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Research into the efficacy of UV lighting has shown that the bacteria responsible for Clostridium difficile infections, Staphylococcus infections and many others can be killed on surfaces in hospital rooms in less than 10 minutes with the proper technology. This includes bacteria known to be resistant to antibiotics.

Targeting bacteria in the gut may be key to preventing infection. A study published in the journal PLOS ONE in July reported that patients with burns and other traumatic injuries experience drastic Antimicrobial surfaces gain a presence in healthcare facilities. Antimicrobial agents, which mitigate the growth of bacteria and other microorganisms, may alter the landscape of disinfection for healthcare facilities.

Some materials, such as copper, have antimicrobial properties on their own, making them increasingly popular choices for use in facility surfaces. Other antimicrobial agents manufactured as coats are applied to existing surfaces, protecting them from transferring bacteria to certain extents.

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Waste is separated into different bags.

orange bags for infectious waste (bodily waste)

clear bags for non infectious rubbish (food wrappers, empty boxes)

Disintegrating laundry bags to prevent laundry staff touching soiled laundry

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Summary;

Hospitals provide PPE

Hospitals provide training on hand washing and infection control, also carry out audits.
Doctors white coats can spread lot's of germs.
10 killer germs listed that can be spread around hospitals maybe causing fatality's to already poorly people such as salmonella and other various killer bugs.
World health organisation set specific standards to hygiene both personally and within hospital trusts to protect the patients and staff with hospitals.

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Doctor's white coat could spread germs

White coats, neckties, and wrist watches can become contaminated and may potentially serve as vehicles to carry germs from one patient to another.

"White coats, neckties, and wrist watches can become contaminated and may potentially serve as vehicles to carry germs from one patient to another," Dr Mark Rupp, one of the authors of the recommendations issued by the Society for Healthcare Epidemiology of America, said in a society news release.

"However, it is unknown whether white coats and neckties play any real role in transmission of infection," added Rupp, chief of the division of infectious diseases at the University of Nebraska Medical Centre.

Ways to prevent transmission of infection

"Until better data are available, hospitals and doctor's offices should first concentrate on well-known ways to prevent transmission of infection - like hand hygiene, environmental cleaning, and careful attention to insertion and care of invasive devices like vascular [blood vessel] catheters."

Read: Germs in the gym

Additional infection prevention measures could include limiting the use of white coats and neckties, or at least making sure they are frequently laundered, the society said.

"As these measures are unproven, they should be regarded as voluntary and if carried out, should be accompanied by careful educational programmes," Rupp said.

"There is a need for education because the public, as well as health professionals, regard the white coat as a symbol of professionalism and competence. In future, patients may see their health professionals wearing scrubs - without white coats, ties, rings, or watches."

Read: Cranberry kills germs in mincemeat

Here is a full list of the recommendations that appear in the February online issue of the journal Infection Control and Hospital Epidemiology:

- Keep arms bare below the elbows, which is defined as wearing short sleeves and no wristwatch, jewelry, or ties.

- Health care workers should have two or more white coats available and have access to easy and cheap ways to launder white coats.

- Coat hooks should be available so health care workers can take off their white coats before contact with patients or their immediate surroundings.

- Any clothing that comes in contact with patients or their immediate surroundings should be laundered frequently. If laundered at home, a hot water wash cycle (ideally with bleach) followed by a cycle in the dryer or ironing has been shown to eliminate bacteria.

- All footwear should have closed toes, low heels, and non-skid soles.

- Shared equipment such as stethoscopes should be cleaned between use on different patients. Items such as lanyards, identification tags and sleeves, cell phones, pagers, and jewellery that come into direct contact with patients or their surroundings should be disinfected, replaced, or eliminated.

Read more:

The age of killer germs
The germs in your car
Where germs love to hide

"White coats, neckties, and wrist watches can become contaminated and may potentially serve as vehicles to carry germs from one patient to another," Dr Mark Rupp, one of the authors of the recommendations issued by the Society for Healthcare Epidemiology of America, said in a society news release.

"However, it is unknown whether white coats and neckties play any real role in transmission of infection," added Rupp, chief of the division of infectious diseases at the University of Nebraska Medical Centre.

Ways to prevent transmission of infection

"Until better data are available, hospitals and doctor's offices should first concentrate on well-known ways to prevent transmission of infection - like hand hygiene, environmental cleaning, and careful attention to insertion and care of invasive devices like vascular [blood vessel] catheters."

Read: Germs in the gym

Additional infection prevention measures could include limiting the use of white coats and neckties, or at least making sure they are frequently laundered, the society said.

"As these measures are unproven, they should be regarded as voluntary and if carried out, should be accompanied by careful educational programmes," Rupp said.

"There is a need for education because the public, as well as health professionals, regard the white coat as a symbol of professionalism and competence. In future, patients may see their health professionals wearing scrubs - without white coats, ties, rings, or watches."

Read: Cranberry kills germs in mincemeat

Here is a full list of the recommendations that appear in the February online issue of the journal Infection Control and Hospital Epidemiology:

- Keep arms bare below the elbows, which is defined as wearing short sleeves and no wristwatch, jewelry, or ties.

- Health care workers should have two or more white coats available and have access to easy and cheap ways to launder white coats.

- Coat hooks should be available so health care workers can take off their white coats before contact with patients or their immediate surroundings.

- Any clothing that comes in contact with patients or their immediate surroundings should be laundered frequently. If laundered at home, a hot water wash cycle (ideally with bleach) followed by a cycle in the dryer or ironing has been shown to eliminate bacteria.

- All footwear should have closed toes, low heels, and non-skid soles.

- Shared equipment such as stethoscopes should be cleaned between use on different patients. Items such as lanyards, identification tags and sleeves, cell phones, pagers, and jewellery that come into direct contact with patients or their surroundings should be disinfected, replaced, or eliminated.

Read more:

The age of killer germs
The germs in your car
Where germs love to hide

# data[].attributes.attachment_link.description
"White coats, neckties, and wrist watches can become contaminated and may potentially serve as vehicles to carry germs from one patient to another," Dr Mark Rupp, one of the authors of the recommendations issued by the Society for Healthcare Epidemiology of America, said in a society news release.

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Infection courses

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Preventing Infection Course (PIC) - October 2018 | Infection Prevention Control

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This exciting 2 day course is ideal for Infection Prevention Leads and will help you meet your CQC educational requirements. An in-depth course with an exceptional opportunities to visit the Microbiology Laboratory and Sterile Services Department. Also includes bespoke sessions from Consultant Microbiologists. Excellent value at £145.00 early bird or £150.00 full price.

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Disclosures: Allen Beuershausen is the Co-founder of Sanitis and Harry Jarbath is the Founder of Sanitis. Sanitis is a global sales and marketing company distributing "next generation" infection control solutions for the health care, food processing and food service, janitorial, and transportation industries.

Abstract

Nosocomial infections are a serious and growing problem in many healthcare institutions in spite of great and frequently expensive efforts to bring them under control. There are multiple, interrelated issues that make it difficult to significantly reduce the spread of pathogens in health care institutions including inadequate assessments of threats, outdated hygiene protocols, poor compliance with existing protocols, and infection control and disinfection products that are either inadequate for their intended purpose or improperly applied. Fortunately, new technologies are available that can make it easier to reduce the incidence of these infections.

The authors of this paper work with many of these technologies on a daily basis and offer their insights into existing infection control products and systems as well as alternative technologies that have helped hospitals to reduce HAIs by 23% to 33%, and schools that have seen reductions in illness-related absences of up to 38.9%.

Main Article

Nosocomial infections, or HAIs (Hospital Acquired Infections), are the bane of health care facilities and their clients world wide, and the problem is not going away any time soon. Hand hygiene, environmental infection control, and improperly disinfected devices such as catheters are among the biggest contributors to the problem. ¹ Products and protocols that have been used for disinfection for many years are not doing the job even when infection control compliance is high, but a range of new eco-friendly disinfectants and devices might change that with wide spread adoption of proper protocols and strict compliance.

Disinfectants are now available that kill bacteria, viruses, and fungi without harming people or the environment ². UV lights can kill pathogens while rooms are idle, fogging systems can effectively disinfect entire rooms after contamination with the toughest pathogens, and electrostatic sprayers can provide virtually 100% coverage of surfaces with aqueous disinfectants in a fraction of the time and with a fraction of the chemicals that are necessary with traditional products and protocols. ³ Novel hand hygiene products now control pathogens that traditional hand sanitizers cannot, and they provide persistence, i.e., continuous protection, to protect even when compliance rates are low. 4,5

Protocols are Key

Proper disinfection and hygiene protocols that are strictly adhered to are critical in maintaining personal and environmental infection control. Even though health care facilities have those protocols in place, there are still gaps in the health care environment that allow pathogens like Clostridium difficile, MRSA, Staphylococcus aureus, and Acinetobacter baumannii, to spread. For example, it is very common for toilets in patient rooms to have no lids, thus allowing fecal bacteria to be ejected in an aerosol with each flush and contaminate surfaces throughout a room. ¹ Even with today's efficient siphonic toilets, bacteria including Escherichia coli have been shown to remain viable in aerosol form for 4 - 6 hours. ⁶ Another source of contamination are hospital water supplies (storage tanks and piping) and ventilation systems where harmful Aspergillus species are commonly found. ⁷ For this reason, gap analysis to compare ideal versus actual operating conditions and food industry-style HAACP (Hazard Analysis Critical Control Point) plans can be extremely valuable for identifying all potential threats and bringing the environment and other sources of nosocomial infections back into compliance when problems do occur.

Soft surfaces such as curtains and upholstery often receive insufficient sanitizing and can harbor any number of pathogens. In fact, a 2011 study performed at one hospital in the University of Iowa hospitals and Clinics system showed that within 1 week of being laundered, 92% of hospital curtains were contaminated with pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) species. ⁸ Many broad-spectrum disinfectants used today can damage soft surfaces, so opportunities to eliminate pathogens on those surfaces are often missed. 9 The use of disposable curtains is one way to help minimize the spread of disease, but there are less wasteful, more cost effective, and more environmentally friendly ways to manage those threats with appropriate disinfectants and application methods.

One of the easiest and most important means of reducing the spread of HAIs is to improve hand hygiene. Unfortunately, this can also be one of the most challenging problems to resolve because of antimicrobial preparations with limited efficacy and health care workers' low compliance rates with existing protocols. ¹⁰ Improved compliance in hand hygiene, with proper use of alcohol-based hand rubs, have been shown to reduce the nosocomial infection rate by as much as 40%. ¹⁰ New, cutting edge antimicrobial hand hygiene products show great promise in reducing the transmission of disease through hand contact even further due to their greater broad-spectrum efficacy, their persistence, and their acceptance by workers who sometimes avoid sanitizing because of skin irritation.

Hand Hygiene

"An antiseptic product should be: broad-spectrum, fast-acting, and if possible, persistent." ¹¹

While this is an excellent recommendation, few if any hand sanitizers or surgical scrubs can provide the efficacy and persistence that the FDA recommends. Fortunately, that is changing with novel hand sanitizers based on more effective and innovative antimicrobial formulations, and new attention to monitoring for compliance with hand hygiene protocols is helping a great deal, as well. The transmission of HAIs through hand contact remains a huge problem. Healthcare facilities around the world use products with different active ingredients and different properties, and in light of the FDA's recent ban on triclosan and their recently announced concern about other active ingredients in hand sanitizers, it is worth reconsidering the products being used. ¹² Table 1 provides an illustration of some of the more common active ingredients in hand sanitizers and illustrates the wide variation in their efficacy and toxicity. Furthermore, common products used in the home such as typical hand lotions can negate the antibacterial effects of active ingredients like CHG (chlorhexidine gluconate). ¹³ It is likely that infection control professionals will see reason to switch to more effective soaps, rubs, and scrubs when more data is available to inform the infection control practitioners.

Table 1: Mechanism And Spectrum Of Activity Of Antiseptic Agents Commonly Used For Preoperative Skin Preparation And Surgical Scrubs ¹⁴

Source: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of Healthcare Quality Promotion

Alcohol-based hand sanitizers, or "rubs", that are currently considered to be the "gold standard" of hand sanitizers because of their quick-acting effects on bacteria and enveloped viruses have little efficacy against non-enveloped viruses like norovirus, and have no persistence as illustrated in the CDC's Table 1 above. ¹⁵ Once they evaporate, which is generally within 15 seconds, skin can become re-contaminated immediately. ¹⁵ Frequent use of alcohol-based rubs can lead to dry, cracked skin that harbors more bacteria than healthy skin, and compliance with hand hygiene protocols can fall off due to the discomfort caused by the use of traditional products. ¹⁶ Many manufacturers of these traditional alcohol-based rubs are developing formulations that are less irritating to the skin, but they still lack persistence.

Chlorhexidine gluconate (CHG) is a common antibacterial and antifungal agent used in hand sanitizers and surgical scrubs in the health care industry, but it is not very effective against non-enveloped viruses. ¹¹ For this reason, CHG is often combined with alcohol to provide efficacy against viruses and increase its persistence. Some of the most popular surgical scrubs are formulated in this way. One advantage CHG does provide is persistence against bacteria and fungi for up to about four hours. Unfortunately, CHG can be very hard on skin.

Iodine/Iodophors have been used as antiseptics for the skin for many years, and they are effective against bacterial, viral, and fungal pathogens. ¹¹ Iodophors are used more commonly in hand sanitizing products, particularly as povidone-iodine which is relatively non-staining and less toxic and irritating as compared to iodine. ¹¹ While iodophors are bactericidal, virucidal, and fungicidal, most formulations require prolonged contact times in order to be effective. ⁵

Chloroxylenol (PCMX) is seen in a number of antibacterial soaps and surgical scrubs, but unfortunately, it is one of the least effective antimicrobials, and the CDC requires a two minute wash time with PCMX in order to meet their minimum standards for hand hygiene. ¹¹ Most other hand hygiene preparations are effective within 15 to 30 seconds and they are more effective. PCMX works well against Gram-positive bacteria, and has fair efficacy against gram-negative bacteria, fungi, and certain viruses. ¹¹

Some of the newest antimicrobial soaps, rubs, and surgical scrubs contain the quatermonium compounds benzethonium chloride (BZK) or benzalkonium chloride (BAC). ¹⁷ BZK and BAC have been used safely for decades as antiseptics and as preservatives in food, toothpaste, and other consumer products, and in many hand sanitizer formulations they provide broad-spectrum efficacy that is recommended by the FDA. ¹⁷ Formulations including hand sanitizers, foaming soap, and surgical scrub combine BZK with synergistic compounds allow the products to provide up to six hours of persistence ( Sanitis). 4,5 These products have been demonstrated in clinical studies to provide up to six hours of persistence even through multiple hand washings, and long-term field trials in hospitals have shown dramatic reductions in HAIs in hospitals that have switched from traditional alcohol-based rubs to these products. ¹⁸ An added benefit to BZK and BAC-based products is that skin irritation and dryness are generally avoided at the concentrations allowed by the FDA, and hand hygiene compliance is less of an issue since health care practitioners are less likely to avoid the products because of discomfort.

Disinfectants

Traditional disinfectants like bleach (sodium hypochlorite), quaternary ammonium cation compounds ("quats"), phenols, and peracetic acid (PAA) are effective and reliable disinfectants that have been used for many years to sanitize and disinfect hard surfaces in homes, offices, hospitals, and just about every place else. ¹⁹ However, few of these can be used on soft surfaces such as bedding, upholstery, and curtains, and they all have shortcomings including toxicity, irritation of eyes and skin, flammability, corrosion or other damage of treated materials, and even a lack of broad spectrum efficacy. ¹⁹

Fortunately, there are technologies in chemical disinfection that avoid the problems of traditional disinfectants such as acute toxicity, skin irritation, and corrosion of equipment. "Cutting edge" formulations with ingredients like chlorine dioxide, hypochlorous acid, and even the old standby, hydrogen peroxide, are providing equal or better results with true broad spectrum efficacy and without the serious hazards and limitations of their predecessors. 19 These "next generation" disinfectants frequently have the added benefit of minimizing the possibility of giving rise to "super bugs", i.e, bacteria that have evolved to be resistant to antibiotics and other disinfectants.

Chlorine Dioxide

Chlorine dioxide (ClO ₂) is an extremely effective "selective" oxidizer that has been used for many decades to sanitize municipal water systems around the world. ²⁰ In the past, it was usually only available as a gas that is generated on site. The gas itself can be hazardous if it leaks into the atmosphere, but in recent years manufacturers have developed ways to stabilize ClO ₂ in water and even to create small quantities of ClO ₂ solutions as needed. ²¹

Chlorine dioxide has a very different chemical structure and properties from bleach (sodium hypochlorite), and can be used much more safely in the concentrations used in hospital disinfectants. Innovations such as shelf-stable ClO ₂ products ( Sanitis) provide broad spectrum antibacterial and antiviral efficacy and extremely effective odor elimination without the hazards associated with bleach and other disinfectants. ²² One important benefit of chlorine dioxide is its ability to eliminate biofilms that can harbor pathogens such as Listeria monocytogenes and Aspergillus species. This makes it especially suitable for water treatment applications when dosed into hospital water systems at very low concentrations. Few disinfectants, including bleach, are capable of eliminating biofilms. ClO ₂ is very eco-friendly when used in solution, and it produces safer and fewer byproducts as a result of its antimicrobial activity than other disinfectants do. ²³

Hypochlorous Acid

Hypochlorous acid is a very effective antimicrobial that is recognized by the Centers for Disease Control (CDC) as having a more prolonged antibacterial effect and more free available chlorine than sodium hypochlorite while being potentially safer for the environment. ¹¹ Hypochlorous acid can be generated in a number of ways that include chemical precursors that are added to water or through "super oxidation" of water by specialized electrical equipment. According to the CDC, "Freshly generated superoxidized water is rapidly effective (<2 minutes) in achieving a 5-log10 reduction of pathogenic microorganisms (i.e., Mycobacterium tuberculosis, Mycobacterium chelonae, poliovirus, HIV, multidrug-resistant S. aureus, E. coli, Candida albicans, Enterococcus faecalis, Pseudomonas aeruginosa) in the absence of organic loading. However, the biocidal activity of this disinfectant decreased substantially in the presence of organic material (e.g., 5% horse serum)." ¹⁹

One of the most interesting developments in hospital-grade disinfectants is the development of disinfectant precursor tablets that are dropped into water to create hypochlorous acid-based solutions as needed and at the strength the user desires. One manufacturer in particular has developed extremely cost competitive tablets that can generate an EPA-registered disinfectant that is National Sanitation Foundation (NSF) certified as a food contact surface sanitizer (classification D2, no rinse required) at low concentration, a hospital-grade disinfectant that kills bacteria, viruses, and fungi, including blood-borne pathogens and C. difficile spores at medium concentration; or a C. difficile disinfectant with a four minute kill claim at the product's highest EPA registered concentration. ²⁴ Even with this broad spectrum efficacy, the product is considered to be non-hazardous under OSHA Occupational Health and Safety Standards on Toxic and Hazardous Substances number 29 CFR 1910.1200. ²⁴

As mentioned above, hypochlorous acid solutions can also be created by electrolyzing saline solutions of water on demand. The resulting "super oxidized" water is very effective as a disinfectant, and very safe for the environment. ¹¹ It can be generated at attractive costs, but the required equipment can be expensive in order to compensate for pH and other parameters, and it does require regular maintenance. The degree, difficulty, and cost of maintenance depend on the design of the equipment that varies from one manufacturer to another.

Hydrogen Peroxide Formulations

Hydrogen Peroxide (H ₂O ₂) has been used as a disinfectant for many years, and for good reason: it is a very effective broad-spectrum disinfectant. It is even sporicidal at higher concentrations (10 - 30% v/v). ²⁵ Unfortunately, it also has downsides as traditionally employed. Hydrogen peroxide decomposes quickly into water and oxygen, and it can be toxic at higher concentrations. 25 The good news is that formulations now exist that get around some of the shortcomings of H ₂O 2.

One of the most effective ways to use these new formulations is through the use of whole-room fogging systems. These systems create a fine mist of hydrogen peroxide-based disinfectant that makes its way into the difficult-to-reach areas. While this requires taking a room out of commission for up to three hours and sealing it to contain the mist in the target area, it can be a very effective way of eliminating even the most difficult pathogens including C. difficile.

Important Note about Disinfectants

Regardless of what disinfectant is used, it is vital that proper protocols (outlined by the manufacturer) for disinfection are in place and that they are strictly adhered to in order to achieve the desired result. These protocols must include cleaning surfaces before they are disinfected to ensure that the chemical of choice makes contact with any pathogens. The degree of disinfection by any product is based on both the chemistry and the contact time it has on the surface.

A far better way to apply disinfectants in an environment is through the use of electrostatic sprayers with disinfectants that do not need to be wiped off. Electrostatic sprayers impart an electrical charge to the droplets of disinfectant as they leave the nozzle of the sprayer. ²⁶ This electrical charge causes the droplets to be attracted to the target object and the droplets repel each other once they are on the surface. This electrical repulsion essentially causes the disinfectant to surround the object to ensure virtually 100% coverage in three dimensions, even covering surfaces that are hard to reach by hand or typical sprayers. ²⁵ Electrostatic sprayers drastically reduce the amount of time and chemical required to disinfect a room, and they are available in backpack, cart, and cordless handheld models. Electrostatic sprayers have been used for decades to apply pesticides to produce in the field and to apply paint to cars on assembly lines, so it is a highly proven technology. ²⁶

Ultraviolet Light

Ultraviolet lights are becoming more popular in health care facilities, and for good reason. Ultraviolet Germicidal Irradiation (UVGI) inactivates pathogens by targeting nucleic acids (DNA and RNA) ²⁷ Ultraviolet light is effective against bacteria, viruses, and fungi, and it has found widespread use in disinfecting surfaces, air, and drinking water. 27 Ultraviolet systems are available as fixed lighting units, portable fixtures, and even robotic units that eliminate some of the biggest limitations of these systems. However, UV systems are not without their limitations.

Just as with chemical disinfectants, UV light systems are dependent on the intensity (concentration) of the light and the contact time. ²⁷ Microbes can only be killed if they are irradiated by the light, so the light source(s) must be arranged or moved to ensure that they are exposed to every surface with the appropriate intensity for the proper amount of time. ²⁸ This can be a challenge even for properly trained operators. Some hospitals have found that their rates of C. difficile infections have increased after spending upwards of $500,000 on UV equipment and hiring several technicians to operate it. Robotic systems can help with this by automating the process and reducing operator error. In any case, it is imperative that operators of UV systems are well-trained and vigilant in their implementation of manufacturer recommended protocols. Having said that, small UV cabinets have proven to be very effective in disinfecting medical devices where the process is easily controlled.

Conclusion

In spite of the challenge of minimizing nosocomial infections, technologies exist that can make it far easier and safer to reduce the spread of illnesses than many realize. The products that utilize these technologies, when used with appropriate care and protocols, can help hospitals and clinics to dramatically reduce the incidence of HAIs and the economic and human costs associated with them. Fortunately, when the ROI on these alternative products and systems is considered, they can pay for themselves very quickly.

Even with these new approaches in infection control, it is still incumbent upon infection control specialists to identify all potential sources of HAIs and address them systematically and holistically. Health care practitioners and custodial staff must remain vigilant and be held accountable for following the processes and procedures that are laid down to minimize the spread of illnesses. With this approach and the right infection control products, pathogens that have become endemic throughout health care systems worldwide may be controlled to a degree not seen before.

References

1. Furness C, Wallace N (2015) Hand Hygiene Compliance Auditing Does Not Work. InfectionControl.tips 12:1-5 https://infectioncontrol.tips/2015/12/27/1291/

2. Birko, "10 Reasons Why You Should Be Using Chlorine Dioxide", Food Safety Magazine, February/March 2005.

3. Whitely B (2016) Electrostatics: A Solution for Healthy Touch Point Surface Treatments. InfectionControl.tips. 5:1-3 https://infectioncontrol.tips/2016/05/10/electrostatics-solution/

4. Bioscience Laboratories. (2014) Clinical Evaluation of the Persistent Antimicrobial Efficacy of Three Test Products and One Control Product Based on ASTM E2752-10. Accessed October 19, 2016. http://www.supplyurneeds.com/uploads/6/5/2/1/65218579/clinical_evaluation_of_the_persistent_antimicrobial_efficacy.pdf

5. Haskins Lab (2012) Pace University. Accessed October 20, 2016. http://www.pace.edu/dyson/initiatives-research/haskins-laboratories

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7. Burge, H., & Aerobiologist, E. P. K. C. (2009). Sources and control of opportunistic fungi in the hospital environment. Environmental Reporter, 8(1).

8. Brunk D (2011) Beware of Curtain! Pathogens Plentiful on Hospital Partitions", American College of Emergency Physicians News, December. Accessed October 21, 2016 https://www.acep.org/content.aspx?id=82855

9. Connell, B (2016) What's Really Hiding behind Hospital Privacy Curtains? Medline Clinical Solutions. June. Accessed October 21, 2016 http://mkt.medline.com/advancing-blog/whats-really-hiding-behind-hospital-privacy-curtains/

10. Dettenkofer, M., & Conrad, A. (2010). Hand Hygiene for the Prevention of Nosocomial Infections. Deutsches arzteblatt international, 107(8), 139-139.

11. CDC Morbidity and Mortality Weekly Report, Guideline for Hand Hygiene in Health-Care Settings, October 25, 2002 / Vol. 51 / No. RR-16

12. Food and Drug Administration (2016) FDA issues final rule on safety and effectiveness of antibacterial soaps. US FDA. Sept 2, 2016. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm517478.htm

13. Frantz, S. W., Haines, K. A., Azar, C. G., Ward, J. I., Homan, S. M., & Roberts, R. B. (1997). Chlorhexidine gluconate (CHG) activity against clinical isolates of vancomycin-resistant Enterococcus faecium (VREF) and the effects of moisturizing agents on CHG residue accumulation on the skin. .Journal of Hospital Infection, 37(2), 157-164

14. Mangram, A. J., Horan, T. C., Pearson, M. L., Silver, L. C., Jarvis, W. R., & Hospital Infection Control Practices Advisory Committee. (1999). Guideline for prevention of surgical site infection, 1999. American journal of infection control, 27(2), 97-134.

15. Blaney, D. D., Daly, E. R., Kirkland, K. B., Tongren, J. E., Kelso, P. T., & Talbot, E. A. (2011). Use of alcohol-based hand sanitizers as a risk factor for norovirus outbreaks in long-term care facilities in northern New England: December 2006 to March 2007. Am J Infection Control, 39(4), 296-301.

16. Klevens, R. M., Edwards, J. R., Richards Jr, C. L., Horan, T. C., Gaynes, R. P., Pollock, D. A., & Cardo, D. M. (2007). Estimating health care-associated infections and deaths in US hospitals, 2002. Public health reports, 160-166.

17. Joynson, J. A., Forbes, B., & Lambert, R. J. W. (2002). Adaptive resistance to benzalkonium chloride, amikacin and tobramycin: the effect on susceptibility to other antimicrobials. Journal of applied microbiology, 93(1), 96-107.

18. Kampiatu, P., & Cozean, J. (2014). A controlled, crossover study of a persistent antiseptic to reduce hospital-acquired infection. African journal of infectious diseases, 9(1), 6-9.

19. Center for Disease Control (2008) "Guideline for Disinfection and Sterilization in Healthcare Facilities", Centers for Disease Control, 2008. Accessed October 19, 2016. http://www.cdc.gov/hicpac/pdf/guidelines/disinfection_nov_2008.pdf

20. Seymour Stanton Block (2001). Disinfection, sterilization, and preservation (5th ed.). Lippincott Williams & Wilkins. p. 215. ISBN 0-683-30740-1.

21. Gómez-López, V. M., Rajkovic, A., Ragaert, P., Smigic, N., & Devlieghere, F. (2009). Chlorine dioxide for minimally processed produce preservation: a review. Trends in Food Science & Technology, 20(1), 17-26.

22. Cha, C. N., Lee, Y. E., Kang, I. J., Yoo, C. Y., An, S., Kim, S., & Lee, H. J. (2012). Bactericidal Efficacy of Vital-Oxide®, Disinfectant Solution Against Salmonella Typhimurium and Brucella Ovis. J Fd Hyg Safety, 27(1), 50-4.

23. Stratilo, C. W., Crichton, M. K., & Sawyer, T. W. (2015). Decontamination Efficacy and Skin Toxicity of Two Decontaminants against Bacillus anthracis. PloS one, 10(9), e0138491.

24. Pyrek, K. M. (2013). Clostridium difficile Prevention and Control Strategies. Infection Control Today. March. Accessed October 21, 2016. http://www.infectioncontroltoday.com/~/media/Files/Medical/Ebooks/2013/03/03-13ICT-CdiffReport-s.pdf

25. Watt BE, Proudfoot AT, Vale JA. (2004) Hydrogen peroxide poisoning. Toxicol Rev. 23(1):51-7.

26. Robertson JT (2016) Electrostatic Technology for Surface Disinfection in Healthcare Facilities. InfectionControl.tips. 10:1-4. https://infectioncontrol.tips/2016/10/14/electrostatic-in-healthcare/

27. Wagenet L, Darling S, Lemley A (2004) Ultraviolet Radiation for Disinfecting Household Drinking Water Cornell Cooperative Extension, College of Human Ecology Fact Sheet 10, December 1993. Accessed October 21, 2016. http://waterquality.cce.cornell.edu/publications/CCEWQ-10-UVWaterTrtforDisinfection.pdf

28. Cotton, C. A., Owen, D. M., Cline, G. C., & Brodeur, T. P. (2001). UV disinfection costs for inactivating Cryptosporidium. American Water Works Association Journal, 93(6), 82.

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Alternative Technologies in Infection Control - www.IC.tips

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Disclosures: Allen Beuershausen is the Co-founder of Sanitis and Harry Jarbath is the Founder of Sanitis. Sanitis is a global sales and marketing company distributing "next generation" infection control solutions for the health care, food processing and food service, janitorial, and transportation industries.

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Infection Control Team

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Infection Control policies and resources to support compliance with the Health and Social Care Act 2008 and CQC requirements produced by an NHS IPC team

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killer germs

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Germophobes beware! What you learn here will definitely rob you off at least one night of sleep.

On the most serious note, it is a fact that there are a lot of nasty germs lurking from all over the place.

However, being near all of those germs does not automatically mean that you will get contaminated and get some horrible disease.

Moreover, chances are that you will most likely be fine. Especially if you have proper hygienic habits and a good immune system.

But, if you like to get a bit scared, here are some of the most horrible germs which are not somewhere across the globe - they are just a couple of meters from you or even closer. The good news is, they need to be in much bigger amounts for them to hurt you, so you are safe.

The most of them occur in the places of high frequency, just like the offices are. So, a managed workplace washroom may be a great idea.

1. Staphylococcus

You do not have to go very far searching for a Staphylococcus bacteria. There are probably some in your own nose, right now. It is also commonly found on the skin of healthy people.

There are over 30 types of Staphylococcus and the most common one is Staphylococcus aureus. In most cases, it causes mild infections and symptoms that are more annoying than dangerous. They usually cause irritating skin infections.

However, this tiny bacteria causes a lot of troubles if it reaches your bloodstream. Your lung and your heart are in grave danger if this happens. S. aureus causes necrotizing pneumonia that is rare but very deadly disease.

Also, it can cause septicemia that is blood poisoning, which can have a deadly outcome if not treated properly. It usually strikes those with weakened immune systems.

Different studies showed that S. aureus caused diseases are more present in New Zealand than in other developed countries. One more reason to be extra careful about your hygiene.

2. Streptococcus

You already have some sort of Streptococcus bacteria in your mouth. There are many types which are mostly harmless when you are healthy. They usually cause tooth decay and a sore throat.

But if something goes terribly wrong, they can cause necrotizing fasciitis or streptococcal toxic shock syndrome. These diseases can be deadly.

Group B Streptococcus (GBS) live in your intestines. Normally, they are harmless and even necessary. However, if you have a seriously dysfunctional immune system, GBS can wreak havoc. It can cause meningitis and septicaemia in newborn babies.

3. Legionella

In nature, you can find Legionella in lakes and streams. However, this bacteria is much closer than you think. Legionella likes to settle in your shower head and water taps.

A certain type of this bacteria, Legionella pneumophilia causes Legionnaires' disease. This is a severe form of pneumonia that can be deadly and a certain percent of survivors has seriously affected life quality.

Therefore, it is of essential importance that your workplace washroom is constantly clean, using excellent cleaning products.

4. Pseudomonas aeruginosa

If you ask a doctor where Pseudomonas is found, the answer will be: in soil, water and plants. In other words, everywhere around you. Although, it seems to like poorly chlorinated swimming pools. Pseudomonas strings like moist surfaces and it does not normally cause troubles.

However, this opportunistic bacteria is extremely dangerous for those that have compromised immune system:

the elderly

HIV positive persons

surgery patients

burn victims

those that have catheters and similar devices

P. aeruginosa can cause blood infections and pneumonia. Treatment is very tricky because P. aeruginosa is resistant to many antibiotics and it also develops resistance very quickly. Therefore, the diseases it causes can easily result in death.

With this in mind, prevention is the best cure for these types of diseases. Sanitary conditions in hospitals and flawless hand hygiene must be enabled in order to protect yourself and everybody around you against this bacteria.

5. Escherichia coli

This is one more bacteria that can live inside you throughout your entire life and never cause you harm. E. coli is found in animals and humans and it is part of the well-balanced gastrointestinal flora.

The fact that you have this bacteria in your intestines, can give you a clue that you can probably find it in toilets. Getting in touch with contaminated water or food, or ingesting it due to poor hand hygiene causes the infections.

Some of the E. coli types cause bloody diarrhea, vomiting and cramps. While healthy adults relatively easily recover from this, children and the elderly are in the greater risk of developing hemolytic uremic syndrome. It is a severe life-threatening disease.

6. Cladosporium

All the germs above are bacteria. Cladosporium is a fungus. This is not an uncommon fungus, as it is the common household mold. It can be found in your carpets, wallpapers or even air if the environment is moist.

It does not cause many troubles, normally. Cladosporium can cause eye irritation, skin infections and sinus infections.

However, this supposedly benign fungus was a part of an outbreak of fungal meningitis. This disease is extremely rare. Still, it is very deadly, as well.

7. Exserohilum

This common household mold fungus does not frequently cause any problems with people. If it does, it usually causes eye infections. While it cannot be transmitted from one person to another, some serious Exserohilum infections include attacks on the sinuses or even lining of the heart.

Still, together with Cladosporium and Aspergillus, this fungus was one of the causes for the fungal meningitis outbreak that killed some patients. Therefore, always make sure that your workplace is free of any mold that might cause your employees any of the health problems.

8. Salmonella

Everybody knows that they should be very careful not to eat questionable food, because they might get food poisoning. In some of those cases, the bacteria that causes food poisoning is Salmonella. It causes diarrhea, cramps, vomiting and high fever.

This lasts for around three days, but the balance in your intestines may take months to recover.

But, that is not all. If Salmonella reaches the bloodstream and infects it, patients will die if not treated with antibiotics promptly. However, these cases are very rare.

You may think that bacteria this dangerous is found only in some exotic places. The truth is, you just need to open up your fridge. It can be found in raw meat and eggs. Luckily for everybody, high temperatures kill it. So, you need to be sure that all your meals are properly cooked.

9. Aspergillus

It is quite easy to miss out on some hidden patches of mold around your home. But, some of it may be packing the Aspergillus fungus. Again, it is not usually dangerous.

Still large quantities of inhaled spores can cause:

invasive or non-invasive pulmonary aspergillosis

chronic pulmonary aspergilloma

severe asthma

Aspergilloma is actually a ball of fungus that forms in the patient's lungs. The invasive aspergillosis has a very high mortality rate with patients that have weakened immune system. It ranges from 25-90%.

10. Clostridium tetani

This bacteria causes a very severe disease called tetanus or lockjaw. Its symptoms include severe muscle spasms that spread throughout the body. The danger lies in the fact that these spasms can compress the lungs and make it extremely difficult to breathe.

Clostridium tetani can be found in soil and manure. It translates - your garden. New Zealand organises immunisation against this bacteria and it is very successful in it.

With the immunisation present in most of the countries, tetanus mortality rate has dropped significantly, but it still means that the C. tetani is a deadly bacteria.

To be on the safe side, you need to make sure that your employees are not infected, at all. Many bacteria and other germs make troubles upon entering the bloodstream through cuts and grazes. Therefore, it is important that you always have a fully stocked first aid kit.

The other thing that comes to mind when thinking about these germs is how easily they can be avoided by proper hygiene. Since your workplace welcomes a lot of people, you need to make sure that the hygiene is flawless.

This is easily achieved with Alsco. We offer sanitary floor mats and uniforms, managed washroom services and many more ways to keep your workplace safe and healthy.

Simply contact Alsco and we will find the affordable solution for your workplace that works the best.

Photo Courtesy from: Flickr Image by U.S. Department of Agriculture

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10 Killer Germs That Are Near You Right Now | Alsco New Zealand

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Germophobes beware! What you learn here will definitely rob you off at least one night of sleep. On the most serious note, it is a fact that there are a lot of nasty germs lurking from all over the place.

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Carrying out hygiene audits.

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CQC inspections in relation to infection prevention and control are essential to ensure providers are complying with the requirements of the Health and Social Care Act 2008: Code of Practice.

CQC inspections now focus on getting to the heart of patients' experiences and to determine if the service is:

Safe | Effective | Caring | Responsive to people's needs | Well-led

How will the new inspections be carried out?

They will be a mixture of announced and unannounced inspections looking at the quality of care provided, leadership and governance.

Who will carry out the inspection?

An inspection team, led by an experienced CQC manager and chaired by a senior NHS clinician or executive. The team includes:

Professional and clinical staff | Experts by experience | Patients | Carers

The approach

The new inspection consists of three phases:

Preparing for an inspection | Inspecting the services | Reporting of findings

Further information on the new approach and when it will be implemented in your area of practice can be accessed via this link http://www.cqc.org.uk/content/our-new-inspection-model

Helping you meet CQC registration requirements

Achieving Care Quality Commission registration is essential for healthcare service providers within the NHS and the private sector. Infection Prevention Control (IPC) has the resources that you need to ensure that you achieve CQC registration requirements to exemplary standards.

The information provided on this website is evidence-based and created by a multi-disciplinary NHS team to guarantee that appropriate standards are achieved.

CQC registration requirements for GP Practices

Working with a team of NHS professionals, we have produced the 'IPC CQC Inspection Preparation Pack for General Practice' and the 'Preventing Infection Workbook and Guidance' specifically for General Practice to help with compliance with the Health and Social Care Act 2008 and CQC registration requirements, together with many other resources available - so, take a look on the Resources page.

CQC registration requirements for Health and Social Care organisations

Working with a team of NHS professionals, we have produced the 'IPC CQC Inspection Preparation Pack for Care Homes' and the 'Preventing Infection Workbook and Guidance' specifically for health and social care to help with compliance with the Health and Social Care Act 2008 and CQC registration requirements, together with many other resources available - so, take a look on the Resources page.

CQC Compliance for Other Healthcare Professionals

Take a look at the Resources page, where there are a number of infection prevention and control resources available. We will also be developing further resources to help organisations achieve compliance with the Health and Social Care Act 2008 and the Care Quality Commission in relation to infection prevention and control training.

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CQC Registration Requirements | Infection Prevention Control

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CQC inspections in relation to infection prevention and control are essential to ensure providers are complying with the requirements of the Health and Social Care Act 2008: Code of Practice.

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Infection prevention and control - King's College Hospital NHS Foundation Trust

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All staff at the hospital have regular training on infection prevention and control. We carry out weekly audits to check that they comply with our strict hand hygiene policies, and there are signs at the entrances to wards and other clinical areas to remind everyone - patients and visitors as well as staff - to clean their hands.

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Providing PPE such as gloves, aprons, uniform, masks.

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Standard principles: hospital environmental hygiene and hand hygiene

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This article describes standard principles for infection prevention and control focusing on hospital environmental hygiene and hand hygiene, both of which are crucial to the prevention of healthcare associated infection (HCAI). The guidelines do not address the additional infection control requirements of specialist settings, such as the operating department or for outbreak situations.