Category Archives: Infection Control

Changing the Bed Linens In Sickness and In Health

According to Microbiologist, Phillip Tierno of New York University

our bed linens can “quickly blossom into a botanical park of bacteria and fungus.”

If left for too long, the microscopic life within the wrinkles and folds of our bed sheets can even make us sick,

> We can recall – years ago – the bed linens in any acute care facility (e.g., hospital) the bed linens were changed daily.   Food for thought <<

 

Humans naturally produce roughly 26 gallons of sweat in bed every year. When it’s hot and humid outside, this moisture becomes what scientists call an “ideal fungal culture medium.”

In a recent study that assessed the level of fungal contamination in bedding, researchers found that a test sample of feather and synthetic pillows that were 1 1/2 to 20 years old contained as many as 16 species of fungus each.

And it’s not just your own microbial life you’re sleeping with. In addition to the fungi and bacteria that come from your sweat, sputum, skin cells, and vaginal and anal excretions, you also share your bed with foreign microbes.

These include animal dander, pollen, soil, lint, dust mite debris and feces, and finishing agents from whatever your sheets are made from, to name a few.

Tierno says all that gunk becomes “significant” in as little as a week. And unclean bedding still exposes you to materials that can trigger the sniffing and sneezing, since the microbes are so close to your mouth and nose that you’re almost forced to breathe them in.

“Even if you don’t have allergies per se, you can have an allergic response,” Tierno said.

Another reason your sheets get dirty quickly has little to do with your behavior or sweat patterns — the issue is simply gravity.

“Just like Rome over time was buried with the debris that falls from gravity, gravity is what brings all that material into your mattress,” Tierno said.

One to two weeks of this buildup is enough to leave anyone with a scratchy throat — especially those with significant allergies or asthma. (One in six Americans has allergies.)

“If you touched dog poo in the street, you’d want to wash your hands,” Tierno said.

“Consider that analogous to your bedding. If you saw what was there — but of course you don’t see it — after a while you have to say to yourself, ‘Do I want to sleep in that?’

So what does Dr. Tierno suggest?

To stem the invisible tide, he said, sheets should be washed once a week — >> More Often when bed linens are visibly soiled and an infection is being treated <<


Proper ways to handle soiled linens:

There is now a common understanding that linens, once in use, are usually contaminated and could be harboring microorganisms such as MRSA and VRE.

Further, the Centers for Disease Control and Prevention (CDC) cautions that healthcare professionals should “handle contaminated textiles and fabrics with a minimum agitation to avoid contamination of air, surfaces, and persons.” Even one of the leading nursing textbooks, Fundamentals of Nursing, states, “Soiled linen is never shaken in the air because shaking can disseminate secretions and excretions and the micro organisms they contain.” This text also states, “…linens that have been soiled with excretions and secretions harbor microorganisms … can be transmitted to others.”

According to Fundamentals of Nursing, when handling linens in any acute care and healthcare facility:

1. You should always wash your hands after handling a patient’s bed linens.

2. You should hold soiled linen away from your uniform.

3. Soiled linen is never shaken in the air because shaking can disseminate the micro-organisms they contain.

4. Linen from one patient’s bed is never (even momentarily) placed on another patient’s bed.

5. Soiled linens should be placed directly into a portable linen hamper or tucked into a pillowcase and the end of the bed before it is gathered up for disposal in the linen hamper or linen chute.

 

To read this article in its entirety – please click on the following link:

http://www.businessinsider.com/how-often-to-wash-bed-sheets-2017-6

 

WHO’s World Hand Hygiene Day In Conjunction With Fight Antibiotic Resistance – It’s In Your Hands

SAVE LIVES: Clean Your Hands

WHO’s global annual call to action for health workers


SAVE LIVES: Clean Your Hands 5 May 2017 – Fight antibiotic resistance – it’s in your hands

The WHO’s calls to action are:

  • Health workers: “Clean your hands at the right times and stop the spread of antibiotic resistance.”
  • Hospital Chief Executive Officers and Administrators: “Lead a year-round infection prevention and control programme to protect your patients from resistant infections.”
  • Policy makers: “Stop antibiotic resistance spread by making infection prevention and hand hygiene a national policy priority.”
  • IPC leaders: “Implement WHO’s Core Components for infection prevention, including hand hygiene, to combat antibiotic resistance.”

Every 5 May, WHO urges all health workers and leaders to maintain the profile of hand hygiene action to save patient lives. Being part of the WHO SAVE LIVES: Clean Your Hands campaign means that people can access important information to help in their practice. This year Pr Pittet and three leading surgeons explain why hand hygiene at the right times in surgical care is life saving.

 

 

Le 5 mai de chaque année, l’OMS exhorte tous les travailleurs et responsables de santé à maintenir haut le profil de la promotion des bonnes pratiques d’hygiène des mains afin de sauver la vie de patients. Faire partie de la campagne Pour Sauver des Vies: l’Hygiène des Mains signifie que soignants et collaborateurs de santé peuvent accéder à des informations importantes pour améliorer leurs pratiques. Cette année, le Pr Pittet et trois chirurgiens de renommée internationale expliquent pourquoi l’hygiène des mains au bon moment au cours des soins chirurgicaux sauve des vies.

 

5 Moments for Hand Hygiene

The My 5 Moments for Hand Hygiene approach defines the key moments when health-care workers should perform hand hygiene.

This evidence-based, field-tested, user-centred approach is designed to be easy to learn, logical and applicable in a wide range of settings.

This approach recommends health-care workers to clean their hands

  • before touching a patient,
  • before clean/aseptic procedures,
  • after body fluid exposure/risk,
  • after touching a patient, and
  • after touching patient surroundings.

 

 

 

 

 

 

For further Information on WHO My 5 Moments for Hand
Hygiene visit:
To download hand hygiene reminder tools for the workplace visit:
To access WHO hand hygiene improvement tools and resources for use
all year round visit:
To see the latest number of hospitals and health care facilities which
have signed up to support the campaign visit:

 

UV-C Disinfecting Takes Its Place At Thompson Hospital and the M.M. Ewing Continuing Care Center in New York State

 

UV Disinfecting

Accomplished by using  short-wave
ultraviolet-C (UV-C) light as a germicidal to destroy viruses, bacteria and other pathogens that can linger on surfaces and hide in shadows.

One piece of equipmnet can disinfect an average-sized patient room in about 8 minutes and is deployed after a room is sanitized with standard techniques and cleaning products.

In  Canandaigua, New York  a nearly 6 foot tall and wielding 20 vertical fluorescent bulbs, the R-D Rapid Disinfector robot is a formidable fighter in the war against germs.

This UV disinfecting robot is The R-D Rapid Disinfector — developed by a Rochester, New York  firm, Steriliz LLC, and is manufactured locally.

Thompson Hospital and the M.M. Ewing Continuing Care Center have begun using this automated disinfecting machine throughout the institutions to help reduce the risks of illness and infections for patients, residents, visitors and staff.

The Disinfector uses short-wave ultraviolet-C (UV-C) light as a germicidal to destroy viruses, bacteria and other pathogens that can linger on surfaces and hide in shadows. This machine can disinfect an average-sized patient room in about 8 minutes and is deployed after a room is sanitized with standard techniques. It is remotely controlled by an associate from Environmental Services.

The UV-C light fills the entire room, reaching and disinfecting areas that human hands might miss. No one is allowed inside the room when the lights are working. This no-touch cleaning system gets rid of some of the most dangerous and difficult-to-destroy bacteria, including Clostridium difficile (C. diff). Disinfectants work on the surface of non-living objects by destroying the cell wall of harmful microbes or interfering with their metabolism.

“This technology, added on to normal, regular, manual environmental cleaning, gives me a sense of ease that we are doing all we can to keep our environment clean and our patients safe,” said Thompson Health Director of Infection Prevention Michelle Vignari. “We are just now starting to see published literature supporting that the addition of UV-C technology in hospitals actually does correlate with a reduction of healthcare-acquired infections.”

This state-of-the-art robot monitors the entire disinfection process. Wireless sensors measure, record and report on UV-C light dosages delivered to specific areas in real time. The machine can be paused and repositioned to maximize efficiency, including targeting shadowed areas. The Disinfector shuts off automatically once the sensors indicate that enough UV-C light has been emitted to kill the germs.

“In a day of delivering high-reliability care, I felt very strongly that we needed a technology that we could measure and evaluate its performance,” Vignari said.

Hospital staff like the Disinfector too.

“It is pretty simple to use and seems to be working great,” said Stephanie Fowler of Environmental Services, who activates the robot after a room is cleaned with traditional methods.

The R-D Rapid Disinfector was developed by a Rochester firm, Steriliz LLC, and is manufactured locally. The Disinfector uniquely provides FDA-patented wireless sensors to measure the amount of UV-C light delivered to an area and real-time online data access and reports. Since being tried in four Rochester hospitals in 2011, several hundred of these Disinfectors are now being used in hospitals, care homes, disaster centers and government installations worldwide.

Steriliz is recognized as a world leader in UV-C disinfection.

“Improving the health and safety of patients is a blessed opportunity,” said CEO and President Sam Trapani. “The potential market for the company’s product is large and we are experiencing a high growth curve.”

To read the article in its entirety please click on the link below:

http://www.mpnnow.com/news/20170318/robot-destroys-germs-with-power-of-light

Member of St. Joseph Hoag Health Network – Mission Hospital Laguna Beach, CA Adds a UV Disinfection Robot To Protect Against the Spread of Infections

6th Graders Receive Up Close and Personal Education with a Light-Pulsing, Disinfecting Robot

Sharing and Educating

Opening eyes of the young with disinfecting

technology being utilized to combat “superbugs.”

 

The only robot in the Verdugo region that zaps away unwanted bacteria and viruses from hospital rooms arrived at USC-Verdugo Hills Hospital two weeks ago.

The Xenex robot emits a pulsating, bright white UV-C light — which is a short, wavelength, ultraviolet light that can save lives. Once surfaces are exposed to the robot’s rays, harmful bacteria and viruses die, greatly reducing the odds patients will be infected with hospital-acquired infections, including those caused by superbugs such as methicillin-resistant Staphylococcus aureus, known as MRSA.

USC-Verdugo Hills Hospital employees joined Xenex employees at Fremont Elementary School, where they showcased the $100,000 machine in teacher Mallory Kane’s sixth-grade classroom, the same place where Keith Hobbs, chief executive of Verdugo Hills Hospital, was a sixth-grader in 1979. “There’s no other place that I would rather be than to come back to my alma mater and share this R2D2, bug-zapping machine with you guys,” Hobbs said.

The Xenex robot pulses UV-C light 67 times per second, and hospital staff take precautions when they operate it because the light can harm their eyes.

“This is not any light bulb in your house,” said Mary Virgallito, director of patient safety for the hospital. “It’s actually filled with a gas called xenon.”

Virgallito said hospital employees manually clean rooms before they activate Xenex. It takes the robot about 15 minutes to clean a patient’s room, and 20 minutes to disinfect an operating room.Hobbs said mothers ask if they can borrow the robot to disinfect their own homes, and Kane suggested it would be helpful in the classroom. Over the past several weeks, many of her students missed school because they were sick.

Jeff Mamalakis, business development manager for Xenex, volunteered to disinfect Kane’s room when school let out. The space would be left with a scent as if lightning had just struck, Virgallito said.  The impromptu high-tech, germ-cleansing session was a dream come true for Kane.

“In sixth grade, the curriculum moves so quickly that even missing one day puts kids so far behind,” Kane said. “Having our classroom disinfected every day would be a dream come true. My kids would be here, everyone would be happy, no one would have to miss school.”

To Read the article in its entirety please click on the following link:

http://finance.yahoo.com/news/uhc-most-xenex-germ-zapping-144500378.html;_ylt=A0LEV18lQNBY2KgA6FZXNyoA;_ylu=X3oDMTEzMXBobHNmBGNvbG8DYmYxBHBvcwMxBHZ0aWQDVUkwMkM0XzEEc2VjA3Nj

Reviewing the Benefits Of Enhanced Terminal Room (BETR-D) Disinfection Study, C.difficile Infection Rates Unchanged

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If you are concerned about C. difficile Infections being battled in Hospitals today review the Abstract and Scientific evidence from the 2015  BETR-D Study

“….adding UV light to bleach in rooms linked to C. difficile had no effect, ” Dr. Deverick J. Anderson, MD, MPH, FIDSA, FSHEA reported

 

MedPage Today  http://www.medpagetoday.com/meetingcoverage/idweek/54043

Adding ultraviolet light or bleach plus UV light also showed a trend toward a reduced risk, Anderson said at the IDWeek meeting, held in 2015 jointly by the Infectious Diseases Society of America (IDSA), the HIV Medicine Association (HIVMA), the Society for Healthcare Epidemiology of America (SHEA), and the Pediatric Infectious Diseases Society (PIDS).

On the other hand, the benefit of what Anderson called “enhanced terminal disinfection” varied among the four pathogens, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), multidrug-resistant (MDR) acetinobacter, and Clostridium difficile.

   What was the BETR-D Study?

The BETR-Disinfection study was performed over 28 months in 9 study hospitals from 4/2012 to 7/2014.

  • Each hospital used four strategies for terminal room disinfection in a randomized sequence.
  • Each strategy was used for 7-month study arms, including a 1 month wash-in period.
  • Two of these strategies used a UV-C emitting device.
  • Standard cleaning involved the use of a quaternary ammonium (reference group A). Three enhanced cleaning strategies were evaluated and compared to the reference: quaternary ammonium + UV-C (B), bleach (C), and bleach + UV-C (D).Of  note, bleach was used for daily and terminal disinfection of all known C. difficile rooms, regardless of study arm.
  • Study cleaning strategies were employed in seed rooms, defined as a room containing a patient on contact precautions for infection or colonization due to the following 4 target MDROs was discharged: MRSA, VRE, C. difficile, or MDR Acinetobacter.
  • The next patient in the room was considered an exposed patient.
  • Primary outcome was the clinical incidence of all target MDROs in patients exposed for at least 24 hours, defined as the first positive culture of a MDRO a) during exposure to the seed room, if positivity occurred ≥48 hr post-admission to the seed room, or b) in the 90 days following seed room exposure for MRSA, VRE, and MDR-Acinetobacter and 28 days for C. difficile.
  • Rates were calculated as outcome/10,000 exposure days using intention-to-treat and per protocol principles

To read the study Abstract in its entirety please click on the following link:

https://idsa.confex.com/idsa/2015/webprogram/Paper53062.html

A study of a large cluster-randomized trial, adding bleach to the standard quaternary ammonium cleaning significantly reduced the risk of transmission of four organisms that cause healthcare-associated infections

A Cluster Randomized, Multicenter Crossover Study with 2×2 Factorial Design to Evaluate the Impact of Enhanced Terminal Room Disinfection on Acquisition and Infection Caused by Multidrug-Resistant Organisms (MDRO)

Anderson and colleagues in the Duke Infection Control Outreach Network tested the four cleaning strategies over 28 months in nine hospitals, with hospitals switching strategies every 7 months.

The goal was to see if they could reduce the overall incidence of the targeted pathogens among patients using a room immediately after a patient known to be colonized or infected by one of the four occupied it. A second primary endpoint was the effect on C. difficile.

He noted that all rooms in which a patient had had C. difficile were cleaned with bleach, so the comparisons were actually between quaternary ammonium and bleach and the same approach adding UV light.

All told, the study had 23,272 patients potentially exposed to a pathogen — they spent at least 24 hours in one of the “seed” rooms where the previous patient had been identified as having one of the pathogens.

Patients in seed rooms became cases if they developed colonization or infection by the pathogens linked to their rooms, as long as they had no history of the pathogen in the previous year and no evidence of community acquisition, he said.

In the four arms, Anderson reported:

  • There were 115 cases in 22,426 exposure days in the standard cleaning arm, for a rate of 51.3 cases per 10,000 exposure days.
  • In the arm adding ultraviolet, there were 76 cases in 22,389 exposure days for a rate of 33.9
  • When bleach was added, there were 101 cases in 24,261 exposure days, for a rate of 41.6.
  • And when both bleach and UV were added, there were 131 cases in 28,757 exposure days, for a rate of 45.6.

The reductions, compared with standard cleaning, were 30%, 15% and 9%, respectively, but only the addition of UV light to quaternary ammonium reached statistical significance (P=0.036).

There were too few cases of MDR acetinobacter to quantify, he said, but it was possible to judge the effect of the various interventions on the other three pathogens.

For MRSA, adding UV light to quaternary ammonium reduced the risk of transmission by 22%, but the difference from standard cleaning fell short of statistical significance. The other two interventions made no difference.

For VRE, on the other hand, all three test strategies reduced the risk of transmission by about 60% — 59% for UV, 57% for bleach, and 64% for bleach plus UV. However, Anderson said, the UV arm was just short of statistical significance, while the other two were significantly different from standard cleaning (P=0.049 and P=0.003, respectively).

But adding UV light to bleach in rooms linked to C. difficile had no effect, Anderson reported.

Note: Not all UV disinfecting products are the same– in the way they are scientifically developed, manufactured, and utilized in the healthcare industry.  It is favorable for Hospital and Healthcare facility decision-makers to ask some tough questions when it comes to evaluating UV technologies. The gold standard for assessing new technologies is to evaluate peer-reviewed literature published and also cited in The Lancet publication.  Please click on the The Lancet article link below to retrieve additional information focused on the BETR-D study.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31588-4/abstract

Findings

31 226 patients were exposed; 21 395 (69%) met all inclusion criteria, including 4916 in the reference group, 5178 in the UV group, 5438 in the bleach group, and 5863 in the bleach and UV group. 115 patients had the primary outcome during 22 426 exposure days in the reference group (51·3 per 10 000 exposure days). The incidence of target organisms among exposed patients was significantly lower after adding UV to standard cleaning strategies (n=76; 33·9 cases per 10 000 exposure days; relative risk [RR] 0·70, 95% CI 0·50–0·98; p=0·036). The primary outcome was not statistically lower with bleach (n=101; 41·6 cases per 10 000 exposure days; RR 0·85, 95% CI 0·69–1·04; p=0·116), or bleach and UV (n=131; 45·6 cases per 10 000 exposure days; RR 0·91, 95% CI 0·76–1·09; p=0·303) among exposed patients. Similarly, the incidence of C difficile infection among exposed patients was not changed after adding UV to cleaning with bleach (n=38 vs 36; 30·4 cases vs 31·6 cases per 10 000 exposure days; RR 1·0, 95% CI 0·57–1·75; p=0·997).

The BETR-D study was supported by the CDC

 

Cdiffradio.com

Cdiffradio.com

 

 

 

Listen to Deverick J. Anderson, MD, MPH, FIDSA, FSHEA discuss UV Intervention Addressing C. difficile and Other Pathogens   July 2016

https://www.voiceamerica.com/episode/94128/uv-intervention-addressing-c-difficile-and-other-pathogens

 

 

*PLEASE NOTE – The C Diff Foundation does not endorse any products, medications,  and/or clinical study in progress. All website postings are strictly for informational purposes only.

 

Bridging Collaboration Between Patients and Healthcare Providers to Reduce Hospital-Acquired Infections

cdiffRadioLogoMarch2015

C. diff. Spores and More” Global Broadcasting Network
will host a special episode on their live radio program (cdiffradio.com)
airing on Tuesday, January 24, 2017 at 1:00 pm EST featuring world-renowned
infectious disease expert, Dr. Hudson Garrett Jr., Global Chief Clinical Officer for Pentax Medical-Hoya Corporation and Chairperson of the Clinical Education Committee
for the C Diff Foundation.

This special episode, Bridging Collaboration Between Patients and Healthcare Providers to Reduce Hospital-Acquired Infections (HAI’s),  will feature a robust discussion on the patient’s role in preventing healthcare associated infections, an overview of medical device hygiene and infection control, the importance of antibiotic stewardship, and applications of evidence-based infection control measures across the entire healthcare continuum of care.

“Healthcare continues to become more and more complex as the acuity and needs of the patient changes along with the correlating technologies. Patients and Healthcare Providers must work together to mitigate the risk for Healthcare Associated Infections and other adverse events,” says Dr. Garrett.

C. diff. Spores and More ™“ spotlights world renowned topic experts, research scientists, healthcare professionals, organization representatives, C. diff. survivors, board members, and their volunteers who are all creating positive changes in the
C. diff.
community and more.

Through the interviews, the C Diff Foundation’s mission connects, educates, and empowers listeners worldwide.

Questions received through the show page portal will be reviewed and addressed  by the show’s Medical Correspondent, Dr. Fred Zar, MD, FACP,  Dr. Fred Zar is a Professor of Clinical Medicine, Vice HeZarPhotoWebsiteTop (2)ad for Education in the Department of Medicine, and Program Director of the Internal Medicine Residency at the University of Illinois at Chicago.  Over the last two decades he has been a pioneer in the study of the treatment of Clostridium difficile disease and the need to stratify patients by disease severity.

 

Take our show on the go…………..download a mobile app today

www.voiceamerica.com/company/mobileapps

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Clorox Healthcare, Sponsor of C. diff. Spores and More Global Broadcasting Network

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