Clearance of MRO post-discharge

[Michael Wishart]

Hi all

I am seeking some information on current practices on ‘clearing’ patients from requiring transmission based precautions for MRO carriage on re-admission. I am aware of different guidelines about ‘clearance’ for MRO’s, but wondered if any facilities actively tries to clear a patient after discharge to the community (not via facility outpatient visits). We are looking at trialling a program for providing patients with information and pathology forms on discharge to have specimens collected with their GP or private pathology collection centre to assist to ‘clear’ them from the MRO prior to the next admission. Obviously this will need to done in conjunction with our current ‘clearance’ guidelines (eg no current wounds, no antibiotic treatment within a specified time frame, no indwelling devices, correct specimen types, etc).

Is anyone doing this currently? Has anyone tried this and stopped?

I hope you this question is clear. Thanks for any responses.

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
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[Beckingham, Wendy]

Hello Michael
here at TCH we have been supplying more a letter to the GP re clearance. Happy to send to you if you would like.
We receive a print also of the patients attending outpatients and this has been a good way to help with clearance swabs
Back to the GP way of seeking clearance, we are continuing even though we have had mixed results I do think it helps with education and information for the GP. We have also placed a posting in the GP liaison newsletter to help with the process.
Happy to talk off line if you wish.

Wendy Beckingham
CNC Infection Prevention and Control
ph. (02) 6244 3695 or mobile 0478408787 orpager 50390
e. wendy.beckingham@act.gov.au
Care Excellence Collaboration Integrity
GERMS CAN KILL…
[CH_Logo_ACT_Health_Lockup_CMYK_HR]

Hi all

I am seeking some information on current practices on ‘clearing’ patients from requiring transmission based precautions for MRO carriage on re-admission. I am aware of different guidelines about ‘clearance’ for MRO’s, but wondered if any facilities actively tries to clear a patient after discharge to the community (not via facility outpatient visits). We are looking at trialling a program for providing patients with information and pathology forms on discharge to have specimens collected with their GP or private pathology collection centre to assist to ‘clear’ them from the MRO prior to the next admission. Obviously this will need to done in conjunction with our current ‘clearance’ guidelines (eg no current wounds, no antibiotic treatment within a specified time frame, no indwelling devices, correct specimen types, etc).

Is anyone doing this currently? Has anyone tried this and stopped?

I hope you this question is clear. Thanks for any responses.

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

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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[Jane Tomlinson]

HI Michael
I do try to follow up our repeated hospital stayer patients at home, I provide information on home decolonisation process & suggest same to treating team, and I send a home screening pathology package, in line with MRO clearances as you noted.
Happy to discuss further if requested
cheers
Jane

How long until Accreditation Visit?
http://qheps.health.qld.gov.au/childrenshealth/html/che/achs-accred.htm
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

>>> Michael Wishart 28/06/13 12:45 >>>

Hi all

I am seeking some information on current practices on clearing patients from requiring transmission based precautions for MRO carriage on re-admission. I am aware of different guidelines about clearance for MROs, but wondered if any facilities actively tries to clear a patient after discharge to the community (not via facility outpatient visits). We are looking at trialling a program for providing patients with information and pathology forms on discharge to have specimens collected with their GP or private pathology collection centre to assist to clear them from the MRO prior to the next admission. Obviously this will need to done in conjunction with our current clearance guidelines (eg no current wounds, no antibiotic treatment within a specified time frame, no indwelling devices, correct specimen types, etc).

Is anyone doing this currently? Has anyone tried this and stopped?

I hope you this question is clear. Thanks for any responses.

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

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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[Rebecca O’Donnell]

Hi Michael,

For years now Katie and I have sent letters to the GP / Specialist inviting them to participate in screening as per Chrisp screening protocols. We do see some GPs take it on their own back and conduct screening however this would only equate to a small group.

We also send the letter out esp. for those patient who have been discharged prior to results being known, file them in their Med records charts so when the readmit there is a record that we have notified their health provider. Again not all GPs will pass this information on for us.

Thanks,

Rebecca O’Donnell | Infection Prevention and Control Co-ordinator
St Vincent’s Hospital Toowoomba | 22-36 Scott Street TOOWOOMBA 4350
T 07 4690 4042 | F 07 46904400
E rebecca.o’donnell@stvincents.org.au | W http://www.stvincents.org.au

P Please consider the environment before printing this email.
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 be 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.

Hi all

I am seeking some information on current practices on ‘clearing’ patients from requiring transmission based precautions for MRO carriage on re-admission. I am aware of different guidelines about ‘clearance’ for MRO’s, but wondered if any facilities actively tries to clear a patient after discharge to the community (not via facility outpatient visits). We are looking at trialling a program for providing patients with information and pathology forms on discharge to have specimens collected with their GP or private pathology collection centre to assist to ‘clear’ them from the MRO prior to the next admission. Obviously this will need to done in conjunction with our current ‘clearance’ guidelines (eg no current wounds, no antibiotic treatment within a specified time frame, no indwelling devices, correct specimen types, etc).

Is anyone doing this currently? Has anyone tried this and stopped?

I hope you this question is clear. Thanks for any responses.

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

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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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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[Beth Bint]

Hi Michael

We offer post discharge clearance to our patients via a nurse-led clearance clinic. We did attempt active recruiting to the clearance clinics, although the results for clearance were very pleasing, it was a very labour intensive process.

We now offer this service via information provided at the time of the result or direct request from the patient. We have a well documented pathway and correspondence documents for this process which we would be happy to share.

We have tried to engage GPs with this process with limited results.

A very important factor is that MRSA screening is not covered by Medicare so healthcare facility must bare the cost of pathology tests, or if the patient chooses to have this performed by their GP the patient should pay for the pathology.

The rationale for this not being covered by medicare is that it is not a clinically indicated procedure (in the majority of instances).

Cheers
Beth

Beth Bint

Infection Prevention and Control Clinical Nurse Consultant | Infection Management and Control Service
Level 1 Lawson House Wollongong Hospital
Tel 02 4222 5898 |beth.bint@SESIAHS.HEALTH.NSW.GOV.AU
http://www.health.nsw.gov.au
________________________________

Hi all

I am seeking some information on current practices on clearing patients from requiring transmission based precautions for MRO carriage on re-admission. I am aware of different guidelines about clearance for MROs, but wondered if any facilities actively tries to clear a patient after discharge to the community (not via facility outpatient visits). We are looking at trialling a program for providing patients with information and pathology forms on discharge to have specimens collected with their GP or private pathology collection centre to assist to clear them from the MRO prior to the next admission. Obviously this will need to done in conjunction with our current clearance guidelines (eg no current wounds, no antibiotic treatment within a specified time frame, no indwelling devices, correct specimen types, etc).

Is anyone doing this currently? Has anyone tried this and stopped?

I hope you this question is clear. Thanks for any responses.

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

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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[Lavina L’Hotellier]

Hi Beth,
I would like to learn more about MRO clearance.
I have one day allocated to Infection Prevention and Control in a small
rural hospital in Victoria.
We are seeing more MRO’s- MRSA, NMRSA, multi resistant pseudomonas more
commonly lately.
I am interested in anything that you are able to share please.
Lavina L’Hotellier
Infection Prevention and Control
Orbost Regional Health
ph- 03 51546777

————————————————–

> Hi Michael
>
> We offer post discharge clearance to our patients via a nurse-led
> clearance clinic. We did attempt active recruiting to the clearance
> clinics, although the results for clearance were very pleasing, it was a
> very labour intensive process.
>
> We now offer this service via information provided at the time of the
> result or direct request from the patient. We have a well documented
> pathway and correspondence documents for this process which we would be
> happy to share.
>
> We have tried to engage GPs with this process with limited results.
>
> A very important factor is that MRSA screening is not covered by Medicare
> so healthcare facility must bare the cost of pathology tests, or if the
> patient chooses to have this performed by their GP the patient should pay
> for the pathology.
>
> The rationale for this not being covered by medicare is that it is not a
> clinically indicated procedure (in the majority of instances).
>
> Cheers
> Beth
>
> Beth Bint
>
> Infection Prevention and Control Clinical Nurse Consultant | Infection
> Management and Control Service
> Level 1 Lawson House Wollongong Hospital
> Tel 02 4222 5898
> |beth.bint@SESIAHS.HEALTH.NSW.GOV.AU
> http://www.health.nsw.gov.au
> ________________________________
> From: ACIPC Infexion Connexion [AICALIST@AICALIST.ORG.AU] On Behalf Of
> Michael Wishart [Michael.Wishart@hsn.org.au]
> Sent: Friday, 28 June 2013 12:45 PM
> To: AICALIST@AICALIST.ORG.AU
> Subject: Clearance of MRO post-discharge
>
> Hi all
>
> I am seeking some information on current practices on clearing patients
> from requiring transmission based precautions for MRO carriage on
> re-admission. I am aware of different guidelines about clearance for MROs,
> but wondered if any facilities actively tries to clear a patient after
> discharge to the community (not via facility outpatient visits). We are
> looking at trialling a program for providing patients with information
> and pathology forms on discharge to have specimens collected with their GP
> or private pathology collection centre to assist to clear them from the
> MRO prior to the next admission. Obviously this will need to done in
> conjunction with our current clearance guidelines (eg no current wounds,
> no antibiotic treatment within a specified time frame, no indwelling
> devices, correct specimen types, etc).
>
> Is anyone doing this currently? Has anyone tried this and stopped?
>
> I hope you this question is clear. Thanks for any responses.
>
> 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
>
>
>
> 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.
>
> ________________________________
> Message protected by MailGuard: e-mail anti-virus, anti-spam and content
> filtering.
> http://www.mailguard.com.au
>
>
> Messages posted to this list are solely the opinion of the authors, and do
> not represent the opinion of ACIPC.
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> 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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>
> You can unsubscribe from this list be sending ‘signoff aicalist’ (without
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> ———————————————————————————————
>
> Illawarra Shoalhaven Local Health District, South East Sydney Local Health
> District and Sydney Children’s Hospital Network (Randwick Campus)
> Confidentiality Notice
>
> This email, and the files transmitted with it, are confidential and
> intended solely for the use of the individual or entity to whom they are
> addressed. If you are not the intended recipient, you are not permitted to
> distribute or use this email or any of its attachments in any way. We also
> request that you advise the sender of the incorrect addressing.
>
> This email message has been virus-scanned. Although no computer viruses
> were detected, Illawarra Shoalhaven Local Health District, South East
> Sydney Local Health District and Sydney Children’s Hospital Network
> (Randwick Campus) accept no liability for any consequential damage
> resulting from email containing any computer viruses.
>
> Messages posted to this list are solely the opinion of the authors, and do
> not represent the opinion of ACIPC.
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