CJD

[SAWMH.ICC]

Good morning Everyone,

We are currently reviewing our Risk assessment tool. We have added Infection Control questions, these include risks for MRO’s, wounds / devices and cCJD.
We don’t have enough space to add all the infection control risks . We have a few questions on CJD but I was hoping to reduce the number to only 2 questions.
Can anyone please share with me, your questions on the risk for CJD?

Thank you

Marlize Senekal
Infection Prevention and Control Coordinator
St. Andrew’s War Memorial Hospital
457 Wickham Terrace, Spring Hill
Brisbane
Ph. 07-3834 4444
Ext. 4328, Pg. 0328

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[Michele.Cullen@HEALTH.VIC.GOV.AU Subject: Re: CJD In-Reply-To:]

Dear Marlize

The CJD guidelines questions should be asked by the treating medical
officer. They should form part of the decision making related to the need
for surgery, as part of the diagnostic work-up, and any surgical
arrangements.
They should only be asked if the patient is having high risk tissue surgery
and is either low risk or high risk for CJD.

Please refer to:
Table 1 on page 4 Known or predicted infectivity of human body tissues
and fluids for CJD
Section 2.3 Patient risk categories on page 5
Section 2.4 Risk assessment on page 5 – Table 2
Appendix 3 Risk assessment tool on page 19
Appendix 4 summary of actions for a surgical procedure on page 21.

Together they help the treating medical officer to decide if:
this is a background/low/high risk patient
the procedure involves high-medium or low-no infectivity tissue
the reprocessing required, that is, routine or additional procedures
(Table 2)

Therefore, there is no need for all patients being admitted to a health
care facility to be routinely asked questions about CJD when they are not
in any of the above situations, particularly when you frequently have to
explain what it is.

NBWe now refer to CJD as CJD and not cCJD – the term classical has been
dropped internationally. That is, it is CJD (in its various forms) and
vCJD.

I am a member of the CDNA writing group which revised the current
guidelines which are not very different to the 2007 version. There is some
clarification and additional detail in some sections but the basic premise
is the same.

I would be happy for you to contact me off line if you wish.

Regards

(Embedded (Embedded image moved to file: pic27048.jpg)
image moved
to file:
pic30484.jpg)

Michele Cullen
Infection Control Consultant | Communicable Disease Prevention and
Control | Public Health
Department of Health | 50 Lonsdale Street, Melbourne, Victoria,
3000
p. 03 9096 5094 | f. 1300 651 170
e. michele.cullen@health.vic.gov.au

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Good morning Everyone,

We are currently reviewing our Risk assessment tool. We have added
Infection Control questions, these include risks for MRO’s, wounds /
devices and cCJD.
We don’t have enough space to add all the infection control risks . We have
a few questions on CJD but I was hoping to reduce the number to only 2
questions.
Can anyone please share with me, your questions on the risk for CJD?

Thank you

Marlize Senekal
Infection Prevention and Control Coordinator
St. Andrew’s War Memorial Hospital
457 Wickham Terrace, Spring Hill
Brisbane
Ph. 07-3834 4444
Ext. 4328, Pg. 0328

Uniting Care Health Email Disclaimer: http://www.uchealth.com.au/disclaimer
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.

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

Replies to this message will be directed back to the list. To create a new
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aicalist-request@aicalist.org.au.

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the quotes) to listserv@aicalist.org.au

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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[Michael Wishart]

Hi Marlize

This is a bit tricky, as you need to be able to identify all of the risks for CJD when asking these questions. Also confounding is the fact that the questions recommended for assessment of CJD risk in Appendix 13 of the January 2013 CJD document from the CJD ICG Working Group (http://www.health.gov.au/internet/main/publishing.nsf/content/AC9448D36D359F50CA2577C40016F0F6/$File/CJDInfectionControlGuidelinesJan2013.pdf) are recommended to be asked of the treating medical officer, not the patient. We have managed to reduce the questions to only 5 on our pre-admission assessment, and they relate to the following risks:

– Patient or two or more family members with history of CJD

– Received human pituitary hormone prior to 1985

– Received dura mater graft prior to 1986

– Recent undiagnosed rapid progressive dementia

– Involved in a ‘lookback’ for CJD exposure

We tried to reduce these questions even more, but we felt we would miss out on some risks if we did not ask explicitly. The trick is to word the questions in a way most patients will understand.

Another option is to include a very simple CJD risk assessment for all patients, and then a more comprehensive assessment for those undergoing vat-risk procedures (defined in the guidelines as: ‘eg neurosurgery, spinal cord surgery, ophthalmic surgery, pituitary surgery’). The major difficulty for this is when is this assessment done and by whom, ensuring you do not miss any eligible patients.

Hope these thoughts help.

Cheers
Michael

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
Please consider the environment before printing this email

Good morning Everyone,

We are currently reviewing our Risk assessment tool. We have added Infection Control questions, these include risks for MRO’s, wounds / devices and cCJD.
We don’t have enough space to add all the infection control risks . We have a few questions on CJD but I was hoping to reduce the number to only 2 questions.
Can anyone please share with me, your questions on the risk for CJD?

Thank you

Marlize Senekal
Infection Prevention and Control Coordinator
St. Andrew’s War Memorial Hospital
457 Wickham Terrace, Spring Hill
Brisbane
Ph. 07-3834 4444
Ext. 4328, Pg. 0328

Uniting Care Health Email Disclaimer: http://www.uchealth.com.au/disclaimer
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.

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

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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[SAWMH.ICC]

Thank you to Everyone who have responded to my question on CJD.

We are currently using the questions below, but like I’ve mentioned, it gets tricky when you don’t have much space to work with and you need to ask all of these.

Best wishes

Marlize Senekal
Infection Prevention and Control Coordinator
St. Andrew’s War Memorial Hospital
457 Wickham Terrace, Spring Hill
Brisbane
Ph. 07-3834 4444
Ext. 4328, Pg. 0328

________________________________

Hi Marlize

This is a bit tricky, as you need to be able to identify all of the risks for CJD when asking these questions. Also confounding is the fact that the questions recommended for assessment of CJD risk in Appendix 13 of the January 2013 CJD document from the CJD ICG Working Group (http://www.health.gov.au/internet/main/publishing.nsf/content/AC9448D36D359F50CA2577C40016F0F6/$File/CJDInfectionControlGuidelinesJan2013.pdf) are recommended to be asked of the treating medical officer, not the patient. We have managed to reduce the questions to only 5 on our pre-admission assessment, and they relate to the following risks:

– Patient or two or more family members with history of CJD

– Received human pituitary hormone prior to 1985

– Received dura mater graft prior to 1986

– Recent undiagnosed rapid progressive dementia

– Involved in a ‘lookback’ for CJD exposure

We tried to reduce these questions even more, but we felt we would miss out on some risks if we did not ask explicitly. The trick is to word the questions in a way most patients will understand.

Another option is to include a very simple CJD risk assessment for all patients, and then a more comprehensive assessment for those undergoing vat-risk procedures (defined in the guidelines as: ‘eg neurosurgery, spinal cord surgery, ophthalmic surgery, pituitary surgery’). The major difficulty for this is when is this assessment done and by whom, ensuring you do not miss any eligible patients.

Hope these thoughts help.

Cheers
Michael

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
Please consider the environment before printing this email

Good morning Everyone,

We are currently reviewing our Risk assessment tool. We have added Infection Control questions, these include risks for MRO’s, wounds / devices and cCJD.
We don’t have enough space to add all the infection control risks . We have a few questions on CJD but I was hoping to reduce the number to only 2 questions.
Can anyone please share with me, your questions on the risk for CJD?

Thank you

Marlize Senekal
Infection Prevention and Control Coordinator
St. Andrew’s War Memorial Hospital
457 Wickham Terrace, Spring Hill
Brisbane
Ph. 07-3834 4444
Ext. 4328, Pg. 0328

Uniting Care Health Email Disclaimer: http://www.uchealth.com.au/disclaimer
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.

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

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

To send a message to the list administrator send an email to aicalist-request@aicalist.org.au.

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________________________________
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Report this message as spam

WARNING : This email contains information, which is CONFIDENTIAL, and that maybe subject to LEGAL PRIVILEGE. This e-mail and any attachments to it (the “Communication”) is confidential and is for the use only of the intended recipient, and may not duplicated or used by any other party without the express consent of the sender. The Communication may contain copyright material of St Vincent’s Health & Aged Care(“SVHAC”), or any of its related entities or of third parties. If you are not the intended recipient of the Communication, please notify the sender immediately by return e-mail, delete the Communication, and do not read, copy, print, retransmit, store or act in reliance on the Communication. Any views expressed in the Communication are those of the individual sender only, unless expressly stated to be those of SVHAC. SVHAC does not guarantee the integrity of the Communication, or that it is free from errors, viruses or interference. Thank-you.

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

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Uniting Care Health Email Disclaimer: http://www.uchealth.com.au/disclaimer

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.

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

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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