Transcript Rosie Lyles

Rosie D. Lyles, MD, MHA, MSc
Head of Clinical Affairs, Clorox Professional Products Company
Clinical Focus
• 10+ years studying the epidemiology and prevention of multidrugresistant organisms and infections like Clostridium difficile (C. diff),
Methicillin-resistant Staphylococcus aureus (MRSA) and
Carbapenem-resistant Enterobacteriaceae (CRE).
Organizational Engagement
• Active member of:
o Association of Professionals in Infection Control and
Epidemiology (APIC)
o Infectious Disease Society of America (IDSA)
o Society for Healthcare Epidemiology of America (SHEA)
• Peer reviewer for the National Institutes of Health, New England
Journal of Medicine and American Journal of Infection Control
Education
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Doctor of Medicine, St. Matthew’s University School of Medicine
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Master of Health Service Administration, St. Joseph College
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Master of Science in Clinical Research and Translational Sciences,
University of Illinois, Chicago
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Combating Public Enemy #1:
Infectious Pathogens
Wednesday, October 21, 2015
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Agenda
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The impact of cleaning and disinfecting in public settings
Understanding the dual challenge: cleaning for aesthetics and cleaning
for health
Infection prevention in public settings
Breaking the chain of transmission
Improving infection prevention and protocol compliance
Conclusion
Q&A Session
Learning Objectives:
• Learn key terminology associated with environmental cleaning, disinfection and best practices.
• Learn how cross-contamination occurs and understand its implications for public health.
• Improved understanding of environmental cleaning and disinfection strategies for preventing the
spread of infections on hard and soft surfaces.
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Why Do We Clean?
Cleaning public spaces serves several
important purposes: to keep public spaces
inviting, appealing and usable, prevent the
spread of germs, and encourage patronage.
The Bottom Line
It also pays to clean. When it comes to the
business of public spaces, cleanliness can
have a real impact on revenue.
Health-related “lost productive time” costs
employers $225.8 billion per year, or $1,685
per employee per year.
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The Dual Challenge: Cleaning for Aesthetics & Cleaning for Health
• Consumer perceptions of facility cleanliness can have a serious impact on a
business’ bottom line, but it’s always important to remember that cleanliness
serves a critical public health function: preventing the spread of bacteria, viruses
and fungi that cause infection.
• In an ideal world, these two jobs – cleaning for appearance and health – would
always be top of mind and consistently accomplished through cleaning and
disinfection protocols. But how close to the ideal are we really?
Cleaning for
Health
Cleaning for
Appearance
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What Does Clean Mean?
• A recent survey of cleaning industry professionals found that only 49% of
respondents believe their staff is aware of the risks associated with the spread
of germs in the restroom.
• 68% said their staff does not understand or only somewhat understands the
differences between cleaning, sanitizing and disinfecting.
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What Does Clean Mean?
Disinfecting
Sanitizing
Cleaning
• Disinfecting kills germs on surfaces or objects using chemicals. The
process does not necessarily clean dirty surfaces or remove germs, but
killing germs on a surface after cleaning can further lower the risk of
spreading infections.
• Sanitizing lowers the number of germs on surfaces or objects to a safe
level, as judged by public health standards or requirements, to lower the
risk of spreading infection.
• Cleaning removes germs, dirt, and impurities from surfaces or objects.
Cleaning works by using soap (or detergent) and water to physically
remove germs from surfaces, but does not necessarily kill them.
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What is Infection Prevention & Control
Infection prevention and control strategies address factors related to the spread of
infections within a given setting and are aimed at breaking the chain of transmission.
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Infectious Agents
It is important for professional cleaning staff to be familiar with the some of the
most common and highly transmissible and infectious germs found in public spaces
so they can implement infection prevention and control protocols designed to
protect against them.
Methicillin-resistant Staphylococcus
aureus (MRSA)
Influenza
Norovirus
Rhinovirus
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Reservoirs
From a facility maintenance perspective, the most important reservoirs of
infectious agents is the physical environment.
BSCs / Offices:
Athletic
Facilities:
Hospitality:
Restrooms
Foodservice:
Schools &
Universities:
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Transmission
There are two general classifications for modes of transmission, direct and
indirect.
Direct
Direct & Indirect Contact
(e.g., MRSA, Norovirus)
Droplet
(e.g., Influenza, Rotavirus,
Bacterial Meningitis)
Indirect
Airborne
Vectorborne
Vehicle
(e.g., TB, Measles
Chickenpox)
(e.g., West Nile,
Malaria)
(e.g., Salmonella,
Listeria, Hepatitis A)
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Transmission: Cross Contamination
Cross-contamination occurs when
bacteria and viruses are transferred
from one surface to another.
This is especially true of public restrooms (e.g., when a woman’s purse is
placed on a restroom floor and then placed on a sink counter, the germs
and bacteria on the floor can be transferred to the purse and then to the
sink.)
One study found that 20% of handbags contained more germs than the
average toilet flush and could potentially cross-contaminate other
surfaces.
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Susceptible Host
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Anyone can be the next sick person, but some settings and building occupants may
be at increased risk for infection.
Characteristics that influence susceptibility can include:
– Age
– Immunization status
– Underlying illness
– Lifestyle
Remember, host susceptibility can have different implications for different types of
settings. settings.
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Breaking the Chain of Transmission
While each facility needs to determine the best infection prevention protocol
for their needs, there are some basic steps every facility should follow to help
prevent the spread of germs that could impact public health.
1. Identifying your enemy
2. Reduce the reservoir
3. Target transmission
4. Reduce host susceptibility
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Breaking the Chain: Identifying Your Enemy
Thorough cleaning and disinfection is the first line of
defense against familiar threats and new challenges.
You can’t always predict what type of germs will walk
through the door so cleaning professionals need proven
products that have extensive kill claims and broad surface
compatibility.
TIPS:
• Select products specifically formulated and (EPA)-registered to kill some of the
most contagious and hard-to-kill pathogens. Bleach and hydrogen peroxidebased products are especially effective.
• Disinfectants with short kill times and a wide range of kill claims provide the
best value, since they do a lot with less, in a short amount of time.
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Breaking the Chain: Reducing the Reservoir
Hard Surface Disinfection
• Take notice of aesthetic issues – in many facilities, visible stains,
soiled surfaces and odors can also signal the presence of
harmful microorganisms which are commonly found in
restrooms and are associated with outbreaks of illness.
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Pre-clean surfaces first to remove debris and bodily soils such as
urine, feces and vomit and then use an EPA-registered
disinfecting product to kill germs.
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Pay particular attention to disinfecting frequently touched
surfaces such as faucet handles, countertops and doorknobs
which need to be disinfected at least once a day.
TIP: Ready-to-use disinfecting wipes can offer an easy solution for disinfecting high
touch surfaces because they are pre-moistened to deliver the proper concentration
of active ingredients every time they are used.
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Breaking the Chain: Reducing the Reservoir
Soft Surface Sanitization
Research has shown not only the presence of pathogens on soft surfaces, but also that organisms can
persist on porous surfaces from several hours to as long as three months. Improve soft surface
sanitization with three simple steps:
1. Routinely launder washable curtains, bedding,
linens, employee uniforms and other soft surfaces
in your facility.
2. Use an EPA-registered product to kill
bacteria on soft surfaces between
laundering and on soft surfaces that cannot
be laundered.
3. Encourage good hand hygiene practices by
staff during and between routine cleanings.
TIP: Spray products that are EPA-registered to kill bacteria on soft surfaces and can be easily
incorporated into a regular cleaning routine
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Breaking the Chain: Target transmission
Cross Contamination Prevention
Cleaning tools and
equipment can become
contaminated during
the cleaning process,
so it is important not to
clean multiple areas
with the same supplies.
Dirty cloths, sponges
and mops can spread
viruses and bacteria to
anything else they
come in contact with.
Staff should regularly
clean and disinfect or
replace equipment
Cleaning professionals
can help prevent crosscontamination in
restrooms by focusing on
germ-prone surfaces and
objects such as counter
tops, urinals, toilets, door
knobs, toilet handles,
stall locks, etc.
TIP: Ready-to-use wipes can help decrease cross-contamination risks since they are
designed to be thrown out after each use. Janitorial carts and closets should also be kept
clean to prevent dirt and germs from traveling throughout a building on equipment.
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Breaking the Chain: Reduce Host Susceptibility
Building occupants also have a role to play in preventing cross-contamination
and infections. Encourage everyone to wash their hands regularly with soap
and warm water, especially after sneezing or coughing, touching used tissues
or using the bathroom, and to stay home when they are sick to avoid
spreading germs throughout the environment and to others.
Remember, infection prevention is everyone’s responsibility.
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Conclusion
Make sure staff understand the terminology associated with environmental cleaning,
disinfection and best practices.
Know your enemy and implement protocols to guard against MRSA, norovirus,
influenza and other important pathogens.
Explain how cross-contamination occurs, why it has important implications for
public health and how to prevent it in your facility.
Environmental cleaning and disinfection strategies are only effective if they are
implemented correctly and consistently. Invest in ongoing training and education to
ensure staff understand the important role they play in preventing the spread of germs
on hard and soft surfaces.
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Q&A Session
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References
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Clorox Professional Products Company and Opinion Research Corporation. (March 2013). Restroom Pet Peeves Omnibus Survey. (Survey of 1,005 U.S. adults).
Stewart, W. R. Lost productive work time costs from health conditions in the United States: results from the American Productivity Audit. Journal of Occupational Environmental Medicine. 45.12 (2003).
Clorox Professional Products Company and ClearVoice Research. (February 2012). Online Survey of Professional Cleaning Service Industry Decision Makers. (Survey of 933 cleaning industry decision
makers across various industries).
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