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In Victoria, we all have the ability to utilise the Authorised Senior Medical Officer (ASMO) consent process for such incidents whereby the patient is unable to consent and the ASMO doctor consents on their behalf, based on the risk assessment to the staff member.
This is timely for staff concerns and protects the patient. Records of such ASMO consent just need to be kept centrally (usually within IP) as it discloses the staff members identity. Results should be feedback to the patient when able.
Kind regards
Maureen Canning
Operations Manager Infection Prevention
Infection Preventionist
PPE Clinical Taskforce
PPE Spotter Program
Western Health COVID-19 microsite http://www.coronavirus.wh.org.auMobile: 0435 518 536 | 83456113 | Email: maureen.canning@wh.org.au
Address: Western Health, Gordon Street, Footscray. Victoria. 3011
Web: http://www.westernhealth.org.auFrom: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Jennifer Breen
Sent: Tuesday, 6 September 2022 08:07
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Consent for BBV Testing [WARNING: Failed Authentication]Good Morning Trent,
I may have not made myself clear.
The testing would only occur in the event of a needlestick/sharps injury during theatre, there is no proposal to test every surgical patient . Each case would be risk -assessed and bloods taken if deemed appropriate. Most organisations have a 4+ hour window following anaesthetic that they would not consider gaining consent appropriate so this would occur in a case where the exposure was assessed as high risk.
Many staff are highly anxious following an injury despite education about risk and reassurance and delays in testing can have an adverse effect on them.
Post-op the patient would receive information about the incident, testing performed, results and post-test counselling as required.Many thanks
Jenny________________________________
From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> on behalf of Trent Yarwood <trentyarwood@GMAIL.COM>
Sent: Monday, 5 September 2022 5:59 PM
To: ACIPCLIST@ACIPC.ORG.AU <ACIPCLIST@ACIPC.ORG.AU>
Subject: Re: [ACIPC_Infexion_Connexion] Consent for BBV TestingHi all,
I very strongly feel that it’s completely inappropriate to be routinely testing patients for BBVs prior to surgery. As noted in the initial question, it’s generally done without consent (although I’m not very fussed about full and documented informed consent for BBV testing, which I think reinforces stigma about BBVs and is a hangover from earlier times).
In any event, the results of the tests shouldn’t change clinical management, because your surgeons / proceduralists should be using standard precautions for all patients regardless of the results and should all be vaccinated against HBV, and in the event they have a percutaneous injury, they need to a) report it to IPC; b) let the patient know, at which point testing can be done anyway. Results for BBV testing only take a few hours to get back in most labs, so they don’t affect the decision about starting PEP, and if the exposure is high-enough risk, then won’t actually change the decision about starting PEP at all.
It’s an egregious waste of money on testing with absolutely zero impact on patient care or staff safety and should be firmly discouraged. (which I grant is very difficult to do in private hospitals).
(personal opinions)
Trent Yarwood
Cairns Sexual Health / Cairns Hospital
No conflicts.—
Trent Yarwood
trentyarwood@gmail.com
PGP Key: 246AF263On Mon, 5 Sept 2022 at 15:08, Michael Wishart <Michael.Wishart@svha.org.au> wrote:
Hi Jenny
We still have both on our surgical consent form currently, but we had previously received legal advice that suggested the consent for BBV testing was not valid unless it was appropriately explained (which we know its not as the surgeon will only focus on the procedural consent). So we do not utilise that consent in the case of a needlestick, which means we need to await the patient awakening post surgery and giving consent (or in the case of post op ventilated ICU patients, get the intensive care team to obtain or authorise consent).
Thats within the private sector in Queensland.
Cheers
Michael
Michael Wishart | Infection Control Coordinator, CICP-E
St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
St Vincents Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
E michael.wishart@svha.org.au |[http://secure-web.cisco.com/1dAkddKJAzgu25iFOG6QbRMIBMz6yjr_pnQtR5NBRb5JH9CLlrx8VzSs6GKiqI7nGupJS-QBFrWaB6IHIIxPok-GM6VLevX7sUV5imGiAlBO-JcAH3NhOAfrVIe0gCDVtM8-7EuAHFxunoZ1TyNQKJ_5Z8Gwxo84Lrvn3q1bRCnkL-t5M7Dai3FvI66lOHuClOyDaUWONBzPqeQHu98RePOK0MJxVKjMlvk]
From: ACIPC Infexion Connexion On Behalf Of Jennifer Breen
Sent: Monday, 5 September 2022 12:18 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: [ACIPC_Infexion_Connexion] Consent for BBV TestingGood Morning,
We would be interested to know how many healthcare organisations have both consent for blood transfusion and consent for blood borne virus testing included in their consent for surgery documentation and any obstacles they faced when doing this.
I understand this is more common practice in the private health sector but currently am more concerned about the public sector.
Many thanks
Jenny Breen
Senior Infection Prevention Clinical Nurse Consultant
Infection Prevention & Control Unit
PO Box 52, Frankston Vic 3199
T Direct 03 9784 8239 Fax 9784 2347 Switchboard 03 9784 7777
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