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  • #69898
    Marie Daws
    Participant

    Author:
    Marie Daws

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    Hi

    I have been informed that our hospital blood and body fluid exposure policy has not been followed since 2005, regarding first aid, as it is impractical for scrubbed theatre staff to rinse the affected site with soap and water (or normal saline for mucous membrane exposures). Current practice involves pouring betadine on the site.

    Has anyone else encountered a similar problem? And have you any ideas how I could manage this?

    Many thanks

    Marie Daws
    Infection Control Coordinator

    Hospital & Day Surgery
    SPORTSMED*SA
    32 Payneham Road
    Stepney SA 5069

    T: (08) 8130 1100
    F: (08) 8130 1101
    E: marie.daws@sportsmed.com.au
    W: http://www.sportsmed.com.au

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    #69900
    Lincoln Fowler
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    Author:
    Lincoln Fowler

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    Dear Marie

    I would view this as an occupational health and safety risk firstly and
    present it as such to the managers of the theatre and/or service
    executive. The management may not agree with the theatre staff
    assessment of practical or practicable.

    Clearly there are infection implications for staff too.

    Regards

    Lincoln Fowler / Infection Control

    Child and Adolescent Community Health

    Department of Health

    E: Lincoln.Fowler@health.wa.gov.au

    L3 WASON, 151 Wellington St, PERTH WA 6000

    http://www.health.wa.gov.au

    Delivering a Healthy WA

    ________________________________

    Behalf Of Marie Daws

    Hi

    I have been informed that our hospital blood and body fluid exposure
    policy has not been followed since 2005, regarding first aid, as it is
    impractical for scrubbed theatre staff to rinse the affected site with
    soap and water (or normal saline for mucous membrane exposures). Current
    practice involves pouring betadine on the site.

    Has anyone else encountered a similar problem? And have you any ideas
    how I could manage this?

    Many thanks

    Marie Daws

    Infection Control Coordinator

    Hospital & Day Surgery

    SPORTSMED*SA

    32 Payneham Road

    Stepney SA 5069

    T: (08) 8130 1100

    F: (08) 8130 1101

    E: marie.daws@sportsmed.com.au

    W: http://www.sportsmed.com.au

    ________________________________

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    #69902
    Michael Wishart
    Participant

    Author:
    Michael Wishart

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    Hi Marie

    I think your facility and operating theatre staff need to review their management of blood and body fluid exposures during procedures, based on a risk assessment. First aid for simple needlesticks is, as far as I am aware, potentially of little value in decreasing the risk of infection post needlestick (there is some debate about this). I don’t think there is much evidence to say that either a soap and water or an antiseptic wash is any better for this.

    However, what you do need to ensure is that any punctures of gloves and skin are managed to minimise the risk of bleeding into a patient. Therefore, you should not be saying it is ‘impractical’ to allow a scrub nurse or proceduralist to change gloves and manage any needlestick wounds, as exposing a patient to their blood would be considered unacceptable in a court of law unless it was a life- and-death emergency (eg open cardiac massage)

    Splashes to mucous membranes do require immediate first aid, and any delay in rinsing mucous membranes after a splash could increase the chances of seroconversion to a blood-borne virus. Unless the scrub nurse or proceduralist is immediately risking the patient’s life by taking time to have their mucous membranes rinsed, occupational health & safety legislation would require your facility to have a process for minimising risks form such exposures. Unless there was a process to allow staff who had splashes to mucous membranes rapid access to copious rinsing, your facility could be found in breach of its duty of care to the staff.

    My thoughts would be to consider these risks, and discuss them with the surgical teams involved. Just to say it is ‘impractical’ would not, in my view, be considered acceptable in managing these risks. The days when healthcare workers risk their own health and safety just ‘because’ are gone, and facilities need to be mindful of the potential legal consequences of not managing these risks well.

    These are my personal thoughts as an experienced occupational health nurse and infection control practitioner. Sometimes we need to remind staff of the risk to them personally as well as to their whole workplace in order to effect a change to the culture.

    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

    Hi

    I have been informed that our hospital blood and body fluid exposure policy has not been followed since 2005, regarding first aid, as it is impractical for scrubbed theatre staff to rinse the affected site with soap and water (or normal saline for mucous membrane exposures). Current practice involves pouring betadine on the site.

    Has anyone else encountered a similar problem? And have you any ideas how I could manage this?

    Many thanks

    Marie Daws
    Infection Control Coordinator

    Hospital & Day Surgery
    SPORTSMED*SA
    32 Payneham Road
    Stepney SA 5069

    T: (08) 8130 1100
    F: (08) 8130 1101
    E: marie.daws@sportsmed.com.au
    W: http://www.sportsmed.com.au

    ________________________________
    This email and any files attached are confidential and intended only for the use of the individual or entity to whom they are addressed.

    If you have received this email in error, you are prohibited from reading, copying, distributing and using the information. Please contact the sender immediately by return email and destroy the original message. Any views expressed in this email are not necessarily the views of SPORTSMED*SA.
    Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.

    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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