According to the Nanaimo Daily News, infection-control experts with the Vancouver Island Health Authority largely blamed inadequate housekeeping practices for the deadly 2008 outbreak of Clostridium difficile at Nanaimo Regional General Hospital.
Documents previously withheld by VIHA and obtained this week by the Nanaimo Daily News through the Freedom of Information Act show health officials knew by July 2008 that the virus, which first appeared at NRGH in April of that year, rapidly spread to five different hospital floors because of inadequate cleaning. Personal contact was an issue, but "housekeeping is really the biggest problem," the documents reveal.
Some members of the public questioned the effectiveness of the private housekeeping contractor, Compass Group Canada, but VIHA signed a second five-year contract in 2009. This time, however, the health authority created an escape clause that allowed health officials to retender the contract at any time. VIHA announced this week that it is looking for another private company to take over the housekeeping and food services for Island hospitals and residential care facilities.
Compass and its subsidiaries have held the Island contracts for six years, during which time hospitals had regular infection outbreaks, failed housekeeping audits and damaging WorkSafe B.C. inspections. This led VIHA to explore other options, according to Joe Murphy, vice-president of operations and support services.
"We need to find a provider to consistently hit quality standards that are written into the contract and that we would expect everywhere in the province," he said.
Other factors led to the spread of C. difficile in 2008, including overcrowding, but improper cleaning methods and insufficient cleaner strength had a significant effect in the 11-month outbreak that began in 2008 and infected 94 people.
Article Taken From "Cleanlink News" May 21, 2010
Friday, May 28, 2010
Wednesday, May 19, 2010
INFORMATION REGARDING BEST PRACTICE GUIDELINES AND STEAM VAPOUR CLEANING
INFORMATION REGARDING BEST PRACTICE GUIDELINES AND STEAM VAPOUR CLEANING
In a continued effort to provide the best and most responsible practices to the Healthcare industry, the Provincial Infectious Diseases Advisory Committee (PIDAC) has recently released the Best Practices for Environmental Cleaning for Prevention and Control of Infections. The latest updated document - December 2009, provides guidelines and recommendations for cleaning the environmental surfaces in a healthcare setting. In addition to practices recognized as effective and traditional, this document includes a Section (6.4) on New and Evolving Technologies in an effort to provide those entrusted with the maintenance of facilites with a tool set to most effectively achieve the best results.
With regards to New and Evolving Technolgies, the recommendations concerning implementation can be summarized as follows:
In a continued effort to provide the best and most responsible practices to the Healthcare industry, the Provincial Infectious Diseases Advisory Committee (PIDAC) has recently released the Best Practices for Environmental Cleaning for Prevention and Control of Infections. The latest updated document - December 2009, provides guidelines and recommendations for cleaning the environmental surfaces in a healthcare setting. In addition to practices recognized as effective and traditional, this document includes a Section (6.4) on New and Evolving Technologies in an effort to provide those entrusted with the maintenance of facilites with a tool set to most effectively achieve the best results.
With regards to New and Evolving Technolgies, the recommendations concerning implementation can be summarized as follows:
- Efficacy of New Product versus Current Method
- Ease to Implement New Technology in the Healthcare Setting
- Is the New Technology Non-Toxic
- Are there any resulting effects on patient care from implementing the New Technology
- Is the New Technology Ergonomic, Safe for Staff Use and in compliance with Occupational Health and Safety requirements
- Cost Implications of implementing New Technolgy
The PIDAC document reinforces the importance of involving all areas - Infection Prevention and Control, Environmental Services and Occupational Health and Safety - in all decision making processes relating to changes in cleaning and disinfection procedures and products.
Part D of Section 6.4 follows:
Reference 160 cites the study in the American Journal of Infection Control, performed with a portable steam vapour cleaning system equipped with the TANCS disinfection system. TANCS offers lab proven performance against C.diff spores, MRSA, VRE and more.
Using the tools supplied with a steam vapour cleaning system equipped with TANCS, cracks, crevices, large surfaces (vertical and horizontal), soft and hard surfaces and equipment can be cleaned and disinfected in one step.
Table 1 in the document lists the items found to harbour microorganisms in the Healthcare Environment. The use of steam on these items will disrupt the transmission of microorganisms. Eliminating the need for dwell time on bed frames, bed rails, door and faucet handles combined with the unique ability of steam to reach areas such as bed frames, all areas of overbed tables, crevices in hoist/lift and slings, mattressess, sink drains, and hinges on toilet seats and commode chairs provides the opportunity for a thorough clean and disinfection.
The process of cleaning with steam eliminates several concerns addressed in the document associated with chemical methods:
- Dilution ratios
- Dwell times
- The need to appropriatley label and safely store cleaning chemicals
- Risk of contamination, inhalation, skin contact or personal injury
- Requirement for MSDS and WHIMIS Training
- The belief that no one product is compatible with all surfaces or effective against all viruses, bacteria, fungi and spores.
- Effectiveness at varying temperatures
- Irritant and allergy concerns
- Reactions with other chemical products existing on surfaces
- Environmental Responsibility
- Requirement for automated dispensing systems
- The need for pre-cleaning prior to disinfection
The use of this broad spectrum cleaning method also aids in the ability to improve the accuracy of a visual assessment to measure cleanliness. When steam is used to provide a visibly clean surface, the heat transfer associated ensures removal of residues (organic or inorganic).
Box 16 offers a sample procedure for room cleaning. All critera are met with a steam vapour cleaning system, including the following concerns:
- Eliminate ‘double-dip’ concerns
- Eliminate need to monitor cloth saturation
- Perform tasks such as tape removal, stain removal and glass cleaning with one tool
- Refresh privacy curtains
- Perform bed and mattress cleaning and pest control without a prolonged bed drying time
- Clean bathroom and shower
- Clean floors
Box 19 is another example of tasks made easier and safer with a steam vapour system:
- No need for cleaning solution, PPE or MSDS
- No wet floor is created with steam
- Avoid repetitive action of wringing out mop
- Eliminate concern over splashed walls and furniture
- No need to change mop head
- No need to monitor cleaning solution in bucket.
Box 30 is the Sample Procedure for VRE Situations - again made simpler and more efficient and thorough using a steam vapour cleaning system.
Within the document, many disadvantages and comments are presented to provide an unbiased and thorough evaluation, allowing for best informed decisions and best practices to be followed in our Healthcare system. The disadvantages of all chemical applications are listed, and should be evaluated. The use of tap water to create steam vapour continues to be the most environmentally responsible and broad spectrum cleaning option available. Lab reports and clinical trial updates are available upon request to verify the efficacy of steam vapour in Healthcare settings.
Further information is available from the writer.
Elle Dietrich
Intersteam Technologies
1-800-281-4413
www.intersteam.com
elle@intersteam.com
Article taken from PIDAC "Best Practices for Environmental Cleaning for Prevention and Control of Infections" December 2009.
Monday, May 3, 2010
Road salt is poisoning water bodies, study finds.
By Martin Mittelstaedt – Environment Reporter
One of the most detailed investigations ever conducted in Canada into the fate of road salt has found that it is polluting groundwater and causing some streams during winter thaws to have salinity levels just under those found in the ocean.
The elevated salt readings were detected in Pickering where researchers from the University of Toronto have been studying how the salt spread on the highways, such as the 401, and other roadways through suburban sprawl affects water quality. They found that so much salty water from the community is ending up in Frenchman’s Bay, a scenic lagoon on the shores of Lake Ontario, that the small water body is being poisoned.
“Our Findings are pretty dramatic, and the effects are felt year- round,” said Nick Eyles, a geology- professor at the university and the lead researcher on the project. “We now know that 3,600 tones of road salt end up in that small lagoon every winter from direct run off in creeks and effectively poison it for the rest of the year.”
He called the findings, which were published recently in the journal Sedimentary Geology, “a really bad-news story” involving a “relentless chemical assault on watershed.”
The Pickering area provided researchers with an ideal place to study the effects of road-salt spreading, because most of the city lies within a relatively compact 27-square-kilometre watershed, where salt spread on roads ended up.
About 7,600 tones of salt is applied each year to roads in the community. About half of this amount seeps into groundwater, which in turn flows into streams year-round, making the water courses more salty than they should be, according to the research. The rest drains into Frenchman’s Bay, which is visible to commuters on the 401 and has a struggling fish population because salt levels are more than double the amounts typically found in the Great Lakes.
The salt water “knocks out fish,” Dr. Eyles said, adding vive, while younger ones move to areas of the lagoon closer to Lake Ontario and its fresher water.
The finding of major impacts on Pickering’s ground and surface water suggests a far greater toll from the use of salt elsewhere across Canada, where an estimated five million tones, or approximately 150 kilograms per Canadian, is used on roads each year to make them safe for travel in winter. The vast majority is applied in Ontario and Quebec.
“It’s a general problem… There are lots of other areas like this,” Dr. Eyles said, referring to the Pickering findings.
Environment Canada has recognized that salt has adverse impacts on wildlife, plants, water and soil, and in 2001 considered adding it to the country’s list of the most toxic substances. Instead, in 2004, the government instituted a voluntary code of practices to encourage municipalities and others to use the de-icer more sparingly, while maintaining highway safety. But with the vast amount used, huge quantities are still polluting soil and water, according to Dr. Eyles. “It’s a toxic material and yet we continue to throw it with gay abandon on our roads,” he said.
The University of Toronto’s research was based on water monitoring between May 2002, and March 2003, before the code went into effect.
It noted that after winter thaws, there were spikes in the amount of salt in streams, with those taking runoff from the 401 having approximately doubled the concentration of the pollutant than water-courses nearby that don’t take its storm water. Runoff from the highway, Canada’s busiest, also contains benzene, toluene, and xylene, hydrocarbons associated with contamination from underground gasoline storage tanks.
Environment Canada says it is currently reviewing whether the voluntary practices code has lead to any reduction in the amount of salt being spread on the roads. “If it is concluded, based on the review of progress, that other steps are needed for the management of road salts, Environment Canada will consider a range of possible options,” the department said in reaction to the study.
Taken from: The Globe and Mail, Friday March 5, 2010
By Martin Mittelstaedt – Environment Reporter
One of the most detailed investigations ever conducted in Canada into the fate of road salt has found that it is polluting groundwater and causing some streams during winter thaws to have salinity levels just under those found in the ocean.
The elevated salt readings were detected in Pickering where researchers from the University of Toronto have been studying how the salt spread on the highways, such as the 401, and other roadways through suburban sprawl affects water quality. They found that so much salty water from the community is ending up in Frenchman’s Bay, a scenic lagoon on the shores of Lake Ontario, that the small water body is being poisoned.
“Our Findings are pretty dramatic, and the effects are felt year- round,” said Nick Eyles, a geology- professor at the university and the lead researcher on the project. “We now know that 3,600 tones of road salt end up in that small lagoon every winter from direct run off in creeks and effectively poison it for the rest of the year.”
He called the findings, which were published recently in the journal Sedimentary Geology, “a really bad-news story” involving a “relentless chemical assault on watershed.”
The Pickering area provided researchers with an ideal place to study the effects of road-salt spreading, because most of the city lies within a relatively compact 27-square-kilometre watershed, where salt spread on roads ended up.
About 7,600 tones of salt is applied each year to roads in the community. About half of this amount seeps into groundwater, which in turn flows into streams year-round, making the water courses more salty than they should be, according to the research. The rest drains into Frenchman’s Bay, which is visible to commuters on the 401 and has a struggling fish population because salt levels are more than double the amounts typically found in the Great Lakes.
The salt water “knocks out fish,” Dr. Eyles said, adding vive, while younger ones move to areas of the lagoon closer to Lake Ontario and its fresher water.
The finding of major impacts on Pickering’s ground and surface water suggests a far greater toll from the use of salt elsewhere across Canada, where an estimated five million tones, or approximately 150 kilograms per Canadian, is used on roads each year to make them safe for travel in winter. The vast majority is applied in Ontario and Quebec.
“It’s a general problem… There are lots of other areas like this,” Dr. Eyles said, referring to the Pickering findings.
Environment Canada has recognized that salt has adverse impacts on wildlife, plants, water and soil, and in 2001 considered adding it to the country’s list of the most toxic substances. Instead, in 2004, the government instituted a voluntary code of practices to encourage municipalities and others to use the de-icer more sparingly, while maintaining highway safety. But with the vast amount used, huge quantities are still polluting soil and water, according to Dr. Eyles. “It’s a toxic material and yet we continue to throw it with gay abandon on our roads,” he said.
The University of Toronto’s research was based on water monitoring between May 2002, and March 2003, before the code went into effect.
It noted that after winter thaws, there were spikes in the amount of salt in streams, with those taking runoff from the 401 having approximately doubled the concentration of the pollutant than water-courses nearby that don’t take its storm water. Runoff from the highway, Canada’s busiest, also contains benzene, toluene, and xylene, hydrocarbons associated with contamination from underground gasoline storage tanks.
Environment Canada says it is currently reviewing whether the voluntary practices code has lead to any reduction in the amount of salt being spread on the roads. “If it is concluded, based on the review of progress, that other steps are needed for the management of road salts, Environment Canada will consider a range of possible options,” the department said in reaction to the study.
Taken from: The Globe and Mail, Friday March 5, 2010
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