Infection Control and Complementary Therapies

Infection Control and Complementary Therapies

By Maureen Spencer, RN, M.Ed., CIC
Infection Preventionist
Executive Director, Finding Inner Peace Yoga School

Introduction
Complementary therapies are very popular in mainstream America. Many healthcare workers use these therapies in healthcare settings or seek these services for stress reduction and healthy lifestyles. Some involve direct contact such as massage, while others require indirect contact through shared equipment. There are also breathing techniques that could generate droplet and airborne particles into a group or private session.

Acupuncture needles, biofeedback electrodes, chiropractic equipment, tuning forks, crystals, colon hydrotherapy, lotions, herbal preparations and essential oils are examples of equipment and products that may be used by a practitioner or applied directly to the skin of a client. In addition, there are yoga mats, blocks, wedges, weights, ropes, balls, chairs, pillows, cushions and heated rooms that may become contaminated between classes and clients.

However, hands are the most common mode of transmission of microorganisms from person to person. Many complementary therapies involve touch and well meaning therapists and teachers may not be aware of the importance of hand hygiene and environmental disinfection between clients and classes. There are simple techniques that practitioners can adopt to prevent the spread of microorganisms in their classes or office.

Sources for Microorganisms

Microorganisms are resilient and use an array of artillery that enhances their “survival of the fittest.” They need a mode of transmission to get onto human skin, to penetrate the body or enter into a portal, such as the mouth. The recent outbreaks of norovirus this past winter shows how quickly a virus can spread among groups of people. Cruise ships, universities, school systems and hospitals experienced intense outbreaks.
Out of curiosity, I sampled 10 yoga mats at a studio recently and the cultures grew “too numerous to count” bacteria, confirming what I suspected - that shared yoga mats could be a source for cross contamination.

Modes of Transmission
There are five modes of transmission for microorganisms – direct, indirect, droplet, airborne and vector borne.
1. Direct transmission is one way certain viruses and bacteria enter the body. HIV and hepatitis viruses are examples of viruses that are transmitted by direct transmission from blood or body fluid exposure, such as when injected with a contaminated needle. Procedures where viruses could be transmitted are:
 Unsterile acupuncture needles
 Unsterile tattoo equipment
 Unsterile colon hydrotherapy equipment
 Contaminated intravenous solutions or equipment, eg chelation or intravenous vitamin therapy.
 Contaminated water or other ingested solution, such as room sprays or homeopathic solutions.

2. Indirect transmission is one of the most common modes of transmission, primarily by contaminated hands and equipment. One in particular, MRSA, has been shown to contaminate cell phones, pagers, stethoscopes, blood pressure equipment, counters and surfaces in the healthcare environment. This organism is now causing outbreaks associated with contaminated locker rooms, tattoo businesses, health clubs, day care centers and other areas where close contact occurs and items get shared. Indirect transmission allows the microorganisms to travel from one place to another by a vehicle for transmission. There are many opportunities in the complementary therapy field conducive to indirect transmission.

Infection Prevention Measures
1. Do not share any invasive device or equipment that comes in contact with
blood. Examples are needles, syringes, multi-dose vials, vacutainer holders,
intravenous therapy tubing and other items used to administer intravenous
therapies.
2. Wash or sanitize hands before and after touching a client.
3. Properly disinfect shared equipment and surfaces at the end of the day with an effective germicide that has activity against common pathogens, such as staphylococcus aureus. There are many natural products on the market that claim to disinfect equipment safely, such as tea tree oil.
4. Have students purchase their own yoga mats, blocks, towels and straps and encourage them to wash them often, especially after heated yoga practice.
5. Wash linens/blankets at least monthly when used on clothed clients.
6. Change sheets between each patient after a massage.
7. Place paper towels over pillows between sessions.
8. Place a tissue over an eye pillow between each client/student use. If you suspect a client may become emotional and cry, place 2-3 folded tissues under the eye pillow.
9. Make sure prepared solutions, such as aromatherapy spray, energized water and spritzers are used within a short period (3-6 months) of time to prevent bacterial growth in the bottom of the bottle. Clean the bottle and rinse with alcohol before refilling it.
10. Use individual bottles of hand soap for handwashing – never refill a container or top it off since this can cause bacterial growth in the bottom of the container.
11. Use only sterile one-time use acupuncture needles.
12. Use only sterile one time use colon hydrotherapy tubing.
13. Do not share towels or other absorbing materials that are exposed to sweat and other body fluids.

Resources:
http://www.consumersunion.org/ (search for MRSA)
http://www.superbugwiki.com
www.cdc.gov