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, December 15, 2017

Are men the fairer sex?

Today I just had to tap out and admit I needed a day at home to rest.  I’ve been fighting a cold for over a week.  It started to hit me Sunday, when I had a 2 day committee meeting….with a group of Infection Preventionists (Sorry if I made anyone sick!).  ‘Tis the season for colds and flus – it is what it is and actually I’m pretty happy that I made it almost to Christmas before catching something. 

This morning, while relaxing, I caught up on some reading and low and behold I came across a study that made me chuckle.  The timing of course with being sick couldn’t have been better!  I came across an article “The science behind man-flu” by Dr. Kyle Sue from the University of Alberta that explored whether men are wimps or just immunologically inferior.  OMG!  Who hasn’t mocked their spouse, partner, brother, father, friend or co-worker for being a baby when sick! 

Across the ages, women have often been called the fairer sex.  It’s a stereotype that is hard to escape.  In trying to understand this association, scientists have shown that we automatically link lighter or fairer colours with female names and qualities, and darker shades with more masculine attributes.   How then is it that when it comes to getting sick, women handle it better than men?  According to the Oxford Dictionary, “man-flu” is defined as "a cold or similar minor ailment as experienced by a man who is regarded as exaggerating the severity of the symptoms."  Sue conducted a literature review to determine if men really experience worse symptoms then women and whether this difference has any evolutionary basis.  One study Sue referenced isolated cells from 63 healthy people and infected the cells with a common virus. The researchers found the cells from women had a stronger immune response than those from men.  Some of the other interesting tidbits included the fact that men had a higher risk of hospital admission with the flu, men had higher rates of flu-associated deaths compared to women, women are more responsive to vaccination than men and while perhaps one of the least scientific supported evidence, a survey found that men suffering from a flu reported taking more time off from work than women.

The things that make you go hmmm…..  I guess it’s true that estrogen does have its advantages from time to time! Too bad it let me down this week, but it gives me the opportunity to drink a hot-toddy before bed!


Bugging Off!

Nicole

Friday, December 8, 2017

Street cleaning causes infections?

 
I think I can say with some confidence that it is very rare that cleaning can lead to infections.  I am aware of a study from many moons ago where a facility found that surfaces cleaned by a particular cleaner were dirtier after cleaning took place.  The reason? In order to be more efficient, the housekeeper would set up their cart the night before, and to minimize waste, topped up rather than getting fresh disinfectant solution.

I’ve been fortunate enough to have had the opportunity to travel to some extent, and visit a number of different countries.  Along my travels I have noticed that some areas are dirtier than others.  I have also noted that some areas of the world go so far as to clean their streets each night to keep the dirt at bay – I happen to know that Bourbon Street in New Orleans is frequently cleaned…..but dirt is not really the issue there.  In general, I would say that street cleaning is a good thing.  It keeps dirt at bay, but it also removes food scraps that could become a food source for insects or rodents. For obvious reasons, cleaning gives a pretty good impression to those who may be new to a given city.  It never occurred to me that street cleaning could be an infection hazard.

I now fear that street cleaning trucks may become categorized in the same league as hand dryers for me thanks to a study published in Emerging Infectious Diseases by researchers from Spain.  The study investigated a case of Legionnaires’ disease that had been confirmed at a street cleaning company that reported a similar case 4 years prior.  The long and the short of it is that researchers felt that the infections were caused by contaminated water tanks used by the trucks during street cleaning concluding that Legionella was being aerosolized through the high-pressure hoses used to clean the streets.

This isn’t the first blog on Legionella.  In my Bugs, NOT Robbers Close Police Station and Summer cough due to cold…or Legionnaires’ disease, I reviewed 2 other outbreaks associated with Legionella.  In fact, Legionella is associated with a number of interesting outbreaks including water or liquid associated with windshield washer fluid, dishwashers, hospital hot water systems, cooling towers, asphalt paving machines and even water births…   According to relatively recent statistics, the CDC reports that Legionnaires’ disease has quadrupled in incidents between 2000 and 2014.

Legionella loves water, so it’s not necessarily surprising that it would be found in the street cleaning trucks.  During the investigation the researchers found that the water from the street cleaning trucks was disposed of each night and refilled the next day with either untreated ground water or drinking water. The tanks were disinfected once/year for 2hrs with a chlorine-based solution.  However, the foam linings in the tanks were never replaced and did not dry out overnight creating a perfect reservoir for Legionella to flourish.  As a result of the investigation, street workers are now required to wear masks during tasks that could lead to potential exposure. The internal foam pieces were removed from the trucks and stricter water treatment measures were put in place.

In the end, cleaning and disinfection is important to minimize the chance that Legionella can take hold and cause chaos.  The upside of studies such as this is that it shows you just never know where the next reservoir for Legionella or any pathogen for that matter may be found.  It’s easy to let our guard down during quiet times….but that always seems to be when the next opportunistic infectious agent crops up and wreaks havoc!  Cleaning saves lives and I guess as this study shows, effective cleaning and disinfection protocols are needed everywhere!

Bugging Off!

Nicole 

Friday, December 1, 2017

What’s in your sink, tap or bottles?

Prior to entering the infection prevention world, I worked for almost a decade in a laboratory where we tested water, soil, waste water, air, and food, among other things.  My focus and expertise were in the Environmental Division where we dealt with contaminated sites (water and soil testing), drinking water analysis, etc.  My least favorite project was measuring, weighing, filleting and dissecting >200 fish in order to test for dioxin and other chemicals of concern.  It was stinky and after the first night, the 2 college students who were supposed to help never came back….

Having lived and worked through one of the worst outbreaks associated with drinking water and understanding the need to ensure we have quality water to drink, I am always curious when I come across an article that impacts drinking water, particularly if bottled water is included, as bottled water does not have the same level of testing requirements as tap water (at in Ontario, Canada).  So it was interesting when I read a recent article by researchers out of Thailand looking at Stenotrophomonas maltophilia isolates from environmental samples.

S. maltophilia is an emerging global multidrug-resistant opportunistic bacterial pathogen that is being found both in healthcare facilities and the community. Similar to many emerging pathogens, it is of particular concern for immunocompromised individuals as this pathogen is associated with a significant mortality.  S. maltophilia is an environmental bacterium found in aqueous habitats, including plants, animals, foods, and water sources that has the ability to cause infections in a range of organs and tissues but is most commonly associated with in respiratory tract infections. 

The researchers found that of the 360 samples taken, the majority of the environmental isolates were found in sink drains, drinking water and tap water.  Of particular interest was the frequency of positive samples found from bottled water, which the researchers speculate could have resulted due to poor management of hygiene during the production of the bottle water.  They also found positive samples from the machine filtered water which also highlights the importance of ensuring there is a preventative maintenance and monitoring program in place for on-site filtered water production.

My interest for this was of course the contamination in bottled water.  We’ve become accustomed to grabbing bottles of water and most incorrectly believe that bottled water is safer than tap water.  In some countries, without a doubt this could be true.  However, in other countries, very strict regulations are in place to ensure that municipal water is of the highest quality and safety.  The dirty truth is that bottled water manufacturers do not have to conduct much in the way of testing to ensure their product is as safe as the water coming out of our taps.

As with any study looking at the environment, it is both interesting and scary to learn about new emerging pathogens we need to be on the lookout for and of course the surfaces and areas we need to be particularly vigilant with.


Jae kan mai na,

Nicole

PS – that’s see you later in Thai!  Thanks Nuch (aka Big Sis)! 

Friday, November 24, 2017

Prescribe Practice for Perfection

Retrieved from: https://upwardpackaging.com/
When you try something new, there’s no hiding that you’re usually very bad at it.  For many, the easiest way to eliminate that feeling of angst is to quit practicing and go do something else, so that’s what most of us do.  Take me for example, I love music.  In fact, going into school, my choice was science or music.  I knew I didn’t want to be a teacher so I chose science, but continued to take music as a minor and while I stopped playing the flute and sax, continued with piano whenever I could get my fingers on the ivory and singing.  Over the last 10 years, life has gotten in the way and these days aside from singing in the car, I’m not very musical.  I decided that perhaps I would take up a new instrument, guitar, because I have lots of family and friends that play, I would be able to sing and play and unlike a piano, and I can take a guitar virtually anywhere I want to.

I did not however, consider the angst I would feel for not being good at an instrument as soon as I picked it up.  Nor did I consider the fact that when I play piano or sing, even from memory, I visualize the notes I am playing or singing.  When I pick up the guitar, I can’t visualize the chords (yet) and that has been paralyzing….and more than just a bit humbling.  I know that practice makes perfect and I have resolved to start taking lessons, get out of my head and just try.

What does this have to do with infection control or the use of disinfectants?  Well, as I’ve talked about in past blogs, perfecting cleaning and disinfection practices can save lives.  More importantly however, practicing the safe use of disinfectants will save lives.  Did you know that more than 30 million workers are exposed to hazardous chemicals in their workplace?  In North America, because of the safety concerns we have programs like OSHA in place to protect workers.  Most of us would immediately think of the SDS as a need to ensure that information on the product is readily available.  While the SDS provides valuable information, many overlook the importance of Work Place labels.

Back in 2015, I wrote a blog “Mommy, this water tastes funny” where a son of a friend of mine drank bleach.  It had been decanted into a water bottle by cleaners while they were on vacation and left on the bathroom counter.  The bottle looked exactly like the bottles of water he had been drinking from for the last several days.  I also know of a story of a healthcare facility where spent hydraulic fluid had been put in an empty Enzymatic Instrument Cleaner bottle and put under the sink…the sink where instruments were reprocessed.  No one realized what was going on until surgeons started complaining of the fact that instruments were slippery to touch.  Just last week, one of my teammates took a call from a veterinary clinic who had taken a bottle of diluted disinfectant and used it in their dental water lines, mistaking it for a bottle of distilled water.  They performed several procedures with pets and were concerned of the side effects for potential ingestion of the disinfectant.

Luckily in all cases, no one died and no one was seriously injured, but none of these stories had to happen if we were practicing safe chemical use.  Safe chemical use is not just about reading the SDS or wearing the correct PPE.  Most importantly, safe chemical use means that the bottles the chemicals are stored in are correctly and adequately labelled so that it’s not just you that knows what the bottle contains.  While the following is verbatim from “Mommy, this water tastes funny”, I feel based on this week’s call it is worthy of repeating what a workplace label must include and you can see, it’s not so much that it’s a daunting task:

1. Product identifier (product name)
2. Information for the safe handling of the product
3. Statement that the SDS is available
4May contain the WHMIS/GHS hazard symbols or other pictograms.

The long and the short is that we need to be safe.  We need to protect ourselves and we need to protect our employees.  Ensuring that every bottle of chemical you have in your facility is properly labelled with a work place label is a very important safety step! 


Bugging Off!


Nicole

Friday, November 17, 2017

Ban the Bad Blowers!

As I’ve mentioned in previous blogs, I like to get my geek on.  Thankfully I was alone in my office when I squealed in delight after reading a Letter to the Editor in the October Special Edition of the Journal of Hospital Infection.  The letter talked about a pilot study comparing the level of microbial contamination found in hospital washrooms when paper towel or hand dryers were used.

I HATE hand dryers.  While I try darn hard to be environmentally conscious and sit on our company’s Green Team, when it comes to drying my hands I have no qualms about the number of trees needed to be cut down to make paper towels.  Why? Because there is enough evidence to show that hand dryers impede hand hygiene and as this study shows when looking at microbial contamination washrooms (restrooms) with hand dryers had higher levels of microbial contamination than washrooms that used paper towel.

Some may be questioning my comment about hand dryers impeding hand hygiene, but back in 2012 guest author Prof. Todd from Michigan State University discussed a survey where researchers found that hand dryers, because they can only accommodate a person at a time and can take up to >1 minute to adequately dry hands, can lead to avoidance of their use, incomplete drying of the hands or worse, wiping clean hands on clothes…..  I will admit there has been more than one occasion where along my travels I have encountered either a line up to get to a hand dryer or gave up on getting my hands dried due to insufficient air flow and/or heat.

In this particular study, the researchers sampled 2 washrooms within one hospital over a period of 3 months.  Their sampling regime included air sampling, environmental sampling of 5 locations and collecting dust samples.  In reviewing the data, significant differences and trends were seen.  In the washroom that utilized paper towels lower microbial levels were found whereas in the washroom that employed the hand dryer the microbial contamination was higher, had a greater range of bacteria and in general the floor, the hand dryer and the dust samples were more heavily contaminated.

I knew there was a reason I had such a loathing for hand dryers….this study simply continues to build upon my bias towards the need to ban their use.  The fact that WHO advocates to dry hands thoroughly on a single use towel strengthens my resolve to avoid the use of hand dryers at all costs!

Bugging Off!
Nicole


PS – I know more investigation is needed, but for me the proof is in the 
pudding - blowers are bad!

Friday, November 10, 2017

Under the weather...

This week I’ve been off site at an amazing Executive Leadership Program.  It’s been insightful, a little humbling and very eye opening.  It has also been a bit sickening…..and by that I mean 5 of the 12 people in our group came down with tummy issues and as we found out last night talking to another group at our facility, 7 of the 30 in their group came down with something as well.

That something...was definitely food-borne, we just can’t decide if it was the Asian coleslaw, the cod or the avocado salad….or maybe all 3!  Needless to say, I have managed to survive enough to complete my course, but all good intentions in writing my blog this week went down the drain (pun intended).

The upside I suppose, is this is a great reminder that where ever we go, bugs will be there!


Bugging Off!


Nicole

Friday, November 3, 2017

Restrooms, You and the Flu!

There are times that my self-control amazes me.  Perhaps not when it comes to chocolate, candy, chips and dip or really good cheese, but upon occasion, like my ability to not work out is truly impressive.  The fact that we have hit November and this is the first blog of the fall to talk about Flu Season is a great example of my self-control.

You may be wondering why I think I’m so impressed with myself, well…..have you be following the Flu Season in Australia and the Southern Hemisphere?  Australia has had a particularly bad flu season with >93,000 lab confirmed cases as of August 18th which happens to be 2.5 times more infections than the previous year.  The deaths and hospitalizations associated with the flu have also almost doubled when comparing recorded numbers year over year.

So what does that mean for North America? Well, if we use Australia and Hong Kong as indicators, and we know they have grappled with one of the worst flu seasons on record, then it’s safe to say that we may follow suit.  One of the reasons is because H3N2 is one of the most predominant strains circulating and it happens to be the strain that wreaked havoc a couple of years ago when our vaccine was a mismatch…  So, with the arrival of November we can and should expect the flu to start showing up.  If we keep on track to when we typically see spikes, we can expect the first  hit sometime in December, about the time that kids return home from school. Then a second hit in late January into February when we start seeing the true colour of Jack Frost and his blustery frigid temperatures.

Which leads me to restrooms and the flu.  “Spring Cleaning” is a well-known phenomenon with its intention to get rid of the dirt and grime that accumulates over the winter after we lock ourselves inside to avoid the cold.  Perhaps we should develop a new phenomenon – Fall Extermination.  We know that germs can be anywhere and we know that germs start “accumulating” in the fall when Cold and Flu seasons hits so maybe if we look at implementing a few key prevention tips we can help reduce the risk of transmission:

  1. Schedule seasonal deep cleaning at the beginning, middle and end of cold and flu season to keep the germs at bay.
  2. Increase the number of hand sanitizers you have on hand and make sure your bathroom is well stocked with soap in order to facilitate hand hygiene.
  3. Have disinfectant wipes readily accessible and encourage employees to disinfect their work areas, telephones, keyboards, door handles etc.
  4. Can you move to hands free options?  The less we touch, the less our hands will pick up and the lower the chance we have to spread things to ourselves.
  5. Just because cold and flu season happens every year, doesn’t mean everyone remembers how to differentiate between the two and how to try and stop from getting sick.  EDUCATE!
  6. Encourage sick employees to head home and recover.  A sick employee is not a productive employee and they’ll just make others sick.
  7. Promote Flu shots; and if you can, hold a flu shot clinic.


As we enter flu season, I hope you implement a few of these things both at work and at home because there’s nothing worse than working with sick grouchy people only to have to head home to a husband with a man-cold……


Bugging Off!


Nicole

Friday, October 27, 2017

Acquired Infections vs Acquired Illness

It’s relatively hard to go a day without seeing some form of media article about hospital acquired infections (HAIs).  Hospitals and Infection Preventionists are being pushed to prevent HAIs so as not to lose out on funding (and of course not to harm patients).  At virtually every tradeshow or conference I attend and speak with Infection Preventionists, I hear “Do you kill X or Y?”  or “How fast is the contact time?” over and over…..ad nauseam.

Depending on the person or the conversation, I have been known to challenge the concept of focusing only on efficacy or speed.  In fact one of my favorite lines is “I don’t care what the product says it will kill or how fast it will kill it, if the staff don’t like using it (or are scared of using it), you can be guaranteed they won’t.” It’s the truth.  I’ve seen it.  I’ve talked with staff who are concerned for their health due to the perception they have of the disinfectant product that has been chosen and they feel forced to use.

The truth is, in the race to ensure we rid every surface of as much as we can in order to minimize the spread of HAIs we have forgotten one important thing.   We have forgotten to consider the balance between efficacy and safety.   It’s relatively easy to go online and find a recipe to make a “safe” disinfectant.  From a chemical engineering perspective it’s also pretty easy to create a disinfectant that will kill everything….assuming we’re not concerned with occupational safety or materials compatibility.  Finding the balance and creating a product that has a pretty broad-spectrum efficacy along with a great safety profile is another thing altogether. 

A recent study published in AJIC investigated health problems associated with disinfectant product exposure and concluded that the PAA-based disinfectant chosen because of its product label effectiveness to reduce C. difficile was directly associated with mucous membrane and respiratory health effects.   The results were based on a survey completed by healthcare workers as well as air monitoring in units that utilized the disinfectant in question.  It was found that there was a higher prevalence of work-related wheeze and watery eyes among users of the disinfectant product.  It was also found that in one unit where the highest level of chemicals was found in the air that there was a higher prevalence of health effects among both product users and non-users.  The researchers also compared the prevalence of asthma among the healthcare workers in the hospital to reported values for the US adult population and found that the prevalence was significantly higher.  The recommendations of the study were to ensure that healthcare workers concerns about occupational illness are taken seriously and to implement controls to reduce exposure to cleaners and disinfectants in order to provide a safe working environment while still protecting patients from HAIs.

The long and the short is that everything we do in life needs to be balanced and that many of our choices will require a trade-off.  In the case of choosing disinfectants, the difficulty being you may be choosing between the health and well-being of a patient over a healthcare worker or vice versa.  When looking at our disinfection needs remember it’s not just about what a product kills or how fast it kills.  We need to consider the safety of the staff that have to use it.  If there is a potential health concern, then what controls need to be put in place such as additional PPE such as respirators or only cleaning 1 or 2 rooms per shift with the product in question.   Alternatively are there changes in cleaning protocols that can be used such as twice daily cleaning (e.g. morning and afternoon) to help keep the pathogen load in the environment lower?  

As I learned today, perhaps we need to use a “Beginner’s Mind” when trying to come up with solutions to the problems we have.  We often look to the experts to come up with a solution, but according to Zen Master Shunryu Suzuki “In the Beginner's Mind there are many possibilities. In the expert's mind there are few." 


Bugging Off!

Nicole


Friday, October 20, 2017

Sword fighting with baseball bats

If you think about growing up, there seems to be kids who naturally are more reserved and less adventurous, and then there are the ones who often act before thinking and have no fear.  You might even wonder if there really is a “dare devil gene”.  I was and still am a dare devil.  I can honestly say that if I or my brother thought of something, we rarely ever failed to follow through on execution.  From building the best hay forts with booby traps to climbing trees to see who could swing the top over the farthest, we did it.  We also successfully built a bike out of wood which steered, but lacked brakes, and were professionals at making swords, spears and may have been known to dabble in making things that could go “boom”.  I’m happy to say that neither of us ever broke anything that required casts, but there may have been the occasional set of stitches and an eye patch, and by the time I was 6, we knew I was allergic to almost every adhesive used in band aids.

I was 5 the first time I had stitches, although surgery was required before the stitches could be put in.  My brother was only 3 at the time so was not involved in this scheme, but the boys down the road sure were!  The collective “we” decided that sword fighting with baseball bats was a reasonable thing to do, and for a while it worked. If I recall, I was holding my own…. that was until my pinkie (check out the picture) got caught between the 2 wooden baseball bats.  I’m not really sure how it happened, but I suspect I went in for a thrust and the neighbour swung to fend me off.  Let’s just say, my pinkie didn’t stand a chance against 2 baseball bats.  That said, I was lucky.  The bone did not break, but the skin from my first knuckle up sure popped off!  In fact it was hanging by a thread and let’s just say, while running around in circles, there was a lot of blood.

The surgeon was able to piece my finger back together, but during the healing process the beginnings of infection set in.  Luckily my mom was a nurse so nothing got out of hand, but I do remember having to soak my finger in a bath every day to draw out the infection to avoid losing more of the finger than I did.  I was lucky.  I kept my pinkie, I grew back a finger nail and best of all when we were learning right from left at school, I never had a problem because I only ever had to look at my pinkie to know which hand was which!

In the stories I shared this week, the HAIs were all associated with adults and several of them older adults with poor immune systems or underlying diseases that would have increased their odds of getting an infection.   I’ll admit, while the infection was in the site of a surgical incision, the original “incision” was not made with a sterile scalpel, so it’s entirely plausible that my foray into sword fighting contaminated the area which made it easier for infection to set in.  The reason I’m sharing my story is because we need to keep in mind that the transmission of pathogens can happen almost everywhere and to anyone.  While I focused on HAIs this week, we see infectious diseases transmitted in schools, at work, on cruise ships, at restaurants, at spas and even other healthcare settings like dental offices. 

The long and the short is that we need to be mindful.  We need to take a pause and if sick, stay home.  We ALL need to wash our hands.  As highlighted in the obituary I shared yesterday, dirty hands can lead to HAIs.  In healthcare settings, we need to support the cleaning staff and allow them the time they need to clean rooms properly and not push them to finish faster in order to get a new patient in the bed.  If we rush, we cut corners and those corners can be deadly. 

As we come to the end of International Infection Prevention Week, I would like to give a shout out to the great jobs done by the housekeepers who work hard to keep facilities clean, to the nurses and doctors who work hard to keep us healthy and the Infection Preventionists who work tirelessly educating and helping to reduce HAIs!


Bugging Off!


Nicole 

Thursday, October 19, 2017

Farewell dear husband, father and friend

I started with Virox in March of 2003.  Shortly after I started, I was introduced to someone who I would now call a dear friend.  Paul Webber, who some of you may know as one of the founders of the Webber Training Teleclass program, took me under his wing. He introduced me to some of the greatest and most influential minds around the world in infection prevention, he helped build my love of infection prevention and the myriad of opportunities there are to educate, and he has spent more than a decade correcting my grammar any chance he gets!

You’ve likely guessed from the title, this story does not have a happy ending.  It’s the story of Paul’s father-in-law and how he lost his life due to a HAI.  Paul wrote about the unfortunate set of circumstances in his father-in-law’s obituary that I am sharing in full.  It’s poignant.  It’s heartfelt and I could not do it justice by trying to create an abridged version.

“On October 30, 2005 David Williamson Milne passed away at Kingston General Hospital after a battle with hospital-acquired infections.  He was loved and is deeply missed by many.

David Milne was the kind of person that you got to know, and like, quickly.  His friends were among society’s small and society’s great, and he treated each with equal respect and appreciation. His Scottish humour and laugh were infectious. Even in the last days he could make us laugh.

His family was the joy of his life and sustained him throughout. As the youngest of a large Manitoba farm family, he was his mother’s joy and primary recipient of her loving largess. He wedded his first love and childhood sweetheart, Catherine, who followed him from posting to posting, with one and then two children, Catherine Jr. and Jacqueline.

As a long-service pilot in the Canadian Armed Forces David Milne’s life was not without risk, but risk balanced in an equation with skill.  His heart surgery was a risk, but it was balanced against the outstanding skill of Dr. Hamilton at Kingston General Hospital.  The surgery was successful and Dave’s recovery was proceeding well, thanks to the care of KGH staff. Unfortunately, a series of hospital-acquired infections set back his progress and ultimately caused is premature passing.

Every year hospital-acquired infections cause or contribute to the death of more people than breast cancers, heart disease, and car accidents combined. Most of these infections are initiated by otherwise caring healthcare workers who forget or neglect to clean their hands. And for each of those who, like our friend David, succumb to one of these unnecessary infections there are many more who ache for their loss. These are not numbers on month-end reports. These are our fathers, our mothers, our children and our dear friends who are dying prematurely because of unclean hands. The little bit extra time that it takes for healthcare workers to wash or to use and alcohol sanitizer is pittance compared to the waste of so many productive, loved and loving lives.

In honour and memory of David Williamson Milne a donation will be made in his name to the Community and Hospital Infection Control Association of Canada.  His family and extended group of friends openly urge those at Kingston General Hospital as well as healthcare workers everywhere to clean their hands before and after every patient contact.  It is absolutely a matter of life and death.

Farewell to a dear husband, father and friend.”

Thank you Paul and Jacquie for letting me share your story.  There is nothing additional that I can add.  I agree completely that cleaning, be it hands or environmental surfaces or medical devices, saves lives.


Bugging Off!


Nicole

Wednesday, October 18, 2017

Cars, Hearts and HAIs

In the story I’m sharing today, one may wonder how cars, hearts and HAIs go together.  In fact when Rob, our Director of Production shared his family’s story I did what I often do when writing a blog – I started Googling.

Rob’s story goes like this.  “In 1996 my father-in-law was in Lewiston, New York and got in a car accident. While sitting in the back of a police car, he had a heart attack and thankfully paramedics who happened to be at the scene of another accident about a mile down the road were able to bring him back to life.  Unfortunately, while in the hospital in New York he contracted MRSA.  After being flown back to Canada, he was put in an isolation ward for 3 months, this is 3 months of wearing gowns, gloves and masks every day we went to see him….  In the end after a quadruple bi-pass you couldn’t slow him down, at least for another 12 years or so…”


Did you know that stress-induced cardiomyopathy is not uncommon?  In fact, it’s known as Takotsubo Syndrome and according to research it’s a temporary and sudden weakening of heart muscles, often triggered by emotional stress or constant anxiety. The sudden emotional stress can cause abnormal contractions of heart muscles and while contractions usually disappeared one to four weeks after the “stress that caused them,” they can sometimes persist which can lead to more serious complications and even death.  If you’ve ever been in a car crash, without a doubt it can put you on an emotional roller-coaster that depending on the severity can take weeks, months or even years for a victim to emotionally recover from the accident.


As Rob mentioned, his father-in-law contracted MRSA while in the hospital.  MRSA is usually spread by direct contact with an infected wound or from contaminated hands, usually those of healthcare providers.  From a risk of contracting MRSA there are 3 key factors; being hospitalized, having an invasive medical device, and residing in a long-term care facility.  Considering Rob’s father-in-law had 2 of the 3 risk factors since he was in a hospital with a weakened immune system and he had intravenous lines and urinary catheters, he was the perfect host for MRSA to travel directly into his body. 


The ending of Rob’s story is a happy one.  Certainly, it was a long road back to recovery, but his father-in-law was able to recover from the ordeal, and I hope like every good father-in-law he gave Rob a hard time for the next decade of his life!

Bugging Off!


Nicole

Tuesday, October 17, 2017

For the love of grandparents


According to Dr. Karl Pillemer of Cornell University, the relationship between grandparents and their grandchildren is second in emotional importance only to the relationship between parent and child. I could not agree more.  I was fortunate to have grown up knowing both of my Great-Grandmothers and both sets of my Grandfathers and Grandmothers.  In fact, in my mid-forties I am still fortunate to have a living Grandmother who is very much with it and at 86 is still driving and only just moving into a retirement home.  Even then she’s only moving because she was able to find a 2 bedroom condo that would meet her needs……  Ask my mother, it was no easy feat!

For many of us, our grandparents hold a very dear spot in our hearts.  You may have fond memories of spending the night at their house, going on vacation with them, eating “special meals or treats” that your grandma always made the best – even if your mom used the same recipe!  In one article I read, the author states that “Grandparents are like shady trees that have an ever welcoming attitude towards life. They are always there to offer their cool shade to the next generation. It seems that they have all the love, affection and warmth in the world stored within them.” I can’t speak for you, but this sums up my relationship with my great-grandmothers and grandparents perfectly and I think my colleagues who provided the stories I’m sharing today will agree.

Today’s blog is dedicated to the memories of the grandfather of our Marketing Assistant Brandon Petrasso and the grandmother of our R&D Laboratory Technician, Shukria Atta.  I hope you caught the fact that I said “memories”.

The story of Brandon’s grandfather goes something like this.  He went in to the hospital for his routine daily dialysis treatment, but after his usual treatment his care team noticed his vitals were reading a little lower than they should be.  To be on the safe side, rather than letting him go home as he normally would, they felt it would be in his best interest to be admitted into the hospital for observation as a precautionary measure.  In trying to determine what was causing his poor health, they realized he contracted Clostridium difficile at the hospital.  Brandon’s grandpa ended up passing away due to complications associated with C.diff

Patients who undergo dialysis treatment have an increased risk for getting an infection because of their weakened immune systems due to the fact that the process of hemodialysis requires frequent use of catheters or insertion of needles to access the bloodstream. However, it should not be a given that every dialysis patient will get a HAI. In fact there is a wealth of supporting documentation to help ensure that infection prevention programs can be put in place to ensure the health and safety of dialysis patients.

The truth is that as we age, our immune systems have to work harder to fight off infections.  There have been a number of studies that look at HAIs and mortality in the elderly population showing that HAIs were more frequent in the elderly population particularly with respect to VAP and infections by Gram-negative pathogens. The overall mortality has also been shown to be greater in the elderly group.

This is the likely case of Shukria’s grandmother. She was admitted to the hospital for something that was not serious and while there, caught something from the hospital.  Because of the fact that she was already too weak and frail, Shukria’s grandmother could not fight the infection and passed away.  She was in Dushanbe, Tajikistan so Shukria was not able to say good bye and even a year later really misses her grandma.   

When Shukria shared her story with me she said “I hope we can save lives by educating the hospitals and clinics.”  This really sums up the spirit of the Talk Clean To Me blog and the reason for asking my colleagues and coworkers to share their stories.  I’m not an expert by any means in every facet of infection prevention, but I certainly know how to clean and how to use disinfectants so that we get them to do what we need them to do.  In the case of the stories I shared today, cleaning certainly saves lives

Thanks Brandon and Shukria for sharing your stories and allowing me to honour the memories of your grandparents.


Bugging Off!

Nicole

 



 



Monday, October 16, 2017

The joys of birth and the nightmares of SSIs


The theme across Canada for International Infection Prevention Week is “It’s a Team Thing”.  It’s a perfect theme and without a doubt 100% accurate.  Lapses in infection prevention in most cases are not attributed to a single thing, but a number of factors.  As mentioned last week, to celebrate IIPW I will be posting a daily blog sharing stories of friends and colleagues I work with at Virox whose lives either directly or indirectly have been touched by an HAI.  It’s easy to play the blame game and point fingers, but I am hoping that by sharing these stories, we can instead think of how as a team we can work together to try and prevent HAIs from happening and reinforce the importance of infection prevention in saving lives.

When I sent the email out to our company asking if anyone had been impacted by an HAI in some way, I was hoping no one had a story to share.  That unfortunately, wasn’t the case.  The truth was many of us had.  What was most alarming is that several shared stories that were almost identical.  The stories I am sharing today are one of those.

The birth of a child should be the most amazing day or your life.  After waiting for 9 months, you get to meet the child that you have felt growing in your belly or seen growing in your wife’s belly.  Let’s be honest, giving birth to a child is not all sunshine and roses. It’s messy.  It’s painful and yes, it can be deadly.

Today, I share the stories of the birth of my VP of Manufacturing's first child and the birth of my CEO's third child.  Both stories follow the same path, an SSI after a C-section.  In Zubair's story, his wife, Mehwish, spent two weeks in the hospital following the birth of their daughter, Zara.  Mehwish was put on antibiotics, needed blood transfusions, and as one can expect, it took a while for her to recover, but she eventually went back to full health.  Zara was born March 15, 2016 and today is a health, beautiful little girl.  

My CEO, Randy, had the same thing happen to his wife Catherine.  With 2 children at home, they thought they knew the game plan.  Instead Catherine ended up with a staph infection, spent 2 weeks in quarantine and ICU where she had multiple cocktails of antibiotics.  In fact at one point, his wife’s health had deteriorated so badly they actually had a priest come to her room.  Even after the SSI cleared, she had 3 to 4 years of poor health due to the impact of the ordeal on her immune system.  As Randy tells the story, Malory who is now 20 would sit on his desk while he worked after he had sent his 2 older children who were 7 and 5 at the time to school wearing pyjamas (Little Mermaid and Batman) which he thought was perfectly acceptable clothing…

SSIs are the most common and costly of all hospital-associated infections.  In fact in the US, they account for 20% of all hospital-associated infections, meaning they occur in an estimated 2% – 5% of patients or 160,000 to 300,000 people each year.  The most common pathogens to cause SSIs include bacteria such as StaphylococcusStreptococcus, and Pseudomonas.  So how do SSIs occur?  Unfortunately, it’s really not that difficult. They can infect a surgical wound through various forms of contact, such as contaminated surgical instruments, the hands of a Healthcare worker or caregiver, through germs in the air, or through germs that are already on or in your body that get spread to the wound.

Luckily for my colleagues, while the start to what should have been one of the most joyous occasions of their lives got off to a rocky start, the story ended with a happily ever after for 2 very proud papas and 2 very beautiful girls.  I hope we can use their stories to learn from our mistakes, learn that the cause of an HAI cannot be pinned on a single person or event, but that we all need to pull our weight to try and help stop them from happening to others – others who may be less fortunate.

Bugging Off!

Nicole

Friday, October 13, 2017

Are you part of the 25% group?




Next week is International Infection Prevention Week.  It’s always a fun time of the year with opportunities to provide education, particularly through games.  In fact I came across an on-line quiz that will tell you “What Germ you are” – if of course you were a pesky pathogen.  I’m happy to say I would be MRSA.  As part of celebrating IIPW, next week I will be doing daily blogs sharing stories of how friends and colleagues I work with have been impacted by HAIs.  There are some stories with happy endings and, well, as you can guess, some not so happy endings. 

Knowing what I will be writing about next week, this week I wanted to share a survey I came across that was conducted by Canada Life looking at presenteeism.  I would hazard a guess that most of us can attest to the fact that we to have gone to work despite being ill and knowing we’ll not be functioning fully.  According to the Canada Life survey, 1 in 4 workers would need to be in the hospital before they would call in sick.  Sound familiar to anyone?  When trying to tease out why people pick presenteeism over caring for themselves the following were the primary reasons:
·        People did not want to appear “weak” for not coming in over a “short-     term illness”
·        People were nervous of being seen as “lazy”
·        People were nervous about being considered as “not dedicated”
·        People were made to feel “guilty for taking time off even if ill” by   coworkers and company leaders

While the survey was conducted in the UK, this trend is not limited to the UK.  Results from the NSF Workplace Flu Survey showed that 98% of American workers judge their colleagues for coming into work sick……BUT it’s the minority that actually feel negative about it!  In fact 67% thought those that do come in when sick are hard workers and only 57% of those surveyed said they would encourage a fellow employee to go home “if they thought they were too sick to be at work”.

I know for a fact that presenteeism is not just related to the corporate world.  In my “Who’s the last man/women (girl) standing” blog I discussed a study published in JAMA Pediatrics that looked at presenteeism in healthcare workers finding the top reasons for working while sick included; concern over who would fill in for them, concern that their patients could not get by without them and a widespread belief that if they stayed home because of a cold or flu they would be perceived as being weak or unprofessional. 

What does this say about us?  I’ll admit, I’ve been known to come in with a cold, but that’s because I firmly believe if I can spread it to one person I instantly start to feel better.  If I’m running a fever, I stay home.  I also send people home, admittedly less about concerns for their health, but for the fact that I don’t want to get sick (or get the rest of the team sick)!  I will even admit, upon occasion, I wonder why someone can’t just “suck it up”…. 

So what group are you in?

Bugging Off!

Nicole 

Friday, October 6, 2017

Heater-Cooler Hurts Hearts

Unless you’re completely without feeling, I would hazard a guess that when you hear of something bad happening to a child be it abuse or neglect, injury or disease or even death your heart hurts a little.  Many of us cannot fathom having a deathly ill child.  I’ve been lucky, but I have a close friend whose son at the age of 19 months was diagnosed with a very rare cancer.  The treatment was long, hard, and heartbreaking, and made worse by the fact that my friend was also a childhood cancer survivor so knew exactly what his son was going through.  I’m happy to say that Liam beat the odds and while he remains cancer free, he will continue to be closely monitored.

While not a brand new issue, heater-cooler units that are used during heart surgeries to regulate the temperature of patients on bypass continue to plague Infection Preventionists, since they are difficult to disinfect, but much needed machines that have been the root cause of several outbreaks.  The most recent I’ve read about impacted 12 patients at a children’s hospital who underwent cardiac surgery this summer.  The outbreak was blamed on a single heater-cooler unit used in a single operating room.

Patients exhibited signs of surgical site infections including swelling, wound drainage, redness and fever caused by Mycobacterium abscessus.  This bacterium is an environmental bacteria that is routinely found in water, soil and dust and while perhaps not the most common bacteria to cause SSIs, it has been known to contaminate medications and other products including medical devices.  Transmission of this bacterium generally occurs by injections of substances contaminated with the bacterium or through invasive medical procedures such as open heart surgery that use medical devices, equipment or material that is contaminated with the bacteria.

In order to ensure more patients were not infected the hospital has replaced the heater-cooler device and completed a thorough cleaning and disinfection of the operating room to remove any chance of future environmental contamination.  As for the 12 patients infected, while they have all been hospitalized, the good news is that some are very close to going home!

This story parallels the story of duodenoscopes.  As we improve our ability to develop more and more technically savvy instruments that can aid in the treatment of patients we increase our risk of developing instruments that are more difficult or nearly impossible to reprocess in a way that we can ensure they are safe to use on the next patient.  I’m not saying that we should halt innovation.  What I am saying is that we should, when bringing these devices into our facilities, consider conducting validation studies to ensure that we can safely reprocess in a manner that is reproducible each and every time.  My motto is if we would not use the device on a loved one, we should not use it on a patient!


Bugging Off!

Nicole