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, August 23, 2019

Does Time Matter?

Has anyone ever told you “slow and steady wins the race”?  Even as a child I was an avid reader.  I had a large volume of Aesop’s Fables.  I quite literally read that book to death.  One of my favorites was The Hare and the Tortoise.

The Hare was once boasting of his speed before the other animals. "I have never yet been beaten," said he, "when I put forth my full speed. I challenge any one here to race with me."
The Tortoise said quietly, "I accept your challenge."
"That is a good joke," said the Hare; "I could dance round you all the way."
"Keep your boasting till you've beaten," answered the Tortoise. "Shall we race?"
So a course was fixed and a start was made.
The Hare darted almost out of sight at once, but soon stopped and, to show his contempt for the Tortoise, lay down to have a nap.
The Tortoise plodded on and plodded on, and when the Hare awoke from his nap, he saw the Tortoise just near the winning-post and could not run up in time to save the race.
Then said the Tortoise: "Plodding wins the race."

What does this do with cleaning and disinfection?  Well, as with many things, it takes time to do things right. There is enough published evidence to support the fact that when cleaning and disinfection is not completed correctly, or rushed, corners are cut which leads to adverse outcomes.  The question becomes: how much time does it take to clean and disinfect a patient room? 

The Association for the Healthcare Environment (AHE) recommends 20 – 45 minutes should be dedicated for terminal cleaning of a room.  A recent study by Chopin et al. investigated whether increased time spent on terminal cleaning would in fact lead to improved disinfection.  Surprisingly, it did not.  The study included 3 arms in which housekeepers were given 25mins, <45mins or >45mins to clean a room. They found that time spent beyond 25mins did not affect disinfection of the high-touch surfaces tested in the study.  In fact, the longer the time spent cleaning, the higher the post-cleaning bioburden was found to be.  The results could be due to random chance or may be a result of different cleaning activities, such as cleaning more surfaces without focusing on properly applying the disinfectant used.

As the researchers indicated, their study did not include observing environmental services (EVS) staff cleaning, so achieving contact time and product application was not recorded.  Again, in recent years a fair number of studies have been published investigating the role that contact time has in ensuring disinfection is achieved.  In general, the longer the contact time the harder it is to achieve the level of kill desired in healthcare facilities.  Similarly, there are different disinfectant chemistries that while contact times may be short their active ingredients dry so quickly that they cannot achieve the contact time as approved by the Health Canada or the EPA.

Does this mean we can skimp on the time we give our staff to clean?  No.  What it continues to highlight is that we need to find that balance between time (both contact time and the time given to clean rooms) and the process used by EVS to clean and disinfect.

Bugging Off!


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