Re: Reviewing management of MRO's in perioperative unit. - ACIPC - Australasian College for Infection Prevention and Control

13/12/2018 at 10:59 am #74948 Quote

Tina Muller

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Author:
Tina Muller

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Morning,

Thank-you to everyone who responded with sound advice.
Im sure I will be contacting you again in the near future when fine tuning my policy.

Regards,
Tina

Tina Muller
Clinical Nurse Consultant / Perioperative & CSD.
Mackay Hospital and Health Service
P: 07 4885 5387
E:tina.muller@health.qld.gov.au

[Email Signature]

From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Robinson, Nikki
Sent: Thursday, 13 December 2018 8:12 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: Reviewing management of MRO’s in perioperative unit.

Hi Tina,
Our approach is to treat all patients the same. We do not screen all patients so would have many unknown colonised patients. By adopting a one approach policy there is no confusion as per Michael & Joanna comments below.
We recover all patients in recovery. The only time we would recover a patient in theatre would be if they were on droplet precautions (only happened once with a norovirus patient with a # NOF)
We dont do bronchoscopies so dont have airborne precautions to contend with in theatre / endoscopy unit.
Thanks
Nikki

Nikki Robinson
Infection Control & Quality Coordinator
Noosa Hospital
07 54559206

From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Michael Wishart
Sent: Thursday, 13 December 2018 7:23 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Reviewing management of MRO’s in perioperative unit.

Hi Tina

Our approach is similar to that described by Joanna Harris. I did a presentation to some per-operative nurses here about this. The key was investigating current practices between patients and plugging the holes (ie who cleans what make sure everyone knows their role).

I think you need to work out what will work in your setting, though. I do not believe a one-size-fits-all approach will work.

Cheers
Michael

Michael Wishart | Infection Control Coordinator, CICP-E

St Vincents 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 http://www.hsnph.org.au

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From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of The Harrises
Sent: Thursday, 13 December 2018 4:31 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: Reviewing management of MRO’s in perioperative unit.

Hello Tina, and welcome.
The important thing is to thoroughly look at the risks associated with MROs in theatre balanced with the risks associated with managing patients known to be colonised. Also recognise that you do not probably know the MRO colonisation status in real time for every single patient.
Here in the Illawarra Shoalhaven in NSW we have adopted a much more horizontal approach to our infection prevention and control policies. Essentially this can be described as doing the right thing for everyone. By doing this we make things simpler for staff, prevent discriminatory practices for those patients with a history of MRO colonisation, and avoid problems such as the ones you have described with wasted theatre time and equipment issues.
I would be very happy to discuss off line, and share policies etc. if you are interested.

JoannaHarris
Nurse Manager, Infection Management and Control Service,
Illawarra Shoalhaven LHD, NSW.
Joanna.Harris@health.nsw.gov.au

Sent from my iPhone

On 7 Dec 2018, at 15:09, Tina Muller <Tina.Muller@HEALTH.QLD.GOV.AU> wrote:
Afternoon,

Im a new member, and very excited to be able to network with such a diverse body of knowledge.

Question?
We are currently reviewing our management of MROs within the perioperative Unit.
Specifically focusing on decanting theatres prior to admitting the patient into theatre.
This includes the anaesthetic drugs trolley which is kept close at hand outside the door.
Yes, we allocate an outside runner.

There are two components that we are keen to focus on.

1. Decanting the Theatre we are discussing the Non-Contact vs Contact Zone
2. Recovering of patient in the theatre ( VRE / ESBL/CRE ) vs PACU (MRSA)

These are the core issue that cause grief among the staff.
Ana Folk- not ready access to emergent equipment if required.
Loss of theatre time in recovering patient in Theatre.

As you are aware, this implicates theatre staff and activity time.
This is addressed with allocating the MRO patients to the end of the elective lists
If we have a spare theatre – we will take the MRO patients there, so there is minimal lost time in their home theatre( while someone else cleans up or recovers the patient)
No so easy to negotiate if this is an emerg patient.

Earlier this year, I emailed across QHealth via SWAPNET, and thank-you to all who responded.
This has given us much to consider, drawing us to the Contact vs Non-Contact area within the actual theatre.

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Before I totally re-write our Policy reflecting the changes, I would like the opinion of the ACIPC Network.
I thank-you for your time and consideration in this matter.

Regards,
Tina

Tina Muller
Clinical Nurse Consultant / Perioperative & CSD.
Mackay Hospital and Health Service
P: 07 4885 5387
E:tina.muller@health.qld.gov.au

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