From hospital curtains to pharmaceutical carts to floors, sanitation protocols need strict adherence to prevent contamination more than ever.
In response to this risk, sanitisers and sterilization products such as wipes and solutions are increasingly being put to use. As far as current medical knowledge knows, the virus is very sensitive to the cleaning and disinfecting agents currently in use.
The US Environmental Protection Agency (EPA) has determined that ‘enveloped’ viruses such as COVID-19 are the easiest type to inactivate using disinfectants.1
A spokesperson for the American Hospital Association says that while frequent cleaning is standard, hospitals are giving special attention to “high-touch surfaces such as in-room phones, TV/nurse calls, light switches and cords, handles, drawer pulls, bed rails, tray tables and bathroom fixtures.”2
However, sterilizing solutions will only achieve maximum efficacy while still fresh. They must be used within a specified period after being opened and have a limited shelf life.
Timestrip time indicators can be a valuable part of the infection control processes here, and a range of standard products is available.
Timestrip Time indicators are a visual alert that a disinfectant is out of date
Whether in a major teaching hospital, a walk-in clinic or a
doctor’s surgery, any type of healthcare boils down to two broad objectives:
improved patient outcomes and the best possible use of resources.
Although historically reconciling patient health and the
harsh realities of budgetary constraints have at times led to difficult
choices, the fact is that by integrating technology and innovation into
decision making around resource allocation, both objectives can be achieved at
the same time.
Indeed, thanks to its high tech / low cost Time and
Temperature Indicator labels, Timestrip® is able to provide healthcare
providers and the pharmaceutical sector with a broad range of practical,
user-friendly solutions that:
✔ Ensure product
✔ Reduce product
✔ Ensure regulatory
✔ Reduce time and
temperature monitoring costs
But what does this look like in practice?
Improving quality control and efficiency
Tenet Healthcare is US healthcare provider that faced the
challenge of needing to effectively manage how it processed bags of whole
blood. On the one hand, it faced the need to comply with local regulatory
requirements related to the use of effective temperature monitoring for blood
products; and on the other, it had to discard any bag of blood that had been
exposed to a temperature above 10°C for more than 30 minutes.
The company needed to be absolutely certain that any unused
bag of whole blood was 100% safe to be returned to storage for future use. It
had also noted ongoing difficulties in using other blood temperature
indicators. Potentially, the latter could lead to doubts about product safety,
which in turn would require that bag of blood to be discarded, possibly
✔ Maintenance of
quality control during transportation and storage
✔ Support in
complying with regulatory guidelines
Cost-effective regulatory compliance
Marathon Distributors is a pharmaceutical and healthcare
logistics services provider in Cyprus and is involved in the distribution of
pharmaceutical products throughout the island. The main cold chain management
issue it faced was around compliance with local and EU regulations, specifically
the country’s Law on Human Pharmaceuticals 70(I) 2001 and the EU guidelines on
Good Distribution & Manufacturing Practices. These mandated the company to
ensure that the pharmaceuticals it delivered were not exposed to a temperature
above 8°C for more than 8 hours during transportation.
Cambridgeshire Community Service NHS Trust is a UK
healthcare provider in south-east England. Part of its work is the delivery of
school-age immunisations to schools in its area. This includes for instance flu
nasal immunisations for primary schools and HPV vaccinations and Meningitis
ACWY and TdIPV for secondary schools.
For the delivery of vaccines, electric Labcold Portable
Vaccine Carriers and pharmaceutical-grade vaccine carriers are used. In order
to maintain the efficacy of the various transported vaccines, two different temperature
ranges need to be managed: 2°C to 8°C and -25°C to 25°C.
In order to ensure the delivery of viable, unspoiled
vaccines, the Trust thus had a requirement for a dual, low-cost solution for
use by its delivery teams.
To achieve this, two Timestrip products have been used in
each vaccine carrier:
● a Timestrip® PLUS (TP 065) to indicate if the temperature
went above 8°C
● a Timestrip® PLUS (TP 217) to indicate if the temperature
exceeded 25°C, and if so, for how long
The feedback from the delivery teams has been extremely
positive, specifically around:
✔ Easy to read
✔ Ease of use
Reliable test kit time data
Clinical Innovations is a US maker of obstetrics devices that wanted to develop a non-invasive test kit for the diagnosis of any rupture of membranes (ROM). Although treatable, spontaneous ROM is a serious medical condition and a major cause of preterm births. Thus, an accurate diagnosis of ROM can be a key factor in determining timely and appropriate medical intervention. Similarly, a false diagnosis of ROM can lead to unnecessary hospitalisation, medication and even induced premature delivery.
Timestrip was able to provide Clinical Innovations with Time
Indicators for its ROM Plus® self-contained test kit. These give clinicians the
essential and immediate data they need to reduce the dangers of any premature
ROM for expectant mothers and their babies.
The test kit uses Timestrip technology with an in-built
20-minute time monitoring indicator that generates the required data within
5-20 minutes, with 5,10 and 20 minutes clearly indicated on the Timestrip. Its
key benefits are:
✔ Clear visual data
✔ Ease of use
✔ Improved health
Hygienic healthcare environment
Beyond pharmaceuticals and blood products, healthcare also
involves various types of disposable items that need replacing regularly.
Especially for the sick, hygiene in the clinical environment is an essential
aspect of patients being able to make a full recovery.
Assuming the absence of any complications, catheters for
instance need to be replaced every 30 days for Foley catheters and every 60-90
days for silicone catheters. Catheter bags however need to be replaced every
5-7 days. If these items are not replaced at appropriate intervals,
opportunities are created for harmful pathogens to develop.
Unsurprisingly, this has also been shown to be the case for
hospital privacy curtains. Dr Kevin Shek was the lead study author into the
rate of contamination of hospital privacy curtains in a burns/plastic ward. In
a report about the study findings in Nursing Times, he said:
“We know that privacy curtains pose a high risk for
cross-contamination because they are frequently touched but infrequently changed.
The high rate of contamination that we saw by the fourteenth day may represent
an opportune time to intervene, either by cleaning or replacing the
Especially in busy hospital departments such as Accident
& Emergency and ICU, hospital privacy curtains can quickly become
contaminated with bacteria such as methicillin-resistant S. aureus (MRSA) and
Clostridium difficile (C. diff). Thanks to Timestrip® Time Monitoring Indicator
panels that change color after a set period of time, clinical staff are alerted
when a privacy curtain needs to be changed. They help a hospital achieve:
✔ Best use of
resources with a low-cost solution
✔ Compliance with
guidelines around frequency of change
✔ Less time needed
to monitor when that change needs to occur
clean hospital environment for patients
adminEfficient, effective healthcare with Timestrip®
There are many ways to measure temperature change and for recording how long a temperature-controlled substance, material, or chemical compound, is maintained outside of its normal required temperature limits for stability, or future use. Time Out is not a new term, or monitoring application, but it is a complex one and certainly needed. The most common is for Pre-Preg and Carbon Fiber materials that must be maintained within strict temperature guidelines for flexibility and strength requirements, plus many Chemical compounds and liquid API’s (Active Pharmaceutical Ingredients). These strict limits also apply to certain bio-logics and vaccines that can only be “out-of-environment” for short periods of time whilst they are being worked with, formulated, or packaged.
These tracking solutions range from RFID tracking and monitoring with expensive tags and readers to complex solution software applications that read and record these expensive electronic devices, attached to the item being monitored, as these pass in and out of the safe temperature zones.
On the low-end monitoring is done by timers with alarms and some form of temperature recorder to show the temperature limits that the materials were exposed to. Combine both elements and you get a Time and Temperature limit that the materials were within showing how long this was for.
But in some applications, simplicity may be a better solution like – a time and temperature breach indicator label, instead of reading separate items and manually recording these for record purposes.
Timestrip Plus labels and Run Timer Labels are used for many applications ranging from monitoring event times related to an expiration of effect use life to monitoring vaccine and bio’ shipments as these pass through a logistics operation, or down the cold chain supply chain. However, if you take a Timestrip Plus label that contains a time element and a temperature limit indicator for an excursion, or the work environment temperature, you have a truly unique and simple way of measuring TOTCE!
The advantage that these labels offer is quite simple by the fact that once the label is outside of its “strike” temperature the chemical will flow down the time indicator scale to show how long the label is outside of the lower product stability-controlled temperature environment. When the material or chemical substance with the label attached is returned to the temperature-controlled environment the chemical will stop flowing and only now show the “Out-Time”. If this item is taken in and out many times the label will begin to form a total aggregated TOTCE as the chemical flows and stops each time it moves in and out of the two environments.
A record of each individual “Out-Time” can be captured by taking a photo with a Smart Phone which will show the time and date that it was taken, and this can be stored as a permanent record linked to the serial number on the label itself that will be clearly seen in the photograph.
Sometimes simple is the best approach based upon the old adage of the “KISS” philosophy, so contact Timestrip today if you want to find out more about this TOTCE solution offering.
adminTime Out of Temperature Controlled Environment – TOTCE
The big word in the logistics and supply chain “world” is RISK, and a risk assessment being performed, or at least having a mitigation plan in place, is becoming part of many certification requirements, like ISO 9001, and other pending or recently introduced federal regulations.
It will be no surprise, I am sure, when I mention certain facts like – “Where humans are involved in a process there will be errors, and 90% plus of all supply chain errors are human errors”; but how do you avoid these?
There are 4 common and accepted ways that Risk can be managed, or mitigated:
Risk Avoidance: Changes made to your processes and players that ensures risks are no longer an issue.
Risk Mitigation: Reduce the severity of the loss or prevent the likelihood of the risk from occurring.
Risk Acceptance: Avoidance of a potential risk area is not possible or economically feasible, so it is acceptable and will not impact your business.
Risk Deflection: After the risk has been identified and quantified, transfer that risk to the control of another player or partner in the process – maybe add it as a clause to be addressed in a vendor contract.
So how do you establish a Risk Mitigation Plan?
Review and audit your supply chain to assess where risk does, or may exist
Assess what the impact of these risks may be and create a list with the highest probability items at the top to address first
Define your risk mitigation strategies for the highest-level items and work down the list from High to Low
Implement the strategies and document them.
What else should I do, or know?
Even though your Risk Management plan includes good SOP’s and WI’s make sure that people are adequately trained in these disciplines
Timestrip Complete is our product that monitors upper and lower threshold temperature breaches, such as 2°-8°C cold chain monitoring for vaccine storage and transport.
The product is in fact made up of two elements: a Timestrip Plus, which is our ascending indicator that measures, for example temperature breaches above 8°C and the amount of time that they have breached, and a descending temperature indicator called Freeze Check Plus FCP for short that logs breaches, for example, below 2°C.
This is why we’ve called the indicator “Timestrip Complete”: It provides complete monitoring for the 2°-8°C cold chain.
Why was Timestrip Complete developed for vaccine storage and transport?
A vaccine is affected by heat and by freezing and the two critical temperature thresholds for storage and transport are 2°C and 8°C.
It’s time and temperature that’s the critical factor leading to degradation of vaccines.
For freezing, the crucial event is whether this has happened or not. Because vaccines are contained in an aqueous solution (water), when it freezes, it expands and the resulting crystallization can destroy the vaccine
How much does a Timestrip Complete cost?
Under US $4 per unit, and considerably less in volume purchase. It’s the lowest cost solution and easiest to implement to achieve complete 2°C-8°C temperature monitoring. Any other tool that does this job involves using a single-use digital data logger, which start at about US$10 per unit
This totally fits in with our company ethos of providing the easiest, simplest and most cost-effective products for temperature monitoring. Many 0°C or 2°C descending indicator on their own for instance normally costs at least US$2.50, so we know that our sub-US $4 price is very competitive.
How do you use Timestrip Complete?
It can be stored at room temperature, is inert until activated and has a button-like feature that needs to be pushed for activation.
There is an extra measure needed in storage to bear in mind— and this is industry-wide for all descending temperature indicators — is that they are always active.
This means they need to ship to end-users above the temperature they monitor and we achieve this by packing them with heat packs to ensure they never go below 2°C.
On the positive side from our clients point of view, because the ascending indicator can be stored at room temperature, they only need to ensure that our products are kept above freezing.
Similar products present the logistic difficulties of needing to be kept above 2°C and below 8°C, so this is a big advantage
Are there other Timestrip Complete products apart from 2°C-8°C?
Yes, this is a key range which we are looking to grow. The product also comes as 0°C-8°C
Timestrip Complete 0°C – 8°C and 2°C – 8°C are also used for the storage and transportation of medicine and biologics.
We are now launching a Controlled Room Temperature indicator that has 15°C and 25°C thresholds. These are designed for environments such as food transportation for airlines.
The key message here though is that we have the technology to produce a variety of complete upper and lower level temperature monitoring — and at a very competitive price.
What’s been the feedback so far from end-users of these complete temperature monitoring indicators?
Timestrip was involved in supporting anti-rabies work in Malawi with a 0°C-30°C indicator for the transportation and storage of canine vaccine. Rabies is huge problem in Malawi and spoilt vaccines seriously hamper efforts to address the situation.
The bottom line was that this 0°C-30°C product was successful in identifying those doses of canine vaccine that were either spoilt because of ambient heat exposure or from freezing caused by the ice-packs that are used during transportation.
This allowed for a re-stocking with unspoilt vaccines that ensured that the anti-rabies field teams’ efforts were effective and thereby measurably supported the prevention of more cases of rabies in Malawi.
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