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

Friday, June 26, 2015

Clean that room STAT!

One consistency within the healthcare sector is that there are too few rooms, and when one does becomes available the urgency to have it cleaned and ready to put back into circulation is enormous.  Why?  Well, there are also targets to meet with respect to admitting patients, and as always...there are patients who need it.

The question that is posed time and time again is how long does it take to clean a room?  In this day and age, the faster we can clean a room the faster we can fill it.  This issue with focusing on how fast a room can be turned around is similar to our question regarding how to find the fastest disinfectant with the most claims.  Something has to be given up.  For disinfectants, that generally means we sacrifice safety for efficacy and contact time.  For cleaning, it generally means corners inevitably get cut and that can be deadly.  Cutting corners with cleaning means that surfaces get missed, and we all know if we do not clean a surface, bugs are left behind leaving the room a danger zone for the next patient.

Don’t get me wrong, I understand that time is money.  But I also know that like a good wine, things get better with time and cleaning is one of the things in life that with the more time you have, the better the end result will be.  It was interesting then to see a research poster at last week’s IPAC-Canada conference by a group of researchers from Queen’s University, the Journal of Environmental Management and Facility Hygiene and the Canadian Association of Environmental Management focusing on Patient Room Cleaning Times in Canadian Acute Care Hospitals.  As the researchers rightly stated, current bench marks are not specific when it comes to the types of rooms and their conditions (e.g. discharge clean? isolation? private? semi-private?). The aim of their study was to determine if and what the benchmarks for terminal and daily routine cleaning would be or should be.

What was interesting to me was how the times were determined.  Nearly 100% of the respondents relied on past experience while only 53% of these same sites used time and motion studies.  When looking at the time to perform daily cleaning, as expected, the larger the room (e.g. the number of beds) the more time it took and as the level of infection prevention precautions increased (e.g. a MRSA vs a C. diff room) the more time it took to clean.  The average time for a daily clean single patient room was 17 minutes while a C.diff patient room with 4 beds was 67 minutes (37 minutes for a single bed).  A similar story unfolded for terminal or discharge room cleaning.

Certainly, this is the most comprehensive study to date in terms of looking at the average time we take to clean a room, but as the researchers so rightly concluded, do we know if these times ensure that the rooms are adequately cleaned?  Do we know if using these times the surfaces are free and clear of pathogens and safe for the next patient?  We do not.  It does however, give us the perfect step off for additional work where we use these times to clean our room and then examine if the room is in fact clean and free of pathogens.

As I said, I understand that time is money and if we can improve upon cleaning times we can turn over rooms faster, and perhaps reduce the manpower needed to clean our facilities and get the next patient in so we can charge for that room.  But I caution that thought and stress the fact that we need to ensure that we are doing what’s right for the patient and our staff.  What if the workload changes?  More discharge rooms or more isolation rooms means more time.  Is there a buffer we should also be looking at?  For example, is there a tipping point where staff cut corners to speed up their cleaning if the number of isolation rooms or discharge rooms they have increases?  I hope we’ll look into that too!

Bugging Off!


Friday, June 19, 2015

Where will the next hotspot for zoonotic diseases be?

I admit, I’m a full fledge junkie when it comes to epidemiology.  Epidemiology studies the patterns, causes, and effects of health and disease conditions by identifying risk factors for disease.  It’s like studying puzzles - and for someone who loves nothing better than finding the optimal way to pack a trunk with all the junk you pack for a vacation, trying to find out the what’s, where’s and why’s of a latest disease outbreak is fascinating.

Take the MERS-CoV outbreak for example, first identified in April 2012 the epidemic has spread to many countries in the Middle East and while it has spread to other countries, all cases have been directly linked back to the Middle East prior to being “exported” via travel.  The WHO calls the latest outbreak in South Korea a “wake up call”.   The outbreak is centered on a single man who visited four (4) hospitals for his illness until it was identified as MERS.  There are currently >160 confirmed cases, just over 20 deaths attributed to the outbreak and over >6000 people in quarantine.

Researchers are working valiantly to uncover what the animal reservoir is and exactly what the mode of transmission for MERS-CoV is.   It was interesting to then read a study by researchers from the Cary Institute of Ecosystem Studies and the Odum School of Ecology looking at Rodent reservoirs as future zoonotic diseases.  The researchers have concluded that Kansas and Nebraska may join China, Kazakhstan and parts of the Middle East as hotspots for future novel zoonotic disease.  Similar to the MERS-CoV situation, emerging infectious diseases are generally dealt with reactively focusing efforts on containing the outbreak.  Once contained, researchers then turn to investigating how it started in the first place.  The researchers of this study are taking a different approach; they are interested in developing an algorithm that could inform early warning surveillance by revealing the distribution of rodent species that are effective disease reservoirs.

Models were developed that considered 86 variables to predict which of the 2277 existing rodent species could serve as zoonotic disease carriers in the future and where they are likely to spread these diseases.  In the end they were able to predict zoonotic reservoir status with 90% certainty and identified over 50 potentially new zoonotic reservoir species and concluded that hotspots for novel rodent reservoirs would like span the globe in areas with significant mammal diversity, middle-income or better economies and with climates that span from arctic to tropical.  One of these predicted hotspots was the Midwestern United States.

With traditional focus being on containment after a deadly outbreak occurs, the ability to predict when and where the next zoonotic disease may arrive from is certainly interesting.  Perhaps now we are closer to a future where we can turn predictions into preventative measures, starting with a focus on areas where rodent populations have increasing interactions through urbanization and agriculture!
Perhaps, this is the answer to getting my cousins from Kansas to move to Canada?

Bugging Off!


Friday, June 12, 2015

IPAC-Canada 2015: Victorious learning in Victoria!

Spring is a season many of us look forward to - longer and warmer days, the snow is gone, the birds are back and flowers and trees are budding and blooming!  Allergy sufferers and asthmatics may rue Springs' arrival, but if you're an Infection Preventionist you are probably downright giddy for Spring as it signifies the arrival of two of the biggest infection prevention and control conferences in North America: IPAC-Canada and APIC.  If you're Canadian, you are probably counting down the hours until you fly off to Victoria to enjoy 5 days of work free, kid free, spouse free educational fun!  If you're like me, you're also probably trying to figure out how to get that last pair of shoes to fit in your suitcase!

The theme of this year's IPAC-Canada conference is "Surfing Waves of Change" and from the agenda, it promises to cover virtually every topic of interest to IPs.  One of my favorite parts of attending conferences is getting a chance to listen to and review the Oral and Poster presentations of research studies conducted by delegates and industry.  This year there are 32 Oral presentations covering topics such as Cleaning, Disinfection and Sterilization, Development and Implementation of Practice, Quality and Process Improvement, Education, Practice Standards and Guidelines and Outbreak Investigation.   The Cleaning, Disinfection & Sterilization track covers a comparison of disposable and reusable cloths for surface disinfection, a collaborative approach to environmental cleaning, flash sterilization, and improvement in discharge cleaning by introducing an environmental hygiene bundle.

I am truly impressed by the 58 Research Poster Submissions as well.  I obviously cannot summarize them all, so here are the big 5 that I will most definitely be checking out! 
  1. Patient Room Cleaning Times in Canadian Acute Care Hospitals concludes there is the need for further research on the correlation between time spent cleaning and the impacts of infections. 
  2. Implementation Review of Dry Ionized Hydrogen Peroxide and Colloidal Silver (DIHPCS) On Direct Daily Patient Care Equipment – the use of antimicrobial surfaces is increasing in interest, and I’m always up to learning about a new technology!
  3. Accelerated Hydrogen Peroxide (AHP) as an Effective Replacement for Chlorine-Based Disinfectants Against Bacterial Biofilms – biofilm development on surfaces and devices is becoming an increased concern and looking for alternative methods to kill biofilms is worth the investigation!
  4. Time and Cost Efficiency and Effectiveness of a Novel ozone-Hydrogen Peroxide vapour Automated Room Disinfection System During a Clostridium Difficile Outbreak on an Acute In-Patient Unit – attending the conference is about learning and a novel room decontamination system is right up my cleaning and disinfection alley!
  5. Improving Cleaning of Shared Equipment at a Community Hospital – we know cleaning of shared equipment can be problematic.  I look forward to seeing what this facility was able to implement!

For those of you attending IPAC-Canada, be sure to find me.  I'd love to catch up or meet you for the first time!  I'll be tweeting too so follow me; @nicolecronkenny.  If you're not attending be sure to follow #IPACCanada2015 to keep up with what is being said! 

Bugging Off!


Friday, June 5, 2015

Is there an animal in your family closet?

As mentioned in the “Welcome to 2015” blog, this year we want to intertwine content from areas outside of healthcare.   One of the areas that we want to spend more time on is around the concept of “One Health”.  This is a growing movement with the intention to create interdisciplinary collaborations, research and education in all aspects of health care for humans, animals and the environment.  The One Health concept recognizes that the health of humans is CONNECTED to the health of animals and the environment and vice versa.

In truth, the concept of One Health is not new.  However, with the emergence and re-emergence of many diseases in recent years we are realizing that interactions among humans, animals, and the environment such as travel, how we live, and what we eat are impacting our health.  Our existence is based on cause and effect.  For example, yesterday while at a trade show I ate a bazillion mini-chocolates for the simple fact that they were in front of me and when it comes to chocolate, my willpower is virtually non-existent.  What was the effect of eating all that chocolate?  I got a headache from too much sugar.

Let’s take a look at a few cause and effect situations from interactions between humans and animals.
  1. Human populations are growing and expanding into areas that were previously inhabited by animals.  The result being that as we increase the number of people that live in close contact with wild and even domestic animals, this closeness provides more opportunities for disease to pass between animals and people.   I think most of us can give examples of how we see more wildlife in our cities.  In fact in the Toronto area a black bear was recently put down because it was running around in a suburb.
  2. Our growth and development has caused changes to climate and land use (e.g. deforestation to build homes and intensive farming practices). The result? Disruptions in environmental conditions and habitats provide new opportunities for diseases to pass to animals.
  3. The world has become a very small place.  Our ability to travel internationally in very short periods of time means diseases can spread quickly across the globe.  Case in point, prior to 2014, who would have thought that North America would ever have seen a case of Ebola virus?

Like humans, animals share our susceptibility to diseases and changes in the environment (e.g. climate, chemical contamination).  Because of this, they can serve as early warning signs of potential human illness.  West Nile Virus is a great example.  Birds often die of the virus before humans get sick.  Being vigilant for signs of disease in animals can help protect our health or at least trigger us to look into what is going on!  We will never know when the next contagion will arrive that can wipe out a significant portion of our human population.  Increasing our focus in the concept of One Health and working with people from all areas; human medicine, animal medicine, and environmental science can and will ensure that we can all happily coexist for generations to come!

I hope you’ll take some time to learn more about the One Health Initiative.  If you don’t do it on your own, you can be sure you’ll see blogs about it in the weeks and months to come!

Bugging Off!