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.

Our expertise is utilized by Infection Preventionists, Public Health Experts, First Responders, Dentists, Physicians, Nurses, Veterinarians, Aestheticians, Environmental Services professionals and janitorial product distributors to develop more sustainable cleaning and disinfection practices in North America.

Our commitment to providing chemical disinfectant education is more than business, it is a passion.

Friday, September 13, 2019

Do You Really Want that Ultrasound Probe Used on You?


For many, we’re closing in on the 2nd week of school.   My son has so far avoided catching his first cold of the school season but I’m sure one will hit soon enough - and of course, flu season is only a few short weeks away.  I just hope nothing too serious hits, so that we can avoid doctor’s visits or trips to the ER, especially after reading a recent article about cleaning mobile patient care equipment!

Like our personal devices, mobile patient equipment (MPE) like thermometers, blood pressure cuffs or bladder scanners can often be overlooked in terms of the frequency or thoroughness of cleaning.  While the practice can be relatively simple and effective in removing potential pathogens, it can be more difficult to effectively implement and monitor MPE cleaning and disinfection programs.  This is in part because MPEs tend to move from place to place, so unless you have a ‘tag and bag’-type process to clearly identify dirty from clean devices, it is harder to verify what ones have or have not been cleaned.  This then leads to the issue of potential transmission of pathogens when healthcare workers either fail to clean or use MPEs that have not been cleaned immediately after use on a patient.

A study published in ICHE by Reese et al discussed the implementation of cleaning and evaluation of MPE cleaning.  The study used ATP as their method for validating cleanliness.  ATP can have its challenges, and as the disinfectant or disinfectants used in the study were not disclosed, it is hard to determine if the results presented could have been skewed by quenching or enhancing of the ATP readings as a result from interactions by the disinfectant.    Regardless, the researchers started with a one-month baseline period to gain an understanding of the level of cleanliness of the MPEs.  Following the baseline period, there was a six-month implementation period with weekly ATP testing.  The results were shared with nurse educators and management, and subsequently shared with nursing staff with the provision of ongoing education.  They then entered a maintenance period for an additional six months where ATP results were collected bi-weekly.

Over all, the ATP results and therefore, the cleanliness of the MPEs did improve and was maintained with a 75% improvement in the levels of cleanliness.  The study also highlighted the areas where no significant improvement was seen.  The ultrasound probes tested in the ED consistently had higher than acceptable ATP readings, and this is consistent with similar studies looking at cleaning in the ED due to the large number of patients and high turnover of patients.

So what can we learn from this study?  It highlights that with focus on MPEs in most areas of a healthcare facility, sustained improvements in the level of cleanliness can be achieved which in turn should minimize the risk of transmission of infectious pathogens and improve overall patient outcomes.  It also highlights that the ED is an area of consistent issues in cleaning MPEs. Perhaps due to the nature of the ED with rapid patient turnover, high patient throughput and the fact that many patients can be critical and take more time, additional staff should be responsible for cleaning of MPEs (and perhaps even implementing a bag and tag program) to ensure that ED staff can immediately identify which MPEs are clean and safe to use and which MPEs are dirty and should not be touched.

If you happen to find yourself in an ED, feel free to do your own audit of cleaning.  Unless you’re in critical condition you’re likely going to have time to waste!  The only issue is that conducting your own audit may then make you wish you had just stayed home!

Bugging Off!

Nicole

Friday, September 6, 2019

Practicing Protection or Causing Contamination?


I think it would be safe to say that we have been told that Personal Protective Equipment (PPE) is intended to protect you from infections pathogens.   Gloves are the most commonly used PPE item.  We see healthcare providers (doctors, nurses, phlebotomists, dentists etc.) wearing gloves.  From a healthcare perspective the gloves work in two ways: they are intended to protect us as patients and of course protect the healthcare worker from picking up the bugs we carry.  If you travel, you likely see the TSA officers wearing gloves, and if you’re astute enough you may also see the fact that their hands are sweating in the gloves, meaning they’ve had them on for most of their shift.  In their case, they put them on with the belief they are protecting themselves from the germs we bring into the airport. In reality they really are just becoming a source for moving and most likely transmitting pathogens like colds and flus from all the surfaces they touch during the course of the time they are wearing gloves.  Then there are the food service workers who put on the disposable gloves on before they make our sub.  They change between customers, but do they wash their hands before putting on the next set?  Did they take them off to ring in your order and take your money?  Think on that.

A study published in the March 2019 Special Edition of The Journal of Hospital Infection looked at what role removing and disposing gloves has on contaminating the environment.  In the study, the researchers observed three disposal methods: an underhanded throw or overhand throw into or towards the garbage bin and my personal favorite: pulling on the gloves to stretch and launch into or towards the garbage bin. When surveyed, none of the participating healthcare workers indicated they disposed their gloves by “flinging” and most indicated they “placed” them into the garbage bin.  In practice, no one placed the gloves into the garbage bin.  Most “tossed” them and missed getting their second glove into the garbage bin 50% of the time.  The next favorite disposal method is the “fling” and that method led to a 40% success rate in getting the second glove into the bin.

When researchers sampled the area around the garbage bin, the vast majority of the sampled areas were contaminated by the gloves seeded with bacteriophage. In addition, the fluorescent dye used was found to extend outside of the sampled area and was widely found within a 0.61m circumference of the participant, as well as on their wrists, fingers and forearms.   As expected, the “flight path” of the glove did show contamination, with the highest contamination directly around the garbage bin.
It has been well established that mixed policies from facilities or government, policy ambiguity and lack of in-depth training leads to workplace non-compliance with PPE protocols. In this study it was assumed that all healthcare workers that participated were aware of the CDC doffing protocol and were not using a personally devised protocol.

The long and the short is during the doffing of gloves, the environment and the healthcare worker can be contaminated.  The question then becomes, if a healthcare worker (who undoubtedly at some point has had training on donning and doffing procedures for PPE and would certainly understand the potential impact on their health) can contaminate themselves and the environment so widely, what do you think is happening in industries outside of healthcare, where the training for donning and doffing likely does not take place?

It certainly makes me think of gloves in a different light and you can be sure I will be watching the doffing procedures for gloves.  If “flinging” is involved I just may choose the exit as quickly as I can, and will certainly try to avoid touching surfaces and wash my hands at the first chance I get!

Bugging Off!

Nicole