prevention

How to properly clean reusable protective equipment

Gaétan Lanthier
Clean medical inhaler
Photo by Mockup Graphics on Unsplash

When we talk about disinfection, we talk about the prevention and control of infection in the environment. Therefore, equipment used for respiratory therapy is considered semi-critical. The equipment must then be cleaned and disinfected properly between patients. The WHO gives us the proper maintenance of respiratory equipment in procedures to follow. The procedures are checklists in steps of a cycle. Let’s explore all the summarized steps up to the cycle finish. And yes, the cleaning step is before the disinfection step!

Checklists for care, cleaning, disinfection and sterilization of respiratory devices

1. Perform hand hygiene

The title and image say it all

2. Don appropriate personal protective equipment

The personal protective equipment to be worn during the disinfectant preparation includes surgical mask/respirator, googles/face shield, long-sleeved fluid resistant gown/gown plus apron, rubber gloves and boots or closed work shoes.

3. Wash with detergent and rinse with clean water

The external device surfaces must be wiped with a damp cloth or disposable wipe that is soaked in detergent and clean water. Then, remaining detergent residue must be wiped off with a dry lint-free cloth. A mechanical action (scrubbing/brushing) should be used to remove visible dirt deposits and calcifications.

4. Disinfect

4a. Physical disinfection – Heat for heat resistant equipement (steam/hot-water)

A high-level of physical disinfection can be achieved with steam (e.g. autoclaving at lower temperature) or hot-water at least 121°C. This is an inexpensive and effective method for sterilization or high-level disinfection.

4b. Chemical disinfection for plastic plus other parts that can be damaged by heat

b) If the disinfection needs to be with chemicals solutions, it should be performed in a well-ventilated area and away from patients. Use a disposable wipe or a fresh cloth that is soaked in a compatible disinfectant. Hydrogen peroxide 0.5% or ethanol 70-90%. Wipe from top to bottom and avoid contact with electrical connectors.

5. Dry equipment / Rinse equipment

a) Physical equipment often has a drying feature within the machine (e.g. washer, pasteurizer or autoclave). Following pasteurization, the wet equipment is typically dried in a hot-air drying cabinet or air-dried. Make sure to carefully inspect and ensure that no water is left in the equipment.

b) If a chemical solution was used for disinfection, rinse the equipment with sterile or clean water (i.e. water boiled for 5 mins and cooled down). It is preferred to use sterile water for rinsing off residual liquid chemical disinfectant from the respiratory device.

6. Store equipment in closed packages

Last step. Title says it all.

This was a summary of the Care, cleaning and disinfection of respiratory equipment in sterile services department’s article by World Health Organization.

This article is a free translation of WHO’s article.

Source:
World Health Organization
– https://www.who.int/publications/m/item/care-cleaning-and-disinfection-of-respiratory-equipment-in-sterile-services-department
– https://www.who.int/images/default-source/health-topics/coronavirus/care-cleaning-disinfection-of-respiratory-equipment.tmb-479v.png?sfvrsn=14530f0b_1

The proper maintenance of respiratory equipment

Rémi Siv
Clean medical inhaler
Photo by Mockup Graphics on Unsplash

When we talk about disinfection, we talk about the prevention and control of infection in the environment. Therefore, equipment used for respiratory therapy is considered semi-critical. The equipment must then be cleaned and disinfected properly between patients. The WHO gives us the proper maintenance of respiratory equipment in procedures to follow. The procedures are checklists in steps of a cycle. Let’s explore all the summarized steps up to the cycle finish. And yes, the cleaning step is before the disinfection step!

Checklists for care, cleaning, disinfection and sterilization of respiratory devices

1. Perform hand hygiene

The title and image say it all

2. Don appropriate personal protective equipment

The personal protective equipment to be worn during the disinfectant preparation includes surgical mask/respirator, googles/face shield, long-sleeved fluid resistant gown/gown plus apron, rubber gloves and boots or closed work shoes.

3. Wash with detergent and rinse with clean water

The external device surfaces must be wiped with a damp cloth or disposable wipe that is soaked in detergent and clean water. Then, remaining detergent residue must be wiped off with a dry lint-free cloth. A mechanical action (scrubbing/brushing) should be used to remove visible dirt deposits and calcifications.

4. Disinfect

4a. Physical disinfection – Heat for heat resistant equipement (steam/hot-water)

A high-level of physical disinfection can be achieved with steam (e.g. autoclaving at lower temperature) or hot-water at least 121°C. This is an inexpensive and effective method for sterilization or high-level disinfection.

4b. Chemical disinfection for plastic plus other parts that can be damaged by heat

b) If the disinfection needs to be with chemicals solutions, it should be performed in a well-ventilated area and away from patients. Use a disposable wipe or a fresh cloth that is soaked in a compatible disinfectant. Hydrogen peroxide 0.5% or ethanol 70-90%. Wipe from top to bottom and avoid contact with electrical connectors.

5. Dry equipment / Rinse equipment

a) Physical equipment often has a drying feature within the machine (e.g. washer, pasteurizer or autoclave). Following pasteurization, the wet equipment is typically dried in a hot-air drying cabinet or air-dried. Make sure to carefully inspect and ensure that no water is left in the equipment.

b) If a chemical solution was used for disinfection, rinse the equipment with sterile or clean water (i.e. water boiled for 5 mins and cooled down). It is preferred to use sterile water for rinsing off residual liquid chemical disinfectant from the respiratory device.

6. Store equipment in closed packages

Last step. Title says it all.

This was a summary of the Care, cleaning and disinfection of respiratory equipment in sterile services department’s article by World Health Organization.

This article is a free translation of WHO’s article.

Source:
World Health Organization
– https://www.who.int/publications/m/item/care-cleaning-and-disinfection-of-respiratory-equipment-in-sterile-services-department
– https://www.who.int/images/default-source/health-topics/coronavirus/care-cleaning-disinfection-of-respiratory-equipment.tmb-479v.png?sfvrsn=14530f0b_1

Are technological devices a source of hospital-acquired infections?

Sara Lafond
Source: Air Force Medical Service

You’ve already seen on this blog just how dirty cellphones can get, but did you know that cellphones and other electronics such as tablets and laptops can also cause contamination in a healthcare setting, potentially making them a source of HAIs? Hospital staff use technology throughout their workday, whether it be to enter patient information in a computer or for personal use on their breaks. If they don’t wash their hands before and after using the device, it can become contaminated causing those workers to spread the bacteria all throughout the hospital.

According to Kelly M. Pyrek (2019),

“A casual online poll of ICT readers shows that 83 percent of survey respondents use their personal mobile technology devices within the hospital, and just 68 percent said they clean/decontaminate these devices regularly. Fifty-seven percent of respondents indicated they use a hospital-issued mobile technology device in the course of their workday; 56 percent report cleaning the device themselves, while 7 percent let someone else clean the device.”

Kelly M. Pyrek, Infection Control Today, 2019

Many hospitals are now realizing that technological devices are a potential source of the spread of infection within a healthcare setting and some of them are beginning to implement protocols regarding the use and disinfection of electronics.

That being said, the cleaning and monitoring of technological devices can be complicated. As James Davis, MSN, RN, explains to Infection Control Today (2019), tech companies such as Apple only tell people to wipe down their devices with a damp cloth. However, that recommendation does not take into consideration the use of devices in a healthcare setting, where bacteria and infection are everywhere.

Some recommendations that Davis and Shivek, Phd, senior product engineer, give include:

  • Always washing your hands before and after using your device
  • Placing a layer between the device and the environment is key
    • Phone covers are becoming increasingly popular, however must be replaced frequently
    • Placing the mobile device in a ziploc bag is another option, especially if it’s being brought into an isolation room
  • No matter what, always wipe down the device before and after using it. Even if it was in ziploc bag or had a cover over it, wiping your device is key to ensuring that harmful bacteria are eliminated.

The cleaning and monitoring of technological devices is a daunting task for healthcare facilities, especially if it is an employee’s personal device. Davis (2019) stresses that because of this, employees should be personally responsible for the cleaning and disinfecting of their mobile devices. Although a complicated task, the recommendations provided by Infection Control Today allow us to understand how to better prevent the contamination of our mobile technology, which may in turn help prevent the spread of infection.

Sources:

https://www.infectioncontroltoday.com/transmission-prevention/contaminated-mobile-technology-making-it-part-your-institutions-cleaning-and

https://www.infectioncontroltoday.com/transmission-prevention/mobile-technology-disinfection-contaminated-devices-pose-threat-patients

COVID-19 and the preventive measures.

Rémi Siv

2019-nCoV is making the headlines these days. What is the 2019-nCoV and what are the preventive measures? Up to now, we don’t fully understand the pathogenic potential and transmission dynamics of this new 2019 coronavirus.

Young woman with respiratory mask

What is it?

In a nutshell, it is part of the coronavirus family. It presents “80% of similarities” with the SARS (Severe acute respiratory syndrome) which killed hundreds of people in 2003. This virus does not spread as well as influenza and doesn’t evolve very quickly. The symptoms are the same as most flu cases: fever, cough, muscle aches, shortness of breath and difficulty breathing.

Last December, the coronavirus appeared in Wuhan, a city in central China. The cities of Wuhan and Huanggang have been quarantined. So far, it has killed 490 people in China and thousands of people have been infected. The virus has also been detected in 23 other countries. In order to limit its spread, measures are being taken in several countries. The WHO (World Health Organization) has declared this virus as an international emergency.

Yellow Crane Tower in Wuhan

What are the preventive measures?

Brief, here are some preventive measures for 2019-nCoV. As suggested by the WHO, the following are strategies for health care-associated infection prevention and control when a case of nCoV is suspected:

  1. Early detection and source control
    – Encouraging health care workers and managers to have a high level of clinical suspicion
  2. Application of standard precautions for all patients
    – Ensure that respiratory hygiene measures are taken by providing a medical mask in case of suspected nCoV infection for those who can tolerate it
    – Cover your nose and mouth by coughing or sneezing into a tissue or bent elbow
    – Wash hands after contact with respiratory secretions
    – Wear personal protective equipment
    – Follow environmental cleaning and disinfection procedures consistently and correctly
  3. The implementation of empirical additional precautions
    – Wear a particulate respirator at least as protective as a NIOSH N95, EU FFP2 certified respirator or equivalent
    – Wear eye protection (goggles or face shield)
    – Use clean, non-sterile long-sleeved coveralls
    – Wear gloves and avoid contact with eyes, nose or mouth with potentially contaminated hands
    – Use disposable equipment or dedicated equipment to be disinfected after each use
  4. Administrative controls
    – Ensure sustainable infection prevention and control infrastructure and activities are in place
    – Provide training and education to health care workers and patients
  5. Environmental and technical controls
    – Ensure adequate ventilation and proper cleaning of the environment

So, do not hesitate to contact us for your needs and questions about our products or hygiene training.

For more details on 2019-nCoV, see the following sources:
https://ici.radio-canada.ca/nouvelle/1482141/coronavirus-chine-questions-reponses
https://ici.radio-canada.ca/nouvelle/1486752/coronavirus-chine-villes-quarantaine-transports
https://ici.radio-canada.ca/nouvelle/1482961/coronavirus-virus-chine-asie
https://www.cdc.gov/coronavirus/2019-nCoV/lab-biosafety-guidelines.html
https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200203-sitrep-14-ncov.pdf

Prevention: The New Focus in Healthcare

Sara Lafond
Source: FreeStockPhotos

Hospital-acquired infections and drug-resistant superbugs are some of the biggest concerns in healthcare right now. In fact, the World Health Organization (WHO) estimates that by 2050, more people will die from antibiotic-resistant bacteria than from cancer (2016). Furthermore, many of the diseases that cause people to be in the hospital in the first place, are preventable, such as heart disease and diabetes. This means that people are needlessly going to hospitals and subsequently risk being exposed to harmful infections. This is one of the reasons why a main priority right now in healthcare is shifting towards prevention and keeping people out of hospitals in the first place.

According to Nancy Brown, from the American Heart Association, “many of the things that bring people to the hospital can be prevented” (2019). In fact, during the World Economic Forum on the Future of Hospitals, which featured Brown as a speaker, it was discussed how 80% of health does not happen at the hospital, but rather, it happens at home, where individuals should consciously be making better decisions to be healthier.

Education about health should be a key priority for governments, hospitals and medical professionals, as it will reduce healthcare costs, prevent risks and occurrences of serious illnesses, and just make people more healthy in general. Brown stated that the way to doing this is to change people’s behaviours, either by inspiration, advocacy or even regulation. She also identified two key factors that are critical in influencing people’s unhealthy habits: environment and lifestyle. To quote her again,

“If you don’t have access to fresh foods, and the only thing you can have is processed and packaged food which is high in sodium and high in added sugar, why are we surprised that there’s an epidemic of obesity and type 2 diabetes?”

Nancy Brown, American Heart Association, 2019

Brown provides very interesting information about prevention, which is becoming more and more important in healthcare. According to Regina Benjamin, MD, it is crucial that disease prevention be intertwined into every aspect of our every day lives.

Benjamin lists 4 keys areas to improve in order to better prevent diseases:

  • Healthy and safe community environments
  • Clinical and community preventive services
  • Empowered people
  • Elimination of health disparities

People have the ability to prevent many diseases. With a good education about health, people can become more knowledgeable about how to take care of themselves and what diseases they are more prone to. This will lead to fewer hospitalizations and healthier people with a better quality of life. That is why this trend in healthcare is so important and it is great thing to move towards.

To watch the World Economic Forum discussion of The Future of Hospitals, see the video below:

Sources:

https://www.youtube.com/watch?v=j5MZP6dbhFI&t=1064s

https://drkevincampbellmd.wordpress.com/2017/02/13/changing-the-focus-of-healthcare-from-treatment-to-prevention/

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3185312/

How to Prevent Cross-Contamination

Sara Lafond

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=