What’s Your New Year's Resolution?

If you’re like many people, as we sprint towards the end of the year, you’re contemplating what 2019 holds in store. Whether you’re dreaming of a New Year and a new start, or screaming and stomping your feet hoping the year will not end, coming up with a New Year’s resolution is a tradition that many of us share. Year after year, the top resolutions are pretty consistent: exercise and get in better shape, eat healthier, lose some weight and focus on self-care, be it personal, emotional or educational. The catch 22 is that all are equally good and bad for your health. If you’re shaking your head in disbelief let me prove it to you!

Exercise is certainly something often prescribed to improve our health. It improves oxygen flow to the brain which makes you feel better because your brain and body can do more. It improves your heart rate and lowers your blood pressure which decreases your risk for a number of diseases and gives you more energy. But, did you know that a study by Northwestern University found more than 7000 colonies of different types of bacteria in dust samples from 42 different athletic facilities in Oregon, including private fitness clubs, public recreation centres and studios for dance, yoga and martial arts. The scary part was that 30% of the samples contained antibiotic resistant bacteria. I’m not sure about you, but hitting the gym is not going to be at the top of my list of New Year’s resolutions!

Eating healthier and losing weight is often at the top of my list. I’m not getting any younger and certainly am finding that I can’t get away with cheat eating the way I used to! Salads are of course an excellent way to eat healthy and still feel that you’re getting a variety as you can change out the toppings and protein to make something different every day. Unless you’ve been living under a rock, I’m sure you’re more than aware of the multiple outbreaks associated with E. coli contaminated romaine lettuce. There are 2 ways to look at this issue. You can throw up your hands and declare that it’s a sign not to eat healthy because the very food that is good for you can make you sick… or continue to eat romaine lettuce because not only are you eating healthy, but a bout of diarrhea or vomiting whether it’s linked to E. coli, Salmonella or Norovirus can be a quick (albeit unhealthy and potentially deadly) way to lose weight.  

You’re probably wondering how self-care can have a downside. People have many different ideas of what self-care can be. If you’re aging and feeling self-conscious of your appearance, particularly if you’re surrounded by millennials, you may be checking out the latest fads like cool sculpting, anti-aging facials or if you’re follicly challenged, there’s procedures that improve your receding hair line.  You may be chuckling, but if you’re treating yourself to some work on your hair line, you had best do your research, because a hair transplant facility not too far from my neck of the woods has been cited for breaches in infection prevention and control such as not following best practice standards for cleaning, disinfection and sterilization of medical equipment.

Another downside of self-care is wanting to improve yourself via education. You don’t need to go back to school to be educated. Reading is a great way to educate and/or improve yourself. The downside being, the more you read, the more you learn and if you’re like me, reading about the latest outbreak, the newest emerging pathogen or how chemicals can impact the health of people, animals and the planet, you may just end up in the bubble that I spoke of last week! If you can come up with a New Year’s resolution that can’t be negatively impacted by lapses in infection prevention please let me know!

 

Bugging Off!

Nicole

5 Everyday Surfaces That May Have You Living in a Bubble!

Have you ever thought that you may need to live in a bubble because you know too much about infection prevention and disease transmission?  Most times I’m fine. I grew up on a farm. I played in barns and I know I’ve probably ate poop at some point in my life. That said, I do find using my knowledge can be fun to taunt others. I’ll admit, I may have been doing that a little bit with some new staff that I’ve been training this week… sorry Linda, Selena and Daniel!

  

I wish I had found the article I’m basing this week’s blog on before I started the training. I would have had more examples of why we should live in bubbles! While the article focused on items or surfaces found in hospitals, my guess is the same would hold true for some of the surfaces regardless of the type of facility we are in. What were the top 5 germ covered surfaces?

1.     CURTAINS: Which really should not be surprising. They are frequently touched. They are infrequently changed and chances are people do not wash their hands after touching them. Let’s be realistic, how many times have you touched a hospital curtain and not washed your hands after. But don’t just focus on hospital privacy curtains. What about the curtains in hotels? Don’t you touch them each night and morning? How frequently do you think they are cleaned or changed? If we have issue with hand hygiene in hospitals, my guess is that hand hygiene of the typical traveller is worse… Seriously, think about it.

2.     STETHOSCOPES: If you’re surprised about this you need to read more. Shared patient care equipment has been linked to many outbreaks and/or transmission of pathogenic microbes including MDRO’s. One study showed that up to 32% of the bells and diaphragms tested were found to have MRSA, C. diff and viruses on them. Don’t just blame the human doctors.Vets and Vet Techs have also been found to be lax in cleaning their stethoscopes between patients.

3.     LINENS: You’ll never be able to look at a bed the same again. The ugly truth is no matter how white the linens appear, they can be a reservoir for bacteria and viruses. In fact studies have shown that C. diff spores can survive commercial washers with industrial detergents. If that’s not bad enough, contaminated bed sheets can spread pathogens to uncontaminated bed sheets as well as spread germs between patients and hospitals. Many hospitals use external laundry services which may be shared by hotels and spas meaning hospital germs could have the potential to contaminate hotel and spa linens.  But even worse, if a hospital cannot get rid of germs from their linens do you think hotels and spas or hair salons will be able to?

4.     TABLETOPS (and other surfaces):  Basically any surface that has the potential to be frequently touched by patients, staff or visitors can serve as ground zero to pathogens. Numerous studies have been published showing that all of the nasty bugs can be found. Understanding that these frequently touched surfaces can lead to transmission of bugs has led to hospitals beefing up their cleaning and disinfection practices. I’m not sure the same can be said about other facilities and building with tabletops and other surfaces!

5.     NECKTIES: I’m sure some of my readers would disagree, but I’ve always thought a well-dressed man in a suit and tie was nice to look at…. Talk about ruining a good thing. Neckties and other items of clothing can quickly become contaminated with pathogenic bugs putting into question what is considered appropriate dress ware for work! Perhaps we should take a page from the story “The Emperor’s New Clothes”.

Well, now that its official that virtually any surface can transmit some sort of disease causing agent and men in suits are soon to be a thing of the past, I’m going to buy myself a bubble. But first, I’m going to eat some chocolate and I’m not going to bother washing my hands. I’m living on the edge – I’ve just written this blog. My fingers have been all over my keyboard and I can assure you, I have not disinfected it in a while!

Bugging Off!

Nicole

Unobvious Items Cause Outbreaks

How many times in your life have you thought or said “knowledge is power”.  Knowledge is a powerful factor that empowers people to achieve great results. The more knowledge a person gains, the more powerful he or she becomes. It’s especially true when conducting outbreak investigations. The more we investigate and uncover the more we can understand what happened or is happening and the better we can resolve the issue and put safe guards in place to avoid similar occurrences in the future.  

The unfortunate part of this is that the knowledge we gain is after a set of unfortunate events where patients have gotten sick, or even worse, died.  Part of our quest for knowledge needs to consider the unobvious. I would hazard a guess that our protocols or standard operation procedures and our training programs could be vastly improved if we looked beyond the obvious and the merely obvious.  Children learn by experiencing their environment.  They’re curious, they touch and get into everything.  As we grow and learn, we start to believe we know everything. Many of us stop being curious.

What if we went into a patient room, or whatever room at whatever healthcare facility we work at and were as curious as kids?  How would you experience the room?  What would you look at?  What would catch your eye?  What if we touched and/or picked up every item in the room, looked at it in detail and asked ourselves how would it cause or could it cause and HAI?  Do you think our knowledge of what could or could not possibly cause an HAI change?  Or are you wondering why I am asking so many questions?

The reason for my curiosity is due to a study I read that was published in the October volume of ICHE the study discusses transmission of HCV in a liver transplant center.  The result of the investigation lead the researchers to conclude that the cause of the transmission was from a reusable blood collection tube holder that was not disinfected between uses.  During the course of the investigation, 34 environmental samples were taken from the inner and outer surfaces of 14 tube holders, a glucometer tray, a tray used for phlebotomy, and a phlebotomy trolley.  The virus was only found on the inner surface of 1 of the 14 tube holders.  The researchers postulate that rapid removal of vacuum-specimen tubes from the sleeved-needle can be followed by a fine splash that then contaminates the inner surface of tube holders.  Additionally, during removal of the double ended needle, the inner surface of the tube holder can also become contaminated.

The authors identified several limitations to the study, however, they also identified an unobvious way that HCV could be transmitted. They concluded that single-use disposable tube holders are preferable to not only prevent needlestick injury but to ensure that we minimize any possible transmission of HAIs.

Regardless of the situation, I hope you’ll consider acting like a child, be curious and explore your world looking for all of the unobvious ways HAIs can be transmitted!

Bugging Off!

Nicole