Welcome to Professional and Technical Services (PTS) – experts in chemical disinfection for infection prevention. Our goal is to educate and provide you the latest resources related to cleaning and disinfection of environmental surfaces, medical devices and hands. As specialists in disinfectant chemistries, microbiology, environmental cleaning and disinfection, facility assessments and policy and procedure creation we are dedicated to helping any person or facility who uses chemical disinfectants.

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Friday, October 30, 2015

Zombies – Do they exist in real life?

With Halloween only a few days away, I thought this was a perfect time to talk about Zombies.  For years, zombies have dominated science fiction.  These creatures, the walking dead, don’t actually exist, right?  Wrong!  There are in fact several very real life diseases that could and can make you act like a zombie.

To set the stage, let’s first define what we think the characteristics of a zombie are. There obviously is no validity that people who are actually dead walk around but there are diseases that make people ACT like the walking dead. Other traits of interest would be rotting or dead flesh, a trance-like state, inability to communicate other than perhaps moaning, a slow shuffling gait and if we’re lucky the penchant for biting people.  So, what are the diseases that can cause you to ACT like a zombie?

Sleeping Sickness – is prevalent in Africa and is caused by the parasite Trypanosoma brucei, which is transmitted by the tsetse fly.  In the late stages of the illness, once the parasites have invaded the brain, victims find it hard to concentrate, become irritable, their speech is slurred and they stop eating.  Most are unable to sleep during the night and find it almost impossible to stay up during the day eventually reducing them to a zombie-like state before going into a coma and dying.  Those that survive are generally left with irreparable brain damage.

Rabies – while not a disease that is truly going to make a person bite someone, it can mimic some of the conditions of the zombie’s lust for brains.  The rabies virus causes massive inflammation of the brain and is transmitted by bites from infected animals.  Symptoms of rabies can include full or partial paralysis, mental impairment, agitation, strange behaviour (which I would like to be better defined as many people accuse me of acting strange....), mania and delirium.  It’s true, there aren’t many people with rabies going around and biting other people, but many rabid animals become very aggressive and attack so....I suppose if a person who had a tendency toward aggressive behavior got rabies, it would be possible!

Dysarthria – is a disorder affecting the motor controls of human speech.  It’s neurological in its origins so it ties in with the brain-based aspects of zombie lore.  There are a number of causes of dysarthria, but all are characterized by a malfunction in the nervous system that makes it difficult to control the tongue, lips, throat or lungs which then leads to difficulty in articulating and can cause the inability to communicate more than unintelligible noises – quite like the moans and groans of zombies.

Leprosy – is caused by a bacterium, Mycobacterium leprae.  Cases of leprosy have been reported going back more than 4000 years, and considering a common feature of zombies is their rotting flesh and decaying body parts, it would seem that leprosy and its similar sounding symptoms would be a natural inspiration for such stories!  It is a myth that leprosy causes body parts to fall off, but it can cause damage and numbness which could cause slow, shuffling walk similar to the gait we associate with zombies.  The skin lesions that are probably the key characteristic of leprosy with some imagination, give skin the diseased, decaying appearance we associate with zombies.

I hope you’ve enjoyed this Halloween trip down zombie lane!

Bugging Off!


Nicole

Friday, October 23, 2015

Nosocomial Nuisances

Where did this week go?  For those of you celebrating International Infection Prevention Week (IIPW), I hope it was memorable with compelling stories or education initiatives to rejuvenate your love of infection prevention and quest for improving the lives of others.  In trying to decide how to close the week off, having been given the topic of Nosocomial, I was looking for an upbeat rah-rah way to end the week but then thought otherwise.  It’s not that I want to be a Debbie-downer or point out flaws, but thought what better way to close out the week than with some stories from my friends and colleagues of their friends or families that have been impacted by a hospital associated infection. In sharing these stories I want to remind everyone why infection prevention is so important.  I have three stories; a worst case scenario leading to death, a story of while you can recover there may be lasting health effects and one that well...I’ll let you read about it.

I actually blogged about my first HAI story, in November2015 – it’s the one with an unhappy ending.  A friend reached out to learn more about C.diff.  Her mother-in-law had gone to the hospital with an UTI and pneumonia and contracted C.diff. We were going to meet so I could give her some disinfectant wipes that the family could use in the room to clean the bedside rails and other high touch areas.  We never met so I could give her the wipes.  Instead I attended a visitation. Her mother-in-law at the age of 67 had died of an HAI and my friend’s sons who were 4 and 6 were left wondering what was going on and asking when Grandma was coming back. A life was lost, senselessly.

The next story is fitting, because not only is it about an HAI, but an HAI that was transmitted to a nurse in the line of duty.  This story comes from one of my colleagues – a family friend who is a nurse was infected with SARS during the outbreak in 2003.  As a result of her bout with SARS she has been left with breathing problems due to the severity of the infection.  From a vibrant nurse she now has troubles walking around the house and is short of breath all the time.  Her lungs have been damaged so badly that she is no longer able to work. 

My last story is a little tongue and cheek, but I assure you it is true.  While it’s a happy story in that this young woman fully recovered, the story still had a sad ending.  This story, also from a colleague, is about a young woman who while being treated for bacterial bronchitis ended up with C.diff.  The first “bout” lasted for about 2 weeks and then she relapsed shortly after her antibiotics were finished.  As many of us know this is not uncommon.  Unfortunately, after a month of his girlfriend being ill, my colleague, a young man at the time, decided it was time to move on.  The young woman recovered from C.diff, but C.diff killed her budding young romance.....

IIPW is a week of celebration and a week of education.  Some of the most effective ways to learn is to reflect on our mistakes and reminisce on past events as the ones I have included above.  While we are all working to Target Zero, the truth is it will be sometime before we get there.  It’s not from a lack of trying, but due to all the moving parts that need to be working in concert and perfect precision.  I am proud of the work that my IP friends do in trying to ensure the patients in their facilities are safe.  Kudos to you!  You deserve to be celebrated!

Bugging Off!

Nicole

Thursday, October 22, 2015

#TBT – Antibiotic Resistant Organisms

Some of you may be frequent TBT (Throw Back Thursday) players.  I often see TBT posts on Facebook with pictures from years gone by and hair or clothing styles that I wish I could forget – the spiral perm being one of them!   For today’s post I thought rather than trying to reinvent the wheel on the discussion about Antibiotic Resistant Organisms (AROs), I would simply go back in time to some of our past blogs where we have covered the topic from virtually every angle.

Doors Keys and Sledgehammers.  “Once upon a time, long, long ago there was door. This door was extremely strong, could rebuild itself and seriously maimed or killed anyone who came in contact with it. In the 1800’s, some bright soul invented a sledgehammer. The people were finally able to break the door down and while the door could rebuild itself, it maimed and killed fewer people. Then in the 1940’s a genius developed a key that could unlock the door and everyone thought the story was over. But this was in fact just the beginning of the Lock and Key war. In 1947 the door changed its lock, the key no longer fit, the door became stronger than ever and the people again began to see the importance of using the sledgehammer. The End.”

I’ll take kill claim for $200 “....confirmed by Rutala and Weber, disinfectant testing for antibiotic-resistant organisms is not necessary, as antibiotic resistant pathogens are not more resistant to disinfectants than antibiotic sensitive pathogens....”

CRE – Deadly, but not the strongest survivor  “Overall, the study showed that CRE is infrequently isolated from environmental surfaces in rooms of infected patients, and if isolated, is only found in small numbers.  These results suggests that CRE does not survive well in the environment in comparison with other key hospital-associated pathogens such as MRSA,VRE, C.diff, MDR Acinetobacter spp and MDR Pseudomonas.”

I hope you’ll take a trip down memory lane with me and reread the blogs.  If not, I hope you’ll consider that disinfectants have been used for well over 100 years without loss of effectiveness. While there is a hierarchy with respect to some bacteria such as spore-formers or Mycobacteria spp. being less susceptible to chemicals that their gram negative or gram positive cousins, there is no current scientific evidence that supports that antibiotic resistant organisms are more resistant to disinfectants.

Bugging Off!


Nicole

Wednesday, October 21, 2015

Effects of Education Efforts


Learning, teaching, coaching, training, rearing, tutoring are all synonyms for educating.  Whether it’s teaching our children to ride a bike or read a book, coaching or mentoring a colleague, training new staff or retraining current staff, everyone everyday imparts knowledge to others in some way.  My favorite definition of education is:

The act or process of imparting or acquiring general knowledge, developing the powers of reasoning and judgement and generally of preparing oneself or others intellectually for mature life.

Certainly, as an educator myself, I hope that with each webinar or seminar I give I am successful in imparting the knowledge I have on the use of disinfectants so that my audience can acquire the ability to reason and stand firm on the decision they have made with respect to their choice of a disinfectant.  This is also why I am so passionate about ensuring we develop a training program that ensures our staff have the knowledge and competencies to do their job.  If they do not, we all lose.  As a manager, we lose because our staff are under performing.  Our staff lose because they do not have the resources to effectively do their job.  Our clients (students, patients, etc) lose because they are now exposed to potentially dangerous pathogens that can make them sick or worse, kill them.

We CANNOT expect our staff to know how to correctly use the products and tools to do their jobs unless we TEACH them how to use them. Certainly in some aspects of our life, such as learning to walk or talk or in my case learning to swim (my mother quite literally “threw” me in the pool as was the rage for teaching babies when I was 4 months old), the concept of THE SINK OR SWIM SQUAD can be an effective learning process. For driving, practicing medicine, ensuring public safety through public health  - and I dare say for using cleaning and disinfecting chemicals - a formal, comprehensive and reproducible education system needs to be in place. Isn’t that the concept behind Young Drivers of Canada or the myriad of Medical or Public Health Schools around the world? Why then is there not a Healthcare Environmental Services School?

If you refer to my I golf; therefore I am a golfer blog from February 2012 you’ll see that I spoke to this exact topic and laid out the foundation for what I think are the crucial areas that all staff using cleaning and disinfectant products need to be taught.  This still holds true for me now.  In fact I have seen the results myself when this type of training is incorporated.  When you have a staff that have been trained to clean with a detailed process and then have them communicate it back to you and demonstrate how to do it, you can save lives.  Knowledge is power.  Let’s impart our knowledge so our cleaning staff have the power to do their jobs effectively.

Bugging Off!


Nicole

Tuesday, October 20, 2015

Reading the Fine Print


Let’s face it, reading labels is probably low on our list of exciting things to do, but I bet we ALL have at least one example of when we wished WE had read the label or someone we know (or knew) had read the label.  For example, I wish my husband (then boyfriend) had read the label on one of my favorite sweaters.  It was wool.  Wool is not meant to be put in the washing machine...or dryer.  The end result was a sweater small enough to fit on a Cabbage Patch Doll.  Then there was the time I brought a number of heat and serve items to work for people to enjoy for their snack or lunch.  The instructions CLEARLY stated to remove the wrapper before putting into the microwave.  Someone ignored those instructions.  The sandwich caught on fire, the microwave died and I no longer bring such items into work to share.......

When it comes to cleaning and disinfectant products reading the label and following instructions is vital.  Here are my top 4 reasons to read the label and follow instructions:

4. YOU CAN SAVE MONEY.  All cleaning and disinfectant products are designed to be used in a specific way.  For concentrates in particular, following the dilution instructions and using automated dilution systems is an easy way to ensure the products are diluted correctly and use only the amount of concentrate that is needed.

3. YOU CAN PROTECT THE ENVIRONMENT.  Understanding how cleaning and disinfectant products should be disposed is vital to their safe use.  Many chemicals can be disposed of down the drain and will biodegrade once entering our sewer systems, however a number of chemicals that are used in cleaning and disinfecting products  are not able to biodegrade and can cause toxic bi-products or bioaccumulate in the environment which can lead to serious health risks to people, animals and our planet.  Ensuring you know how to dispose products safely is a must.

2. YOU CAN PROTECT YOURSELF. Labels provide detailed information on how they should be handled and not all products are created equal.  Some chemicals are known carcinogens while others can cause irreversible eye damage or lead to the development of occupational asthma.  Ensuring you know what products you are using and what PPE (personal protective equipment) needs to be worn will ensure that you can protect yourself and safely use the products.

1. YOU CAN SAVE LIVES.  The reason disinfectants are used is to kill bugs.  But to do so, the product needs to be used correctly meaning you need to apply the product to the surface and ensure that surface stays wet for the contact time listed on the label.  If you do not know the contact time of your product, that’s a problem.  If you know the contact time, but do not use the product in a manner to ensure the contact time is met you run the risk of leaving pathogens behind on the surface which can infect or even worse, kill someone.

If you’re still trying to put some events together for International Infection Prevention Week, why don’t you create a “Can You Read the Label” game?  The caveat to winning of course, is once the contestant has read the label they then use the product correctly!

Bugging Off!

Nicole


Monday, October 19, 2015

CCM = Clear, Compelling and Memorable

At the sight of the letters "CCM", those of you who are old enough may initially have leapt to CCR (Credence Clearwater Revival); particularly if you’re following The Voice and watching John Fogerty work with “Adam Levine” (interpret the quotation marks as dreamy teenage googly eyes...or as in my case dreamy unteenager...).  CCM is something coined by my CEO.  It is a concept that he challenges everyone at our company with.  Whether we are writing a blog, creating marketing materials, writing a report on an open innovation project or giving a presentation, we are expected to deliver our message(s) in a way that is clear so that the reader or listener understands what we are talking about, compelling so that they want to take action and use the information that has been provided and memorable so that they can easily recall what they learned and share it with others.

Today is the start of International Infection Prevention Week.  Many of you will have a week’s worth of events, games and education sessions planned for your facility.  In honour of IIPW, we will be posting a blog each day using the theme C.L.E.A.N. The topics will focus on Communication, Labels, Education, Antibiotic Resistant Organisms and Nosocomial Infections. 
Hence the start of the blog talking to CCM! Communication by its definition is the purposeful activity of information exchange between two or more participants. As we all know, within the infection prevention and control industry communication is a crucial tool to ensure any guideline updates, outbreak notices, management measures, and other initiatives are effectively sent out to everyone who might need to know that important information, and certain large communication tasks can sometimes seem daunting. With this in mind, the following are the keys to successful communication:

USE STANDARD TERMINOLOGY: When developing a training program, writing an article, or creating marketing material we need to ensure we utilize the keys to an effective communication.  As experts in our field it is easy to ramble away using jargon and acronyms that make sense to us, but may be meaningless to others.  I LOVE acronyms.....just ask my colleagues.  But if you haven’t defined what the acronyms are or you’re using words that the layperson would not know, your attempts at CCM will be lost.  Another reason to avoid big words is that these are often ones you trip over when speaking, particularly if they are not ones you use with some frequency.  For example, I almost always trip over the word “anecdote”.  I therefore try to keep it simple and when I’m presenting I usually just say “story” instead.

ENSURE STATMENTS ARE DIRECT AND UNAMBIGUOUS: Words sounding the same but having different meaning (e.g. there, their, they’re) can impact the message. The use of phrases or slang is another area to avoid.  Certainly, we all want to be “cool”, but as the communicator it is your responsibility to ensure the person or people you are communicating with receive and understand the message you are trying to convey-  as a rule of thumb, it is better to avoid such words. 

CONSIDER CULTURAL DIFFERENCES: This is one area that we cannot underestimate when communicating. Words, colours and symbols have different meanings in different cultures and if used improperly, it can lead to the person/people you are trying to communicate with thinking you are rude or disrespectful.  This is where team work can help.  By developing a team of people who help build the content you want to communicate or review the content you have developed and ask them to review to ensure that you have not inadvertently made a cultural blunder.

NONVERBAL COMMUNICATION: Communication experts will tell you that up to 55% of human communication may occur through non verbal facial expressions such as eye contact (or lack thereof), rolling of the eyes, clenching of the jaw, scowling or crossing your arms over your chest, etc are actions that we often do not even realize we are doing, but can have dire consequences in conveying your message in the way you had intended.  Speech also contains nonverbal elements or paralanguage such rhythm in how you speak, the intonation (energetic, aggressive, etc), tempo (too slow, too fast) and stress.  Similar to the impact facial expressions have on communication, paralanguage can impact up to 38% of your message meaning the words you use only account for 7% of your total message.
Happy International Infection Prevention Week!  If you’re not celebrating, I hope I’ve still provided some clear, compelling and memorable reasons to rethink or relook at what your next communication message will be.....

Bugging Off!

Nicole


PS – honey...can you PLEASE put the laundry away before I get home on Wednesday?  J XOXO J 

Friday, October 16, 2015

Pet Turtles Pose Health Problems

I grew up on farm.  From a young age, I had a penchant for animals.  I believed, and still do that most animals can be made into pets.  I’d bore you to death if I named them all.  We of course had dogs and cats, but we also had rabbits and guinea pigs as well.  Then there were the non-traditional pets. There was Joy our Jersey who we milked, but would let my brother and I ride her like a horse.  We had a capon named Cookie who was very friendly and our hand feeding was likely the reason for him having a dressed weight of 13.5lbs. Then there were my various horses, but particularly Wally who I competitively show jumped under the name “The Other Man” who I used to play tag with in the field.  Do you see a pattern with all of my pets?  They were soft and cuddly.

My definition of a pet is just that – soft and cuddly.  Perhaps not in the curl-up-in-your-lap kind of way, but you can certainly hug a cow or horse!  So when I hear of people with pet turtles I wonder where the cuddling enjoyment in that is!  I also probably have a bias towards them because I know they have been the root cause of more than one outbreak associated with Salmonella; and they apparently have caused yet another.  The two outbreaks in question is on-going and dates back to January 22nd of this year.  There are 2 strains of Salmonella involved (S. Sandiego and S. Poona) which as sickened 51 people and hospitalizing 15 from 16 different states.  Fifty percent (50%) of those ill were children 5 yrs old or younger.

The CDC warns, and rightly so, that ALL turtles regardless of size can carry Salmonella even if they look clean and healthy.  Diligent hand hygiene is needed and when cleaning their tanks the areas should be thoroughly cleaned and disinfected afterwards.  Presently, the CDC believes the outbreak will continue at a low level for the next several months due to the fact that consumers may not be aware of the risk of Salmonella infection and also due to the fact that small turtles, when cared for properly, can have a long life expectancy.

The investigation has been a collaborative process with members from the CDC, Public Health, Veterinary, Agriculture and Wildlife officials from the various states working together along with the FDA Center for Veterinary Medicine.  Of the people interviewed as part of the outbreak investigation, 59% confirmed contact with small turtles or their environments.  80% of the ill people indicated contact with small turtles that were purchased from street vendors or received as gifts.

This is a great reminder of the concept of One Health - People, Animals (e.g. pets) and the Planet are all connected.  I hope the lessons learned from this is that while cute, turtles may not make the best pets unless there is a responsible care taker who understands the importance of diligent hand hygiene and environmental surface disinfection. Additionally, if we allow young children to touch or handle turtles it's important to be vigilant about NOT letting them put their hands into their mouths until AFTER their hands have been washed!
For me – I think I’ll keep to my “it must be cuddly” definition of a pet.  It’s not that cuddly equates to a lack of diseases that may make me sick.  It’s just that it has served me well so far, and as the adage goes, if it’s not broke don’t fix it!

Bugging Off!

Nicole


Friday, October 9, 2015

Friday or Long weekend outbreaks?

For many of us Canadians, this past week has been all about running around and trying to get organized for our Thanksgiving Weekend.  If you’re lucky, you’re not hosting the big family event and just need to show up to eat the fabulous meal that some loving relation has slaved over.  In my family, we potluck – whoever is hosting does the turkey, stuffing, potatoes and gravy and the rest of us bring the other fixings.  I’m on dessert duty – a dairy free, gluten free cheesecake.  Trust me it will be delicious!

For anyone in the infection prevention world it has long been known (or believed to be true) that outbreaks ALWAYS occur on Fridays at 4:30pm.  Our anecdotal notion that outbreaks are more likely to be reported on Fridays is so strong that a group of researchers undertook a study to determine if there really is such a relationship.  Although various associations between days of the week and different healthcare outcomes have been described in literature, the data that supports the Friday Outbreak theory was sparse.  The study analyzed data for over 900 institutional outbreaks over a 4 year period.  The analysis did in fact uncover a clear pattern.  Reporting of outbreaks on weekends (Saturday and Sunday) was below the average and Monday was the most likely day of the week for an outbreak to be reported with Friday also showing another high peak in reporting.

Logically thinking, this makes sense.  On weekends we generally only have infection preventionists on call and people may be loath to call them.  Peak reporting on Monday then becomes the “catch up” time of dealing with whatever happened over the weekend; and Friday – well that’s “deadline time” of trying to get everything off your plate to enjoy the weekend!

Regardless of the day of week the outbreak is declared, rapid detection of outbreaks without a doubt helps ensure that the outbreak can get contained in a shorter period of time which is obviously important for the safety of our patients and staff!  Weekend outbreaks that go uncontained without a doubt will lead to a higher attack rate and increases the risk of higher mortality rates.

Fingers crossed that my fellow Canadian’s have a no outbreaks to declare today, and that no outbreaks occur over the weekend so you all can enjoy a relaxing weekend of reconnecting and celebrating with family and friends!

Bugging off – I have a dessert to make!


Nicole

Friday, October 2, 2015

Shigellosis Skyrockets in Kansas City

It’s very likely that you may not have heard about the outbreak in Kansas City.  But due to the significant numbers and the fact that Public Health officials are seeing an unusual pattern of resistance I thought I would share. 

Shigellosis is an infection caused by a family of bacteria known as Shigella.  Shigella is frequently found in water polluted with human feces, and is transmitted via the fecal-oral route (e.g. you’re eating poop) directly from person-to-person and often associated with causing outbreaks in the child care settings where there is poor hygiene among children. Symptoms generally include diarrhea, abdominal cramping, nausea, vomiting, and fever. As a bacterial infection, it can be treated by antibiotics although often times people can be asymptomatic and pass the infection on to others without knowing.

Public Health officials from Kansas City Missouri do not know the source of their current outbreak, but they do know that they are seeing unprecedented numbers which have mostly struck children in daycare and elementary schools. From January 1 to July 1 of this year, there were only 16 cases, but in the last 2 months there have been 134 identified cases – 15 times the yearly average! 

Health officials are urging people in the Kansas City area to wash their hands properly with soap and warm water (plain soap is just fine!) to prevent the spread of the illness. It’s also important to use hand driers or disposable paper towels to dry hands rather than hand towels.  Because it does not take very many organisms of Shigella to become sick, bacteria left behind on the hand towel can in fact lead to transmission and infection of the next unsuspecting person who is washing his or her hands. 

With luck I hope the source of the transmission is found to avoid more cases.  In the meantime....I’ve been gone for a week, I’m going to go run around the house and change out our hand towels, dish towels, dish cloths.....I’m not saying we have Shigella.  I’m saying there have only been two males in the house and you just never know what may be lurking on them after a week!

Bugging Off!

Nicole