Natasha Salt, Director, Infection Prevention and Control at Sunnybrook, notes that there is a proper way to clean your hands effectively.

Follow these steps when washing your hands with soap and water:

1. Wet your hands with clean, running water. Water temperature should ideally be warm as you’re more likely to spend long enough scrubbing if the water isn’t too cold or too hot.
2. Lather your hands by rubbing them together with the soap. This means friction on the backs of your hands, between your fingers, on your thumbs and under your nails.
3. Scrub for at least 15 seconds – that means 15 full seconds of rubbing soap on your hands (the time spent turning the taps on and off, and drying your hands, doesn’t count). One trick to make sure you’ve washed your hands for long enough is to sing ‘Twinkle, Twinkle, Little Star’ in your head (by the end of the lullaby your hands should be properly cleaned).
4. Rinse your hands well under clean, running water.
5. Dry your hands using a clean paper towel or towel. Using a hand dryer that blows hot air is a no-no as the action of blowing from the hand dryers stirs up bacteria from the floor, and other parts of the room.
6. Use the paper towel to turn off the taps.

What if you don’t have access to running water and soap? Alcohol-based hand sanitizer kills germs and some have moisturizers in them, which can keep the skin on your hands in better condition. A word of caution though: not all 70 per cent isopropyl alcohol formulations are the same. Some are not formulated with the intention of cleaning hands, evaporating too quickly, with the result that germs remain on your hands. It’s important for the sanitizer to be formulated for hand sanitizing so it has the ability to stick to your hands and you have enough time to create 15 seconds of friction to kill germs.

In the case that you don’t have access to soap and water or alcohol-based hand sanitizers: don’t touch your face. Germs enter your body through your eyes, nose and mouth.

“There’s a reason we talk about hand hygiene all the time,” says Natasha. “Please be diligent and clean your hands frequently.”

Additional tips to help you protect yourself and others against COVID-19 and other illnesses:

• Stay home. Don’t go out unless you have to, such as to get groceries once a week.
• If you must leave home, keep two metres (six feet) away from others. This is so that respiratory droplets can’t pass between you. Learn more about physical distancing and why it’s so important.
• If you are ill, even with mild symptoms, you need to stay home. Use a grocery delivery service or ask a friend to purchase groceries for you and drop them off outside your door.
• Practice proper cough and sneeze etiquette by coughing/sneezing into a tissue, or into your sleeve or arm (and immediately washing your hands afterwards).
• Remember: don’t touch your face, especially your eyes, mouth and nose.
• Clean frequently touched objects and surfaces, like bathroom sinks, kitchen counters, etc.

For more information on Sunnybrook and COVID-19, visit sunnybrook.ca/coronavirus

The post How to clean your hands effectively appeared first on Your Health Matters.

“Patients in the hospital are vulnerable and are at higher risk of developing more severe illness from the flu, or even a simple cold. If you have a contagious illness, it’s important you don’t visit people in the hospital until you’ve fully recovered,” says Dr. Jerome Leis, Medical Director of Infection Prevention and Control at Sunnybrook.

Here are three reasons you shouldn’t visit patients in the hospital when you’re sick:

1. You can pass your illness on to others

There are posters around the hospital and a recording on the main phone line, asking visitors not to come to Sunnybrook if they’re sick.

Before you visit someone in the hospital, be honest with yourself about your own health: it’s easy to dismiss a minor cough or runny nose as an allergy, aspiration or unrelated non-infectious issue.

However, these can be signs of a contagious infection, which can spread quickly to other patients and staff. The resulting outbreak can have a huge impact not just on other patients, but also on the hospital’s ability to function efficiently.

2. It creates a domino effect

When patients get an infectious illness while in the hospital, it creates a domino effect.

Their hospital stay becomes longer and they need more care, leading to delays in care for other patients. For example, surgeries can be delayed or even cancelled, and patients can wait longer in the Emergency Department for a bed.

“This is one of the reasons we often see a spike in our occupancy rates in the winter months. Patients are getting illnesses like the flu, even when that isn’t the reason they were originally admitted to our hospital, causing them to stay longer,” says Dr. Leis.

3. Patients need more time and help to recover

When a patient catches the flu while in the hospital, it can cause additional complications and delays in their recovery.

“Sometimes, it can mean the difference between a patient being able to go home or needing rehabilitation and additional support, because the flu they caught in hospital caused them to become even weaker,” says Dr. Leis.

The post Don’t visit patients in the hospital when you’re sick appeared first on Your Health Matters.

Over the past century, access to effective antibiotics has saved millions of lives, and enabled major medical and surgical breakthroughs. The misuse and overuse of antibiotics, however, has contributed to a phenomenon known as antibiotic resistance.

“Antibiotic resistance is rising to dangerously high levels in all parts of the world, including Canada. It threatens our ability to treat common infectious diseases, resulting in prolonged illness, disability and death,” says Christine Peragine, Pharmacist and Clinical Research Fellow in Antimicrobial Stewardship and Infectious Diseases at Sunnybrook.

Antibiotic resistance is increasing the overall cost of health care, by contributing to lengthier hospital stays for patients and more intensive care unit admissions.

It’s also impacting many of the medical advancements we take for granted, like organ transplants, chemotherapy for cancer treatment, diabetes management and major surgeries. To be successful, these conditions and procedures require effective antibiotics, because they have a high risk of infection. If current trends continue, it will become more difficult to achieve good outcomes for patients.

Here’s what you need to know about antibiotic resistance:

What is antibiotic resistance?

Resistance develops when potentially harmful bacteria change in a way that makes them immune to antibiotics. Resistant bacteria survive, multiply and spread, causing more harm.

How does antibiotic resistance happen?

Drug resistance is a natural evolutionary phenomenon. When people take antibiotics for a bacterial infection, the antibiotic kills off the “weaker” organisms. However, there may be some organisms that are resistant to the antibiotic, so they aren’t killed off. This allows them to multiply and spread, meaning that the next generation of the bacterial infection will no longer respond to (or be killed off by) that antibiotic.

Why is antibiotic resistance a problem?

Antibiotic resistance is a problem because standard treatments become ineffective. An antibiotic that used to work on certain infections no longer does. People are unable to recover from infections, and may then spread those infections to others.

In Canada, the prevalence of resistant- and multi-drug resistant bacteria (also known as ‘superbugs’) is increasing. We are one step away from creating a superbug resistant to all commercially available antibiotics that would be capable of defeating every antibiotic in the medicine cabinet.

What can you do to reduce antibiotic resistance?

If you’ve been prescribed antibiotics, there are a few easy steps you can take to prevent antibiotic resistance:

1. Only take antibiotics in the way they have been prescribed to you

2. Don’t ask for antibiotics to treat viral infections like colds and the flu. Antibiotics have no effect on viruses, and won’t speed up your recovery from viral infections

3. Clean your hands often! It is possible to pass on antibiotic resistant bacteria to others, so prevent the spread of germs by practicing good hygiene

The post Antibiotic resistance: why you should care appeared first on Your Health Matters.

An e-monitored hand hygiene pump on D2, the first unit to install them at Sunnybrook.

Cleaning your hands is recognized as one of the best ways to keep patients safe and prevent the spread of infections. But what’s the best way to actually measure hand hygiene rates?

For years, hospitals have sent auditors from unit to unit to monitor how often staff members are cleaning their hands. Now, a new study is trying to show that using technology to measure hand hygiene rates can provide more accurate results.

“In-person audits can actually overestimate hand hygiene rates by three to five times. Electronic monitoring, on the other hand, provides more accurate, real-time measurement of hand hygiene in a specific clinical area, which helps staff improve their rates more quickly,” says Dr. Jerome Leis, medical director, Infection Prevention and Control at Sunnybrook Health Sciences Centre.

Sunnybrook is leading a five-hospital improvement study that aims to detect a reduction in healthcare-associated infections by improving hand hygiene compliance (a measure of how often staff use alcohol-based hand sanitizer to clean their hands when moving between rooms or delivering patient care).

To do this, electronically monitored, or e-monitored, hand hygiene pumps have been installed on 18 inpatient units in Greater Toronto Area hospitals. That number will soon expand to 25, and depending on what the results show, e-monitored pumps could become the new standard of practice in Ontario.

How e-monitoring works

E-monitored hand hygiene pumps are equipped with a sensor that counts hand hygiene events. That number is compared to a pre-determined number of hand hygiene opportunities, giving each unit a compliance rate measured by percent.

“To come up with that number, we collaborated with the manufacturer of the pumps and sent them information about each unit’s level of acuity, model of care, patient census and type of patients,” says Dr. Leis. The presence of visitors on the unit was also taken into account when determining the number of hand hygiene opportunities.

One of the biggest surprises was realizing just how many hand hygiene opportunities actually exist. “In a two month period alone, one of our units had 170,000 hand hygiene opportunities,” says Dr. Leis. He adds that the system is accurate and has been validated in different care settings worldwide.

The limitations of observational audits

Hand hygiene compliance rates have plateaued at around the 85-90% range across most hospitals in Ontario. While those numbers seem high, multiple covert studies have shown that actual compliance is less than 50%.

The reason for such a large discrepancy? “People change their behaviour when they know they’re being watched, which is something known as the Hawthorne Effect,” says Dr. Leis.

Under the current observational, in-person auditing system, units only receive feedback on their hand hygiene rates every three months. E-monitored systems allow participating units to get weekly feedback on their performance. Units will also be able to track their improvement using technology that provides accurate measurement of hand hygiene compliance.

According to Dr. Leis, while many healthcare providers think they have good hand hygiene compliance, you actually need to clean your hands between eight and 20 times per hour (assuming a four-patient assignment) to have perfect hand hygiene compliance. Over a single eight-hour shift, this is an average of 120 hand hygiene events.

“Many staff members tell me they are cleaning their hands, and I believe them. But the question is whether they are cleaning enough – if you’re not cleaning your hands more than 1-2 times per hour while caring for multiple patients, your compliance is likely suboptimal,” says Dr. Leis.

A higher number of hand hygiene opportunities, combined with a more accurate measurement system, means hand hygiene compliance rates recorded by e-monitored pumps will be much lower than the numbers we’re used to seeing, at least initially.

Preliminary results

The first e-monitored hand hygiene pumps were installed on an inpatient unit at Sunnybrook in July 2017. The improvement in hand hygiene rates was immediate.

“On that unit, we started with a baseline hand hygiene rate of 35%. By August, the compliance rate had already gone up to 58%, surpassing our original 3-month goal of 55%, so were very pleased to see that happen so quickly,” says Dr. Leis.

E-monitoring recently rolled out to two more units at Sunnybrook, and will be implemented in two more in January 2018. Dr. Leis is hopeful it will become the norm in the near future.

“Our study involves multiple hospitals and a large number of patients, which we expect will allow us to determine the benefit of this technology in preventing hospital-acquired infections. This data will help us determine whether to install these pumps in as many units as possible.”

The post How technology is changing the way we clean our hands appeared first on Your Health Matters.

October 17-21 is National Infection Prevention and Control Week. To mark the occasion, we decided to learn more about what exactly infection prevention and control is, and how important it is in a hospital environment. We asked Natasha Salt, Interim Director, Infection Prevention and Control at Sunnybrook, to answer a few questions below:

What does an infection control professional do, and who are they?

We are dedicated to preventing and controlling the transmission of healthcare associated infections to patients, clients, residents, healthcare workers, visitors and others.

Our team is made up of diverse individuals with backgrounds ranging from nursing, epidemiology, public health, health sciences, physicians and microbiology laboratory technologists who are Certified Infection Control practitioners. We are part of your healthcare team and work diligently to prevent health-care associated infections.

What does infection prevention and control look like at Sunnybrook?

At Sunnybrook, Infection Prevention and Control is responsible for administering programming for our Hospital, Long-Term Care and Rehabilitation facilities. We promote best practices in infection control to ensure the safety of our patients/clients/residents, visitors and staff.

Preventing healthcare associated infections is a high priority, and we work alongside healthcare teams to ensure all measures are taken to reduce infections and prevent transmission. Our staff members are actively involved in providing information to healthcare workers, patients and visitors on how to reduce the risk of infections through education, audits, surveillance, posters, pamphlets and other tools.

Why is infection prevention and control so important in a hospital environment?

Healthcare-acquired infections are one of the most common complications of health care. They are a significant patient safety issue, and can also be an Occupational Health and Safety issue. A well-functioning Infection Prevention and Control program helps minimize these risks for our patients, residents, visitors and our staff.

What do you enjoy most about your job?

Infection prevention and control has multiple roles within an organization and is embedded in all areas. A sample of the work we do includes: providing education to patients and staff members, investigations of infections or outbreaks, prevention of infections through activities such as monitoring hand hygiene or auditing practices, construction planning for new buildings or renovation of existing spaces and research. The diversity of the role keeps the job very interesting and gives us a wide-ranging skill set.

What is a common misconception that people have about infection prevention and control?

People believe that gloves alone can prevent the transmission of infection, but they are not an appropriate substitute for proper hand hygiene using alcohol-based hand antiseptics or soap and water. Gloves provide a barrier during contact with a patient but they cannot, by themselves, prevent the transmission of organisms that can cause an infection. Proper hand washing/antisepsis is the only way to prevent the transmission of organisms, and this needs to be done before and after using gloves.

The post Just how important is infection prevention and control? appeared first on Your Health Matters.

With cold and flu season here, I spoke to Dr. Mary Vearncombe, former Medical Director of Infection Prevention and Control at Sunnybrook, about how to best minimize the spread of germs and stay healthy.

First though, the difference between a cold and the flu: a cold is a viral infection that brings along a stuffy nose, sore throat, cough and general crummy feeling. In healthy people, it doesn’t usually lead to serious health complications.

The flu is an acute respiratory infection that brings along a fever, cough, chills, aches and pains, and can lead to serious complications like pneumonia. For the elderly, pregnant women, chronically ill or young children, influenza can be deadly. It kills around 3,500 people per year in Canada.

Both colds and flus can feel pretty yucky if you catch one. So here are Dr. Vearncombe’s tips for avoiding both this year:

Clean your hands.

Wash with soap and water or use alcohol-based hand sanitizer. Both are effective at removing (washing) or killing (hand sanitizer) bacteria and viruses, including respiratory viruses.

Hand sanitizer should contain alcohol at a minimum concentration of 60 per cent to be effective. Many people find alcohol-based hand sanitizer to be a convenient way to clean hands, especially in public places where hand washing sinks with soap and water are not always available. Keep an alcohol-based hand sanitizer in your purse, pocket or backpack.

Get the flu shot.

We are all susceptible to influenza virus, even those of us who consider ourselves healthy.

“If we get influenza, it may be relatively mild for us and we think we have ‘just a bit of a cold’,” Dr. Vearncombe said. “But, we are still infectious to others who may be more susceptible to serious influenza virus infections.”

And we all have these vulnerable people in our lives: elderly parents or grandparents; pregnant relatives or friends; infants and young children; friends and relatives with chronic diseases such as heart or lung disease, diabetes or cancer. By getting the flu vaccine as healthy people, we protect ourselves and therefore help to protect our vulnerable friends and loved ones. (And remember, you can’t get the flu from the flu shot. You may get arm tenderness or mild aches afterwards.)

Get your kids the flu shot or nasal vaccine.

Kids should also get the flu shot or nasal vaccine. A recent US study questioned the effectiveness of the nasal version, but data from studies in Canada, Finland and the United Kingdom suggest it’s effective for use in children. View Health Canada information on the nasal flu vaccine here.

Stay home if you are sick.

Many of us have a strong work ethic and want to drag ourselves in to work even when we are feeling ill. Stay home if you have the flu or a bad cold with a fever.

“Respect your colleagues at work: nobody wants your viruses,” Dr. Vearncombe said. “If you go to work, you will compound the problem by making others in your office ill.”

And this doesn’t just mean staying home from work. Protect your vulnerable family, friends and neighbours. If you promised to go visit your elderly grandmother, call and reschedule; your trivial infection may result in life-threatening pneumonia for her. If you’ve got an acute respiratory infection, now is not the time to take the bus to the movie theatre.

Practice healthy habits.

“Keep your immune system healthy: eat properly, exercise, get enough sleep,” Dr. Vearncombe says. “If possible, keep your distance from people with obvious symptoms of respiratory infection, e.g., coughing, sneezing.”

If you are coughing/sneezing, cover your nose and mouth with a tissue (or “sneeze in the sleeve”), discard the tissue in the garbage immediately after use and clean your hands.

“Most of this is what your mom always told you to do,” Dr. Vearncombe says. “And, as always, mom was right!”

Talk to your doctor or pharmacist about the flu vaccine.

A version of this post appears in the Town Crier newspaper in Toronto, Ontario.
This post has been updated to reflect 2017/2018 flu information

The post Launch your best defence this cold/flu season appeared first on Your Health Matters.

Today is “Save Lives, Clean Your Hands” Day, and what better way to recognize it than with some hand washing myth busting? We talked to Dr. Mary Vearncombe, Medical Director, Infection Prevention and Control at Sunnybrook, who set the record straight on five hand washing myths:

1. What’s the best water temperature for washing my hands- cold, warm or hot?

You’re right if you guessed… warm! Surprised? “Using very hot or very cold water makes it less likely that you’ll wash your hands for long enough,” says Dr. Vearncombe. Plus, warm water is nicer to the sensitive skin on our hands. Remember, the action of rubbing soap on your hands is what lifts dirt and bacteria off your hands, which is then rinsed away by the water. You’re not going to ‘kill’ any bacteria by using scalding hot water to wash your hands!

2. How long do I need to wash my hands in order for them to be properly washed?

The minimum amount of time is 15 seconds. And that means 15 full seconds of rubbing soap in your hands (the time spent turning the taps on and off, and drying your hands, doesn’t count). One trick to make sure you’ve washed your hands for long enough? “It also takes 15 seconds to sing ‘Twinkle, Twinkle, Little Star’ in your head, so if you sing that to yourself while washing your hands, they should be properly cleaned by the end,” says Dr. Vearncombe.

3. What’s the best way to dry my hands?

Using a hand dryer that blows hot air is a no-no. “The action of blowing from the hand dryers stirs up all kinds of bacteria from the floor, and other parts of the room,” says Dr. Vearncombe. Instead, paper towels or towels are the best methods for drying your hands. Use them to blot your hands dry, rather than rubbing them, so you aren’t being as hard on your hands.

4. Are hand sanitizers more effective than soap and water?

Yes, alcohol-based hand sanitizer is as good as, if not better than, soap and water (as long as your hands aren’t visibly soiled). There are a number of reasons that hand sanitizer is the better choice, according to Dr. Vearncombe:

1. The alcohol in hand sanitizer kills bacteria, while soap and water only removes it
2. Hand sanitizers have moisturizers in them, which keeps the skin on your hands in better condition (especially if you work in health care and have to wash your hands often)
3. It’s faster. You still need to rub the sanitizer into your hands for 15 seconds, but that’s all you need to do- no adjusting the water temperature, drying your hands, etc.
4. Hand sanitizer can be where you need it, when you need it. It’s not always possible to have running water and soap nearby, but it is possible to have hand sanitizer within arm’s reach.

5. Do alcohol hand sanitizers cause bacterial mutation and resistance?

No, they do not. “This has been researched multiple times, but no evidence of bacterial mutation or resistance from alcohol hand sanitizer has ever been demonstrated,” says Dr. Vearncombe.

The post Are your hands clean? Five facts that might surprise you appeared first on Your Health Matters.

The Ontario Ministry of Health developed the Just Clean Your Hands (JCYH) program for Ontario healthcare facilities that defines when you should clean your hands. They narrowed it down to the most critical 4 moments of hand hygiene to prevent transmission. If you are about to enter a moment of hand hygiene, stop and clean your hands!

Know and Perform the 4 Moments of Hand Hygiene:

1. Before contact with a patient /patient environment

2. Before conducting a clean procedure (even if gloves will be worn)

3. After potential exposure to bodily fluids (even if gloves were worn)

4. After contact with the patient /patient environment

Figure 1. Just Clean Your Hands – 4 Moments of Hand Hygiene

When on the Unit, Take Note and Locate Alcohol-based Hand Rub Stations.

Having Alcohol-based Hand Rub readily available is just as important as remembering and performing the 4 Moments for Hand Hygiene. Alcohol-based Hand Rub is the preferred method for Hand Hygiene over traditional soap and water at point-of-care.

The next time you’re on a Unit, take a look around and see if you can spot where all the alcohol-based hand rub bottles are located. If there isn’t one near the entrance or at the bedside speak up and bring it to the attention of a staff member or the manager.

Public Health Ontario has loads of great resources available online just visit: http://www.oahpp.ca/services/jcyh/index.html and click the links for your needs.

We Want Your Input!

Healthcare provider compliance with hand hygiene has traditionally been challenging because of the changing environment and conditions in which healthcare providers work.

Within healthcare provider groups, the physician group has made great strides, but there is room for more improvement, especially among residents and fellows.

If YOU have an idea on how to raise awareness for Hand Hygiene in your area WE want to hear about it! We want to make it safer for patients one hand at a time.

Contact Ben de Mendonca in the Quality and Patient Safety Department by e-mail at ben.demendonca@sunnybrook.ca if you have specific ideas or want to learn more.

The post Hand Hygiene…Did you know??? appeared first on Your Health Matters.