and inform them of your discomfort. You will be directed to the healthcare center care that can help you.

What to do to prevent the spread of Ebola virus

The Ministère de la Santé et des Services sociaux in collaboration with the Institut nationale de santé publique du Québec has issued recommendations in case of an outbreak. It is important that each healthcare center that can receive a potentially infectious patient put in place appropriate precautionary measures. Thus, it is important to have the required equipment for this type of care.

Robots to destroy Ebola?

xenex-robots

Credit photo: Xenex website

Robots are soldiers in a war againt HAI’s

Two Canadian hospitals have recently acquired a machine enabling surface disinfection in health institutions.

The Juravinksi hospital in Hamilton has started a year trial of a robot that costs 95 000 $ that burns the bacteria with UV rays: the Xenex Robot System. The general hospital of Vancouver has also started a trial of a UV robot that is 1.65 meters tall, called the Tru-D Smart UVC, working with UV rays as well. The effectiveness of these machines relies on the properties of the UV rays, or rather on the xenon UV rays, to sterilize and kill microscopic contaminants.

Ebola outbreak

Recently, with the Ebola Outbreak, the Texas Health Presbyterian Hospital in Dallas, where 42-year-old Thomas Eric Duncan, the first person to be diagnosed with Ebola in the US, was being treated, also uses such device. But was it enough? See this other blog post from my collegue: The Dallas case rises a question: Should protocols for infection control be revised?

What about your hospital?

The goal of these robots is not to replace the cleaning staff, nor the products employed for critical disinfections, but rather to complete their work, and to avoid that a single microscopic bacteria could take the life of a person whose immune system is weak.

Is your plan ready? Is your staff trained well enough? Do you have a stabilized chlorinated cleaner disinfectant in stock?

Do not miss our next post, which is going to explain how UV disinfection works!

More about Ebola Virus

There are a lot of ramblings about Ebola in 2014 on the web, you will find these articles interesting:

Ebola, How to disinfect surfaces

Ebola virus, Are we Ready?

Cleaning in Hospitals (part 2)

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source: http://tvanouvelles.ca/lcn/infos/lemonde/archives/2014/10/20141007-174935.html

The Dallas case rises a question: Should protocols for infection control be revised?

protocol-ebola

A nurse from the Texas Health Presbyterian Hospital, where a patient was treated for Ebola, contracted the disease. This is the first case of Ebola transmission in North America. Although the authorities are reassuring, the question arises in hospitals: Are protocols in place really effective?

The nurse in question, Ms. Nina Pham wore protective equipment as directed by the hospital. Indeed, she claims to have followed protocol at all times and she is unable to identify how she could have contracted the virus. It is assumed that methods of environmental control were in place so the room was disinfected daily with sodium hypochlorite as prescribed.

A breach of protocol?

The director of the CDC (Center for Disease Control), Dr. Thomas R. Frieden believes that treatment protocols were not followed to the letter “Clearly there was a breach in protocol. We have the ability to prevent the spread of Ebola by caring safely for patients.”

CDCs are investigating in order to identify how Ms. Pham may have acquired the infection. Protocols are of course being examined. They would be sufficient to protect healthcare workers from infection by the virus if followed properly. Nevertheless, removing the protective equipment is always pointed out as a critical step. In Europe, another investigation is under way to understand how a Spanish nurse found herself in the same situation.

No reported case in Quebec, yet

The Ministère de la Santé et des Services sociaux in collaboration with the Institut nationale de santé publique du Québec has issued recommendations in case of an outbreak. It is important that each healthcare center that can receive a potentially infectious patient put in place appropriate precautionary measures. Thus, it is important to have the required equipment for this type of care.

At Lalema, we can help you by providing all the necessary protective equipment and disinfectant ! For any special needs, please contact us.