[Emma Trippe]

What is a mask bracket?

Emma Trippe
Infection Control Consultant
[cid:image001.png@01D7A634.CB35CD50]
Calvary Riverina Hospital
Hardy Avenue, Wagga Wagga, NSW, 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.au

Calvary acknowledges the Traditional Custodians and Owners of the lands on which all our services operate, commits to Closing the Gap and to the ongoing journey of Reconciliation.

Hospitality | Healing | Stewardship | Respect
Continuing the Mission of the Sisters of the Little Company of Mary

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Hi Glenys,

No one is using them with N95 masks, just the surgical mask.

Kind regards,

Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control

IPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’

Hi Fiona,

Interesting!

Are they being used with N95 masks in addition to surgical masks?

If so, have you done any fit testing with the Mask Bracket/Face Mask Inner Support Frame in situ?

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
E: infexion@ozemail.com.au
[Description: ICC Diagram ICCversion]

Dear Brains Trust,

We have recently started to see the use of face mask brackets / inserts creep into use in our facility with staff wearing surgical face masks.

We have been unable to find any specific literature but from an infection prevention and control point of view we have a number of concerns including:

* Does it create a gap in the seal between mask and face?

* Does it potentially pose a risk as a pressure causing agent?

* Is removal of the mask in a manner that won’t contaminate still possible with the bracket in place?

* Is the bracket stored in a clean space?

* Is the bracket cleaned after use and before storage?

Does anyone have any references regarding these products or has anyone investigated and / or authorised the use of these products within their facility.

Kind regards,

Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control

IPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’

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[Emma Trippe]

Hi Gaby , we are now using Chlorhex gel square /dressing
Thanks Emma

Emma Trippe
Infection Control Consultant
[cid:image001.png@01D6EE5B.440BFFC0]
Calvary Riverina Hospital
Hardy Avenue, Wagga Wagga, NSW, 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.au

Calvary acknowledges the Traditional Custodians and Owners of the lands on which all our services operate, commits to Closing the Gap and to the ongoing journey of Reconciliation.

Hospitality | Healing | Stewardship | Respect
Continuing the Mission of the Sisters of the Little Company of Mary

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UNOFFICIAL

Hello,

Just wondering what other facilities are doing in relation to central line disc use – chlorhexidine gluconate or polyhexamethylene biguanide.
Any thoughts on either would be appreciated.
Thanking you in advance,

Kind Regards,
Gaby.

Gabriela Defries | RN | Infection Prevention and Control Unit
Canberra Health Services | ACT Government
Canberra Hospital | Building 24 Level 2| PO Box 11, Woden ACT 2606

Reliable | Progressive | Respectful | Kind
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[Emma Trippe]

[Emma Trippe]

[Emma Trippe]

Hi Cate , I did read somewhere in Covid19 literature ( I’ll try & find it !!) that the aircon should be on fresh not recycled,
Thanks Emma

Emma Trippe
Infection Control Consultant
[cid:image001.png@01D6A7CA.89770780]
Calvary Riverina Hospital
Hardy Avenue, Wagga Wagga, NSW, 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.au

Calvary acknowledges the Traditional Custodians and Owners of the lands on which all our services operate, commits to Closing the Gap and to the ongoing journey of Reconciliation.

Hospitality | Healing | Stewardship | Respect
Continuing the Mission of the Sisters of the Little Company of Mary

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HI everyone
Could you let me know what advice you give to members of the public waiting in their car for a COVID-19 test? Do you advise them to have windows up with A/C on fresh air or recycled air? The temp has been in the 40’s here so A/C is essential.
There seems to be 2 differing opinions. Our policy when transporting patients with active TB apart from PPE is to drive with windows down if possible and A/C on fresh air. I support windows up with COVID-19 but am confused about the A/C on recycled.
Any thoughts on his big pressing issue- ha ha
Regards
Cate Coffey
RN BaAScN MPH&TM Grad Cert Infection Control Nursing
Clinical Nurse Manager

Central Australia Health Service
Department of Health
Northern Territory Government

Infection Prevention and Control Unit
Alice Springs Hospital
PO Box 2234, Alice Springs, NT 0871
cate.coffey@nt.gov.au

t. 08 8951 7737
http://www.health.nt.gov.au

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[Emma Trippe]

[Emma Trippe]

Hi All,
Not to confuse matters – but is the beard net worn in theatres ( if person is scrubbed) for all types of beards or just beards not covered by mask ect?
Thanks Emma

Emma Trippe
Infection Control Consultant
[cid:image001.png@01D5D1EE.29773EC0]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.au

Hospitality | Healing | Stewardship | Respect
Continuing the Mission of the Sisters of the Little Company of Mary

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Hi Kylie

There are things called beard nets! We have a staff member in theatre who wears one (his beard is for cultural reasons)
They are often worn in the food (preparation) areas

Good luck

jo
Joanne Cocks | Infection Control Coordinator
St Vincent’s Melbourne | PO Box 2900 | 41 Victoria Parade, Fitzroy VIC 3065
t: +61 3 9231 4069 | f: +61 3 9231 4068 http://www.svha.org.au

[Description: Description: email signature_envision]

Hi everyone,

I’m looking for a policy or information that can provide guidance on how a dental practitioner/dental assistant could manage with a larger beard?
My instant thought is that a mask would struggle to fit over it, and with the likelihood of frequent and routine generation of aerosols – the beard would have to go. Are there hairnets or other resources that could work to support the health care worker to keep the beard, yet still manage the infection control risk?

What if the beard is worn for cultural reasons? Does culture trump infection control?

Thanks a lot for considering this, I would value any insights.

Kylie

Kylie Robb
MHSM (Clinical Leadership), CICP-P
Practice Services Manager
Australian Dental Association NSW Branch
Level 1, 1 Atchison Street, St Leonards, New South Wales 2065
t: 02 8436 9936 m: 0438 628 664
E: kylie.robb@adansw.com.au | W: http://www.adansw.com.au

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[Emma Trippe]

Hi Kristin,
AS4187 range of humidity is up to 68% I believe , if it goes over that regardless of temp , parameters are not being met & condensation may form
And range of temp for sterile stock storage is 18-25C
You may need to look at your return air flows and air exchange rates in the Sterile stock Dept
Cheers Emma

Emma Trippe
Infection Control Consultant
[cid:image001.png@01D5A5CB.08454840]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.au

Hospitality | Healing | Stewardship | Respect
Continuing the Mission of the Sisters of the Little Company of Mary

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Dear colleagues,
At what level of humidity and over what time frame would it take for condensation to form in a sterile storeroom where temperatures have fluctuated between 19 and 26 degrees over a 24 hour period and humidity has peaked at 90%?
Reason being, we have been advised that sterile stock is uncompromised at 26 degrees unless condensation has formed causing the trays to become damp.
Thanks for your assistance.
Kind regards
Kristin
Kristin Ryan-Agnew
Kristin Ryan-Agnew (MPH/Grad Cert IP&C)
Infection Prevention & Control Clinical Nurse Consultant
The Tweed Hospital

[cid:image001.png@01D36E89.D6B88C30] National Standard 3 : Preventing and Controlling Healthcare Associated Infections

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[Emma Trippe]

Hi Deb, we purchased an ANTT model , very simplistic and outlines each step you need to take in terms of running the program & to educate auditors & staff ect

Emma Trippe
Infection Control Consultant
[cid:image001.png@01D58E75.8A109CC0]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.au

Hospitality | Healing | Stewardship | Respect
Continuing the Mission of the Sisters of the Little Company of Mary

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Firstly
Thank you so much to those who replied with such great ideas,
I took advice from everyone and created an article talking about our Infection Prevention passion and how we consider it to be a multi-disciplinary effort,
I gave information and advice surrounding pre op to post op measures with some info surrounding post op infection signs

I think it came out well.

Also just checking, has anyone done a course to accredit them for ANNT auditing? I would be interested to hear what is available

Thank you
Deb

Deborah Vos
Infection Prevention & Control Coordinator
Glenelg Community Hospital
5 Farrell St Glenelg South SA 5045
P: (08) 8294 5555
E: d.vos@gchi.com.au
W: http://www.glenelghosp.com.au
[cid:image002.png@01D504DE.6DEA4C60]

Hi Deb & Michael,
These sound like great ideas. Working in general practice I ca say that advice about dressing materials can also be helpful, especially if they are new fancy types of dressing. We don’t have easy access to a wide range of dressing unless they are pre-ordered and privately purchased so to set expectations about specialised dressing would also be helpful. General practice under Medicare cannot charge bulk-billed patients for dressing so we often need to get patients to order expensive dressing separately. General Practice already supplies a lot of dressing and bears the cost, which for small business can be very expensive. The GPs & RNs will appreciate your advice.

Kind regards
Karen
Karen Booth
RN BHSCN GAICD
President APNA
Australian Primary Health Care Nurses Association
M: 0411 898 884
karenbooth1@bigpond.com

Australian Primary Health Care Nurses Association (APNA)
Level 17/350 Queen Street, Melbourne VIC 3000
p: 1300 303 184 f: (03) 9322 9599
president@apna.asn.au | http://www.apna.asn.au
[cid:image001.png@01D58B2F.D3F63730]

Hi Deb

What a great opportunity!

As a small surgical hospital, I would suggest you focus on what the GP’s would most need to know to help improve patient outcomes. Here are some ideas:

1. You could talk about antibiotic surgical prophylaxis and the guidelines.
2. You could talk about the risk factors for surgical site infections, and how pre-operative preparation can help reduce the risks.
3. You could talk about wound management post op, and reporting of surgical site infections back to the hospital (if that fits in with your infection control plan).
4. You could talk about the facility MRO screening program, and how GP’s can help with clearance (if you have a process).

There are lots of things that you could talk about, but my preferences would be things that may improve your patient’s outcomes if the GP’s implement or follow them.

Cheers
Michael

Michael Wishart | Infection Control Coordinator, CICP-E

St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au

[cid:image001.jpg@01D58B0E.A1397D00]
[2019 conference email signature]

Hi all,

I am still fairly new to my role as IPC and I find enormous value in reading your emails.
I have been asked to submit an article/item of interest for a newsletter that our hospital plans to publish for local Gp’s in the area to let them know about our growing range of surgical specialties
We are a small community hospital with no medical patients, only a few surgical patients staying 3-6 nights and day surgery.

I would be appreciative of any ideas,
Thanks in advance

Deb

Deborah Vos
Infection Prevention & Control Coordinator
Glenelg Community Hospital
5 Farrell St Glenelg South SA 5045
P: (08) 8294 5555
E: d.vos@gchi.com.au
W: http://www.glenelghosp.com.au
[cid:image001.png@01D58B0C.E2ABB570]

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[Emma Trippe]

We ask our Reps to change whilst in the facility/operating change room into our scrubs that have been adequately laundered and stored as per Laundry Standard 4146
We have an visitor registration book in theatres with associated name badges for identification & security purposes
Thanks Emma

Emma Trippe
Infection Control Consultant
[cid:image001.png@01D58E4E.5562CFB0]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.au

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Apologies, Steven, I forgot to ask you to fully identify yourself before I approved this post, although I am sure you are an employee of Draeger…

My response to this idea would be that it would not fit neatly into out scrub uniform policy. We require any person entering the OR suite to change out of clothes that are worn outside the hospital buildings into freshly laundered scrubs. Company reps would need to bring their freshly laundered scrubs with them to change into, and if they visited many hospital in a day this would be problematic.

It is a good idea for identification of company reps, but maybe not with specific scrubs.

Will be interested in further comments, though.

Cheers
Michael

Michael Wishart | Infection Control Coordinator, CICP-E

St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au

[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]

Afternoon All

We are considering “company scrubs” , branded, to help identify company reps who often work in direct clinical areas where scrubs are worn , especially in the OR.
We would like the group verdict on this proposal.
Issues already considered

Clean and correctly fitted scrubs

Regular laundry , with several sets per rep.

Disposable scrubs? …

Best regards / Mit freundlichen Gren

Steven Doak

Steven.Doak@draeger.com

Hi Marija

Yes, an old chestnut, still causing issues. I have to say upfront, though, that the evidence that scrubs make any difference (in any setting) to reduce infection risk is pretty non-existent. So I consider more an staff aesthetics and protection of clothing issue than an infection n prevention one.

1. Wearing of scrubs in endo and for bronchs is not universal, but staff have the option, when they are done outside the main theatre suite.

2. Bone marrow often biopsied in the ward, and no one has scrubs on. Some are done in Cath lab procedure room, but even then the proceduralists (who is not a cath lab staff member) wears scrubs – they may have a cover gown on rather than scrubs.

3. We have a policy that scrubs are only changed if visibly soiled, or after leaving and re-entering the building (eg walking between hospitals). No cover gowns required when visiting wards, etc, but we try and stop them visiting wards with visibly soiled scrubs!

4. We have designated tea rooms in all procedural areas, so not food outside of these. Staff may have a designated, labelled water bottle (we prefer the non-spill type) within the theatre suite, but not in the actual theatres (difficult to stop our visiting anaesthetists from bringing their drinks in their case and tipping then under their masks during procedures, though… ).

I think because of lack of ‘evidence’ to support any position this will always remain a controversial topic!

Cheers
Michael

Michael Wishart | Infection Control Coordinator, CICP-E

St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au

[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]

Good afternoon all,

This might be the chestnut that keeps giving but I am just wondering what practices are in place at your healthcare facilities with regard to:

1. The wearing of surgical scrubs for endoscopy, bone marrow biopsy, interventional radiology, thoracic procedure areas which may be co-located within general surgical suite/ zone?

2. Staff changing their scrubs when leaving and re-entering the theatre?

3. Staff consumption of food and beverages within the theatre areas including recovery nurses station?

I know it seems common sense and standards are available, but we are constantly informed to provide the evidence. Just wanting to benchmark with other HCF.

Any feedback/comments greatly appreciated.

Kind Regards

Marija Juraja |Nurse Unit Manager -CALHN Infection Prevention & Control Unit|
Division of Acute Medicine (RN, GCNS Inf Ctrl, CICP-E)
The Royal Adelaide Hospital| Central Adelaide Local Health Network
8E Rm256 Port Road, ADELAIDE 5000
The Queen Elizabeth Hospital | Central Adelaide Local Health Network
Level 8 Tower Building | 28 Woodville Road, WOODVILLE SOUTH 5011
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Adjunct Clinical Lecturer | University of South Australia | Division of Health Sciences
[cid:image001.jpg@01D4C9F1.E7C51060]
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[Emma Trippe]

Thanks so much Michael, I did read that earlier but I’ve recently heard the date has been pushed back to 2025 re CSSD compliance re AS4187 ?? Is there any notation describing this??
Thanks again , Emma

Emma Trippe
Infection Control Consultant
[cid:image001.png@01D585B4.445C12F0]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.au

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Hi Emma

This was posted on the list in August:

As you are aware, concerns have been raised with the Commission about the application of Standard Australia standard AS/NZS4187:2014 – Reprocessing of reusable medical devices in health service organisations.

The Commission agreed at the June meetings of the IJC and the Private Hospital Sector Committee to conduct a workshop to consider these issues and redraft the current Advisory AS18/07 in the interim.

Please be advised that an amended Advisory AS18/07 – Reprocessing of reusable medical devices in health service organisations was released today. It can be found on our website at the following link – https://www.safetyandquality.gov.au/publications-and-resources/resource-library/as1807-reprocessing-reusable-medical-devices-health-service-organisations

Please contact Margaret Banks on 02 9126 3684 if you have any queries in relation to this matter.

Thank you.

Kind regards,
Katherine

Katherine Norden
Manager, Secretariat and Corporate Governance
Australian Commission on Safety and Quality in Health Care
GPO Box 5480 Sydney NSW 2001 | Level 5, 255 Elizabeth Street, Sydney NSW 2000
T (02) 9126 3532 | http://www.safetyandquality.gov.au
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Cheers
Michael

Michael Wishart | Infection Control Coordinator, CICP-E

St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
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E michael.wishart@svha.org.au |
W https://www.svphn.org.au

[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]

Hi Brainstrust,
have the dates re compliance to AS4187 recently changed??
Thanks,
Emma

Emma Trippe
Infection Control Consultant
[cid:image001.png@01D585A0.1CDB66E0]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.au

Hospitality | Healing | Stewardship | Respect
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[Emma Trippe]

Hi Fiona we remove blunt needles post drawing up & place a “red cap’ on in line with AnTT practices . We tell all staff not to recap any needle .
Thanks Emma

Emma Trippe
Infection Control Consultant
[cid:image001.png@01D57A92.BC3E48B0]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.au

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Hi All,

We are currently having discussions about how to safely draw up medications and whether it is suitable to recap a blunt fill drawing up needle to expel air from a syringe.

One side of the argument is that the blunt fill is recapped so that when air is expelled the contents are not aerosolised. The other side is that a needle (blunt or otherwise) should never be recapped.

I would be interested to know other people’s thoughts and what evidence if any you have for this.

Kind regards,

Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
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IPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’

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[Emma Trippe]

[Emma Trippe]

[Emma Trippe]

We too found non- clinicians too difficult to train & they proved not to be reliable on data collection

Emma Trippe
Infection Control Consultant
[cid:image001.png@01D5537B.A1EDB290]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.au

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Hi Janine,
We tried training non clinicians and they had real trouble identifying procedures, as Ruth also found. In the end it was too difficult and could not get them over the pass mark for being auditors.

Kelly
I acknowledge the traditional owners of the land on which we work and live, and respect their ongoing custodianship of the land. I pay respect to Aboriginal people, and Elders past and present.

[cid:image001.png@01D3593E.B14EC410]

Kelly Barton
Infection Prevention & Control Officer
RN BHSc (Nursing). Grad Cert (Infection Control)(Advanced Acute Care). Nurse Immuniser.
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Hi Janine

I have previously trained non clinical staff however they needed extra support as had issues with identification of clinical procedures.

Kind regards

Ruth Foulkes Bn, MHC

District Clinical Nurse Consultant Infection Control
Clinical Governance Unit | Mount Isa Hospital
North West Hospital and Health Service | Queensland Government

p: 07 4764 4021
c: 0429474493
a: 30 Camooweal Street, Mount Isa QLD 4825
w: http://www.health.qld.gov.au
e: ruth.foulkes@health.qld.gov.au
[id:image001.jpg@01D3265A.6C9088C0]
[cid:image002.png@01D3272D.2E9C6790][cid:image003.png@01D3272D.2E9C6790][cid:image004.png@01D3272D.2E9C6790][cid:image005.png@01D3272D.2E9C6790]

Queensland Health acknowledges the Traditional Owners of
the land, and pays respect to Elders past, present and future.

Good Morning,

Do any facilities have HH auditors that are non-clinicians e.g. operational staff & admin staff?

I’m aware that HHA recommend that you should only have professional staff as auditors but have been asked the question by my line manager?

If you do, can you advise if they audit all staff and all wards?

Many thanks in advance.

Regards

Janine Egart
Clinical Nurse Consultant – DDH
Infection Prevention & Control
Clinical Governance

p: 07 46166206 | m: 0400704118 – SD 1947
a: Pechey Street, Toowoomba,QLD 4350
e: Janine.egart@health.qld.gov.au | w: Darling Downs Health
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Caring for our communities: healthier together
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Darling Downs Health acknowledges the Traditional Custodians of the land, and pays respect to Elders past, present and future.

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This email, including any attachments sent with it, is confidential and for the sole use of the intended recipient(s). This confidentiality is not waived or lost, if you receive it and you are not the intended recipient(s), or if it is transmitted/received in error.

Any unauthorised use, alteration, disclosure, distribution or review of this email is strictly prohibited. The information contained in this email, including any attachment sent with it, may be subject to a statutory duty of confidentiality if it relates to health service matters.

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If not an intended recipient of this email, you must not copy, distribute or take any action(s) that relies on it; any form of disclosure, modification, distribution and/or publication of this email is also prohibited.

Although Queensland Health takes all reasonable steps to ensure this email does not contain malicious software, Queensland Health does not accept responsibility for the consequences if any person’s computer inadvertently suffers any disruption to services, loss of information, harm or is infected with a virus, other malicious computer programme or code that may occur as a consequence of receiving this email.

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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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