Launching Today: The New Universal Medical Online Store

It’s Launch Day

Are you ready for liftoff?

Today is the big day. We’ve been working hard to bring you a mobile-friendly site that is faster, easier to navigate and more user-friendly. And that day is finally here.

How do I prepare for launch?

To begin using our newly designed site, you’ll need to reset your current account password. The example below shows you what the password reset page will look like. Once you have navigated to the “Forgot Your Password” page, you can enter your email address in the “Email Address” box and press submit.

Watch Our Screencast

We’ve recorded a screencast to help walk you through the password reset process. Click on the image below to watch the screencast.

 

Password-Reset-Screen

 

Resetting Your Password Is Easy

To reset your password, simply click on the orange “Reset My Password” button below and enter your existing account email address in the box of the example “Forgot Your Password” page shown above.

 

Have you visited our new site yet?

Over the past several months, we’ve been working hard to bring you a mobile-friendly site that is faster, easier to navigate and more user-friendly. We can all agree that technology moves fast. And to keep up, we’ve redesigned the site from the ground up with a clean and modern design that provides you with an optimal viewing experience across a wide range of devices. We want you to enjoy your shopping experience across all your devices (from desktop monitors to mobile phones and tablets).

Why not take a look?

We couldn’t be more excited about our newly redesigned site and how it will make shopping faster, easier, and more enjoyable for our customers. Visit www.universalmedicalinc.com or simply click on the screenshot below to see our new eCommerce site for yourself.

 

New-Site-Screen

 

Do You Have Any Questions?

We’re here to help. You can call, email or live chat with us during our normal business hours (M-F 9AM to 5PM EST) with any questions, issues or comments.

The Importance Of Radiopaque Markers In Digital X-Ray

Radiopaque Anatomical Markers

Radiographers are taught from day one in school to place radiopaque anatomical markers within the primary beam of radiographs.  We do so as a method of “best practice” to properly distinguish the patient’s right from left on the radiographic image per legal requirements. Conditions like dextrocardia (when the heart is positioned on the right instead of the left) and situs inversus (when all of the internal organs are on the opposite side compared to normal anatomy) exist which can easily be misinterpreted and would normally cause a technologist to inappropriately orient the image to appear similar to normal anatomy.  But when radiographs misrepresent right from left, this presents a huge risk for medical errors.

Computed Radiography & Digital Radiography

When Computed Radiography and Digital Radiography entered the scene, radiologic technologists were provided with a method of digitally annotating right and left.  This further led some to question the necessity of placing radiopaque anatomical markers within the primary beam of each radiograph.  If you’re like me, you’ve more than likely witnessed a decline in the use of markers in your radiology department but make no mistake; they are more necessary now than ever with the introduction of digital radiography.

A Cautionary Tale

Several years ago when I was working with a new Computed Radiography system in a hospital, I was on portable-duty which consisted of 50-60 portable chest and abdomen exams per day on average.  Another technologist, who was assigned the “float” shift, was asked to rotate where needed within the department.  I asked this technologist for help with a STAT portable chest x-ray in ICU around mid-morning, and by mid-afternoon I found myself in the Chief Radiologist’s office with the Radiology Director and Manager.  The door was closed, faces were red, and it was uncomfortably quiet.

After what seemed like an eternity, the Chief Radiologist displayed a portable chest radiograph on his monitor and asked “do you recognize this exam?”  I looked for several seconds and said, “No, I actually don’t.”  They looked at one another confused, and then asked me to critique the image.  I started to go through my image critique steps learned in school one by one, noting the presence of what I thought might be a pneumothorax, and they stopped me when I said there was no marker present.  The radiologist then asked me, “How would you know if this exam was oriented properly on the screen?”  I rattled off some details that would give anyone clues, but when I discussed the location of the heart, he stopped me again.  He horizontally flipped the image and stated “is this hung correctly?”  Ultimately, I concluded that there was no way to know whether the exam was hung appropriately due to lack of a radiopaque anatomical marker or a blocker (which we could use in film/screen imaging to determine if we knew the projection – PA vs. AP).

They all looked at one another again and the radiologist asked me “Did you perform this radiograph?”  I did not remember viewing an image similar to that one during my exams performed that day, so I let them know I didn’t remember performing it.  They asked me if anyone was helping me throughout the day, and my heart sunk, knowing I had to name the only person I had asked for help that day.  They invited me to exit the room and resume my shift.  My manager encouraged me to continue using my markers, and he informed me he would follow up with me before I left for the day.  The door closed behind me.

Later that afternoon, I was called back into the same room that displayed the same chest radiograph.  The radiologist was a bit less intimidating, but not much.  He explained to me that the radiograph indeed displayed a pneumothorax… a “tension pneumothorax.”  He asked if I knew what that was, and at the time I did not.  A tension pneumothorax occurs when one lung is punctured and air enters the pleural cavity around the punctured lung.  The “tension” portion occurs because air entering is not allowed to escape the pleural cavity, and the mediastinal structures as a result are shifted to the opposite side (in this case, from the patient’s left to their right).

After their investigation, it was concluded that the technologist exposed the image without placing a radiopaque marker within the primary beam.  When the image displayed at the computer terminal during processing, it was most likely appropriately displayed.  Due to the appearance of the mediastinal organs on the patient’s right side, the technologist viewed prior radiographs to ensure the patient had normal anatomy (which he confirmed).  He then mistakenly flipped the image horizontally so that the heart appeared on what he thought was the patient’s left side, digitally annotated a “left” marker, then sent the image to the radiologist for dictation.

The radiologist, upon viewing this STAT exam, called the physician who was in ICU and informed them that the patient had a pneumothorax on the right side, although it was actually a tension pneumothorax on the patient’s left.  Because the technologist had inappropriately flipped the image, the ordering physician inserted a chest tube on the wrong side, into the unaffected lung, causing further complication which lead to a Code Blue being called and a much longer recovery process for the patient who was already undergoing treatment for several other problems.

I found out I was originally called into the Chief Radiologist’s office immediately following a 30-minute scolding by that patient’s physician who inserted the chest tube on the wrong side because of an error made in the radiology department.  The patient eventually recovered, but imagine what could have happened as a result of the technologist’s error.  I was glad to be off the hook, but I never found out if the technologist was disciplined or if charges were ever pressed against the hospital.

Lessons Learned

Having experienced something like this, it is easy to see the importance of radiopaque markers on a radiograph.  It is discouraging to know that many departments see a decline in their usage simply because we can place one there after the image is processed; because it’s easy.  It may be true that it is more difficult to remember to place a marker or to remember to simply bring your markers to work with you, however, It is my opinion that allowing this to happen not only encourages error, but causes liability for the technologist, radiologist, and institution that is providing radiographic services.  It should be a goal to have radiopaque anatomical markers on 100% of radiographs.  It is required for images to be admissible in a court of law, and it truly is “best practice.”

Risks vs. Benefits

Whether images need to be repeated if a marker is occasionally not visible on an image, warrants a risks vs. benefits discussion with on-site personnel including the radiologist/s.  Technologists can be held accountable, however, during evaluations and upon the occurrence of failure to use these markers.  Furthermore, it is important for employers to encourage and enable technologists to use these markers and have a quality assurance process with follow-up.  It would also be wise to consider other options such as purchasing disposable, single-use markers which can be utilized for isolation cases which infection control becomes an issue, or for when a technologist misplaces their markers.  There are tools at our disposal which are cost-effective that can prevent situations like the one mentioned earlier.

About the Author 

Jeremy Enfinger is an experienced Radiologic Technologist, Radiography Program Instructor, and published author. He has served in leadership roles in hospital, outpatient and academic settings. His experience includes writing examination questions for the national ARRT Radiography Exam and multiple – modality training. He continues to pursue excellence in education and patient care. An avid blogger, Jeremy strives to promote standards of excellence in imaging through his online community with the sharing of veteran tips and techniques for high-quality imaging.

Free eBook

 

For any radiologic technologist looking to make improvements and fine-tune their image critique skills; this is a must-have resource. To receive your copy first, sign-up for the “Topics in Radiography” email list and you’ll be able to download the book for free on April 18, 2015.

 

 

 

Radiation Protection During Mobile Exams

Do you wear a lead apron during portable exams?

I have found in my years of experience as a radiologic technologist that practices vary from one radiologic technologist to the next.  Of course, we utilize some form of radiation protection when it comes to using a c-arm for mobile fluoroscopy in the operating room.  Fewer people wear lead when performing plain film images during surgical procedures.  And most don’t seem to worry about radiation protection during routine portable exams like chest x-rays and abdomen films.

Why is this?  

We learn in school that lead shielding is required when performing these exams.  For those of you who do not wear radiation protection for mobile exams, I am about to show you something which may cause you to change the way you prioritize wearing radiation protection apparel.

For some context, I want to step back in time, when Computed Radiography (CR) was first implemented at a hospital I was a clinical instructor for.  My job was to accompany student technologists while they performed their exams and to educate and evaluate.  Having never been to the operating room at that facility, I was given the opportunity to tag along with one of the staff techs who had been observing my student for the day.  They were assigned to perform a cross-table lateral lumbar spine image during a discectomy.

I watched as the staff technologist carefully walked around the table, being mindful of the sterile field, and positioned the draped image receptor next to the patient.  My student used the portable x-ray machine to align a horizontal beam to include the lumbar spine for the prone patient.  When they were finished setting up, they indicated to the O.R. staff in the room that they were ready to expose the image.  All of them, including the physician left the room while the three of us from the radiology department stayed to make the exposure.

We had taken two CR image plates into the room with us.  One was positioned next to the patient, and the other had been placed against the wall behind us.  The student made the exposure, extending the full length of the cable that attached the exposure switch to the portable x-ray machine, which was about 12 feet.  The staff technologist and I backed up to the wall behind us – I would guess an additional 3 feet behind the student technologist who exposed the image.  We all wore lead aprons.

Upon returning to the radiology department to develop the image, the student made a mistake that every technologist has done in their career.  He was carrying both the exposed image plate of the lumbar spine image as well as the unexposed image plate that had been resting against the wall behind us, and he forgot which one was the exposed plate.  The logical solution was to process both image plates under the “lateral lumbar spine” algorithm and discard the image that was not exposed.

The first image was not the lumbar spine image we had hoped it would be.  Instead, something peculiar appeared on the monitor in front of us as the scanner slowly revealed more and more of the image during processing.  Once the entire image had been scanned and the processing the algorithm was applied, it was clear that this was an image of a lower leg (a portion of the tibia and fibula).

Thinking we had come across someone else’s image plate that had been exposed for a different patient (and thankful we did not use that plate to image the lumbar spine), we began asking around the department to see if anyone was missing a tib-fib image from any of their exams.  No one was missing an image.  I decided to examine the image further on a PACS monitor for larger viewing.  The image quality was poor, and the resolution was horrible.  The exposure indicator proved that the image was slightly over-exposed.  I then realized what I was looking at.  This was the cassette that was leaning against the wall in the operating room approximately 15 feet from the patient that was x-rayed.  If you recall, the staff technologist and I had backed up against the wall prior to the exposure being made for the lumbar spine.  This was an image of the staff technologist’s leg, which was positioned just a few inches in front of the image plate during the lumbar spine exposure.  This was purely created by scatter radiation from the exposure we took in surgery.

Here are some examples of images created solely from scatter radiation in an experiment based off of lessons learned from this experience:

S# was 1190 at 8 foot distance from lateral lumbar spine phantom, which indicates about 1/4 the exposure required to produce a diagnostic hand x-ray

S# was 980 at a 6 foot distance from lateral lumbar spine phantom

I also decided to x-ray a chest phantom to simulate a portable chest x-ray using 120 kVp and 5 mAs. The following image was created from scatter radiation from about 10 feet away from the chest phantom.

S# was 2780

Though the last image produced from the chest phantom didn’t receive nearly the exposure as the one from the lumbar spine phantom, it is still obvious that there is enough radiation to penetrate the fingers from 10 feet away.  Now that you’ve read this and seen evidence of the radiation we work with every day as a radiologic technologist, are you going to change your practices?  If you already use radiation protection for your mobile exams, will you encourage your co-workers and student technologists to adopt these habits?

Registered radiologic technologists vow to keep radiation dose “As Low as Reasonably Achievable” (ALARA).  It is our duty not only to protect patients from the harm that can be caused by radiation, but to protect yourself and your co-workers from it as well.  Let us not forget the three basic principles of radiation protection; time, distance and shielding.  Keep the amount of time you are exposed to radiation low.  Keep as much distance from a radiation source as possible.  And finally, use shielding, including during mobile examinations.  Consistent application of all three of these basic principles of radiation protection will keep you, your patients and your co-workers as safe as possible.

About the Author 

Jeremy Enfinger is an experienced Radiologic Technologist, Radiography Program Instructor, and published author. He has served in leadership roles in hospital, outpatient and academic settings. His experience includes writing examination questions for the national ARRT Radiography Exam and multiple – modality training. He continues to pursue excellence in education and patient care. An avid blogger, Jeremy strives to promote standards of excellence in imaging through his online community with the sharing of veteran tips and techniques for high-quality imaging.

Additional Reading Written by Jeremy Enfinger via Topics in Radiography Blog

Experiments with Scatter Radiation (original post from 2009 – with updated images and technical factors)

Reducing Radiation Dose in Diagnostic Radiography

Podcast: How To Communicate Radiation Risks To Patients

What Everyone Should Know About Digital Radiography

Gold Standard Cleaning For X-Ray Aprons & Lead Wearables

What Does Gold Standard Cleaning Look Like For X-Ray Aprons And Lead Wearables?

Thus far in this lead apron based blog series, we have examined the infection issues and concerns associated with contaminated lead x-ray aprons and the science behind how staff members can easily test such surfaces for contamination using ATP testing.

This third blog entry will examine methodologies and practices utilized by clinical staff and facilities in the “cleaning” and maintenance of these protective lead wearables, and also explore what “cleaning” such a surface really entails. In discussing bioburden levels in the previous blog, we addressed how one cannot judge cleanliness on a surface by appearance alone.  Let’s take a deeper dive into what it means to truly clean and sanitize these protective, lead garments.

Survey Says…

In researching the topic, speaking with professionals at symposiums and inquiring with colleagues and peers, there is little consistency across the continuum of care with how these garments are cleaned and/or serviced. Shockingly, a number of Radiology, Cath Lab and Operating Room staff have lamented that such surfaces “never” get cleaned, while other staff and administrators have shared that such surfaces are sometimes cleaned, “when the case load is light on a Friday” or “on the midnight shift by the environmental services department.” Both patient and staff safety are at risk due to lack of staff compliance and clinical efficacy issues posed through improper cleaning practices.

Online research lead to a few administrators sharing that they ran these lead aprons through a cart washer, which lead manufacturing companies clearly advise not to do. Clinicians have also shared that they try to use products such as Lysol or Febreeze to “eliminate the odors” yet admit the lead wearables still aren’t “clean.” One of the more popular concepts considered in attempting to clean and service these wearables entails the discussion of “using sanitizing wipes” on such high-touch surfaces.  Unfortunately, the use of these wipes alone does not properly clean and sanitize the garments.

Pesky Directions

There are a number of sanitizing/disinfecting wipes on the market that some clinicians claim to use on lead aprons and wearables. When taking a closer look at the labels on these products, one may very well discover that most wipes are actually not recommended for use on lead wearables. Additionally, some wipes contain bleach and corrosive agents, which are both advised not to be used on aprons, according to the companies that manufacture them. A majority of the wipes on the market today are indicated for use on “non-porous” surfaces such as tables, bed rails, door handles, etc. rather than a porous surface such as a nylon covering of a lead wearable. Though the use of wipes might afford convenience to the user, the real issue with doing so lies in their clinical inefficiency in successfully cleaning the surface, not to mention completely removing any bioburden.

Wax Then Wash?

If your car had dirt, road tar and bird droppings on it, would you attempt to wax it in that condition?

For best outcomes, you would first clean and remove those elements before attempting to wax the car.  The same is true for other surfaces, including lead wearables.  Professionals who routinely assess bioburden understand the importance of a proper cleaning before sanitizing or disinfecting an item.  If an item is not properly cleaned and organic matter remains, nutrients also  remain to better foster the growth of surviving bacteria or future bacterial contamination.  This is by definition a risk factor for increased hospital associated infections.

All You Can Eat Buffet

In watching the news of late, one can gather that the world of microbiology is ever changing.  Bacteria are highly adept at persisting.  Through changes in their DNA they can gain antibiotic and/or antiseptic resistance, and these changes can happen through mutations or through integration of foreign DNA, but where would they find foreign DNA?  When bacteria die and the cells break open, then the DNA is accessible to the remaining bacteria.

The Problem with Sanitizing and Disinfecting Wipes

When facilities only use wipes on a surface and don’t completely remove the debris, they are in essence creating an “all you can eat buffet” for the surviving bacteria to thrive upon. If the dead bacteria had antibiotic or antiseptic resistance markers, now that DNA is fair game for susceptible bacteria to gain resistance!   In fact, numerous studies have shown that certain bacteria can pick up various genes from different species that makes them more pathogenic (either by making it antibiotic resistant, antiseptic resistant, or by allowing it to survive in a host better).

Layers Of Bacteria? Gross?

As if that wasn’t scary enough, what if I told you that some bacteria could gain antibiotic and antiseptic tolerance simply by growing?  (IT IS TRUE!)

Some bacteria can attach to a surface (particularly porous or textured surfaces such as lead wearables) and as they grow and form groups of bacteria (colonies) that can then form a biofilm.  Biofilms are clusters of bacteria that have attached and produced an extracellular polymeric substance (EPS) which are essentially a protective coating.

Extracellular Polymeric Substance (EPS)

EPS consists of DNA, proteins, lipids (fats) and polysaccharides (sugars).  This coating protects the bacteria inside the human body from cells that can either tag the bacteria for destruction or destroy the bacteria outright.  Externally (on a surface) it can protect the bacteria from anti-microbial drugs or antiseptic agents.  In fact, bacterial biofilms are 10 – 1,000 times more resistant to antibiotics than there standalone bacterial counterparts.  Their EPS is essentially a bacterial Teflon coating.  This Teflon coating only gets stronger when multiple species of bacteria co-inhabit the same biofilm, and if these attributes weren’t scary enough, bacteria in a biofilm can sense their microenvironment and may even produce toxins while in a biofilm that they wouldn’t normally produce.

Biofilm Life Cycle

Like all living things, biofilms have a life cycle, and a part of that life cycle involves dispersion of some bacteria that are then free to go and attach elsewhere, including in a human host. In 2007, the National Institutes of Health estimated that approximately 80% of chronic infections were biofilm related; thus, biofilms remain a serious problem in many facilities. When surfaces such as the nylon covering of a lead wearable are not cleaned properly, it allows different bacteria to begin to congregate.

Layers of Bacteria

Thinking this all sounds like something from a fictional book or movie, as if biofilms can only exist in some weird lab conditions or in some rare disease?  Nope!!!!

The most common example of a biofilm is one that everyone is probably familiar with, but may not realize is a biofilm, is dental plaque!  Biofilms are so hard to remove from surfaces that companies have spent millions of dollars trying to prevent their formation.  If you think about dental plaque, it makes sense.  We brush our teeth twice a day to best prevent plaque.  Unfortunately, when it comes to medical devices or any surface (particularly a porous or textured surface) in a medical treatment facility (such as lead wearables), biofilms can form once the surface is exposed to organic matter such as blood.  Now with the mental picture of layers of bacteria (such as plaque) on surfaces in medical treatment facilities, consider that some high-touch surfaces, such as radiological shields and aprons have not been properly cleaned for years (if ever!)

Elbow Grease Helps Break Up Biofilms

Biofilms are so tolerant of antimicrobials and antiseptics, that even the CDC positions the best way to remove a biofilm is to disrupt it physically, and they have included the ‘use of friction’ in their definition for proper cleaning.  Studies have been done that show that physically disrupting the biofilm by using friction is the primary means for destruction of the layers and thus removal of the biofilm.  (In the example of dental plaque, this would be equivalent of one going to the dentist and having them scrape the teeth in order to remove the plaque.)  The procedural process and outcomes are different when looking at the process of “cleaning” and “sanitizing” and it takes both of these separate processes to eradicate biofilms from porous, high touch surfaces. The surface on a lead wearable first needs to be cleaned before it can then be sanitized.

  • Cleaning – According to the CDC, cleaning entails the use of EPA registered products, coupled with the use of friction to physically remove dirt, microorganisms and bioburden and then removing/rinsing them away from the surface. Though a vast majority of the bioburden is removed during this process, the cleaning process does not always remove 100% of all bioburden & microorganisms.
  • Sanitizing – This process then “inactivates” 99.9% of all remaining microorganisms on environmental surfaces if allowed to sit visibly wet or “dwell” on the surface for the recommended amount of “dwell time” as per manufacturer instructions and guidelines.

Cleaning and Sanitizing really can’t be done in one-step, let alone with just a wipe. When you go to the dentist, the first step in the process is to scrape the plaque from the teeth before they are polished, just like your car needs to be adequately washed and dried, before it can be then waxed. Cleaning and sanitizing of a neglected surface such as a lead apron cannot be accomplished in one step either. In an effort to address such biofilms “head on” X-Ray apron servicing companies, such as Radiological Care Services (IN) are implementing multi-step, cleaning and sanitization programs for X-ray aprons and lead wearables. These programs are built in accordance with governing bodies, such as the CDC, JCAHO, AORN and HFAP, which position that surfaces should first be cleaned, before attempting to sanitize or disinfect them.

Stay Tuned For The Next Post

Stay tuned for the next follow up blog post, as we look specifically at what policies, regulations and expectations these governing bodies have of high touch surfaces, such as X-ray aprons and lead wearables. Between now and then, go brush your teeth and think about the layers of bacteria building up on lead wearables and aprons as they continue to invite bacteria to the biofilm party!

About The Author:

Kathleen R. Jones received her BS from Purdue University (West Lafayette) in Biology specializing in Genetics and Microbiology.   After working for five years in Quality Control she then completed her MS at Purdue University in Indianapolis.  Her growing interest in Infectious Diseases lead her to the Uniformed Services University of the Health Sciences where she obtained a Doctorate in Emerging Infectious Diseases.  Kathleen has a passion for progressive sciences and initiatives, and employs her keen understanding of the biofilm formation and elimination processes into her research and work.

How Do I Select The Right Laser Eye Protection?

LASER stands for Light Amplification by Stimulated Emission of Radiation. Lasers emit a narrow beam of light and that beam of light is emitted in short bursts and focuses precisely on the desired target. The energy emitted by the laser can be absorbed, scattered, transmitted or reflected. When used in medical procedures, lasers transmit most of their energy to the intended target and that is why proper laser eye protection is so important.

The Eye is Vulnerable to Laser Radiation

The human eye is extremely vulnerable to laser radiation. When working with medium to high-powered laser systems, it is vital to wear the correct laser eye protection for the specified laser type. Unprotected exposure to lasers can result in the development of cataracts or even a corneal burn, which can ultimately result in vision loss. By selecting and wearing the appropriate pair of laser safety glasses, medical personnel can keep their eyes protected from applications and procedures that require a laser system. Protective laser safety glasses must be matched in terms of wavelength frequency and the type of laser being used (e.g., YAG laser glasses, Holmium laser glasses) for your specific application. That is why it is important to understand the consequences of laser radiation exposure.

3 Ways Lasers Can Damage Your Eyes

There are three ways that lasers can damage your eyes including thermal, photochemical, and mechanical damage. Laser safety glasses provide valuable laser eye protection by shielding vulnerable eye tissue from the high-intensity radiation emitted. Laser safety glasses are not only a vital safety component, they are also required in all facilities where medical, surgical, cosmetic or dental laser procedures are performed. Laser safety glasses are also used in research and forensic laboratories.

What Types of Eye Protection are Available?

There are several levels of laser eye protection available. Laser safety glasses are measured in optical density and this number reflects the ability of the filter to block the light that is transmitted at a particular wavelength. The higher the optical density, the more light from the wavelength is blocked. For example, laser safety glasses with an optical density of seven will block all but 0.00001% of the laser frequency.

How Do I Select the Right Laser Eye Protection?

Selecting the right laser eye protection may seem overwhelming; we have simplified the selection process for you by creating a white paper that discusses the eight key factors you’ll want to consider when selecting the right laser eye protection. It is extremely important to protect your eyes and yourself from the harmful effects of laser radiation. Remember, the damage done to your eyes from laser radiation exposure can be permanent. If you have any additional questions regarding how to select the right laser eye protection please comment below or email us at info@universalmedicalinc.com.

 

 

//universalmedicalinc.wistia.com/medias/7w4vgr7ohi?embedType=seo&videoWidth=360

 

 

Evaluating Microorganism Levels On X-Ray Aprons And Lead Wearables: The Science Of ATP Testing

How Have Microorganisms and Bioburden Been Measured?

In the previous blog post regarding X-Ray lead aprons, we explored the history of healthcare associated infections or HAIs, and how transmission risks are posed to patients and staff via contaminated “high touch, non-critical surfaces,” including X-Ray aprons and protective lead wearables.  In laying out the content of this blog, I was reminded of the phrases, “things aren’t always as they appear” and “don’t judge a book by its cover.” Is it possible that newer (clean looking) X-Ray aprons can carry a higher level of biological contamination when tested in comparison to older X-Ray aprons (which are dirty looking & smelling)? It is completely possible and plausible due to the concept of bioburden.

What is Bioburden?

Bioburden is defined in numerous medical dictionaries as the number of microorganisms contaminating an object.  So how does one assess for bioburden?  The gold standard for assessing for bacterial/fungal contamination has been to assess for colony forming units or CFUs.  A CFU equals one viable bacterium that has the ability to spread and replicate.

3 Main Ways to Measure CFUs: 

  1. A scientist could dilute the sample and count the bacteria by microscopic examination or through the use of a cell counter.  However, if bacteria are too small or clump together, then this method is problematic.  This method will yield total bacteria counts, both living and dead.
  2. A scientist could use Optical Density (OD) to estimate the number of viable bacteria in a sample.  This is where the scientist measures how cloudy a liquid culture of bacteria is.  While the bacteria are actively growing the liquid culture should continually become more and more cloudy.  Again, this method will yield total bacteria counts, both living and dead.
  3. A scientist could make serial dilutions of a liquid culture and plate out the bacteria in known dilutions until they can count single colonies and extrapolate back to figure out total CFU in a sample. This method only yields viable bacteria totals.

4 Challenges Associated with Bioburden Assessment

Assessing for bioburden (microorganisms) by calculating CFUs is not as easy or straight forward as one might imagine.

  1. The first challenge posed is that one needs to have a lab in which to grow bacteria, and depending on the bacteria one is dealing with there are different governmental regulations to follow.
  2. The second challenge presented is that of time, one needs to have the time and equipment to properly grow the bacteria/fungus.  Different species of bacteria or fungus grow at different rates, for example, culturing of bacteria on plates can take anywhere from overnight to multiple days.
  3. A third and very important challenge is posed by the bacteria and fungus themselves.  They are similar to people in the fact that not all of them grow and thrive under the same conditions.  In lab work, if only one kind of food source is used, one will only be able to assess for bacteria that grow on that particular food source.
  4. Finally, one needs to have a trained technician who knows how to assess which bacteria to grow under the correct conditions and then also how to properly count the bacteria.

While assessing for CFUs has traditionally been viewed as the gold standard for assessing bioburden, and it is vitally important for various microbial studies, it is not a good way to assess bioburden in real time.  It can be complicated.

What is ATP and How is it Evaluated?

What if there was an easier way to determine surface levels of biological contamination?

What if there was an easier way to assess for a molecule that is found only in living cells, both bacterial and human living cells?

There IS an easier way to evaluate for this molecule in real time (by using a simple swab and handheld reader), and it can be used by any hospital staff member as a surrogate for such complicated CFU work.  Let me introduce you to the molecule known as the “molecular workhorse,” called adenosine triphosphate (ATP).

Adenosine Triphosphate (ATP)

ATP is an energy molecule utilized by cells. It is present in humans, animals, plants and microbial cells.  ATP levels rise as a cell is undergoing apoptosis (programed cell death), but is generally consider to be completely degraded within 30 minutes of cell death (1).  This makes ATP a useful marker for the presence of unwanted biological contamination, including organisms that can cause infection and disease.

Okay – Get to the Point!

An increase in biological cells on a surface results in an increase in the amount of ATP present on that surface, thus making ATP an effective marker for the assessment of the hygienic status of an environmental surface. Simply stated, the amount of ATP present on a testing swab is a quantitative measurement of the cleanliness of the surface tested! In fact, ATP cell viability assays were determined to be the fastest, most sensitive, and least prone to artifacts, partially due to a lack of an incubation period (2).  The sensitivity of laboratory cell based ATP cell viability assays can detect fewer than 10 cells per well (2).  This technology has been modified to create a portable, ATP bioluminescence test, using a swab instead of plated cells.  This now allows for a real time assessment of bioburden on site.  These tests have been used to assess bioburden in many healthcare settings, including the ICU (3).  ATP measuring units, called luminometers, are handheld, user friendly, and display the results in seconds. (It doesn’t take a scientist to use an ATP luminometer!) The read out of an ATP bioluminescence test is not in CFUs, but is in relative light units or RLUs.  In the past, some scientists have questioned the validity of using a bioluminescence test instead of assaying for CFU.

Is There a Correlation Between CFUs & RLUs? 

Like most assessments, ATP bioluminescence assays also have limitations, but they are an excellent surrogate that allows the everyday staff member to assess bioburden in real time.  Those new to ATP bioluminescence testing often inquire about a correlation between CFUs and RLUs.  (Most laboratory microbiologists have the capability to perform CFU testing, and are not confined to real time assessment of bioburden.)  The most controlled way to achieve this is to look at different known amounts of CFUs and assess whether or not the RLUs increase accordingly.  That is exactly what Dr. Sciortino’s group did when they assessed three different portable ATP bioluminescence kits for their ability to detect various CFUs of two different HAI relevant bacteria (Staphylococcus aureus and Acinetobacter baumannii) and one strain of fungus (Candida albicans).

What they discovered was there was a linear relationship between bacterial CFUs and RLUs for all three luminescence kits, and for two of the three kits between fungal CFUs and RLUs (1).  Such research validates that the use of ATP luminometers can be used to assess for bioburden on surfaces in real time.  This research, plus Dr. Jaber’s study, in which 25 lead aprons were cultured for CFUs and showed that 21 were colonized with Tinea species (the family of fungus that causes ringworm) and 21 were colonized with Staphylococcus aureus, of which 3 aprons were colonized with MRSA (4), validates the ATP bioluminescence results for X-ray aprons and protective lead wearables.

In fact, these X-ray aprons and protective lead wearables, which are worn throughout many different areas within a healthcare system, including the operating rooms, cath labs, radiology/imaging areas, emergency rooms and beyond are regularly testing with RLU readings in the THOUSANDS to HUNDREDS OF THOUSANDS (5), which is scary. The bottom line is regardless if you are a classically trained microbiologist used to looking at CFUs or a hospital staffer looking at luminometer readouts in RLUs, when surfaces inside an OR or Cath Lab are testing in the hundreds of thousands range, it is a problem!

Is ATP Testing Growing in Use?

Through utilization of ATP luminometer testing systems, companies like Radiological Care Services (Indianapolis) are able to enter a facility’s Cath Lab, OR or Radiology Department and test lead apron inventories on site, providing real time numbers (bioburden levels) in a matter of seconds. An advocate for ATP luminometer testing, Dr. Sciortino even states, “ATP system monitoring may uncover the need for new disinfectant designs that adequately remove hospital surface biofilms, rendering used hospital equipment to its native state whereby a zero reading by ATP monitoring can be achieved” (1).  If you look back at the first blog post, “Contaminated X-Ray Aprons and The Risk of HAIs”, I positioned that “using wipes alone” was insufficient and through the use of ATP testing, Dr. Sciortino could be inferring a similar position.

Looking Ahead…

In the next blog post, we’ll specifically look at the science/methodology behind the use of sanitizing wipes and we’ll further explore the differences between true “cleaning” and “sanitization.” We’ll later examine what the governing bodies, such as AORN, CDC, HFAP and JCAHO state regarding their expectations of such surfaces within healthcare facilities. Understanding the science behind HAIs, testing for biological contaminants on surfaces, biofilms, and the difference between “cleaning” and “sanitization” will help us understand that current healthcare protocols in regards “non-critical, high touch surfaces” need to be changed in order to better protect hospital patients and staff.

About The Author:

Kathleen R. Jones received her BS from Purdue University (West Lafayette) in Biology specializing in Genetics and Microbiology.   After working for five years in Quality Control she then completed her MS at Purdue University in Indianapolis.  Her growing interest in Infectious Diseases lead her to the Uniformed Services University of the Health Sciences where she obtained a Doctorate in Emerging Infectious Diseases.  Kathleen has a passion for progressive sciences and initiatives, and employs her keen understanding of the biofilm formation and elimination processes into her research and work.

Sources:

  1. Sciortino, C. V. and R. A. Giles.  2012. Validation and comparison of three adenosine triphosphate luminometers for monitoring hospital surface sanitization: A Rosetta Stone for adenosine triphosphate testing.  AJIC.  40 (e233-9)
  2. Riss T.L., R.A. Moravec, A. L. Niles, H.A. Benink, T.J. Worzella, L. Minor. Minor, L, editor.  2013,  Cell Vialblity Assays. In: Sittampalam G.S., N.P. Coussens, H. Nelson, et al., editors. Assay Guidance Manual [Internet]. Bethesda (MD): Eli Lilly & Company and the National Center for Advancing Translational Sciences; 2004-. Available from: //www.ncbi.nlm.nih.gov/books/NBK144065/
  3. Moore, G., D. Smyth, J. Singleton, P. Wilson. 2010. The use of adenosine triphosphate bioluminescence to assess the efficacy of a modified cleaning program implemented within an intensive care setting.  AJIC. 38(8):617-622 DOI: //dx.doi.org/10.1016/j.ajic.2010.02.011
  4. Jaber, M., M. Harvill, E. Qiao.  2014.  Lead aprons worn by interventional radiologists contain pathogenic organisms including MRSA and tinea species.  Journal of Vascular and Interventional Radiology.  25:3:S99-S100.  DOI: //dx.doi.org/10.1016/j.jvir.2013.12.279
  5. “Outcomes: What do your numbers look like?” Radiological Care Services. Nov 20, 2014. //www.radcareservices.com/radiolgical-care-services-outcomes.html

Contaminated X-Ray Aprons And The Risk Of HAIs

Contaminated, Dangerous, and Unacceptable: The Impact of Contaminated X-Ray Aprons and the Risk of Health Care-Associated Infections (HAIs)

Infection Prevention checklists today include many new areas of concern such as contamination in lab coats, neckties, telephones, remote controls, privacy curtains and more. X-ray aprons and protective lead wearables are worn throughout many different areas within a healthcare system, including the operating rooms, cath labs, radiology/imaging areas, emergency rooms and beyond. Clinical studies have proven that X-ray aprons silently carry a number of microorganisms – Dr. Jaber (Wayne State) cultured 25 lead aprons to discover 21 were colonized with Tinea species (the family of fungus that causes ringworm) and 21 were colonized with Staphylococcus aureus, of which 3 aprons were colonized with MRSA (1).  

The Association of periOperative Registered Nurses (AORN) makes cleaning recommendations for items such as kick buckets, stools, patient restraints, keyboards, surgical lights and more; however, lead aprons which are routinely engulfed in sweat, blood, bodily discharge and surgical debris/residue have been consistently overlooked. Healthcare systems can no longer compromise both patient and staff safety through such perilous practices.  (Note – upcoming posts will further explore “current cleaning practices,” as well as cleaning recommendations and guidelines from National Governing Bodies such as the CDC/JCAHO/HFAP and AORN.)

Health Care-Associated Infections

HAIs are the 4th largest killer in the United States, claiming 100,000 American lives each year – more deaths than AIDS, breast cancer and auto accidents combined (2).

Hospitals are meant to be safe havens.  They are meant to be a place of refuge against disease, a place to heal and a place to recover from surgery or injury.  If that is the dream, then the nightmare would be a place in which you end up more ill than you were when you were first admitted!  Unfortunately, that nightmare becomes a reality for many unsuspecting patients and staff members today. One reason for this nightmare is the acquisition of a Health Care Associated-Infection or Hospital Acquired Infection (“nosocomial infection”).

The World Health Organization (WHO) uses a 1995 definition for a Hospital Acquired Infection (HAI):

An infection occurring in a patient in a hospital or other health facility in whom the infection was not present or incubating at the time of admission.  This includes infections acquired in the hospitals but appearing after discharge, and also occupational infections among staff of the facility (3).

HAIs in our Healthcare System

Think about it – it only makes sense that hospital acquired infections would be prevalent in our healthcare systems today.  Hospitals & medical facilities are places that people congregate when they are immunocompromised and/or are sick and in need of some type of care or treatment.

World Health Organization Study

In fact, a WHO study of various hospitals in 14 countries across Europe, Eastern Mediterranean, Southeast Asia and Western Pacific regions in the late 1980s concluded that 8.7% of patients had at least one Hospital Acquired Infection equaling 1.4 million afflicted people at any one time (4-5).

Centers for Disease Control and Prevention Estimate

In the United States alone, the CDC estimates roughly 1.7 million annual hospital-associated infections, from all types of microorganisms including bacteria combined, cause or contribute to 100,000 deaths each year (6). In fact, approximately 1 in 25 hospital patients has a hospital acquired infection at any one time (7). While these statistics are startling and horrifying, sadly they do not paint the complete picture. These statistics are patient specific and do not include the number of healthcare workers and hospital staff who have also acquired Hospital Acquired Infections.

Economic Impact of HAIs

Such infections lead to additional stress, longer hospital stays, lost wages for healthcare providers and higher morbidity and mortality rates overall.  HAIs also have a HUGE economic impact.  In addition to being the 4th largest killer in America, it is estimated Hospital Acquired Infections will cost the healthcare system an additional $30 Billion (2).

Why do HAIs Occur? 

We live in a medically advanced society, so why do Health Care Associated-Infections still run rampant, and what are we doing about them?  That is a good question, but the answer is multifaceted.  The first point to consider is that patients are usually immunocompromised when in need of healthcare services. They are either already ill or they have had a procedure that puts immense stress on their bodies, e.g., a joint replacement, major illness or other surgical procedure or treatment. 

As wonderful as modern medicine is, it is not without risks.  In fact, many diagnostic and/or therapeutic procedures involve the use of a medical device, e.g, catheters, intubation tubing, scopes, etc. These devices and even many “non-critical” surfaces and “high touch objects” such as X-ray aprons and lead wearables can become contaminated when not properly cleaned and sanitized.

Healthcare facilities are a place where sick and immunocompromised patients regularly navigate and patients are often transferred between units/floors.  This allows infectious agents to travel to different areas in a hospital and expose multiple people, including patients, family and staff members.

Infectious Agents

Infectious agents (bacteria, viruses, parasites, and fungi) present their own issues.  There are species that form spores that are resistant to most mechanisms of eradication. Kramer’s group recently performed a meta-analysis of the literature and summarized that most clinically relevant species of viruses could easily survive on dry, inanimate surfaces for between a few HOURS to DAYS and clinically relevant bacterial and fungal species could survive for DAYS to MONTHS (8).  The longer the infectious agent can be found in the environment the greater the chance that it can be passed to a new host.

The Need for New Policies/Protocols

Unfortunately, Health Care-Associated Infections (HAIs) are still a substantial source of morbidity and mortality throughout the healthcare continuum today.  While recent initiatives such as improved hand washing policies have helped that burden, there are additional new policies/protocols with regards to cleaning that need to be implemented in order to address other critical “high touch objects” such as X-ray aprons and lead wearables.

Education and Awareness

Through education and open-mindedness, we can bring awareness to the importance of following the cleaning recommendations of the governing bodies, such as the CDC/JCAHO/AORN and HFAP.  In knowing that infectious agents can still adapt to become drug resistant, antiseptic resistant, and increase their ability to survive in the environment, so, we too must adapt and be open minded to new concepts in our vigilant fight against hospital acquired infections.

Oft-Overlooked: X-Ray Aprons and Lead Wearables

X-ray aprons and lead wearables can no longer be overlooked, and they will need a renewed commitment to servicing. They need to be properly cleaned prior to sanitization efforts, in accordance with the guidelines of the CDC & JCAHO.  In my next blog entry, we’ll dive into the science behind testing X-ray aprons for the presence of microorganisms and examine how these surfaces are measured and evaluated.

SPOILER ALERT – If you think you have an idea of how contaminated such surfaces are inside of our healthcare systems, you will be in for a SURPRISE!

About The Author:

Kathleen R. Jones received her BS from Purdue University (West Lafayette) in Biology specializing in Genetics and Microbiology.   After working for five years in Quality Control she then completed her MS at Purdue University in Indianapolis.  Her growing interest in Infectious Diseases lead her to the Uniformed Services University of the Health Sciences where she obtained a Doctorate in Emerging Infectious Diseases.  Kathleen has a passion for progressive sciences and initiatives, and employs her keen understanding of the biofilm formation and elimination processes into her research and work.

Sources:

  1. Jaber, M., M. Harvill, E. Qiao.  2014.  Lead aprons worn by interventional radiologists contain pathogenic organisms including MRSA and tinea species.  Journal of Vascular and Interventional Radiology.  25:3:S99-S100.  DOI: //dx.doi.org/10.1016/j.jvir.2013.12.279
  2. “What is RID?” Committee to Reduce Infection Deaths.  n.p.  d.p.  Web.  Nov 7, 2014.  //www.hospitalinfection.org/objective.shtml
  3. Benenson, AS.  1995.  Control of communicable diseases manual.  16th edition.  Washington, American Public Health Association.
  4. Tikomirov, E.  1987. WHO Programme for the Control of Hospital Infections.  Chemiotherapia. 3:148-151.
  5. Mayon-White, RT, G.  Ducel, T. Kereselidze, E. Tikomirov.  1988.  An internal survey of the prevalence of hospital-acquired infection.  J. Hosp. Infect.  11 (SupplementA): 43-48
  6. Klevens, RM, JR Edwards, CL Richards, TC Horan, RP Gaynes, DA Pollock, DM Cardo.  2007.  Estimating health care-associated infections and deaths in U.S. hospitals, 2002.  Public Health Rep 122:160-166
  7. Magill, SS, JR Edwards, W Bamber, ZG Beldavs, G Dumyati, MA Kainer, R Lynfield, M Maloney, L McAllister-Hollod, J Nadle, SM Ray, DL Thompson, LE Wilson, SK Fridkin.  2014.  Multistate Point-Prevalence Survey of Health Care-Associated Infections.  N Engl J Med 370:1198-1208
  8. Kramer, A., I. Schwebke, and G. Kampf.  2006.  How long do nosocomial pathogens persist on inanimate surfaces? A Systemic Review. BMC Infectious Diseases.  6:130  Doi: 10.1186/1471-2334-6-130

Laser Safety Glasses: The Ugly Truth About Laser Radiation Exposure

Avoiding Eye Damage

In the time that it takes to blink an eye, laser radiation damage to the eye may have already occurred. Unprotected exposure to lasers can result in the development of cataracts or even a corneal burn, which can result in vision loss. If you are working with or around lasers, it is very important to understand the consequences of laser radiation exposure. We have decided to dedicate this post to educating you about laser beams and the safety precautions you should take when working around them.

Laser Beam Exposure

In addition to direct laser beam exposure, there are several other types of dangerous indirect laser beam exposures. Intra beam exposure occurs when the eye or skin is directly exposed to all or a part of the laser beam. It is also important to be careful of specular reflections. This is when the laser beam is reflected off mirror like surfaces. Reflections from flat mirror surfaces can be as harmful as exposure to a direct laser beam. Curved mirror surfaces decrease the intensity of the beam, but there is a larger area for possible laser radiation exposure. Diffuse reflections happen with surfaces that reflect the beam in many directions. Because the beam is reflected in so many directions, this exposure does not have the same power and energy of a direct beam. It is important to keep in mind that diffuse reflections are still harmful.

Protecting Your Eyes

The biggest risk with working around lasers is having any of these types of exposures enter the eye unprotected. In the human body, the eye is the most sensitive to light. When the eye is exposed to a laser beam, the lens in the eye focuses the beam into a tiny spot. This can actually burn the retina of the eye. At different wavelengths, lasers cause several types of eye injuries. Exposure to laser radiation with wavelengths that are less than 400 nanometers and greater than 1400 nanometers result in cataracts and burn injuries. This is because the eye absorbs this level of exposure through the cornea and lens. The most damaging wavelengths are between 400 and 1,400 nanometers, which results in the heating of the retina and can cause retinal burns. The image below shows which parts of the eye absorb the laser rays at different wavelengths.

Determine The Appropriate Protection

Fortunately, wearing laser safety glasses or goggles can protect the eyes from the risks that lasers pose. The U.S Occupational Safety and Health Administration require staff to wear laser safety glasses or goggles when operating or around lasers that are Class 3b and Class 4. Class 3b lasers are lasers that powered from 5 to 500 milliwatts and Class 4 lasers have output powers of more than 500 milliwatts. These laser safety glasses and goggles provide protection from reflected laser light and direct beam exposure. Laser safety eyewear is available for different wavelength ranges and for specific types of lasers. It is recommended that you find out the class of the laser you are working with as well as the appropriate wavelength range to ensure the best possible protection.

We can’t emphasize enough how important it is to protect your eyes and yourself from the harmful effects of laser radiation. Remember, the damage done to the eyes from laser radiation exposure can be permanent!

What You Need To Know About Ultrasound Gels And Warmers

The Importance of Ultrasound Gels

Ultrasound gels are placed on a patient’s skin at the beginning of an ultrasound procedure or exam. Ultrasound gels serve several purposes including its use in a variety of procedures, treatments, and routine exams.

Ultrasound technology works by sending a pulse of high-frequency sound waves into the patient’s tissue using an ultrasound transducer or probe.  The ultrasound gel is placed on a patient’s skin and the transducer carefully glides the gel across the patient’s body. This device sends and receives sound waves which are transmitted to a computer screen for a sonographer to view. The computer screen monitor captures real-time imaging of the patient’s internal organs, also allowing for a screen shot image in case a printout is needed.

Conductive Medium

Ultrasound gels are considered a type of conductive medium used in a multitude of ultrasound diagnostic procedures and treatments. Ultrasound gel can be applied to many different areas of the body therefore being an essential tool in a variety of procedures, treatments and routine exams.

Different Gel Formulations

Ultrasound gels are available in different formulations and sizes. For example, the Aquasonic 100 Ultrasound Transmission Gel dispenser bottle is a favorite among many doctors offices and medical centers. This dispenser bottle is used and recommended by manufacturers of medical ultrasound equipment worldwide. The Aquasonic 100 gel formula is hypoallergenic, bacteriostatic, non-sensitizing and non-irritating.

Packaging Designed For Your Needs

The Aquasonic 100 Ultrasound Transmission Gel is available in 20g single-use packettes, 60g Doppler size tubes, 0.25 liter dispenser, 1 liter with dispenser cap, and 5 liter SONICPAC with refillable dispenser. A variety of ultrasound gels are available in refillable containers, dispenser caps and pumps to accommodate your medical setting.

Ultrasound Gel Warmers

An ultrasound gel warmer is a unit designed to keep ultrasound gel bottles at a warm temperature. Ultrasound gel warmers are primarily used to increase patient comfort. These ultrasound gel warmers are easy-to-use and come in a couple different configurations including single bottle and multi-bottle. Using a gel warmer will keep patients relaxed since cold ultrasound gel can cause discomfort for patients. These warmers are constructed of high-quality materials and are made for multiple uses.

Ultrasound gels and warmers are essential tools found in many hospitals, clinics, and doctors offices today. Still not sure which gel is right for you? Why not try a free sample to help you decide? Visit our ultrasound gels and warmers page and select the ultrasound gel that you would like to try and we’ll be in touch shortly.

 

 

Why Global Handwashing Day Is Important

Handwashing with soap could prevent about 1 out of every 3 episodes of diarrheal illnesses and almost 1 out of 6 episodes of respiratory infection like pneumonia. Handwashing is a simple and inexpensive method of effectively removing germs from your hands. Global Handwashing Day is celebrated annually on October 15 worldwide.

What is Global Handwashing Day?

Starting in 2008, “Global Handwashing Day is a way to support a global and local culture of handwashing with soap, shine a spotlight on the state of handwashing in each country, and raise awareness about the benefits of handwashing with soap.” Founded by the Global Public-Private Partnership for Handwashing with Soap, Global Handwashing Day encourages school children, teachers, and families to get involved.

Did You Know?

There are 1,500 bacteria living on each square centimeter of your skin right now. Our hands spread germs; people frequently touch their eyes, nose, and mouth without even realizing it – spreading germs that can make us sick.

“Handwashing with soap is one of the cheapest, most effective ‘vaccines’ against viral diseases, from the seasonal flu, to the common cold,” said Sanjay Wijesekera, head of UNICEF’s global water, sanitation and hygiene (WASH) programmes.

Are You Washing Your Hands Long Enough?

Take a look at our helpful video on proper handwashing to learn more.

Most people do not wash their hands long enough. It is recommended that you wash your hands for a minimum of 20 seconds to properly remove germs.

Handwashing Saves Lives

“Although people around the world clean their hands with water, very few use soap to wash their hands. Washing hands with soap removes germs much more effectively.”

  • Millions of children under the age of 5 years die from diarrheal diseases and pneumonia, the top two killers of young children around the world.
  • Handwashing with soap could prevent about 1 out of every 3 episodes of diarrheal illnesses and almost 1 out of 6 episodes of respiratory infection like pneumonia.
  • 2.2 Million children die per year from diseases often prevented by proper hygiene

According to the Centers for Disease Control and Prevention “Handwashing is not only simple and inexpensive, but remarkably, handwashing with soap can dramatically cut the number of young children who get sick.”

How Can You Participate?

There are a variety of ways that you can participate in Global Handwashing Day including:

  • Make sure you and your family know when and how to properly wash your hands.
  • Visit Facebook and Twitter to learn more about Global Handwashing Day games and activities.
  • Download handwashing resources from: //globalhandwashing.org/ghw-day/tools
  • Get social by searching for and using the hashtag #iwashmyhands on Twitter, Facebook, and other social media platforms.

Remember that properly washing your hands (for at least 20 seconds) is a simple and effective method of preventing the spread of germs that should be practiced daily. For more information on handwashing, visit the CDC’s handwashing website.