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Re: Norovirus

#70600
Jane Tomlinson
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Jane Tomlinson

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HI Terri
What a great discussion, here at RCH Brisbane we use P2 masks until vomiting has ceased, then we swap to contact precautions – we also see significant long standing norovirus colonisation in our oncology patients.

My rationale is that the vomiting is likely aerosol and that I should provide the best protection to my HCW.

We find outbreaks are usually from environmental persistence of a child’s vomit, and usually once we do a disinfectant clean – and find this usually stops any new cases in outbreak (of course we also close area to admission and have all exposed pts ‘at risk’ under contact precautions).

cheers
Jane

We Passed Accreditation – met with merit for standard 3 Infection Prevention – many thanks for your assistance and great work

Jane Tomlinson RN
Clinical Nurse Consultant
Infection Management and Prevention Service
Royal Children’s Hospital
Children’s Health Queensland
T: 07 3636 7856 | M: 0408 236 266
| F: 3636 5505
E: jane_tomlinson@health.qld.gov.au
Ground Floor, South Tower
Herston Rd, HERSTON QLD 4029
http://www.health.qld.gov.au/childrenshealth

>>> TERRI CRIPPS 25/10/13 15:52 >>>

Hi everyone,

Always on a Friday afternoon!
We have had a great debate here about what sort of precautions Norovirus requires and what sort of isolation room they need to be nursed in.

The NSW Ministry of Health Infection Control policy PD2007_036 states:
Contact and Airborne precautions.
P2 mask when there is potential for aerosol dissemination e.g. patient vomiting or toileting (diarrhoea), disposing of faeces.
Airborne = negative pressure room if available and P2 mask
Contact = gown/apron, gloves
Ensure consistent environmental cleaning and disinfection.

I have always advised the staff that contact and DROPLET precautions are required if the patient is vomiting or has profuse/explosive diarrhoea. I have also advised that a surgical mask is sufficient (if worn correctly). Our little ones dont vomit and expel faeces as far as adults do too.
We do not have the luxury of having a negative pressure room for them to be nursed in either as we do not have that many.
I think CDC simply suggests single rooms and contact precautions.

Just thought I would ask the other experts out there what they think about this topic?
Also if I advise staff to follow the contact and droplet precautions and surgical mask route, am I going against policy?

Any help on this matter would be appreciated. Happy to admit I am wrong!

Terri Cripps | Clinical Nurse Consultant Infection Control | Sydney Childrens Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 |8 : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140

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