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  • #70701
    Cath Murphy
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    Author:
    Cath Murphy

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    Happy new year all

    As you may know there’s a subtle movement in Australia towards more widespread adoption of single-use items such as venepuncture tourniquets, lower limb surgical tourniquets, BP cuffs and ECG leads. Tom Gottlieb recently did some elegant research on venepuncture tourniquets and AT ACIPC 2013 Karen Vickery presented new perspectives on biofilm on reusable equipment. Single-use items have been adopted widely in the US for some years and recommendations to that effect are included in many Standards published by relevant professional associations eg AORN.

    Whilst appreciating that demonstrating causality between reusable equipment and transmission of colonising organisms or infection is difficult either is biologically plausible. There are also issues of non-cleaning, lack of clarity about who’s role it actually is to clean reusable equipment, how frequently they need to be cleaned or reprocessed etc. These issues have plagued us for at least 3 decades that I know of and likely longer. I’m wondering what others in Australia and beyond think about single-use pt care items

    So my questions are:

    1. Has any ACIPC colleague successfully built a business case to convert their facility to single-use pt equipment? If so who was involved in that process?;

    2. Which pieces of pt equipment do folks think are most in need of single-use alternative options?;

    3. Other than price, storage, supply and environmental/waste issues and lack of detailed science what other factors would need to be addressed to help convince you or your organisation’s decision makers to invest in specific single-use equipment?.

    I’d be grateful for any discussion here or as PMs on the email address below. If anyone is interested in my further work around this issue please email me.

    Regards
    Cath

    Dr Cathryn Murphy RN MPH PhD CIC
    Executive Director
    Infection Control Plus Pty Ltd
    Cath@infectioncontrolplus.com.au

    Adjunct Professor
    Griffith University, School of Nursing and Midwifery
    http://www.infectioncontrolplus.com.au
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    #70702
    Montague, Cathi (Health)
    Participant

    Author:
    Montague, Cathi (Health)

    Position:

    Organisation:

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    Hi Cath you raise a very interesting series of questions and I shall watch the answers of others with keen interest!

    Single use only is definitely becoming a burgeoning industry that dramatically increases resource use and waste.

    This also poses many risks to health staff when a non-invasive item is marked as single use (rather than single patient) and could technically be re-used for that same patient given appropriate cleaning.

    A common dilemma is for patients returning home and needing to be educated in home-care of clinical equipment – the balance between sound IP&C practice and resource / fiscal sensibility can be a challenge.

    Clinical staff are potentially left open to liability if using or recommending use of clinical equipment / supplies that lies anywhere outside of the manufacturers recommendations.

    We have however sought single use specifically for some items e.g. minor surgical instrument packs, tourniquets, breast milk expression kits, given the high prevalence of BBV within our population group and the isolation of some of our services which precludes expertise /competency / resources to ensure efficacy of cleaning the item involved.

    Best Regards,
    Cathi

    Cathi Montague RN, MClinNsg, FCENA
    Nurse Management Facilitator – Clinical Care Systems Co-ordination

    ‘High quality, compassionate health care’

    SA Prison Health Service
    Central Adelaide Local Health Network
    SA Health

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    Happy new year all

    As you may know there’s a subtle movement in Australia towards more widespread adoption of single-use items such as venepuncture tourniquets, lower limb surgical tourniquets, BP cuffs and ECG leads. Tom Gottlieb recently did some elegant research on venepuncture tourniquets and AT ACIPC 2013 Karen Vickery presented new perspectives on biofilm on reusable equipment. Single-use items have been adopted widely in the US for some years and recommendations to that effect are included in many Standards published by relevant professional associations eg AORN.

    Whilst appreciating that demonstrating causality between reusable equipment and transmission of colonising organisms or infection is difficult either is biologically plausible. There are also issues of non-cleaning, lack of clarity about who’s role it actually is to clean reusable equipment, how frequently they need to be cleaned or reprocessed etc. These issues have plagued us for at least 3 decades that I know of and likely longer. I’m wondering what others in Australia and beyond think about single-use pt care items

    So my questions are:

    1. Has any ACIPC colleague successfully built a business case to convert their facility to single-use pt equipment? If so who was involved in that process?;

    2. Which pieces of pt equipment do folks think are most in need of single-use alternative options?;

    3. Other than price, storage, supply and environmental/waste issues and lack of detailed science what other factors would need to be addressed to help convince you or your organisation’s decision makers to invest in specific single-use equipment?.

    I’d be grateful for any discussion here or as PMs on the email address below. If anyone is interested in my further work around this issue please email me.

    Regards
    Cath

    Dr Cathryn Murphy RN MPH PhD CIC
    Executive Director
    Infection Control Plus Pty Ltd
    Cath@infectioncontrolplus.com.au

    Adjunct Professor
    Griffith University, School of Nursing and Midwifery
    http://www.infectioncontrolplus.com.au
    [cid:image001.jpg@01CF0C57.517E6640][cid:image002.jpg@01CF0C57.517E6640][cid:image003.jpg@01CF0C57.517E6640]

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    #70703
    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Position:

    Organisation:

    State:

    Hi Cath,
    I had not heard of a movement back to single use items so I will be interested to hear members’ responses on this topic. For oldies like me it has been interesting to see the disposable/reusable “cycle” over the decades.

    * in the 60’s we reused needles, glass syringes, gowns, etc, to reduce procurement costs;

    * in the 70’s the cost of labour to process reusables (and modern technology enabling economic production of disposables) moved us to disposables;

    * In the 80’s and 90’s waste disposal costs together with environmental impact of disposables, caused many to move to reusables again;

    * Now with staff shortages, in-house processing of reusables is being re-examined (NB. processing by external contractors can still be economical, e.g. reprocessing single-use medical devices saves USA hospitals $300m annually.
    As you point out, there have been relatively few evidence-based articles implicating disease transmission with either protocol.
    The decision to use disposables or reusables must be evidence-based encompassing patient and staff safety, labour costs, procurement costs, and environmental impact. I look forward to members’ comments

    Best regards, Terry

    Terry Grimmond FASM, BAgrSc, GrDpAdEd
    Consultant Microbiologist
    Grimmond and Associates
    Ph/Fx (NZ): +64 7 856 4042
    Mob (NZ): +64 274 365 140
    E: tg@gandassoc.com
    “This email (including any attachments) is intended only for the use of the individual or entity named above and may contain information that is confidential and privileged. If you are not the intended recipient, you are reminded that any dissemination, distribution or copying of this email or attachments is prohibited. If you have received this email in error, please notify me immediately by return email or telephone and destroy the original message. Thank you.”

    Happy new year all

    As you may know there’s a subtle movement in Australia towards more widespread adoption of single-use items such as venepuncture tourniquets, lower limb surgical tourniquets, BP cuffs and ECG leads. Tom Gottlieb recently did some elegant research on venepuncture tourniquets and AT ACIPC 2013 Karen Vickery presented new perspectives on biofilm on reusable equipment. Single-use items have been adopted widely in the US for some years and recommendations to that effect are included in many Standards published by relevant professional associations eg AORN.

    Whilst appreciating that demonstrating causality between reusable equipment and transmission of colonising organisms or infection is difficult either is biologically plausible. There are also issues of non-cleaning, lack of clarity about who’s role it actually is to clean reusable equipment, how frequently they need to be cleaned or reprocessed etc. These issues have plagued us for at least 3 decades that I know of and likely longer. I’m wondering what others in Australia and beyond think about single-use pt care items

    So my questions are:

    1. Has any ACIPC colleague successfully built a business case to convert their facility to single-use pt equipment? If so who was involved in that process?;

    2. Which pieces of pt equipment do folks think are most in need of single-use alternative options?;

    3. Other than price, storage, supply and environmental/waste issues and lack of detailed science what other factors would need to be addressed to help convince you or your organisation’s decision makers to invest in specific single-use equipment?.

    I’d be grateful for any discussion here or as PMs on the email address below. If anyone is interested in my further work around this issue please email me.

    Regards
    Cath

    Dr Cathryn Murphy RN MPH PhD CIC
    Executive Director
    Infection Control Plus Pty Ltd
    Cath@infectioncontrolplus.com.au

    Adjunct Professor
    Griffith University, School of Nursing and Midwifery
    http://www.infectioncontrolplus.com.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.

    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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    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.

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    #70704
    Wilkinson, Irene (Health)
    Participant

    Author:
    Wilkinson, Irene (Health)

    Position:

    Organisation:

    State:

    Hi all,
    as a fellow “oldie” I agree with Terry’s assessment of the trends over the years. I also support the final point about the issues involved in the decision making process. What has always puzzled me is how to accurately measure the environmental impact of either disposable or re-usable items?

    Irene Wilkinson
    Manager, Infection Control Service,
    Communicable Disease Control Branch
    SA Health
    11 Hindmarsh Square,
    Adelaide SA 5000
    ________________________________________

    Hi Cath,
    I had not heard of a movement back to single use items so I will be interested to hear members responses on this topic. For oldies like me it has been interesting to see the disposable/reusable cycle over the decades.

    in the 60s we reused needles, glass syringes, gowns, etc, to reduce procurement costs;

    in the 70s the cost of labour to process reusables (and modern technology enabling economic production of disposables) moved us to disposables;

    In the 80s and 90s waste disposal costs together with environmental impact of disposables, caused many to move to reusables again;

    Now with staff shortages, in-house processing of reusables is being re-examined (NB. processing by external contractors can still be economical, e.g. reprocessing single-use medical devices saves USA hospitals $300m annually.
    As you point out, there have been relatively few evidence-based articles implicating disease transmission with either protocol.
    The decision to use disposables or reusables must be evidence-based encompassing patient and staff safety, labour costs, procurement costs, and environmental impact. I look forward to members comments

    Best regards, Terry

    Terry Grimmond FASM, BAgrSc, GrDpAdEd
    Consultant Microbiologist
    Grimmond and Associates
    Ph/Fx (NZ): +64 7 856 4042
    Mob (NZ): +64 274 365 140
    E: tg@gandassoc.com
    “This email (including any attachments) is intended only for the use of the individual or entity named above and may contain information that is confidential and privileged. If you are not the intended recipient, you are reminded that any dissemination, distribution or copying of this email or attachments is prohibited. If you have received this email in error, please notify me immediately by return email or telephone and destroy the original message. Thank you.”

    Happy new year all

    As you may know theres a subtle movement in Australia towards more widespread adoption of single-use items such as venepuncture tourniquets, lower limb surgical tourniquets, BP cuffs and ECG leads. Tom Gottlieb recently did some elegant research on venepuncture tourniquets and AT ACIPC 2013 Karen Vickery presented new perspectives on biofilm on reusable equipment. Single-use items have been adopted widely in the US for some years and recommendations to that effect are included in many Standards published by relevant professional associations eg AORN.

    Whilst appreciating that demonstrating causality between reusable equipment and transmission of colonising organisms or infection is difficult either is biologically plausible. There are also issues of non-cleaning, lack of clarity about whos role it actually is to clean reusable equipment, how frequently they need to be cleaned or reprocessed etc. These issues have plagued us for at least 3 decades that I know of and likely longer. Im wondering what others in Australia and beyond think about single-use pt care items

    So my questions are:

    1. Has any ACIPC colleague successfully built a business case to convert their facility to single-use pt equipment? If so who was involved in that process?;

    2. Which pieces of pt equipment do folks think are most in need of single-use alternative options?;

    3. Other than price, storage, supply and environmental/waste issues and lack of detailed science what other factors would need to be addressed to help convince you or your organisations decision makers to invest in specific single-use equipment?.

    Id be grateful for any discussion here or as PMs on the email address below. If anyone is interested in my further work around this issue please email me.

    Regards
    Cath

    Dr Cathryn Murphy RN MPH PhD CIC
    Executive Director
    Infection Control Plus Pty Ltd
    Cath@infectioncontrolplus.com.au

    Adjunct Professor
    Griffith University, School of Nursing and Midwifery
    http://www.infectioncontrolplus.com.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.

    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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    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.

    You can unsubscribe from this list be sending ‘signoff aicalist’ (without 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.

    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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    #70712
    Ruth Barratt
    Participant

    Author:
    Ruth Barratt

    Position:

    Organisation:

    State:

    Hi all,
    I am interested in this discussion as I really think that environmental impact is an important consideration for us as IPC professionals. I concur that some single use patient items are useful – especially for patients in isolation, but I am concerned about the environmental (disposal) implications of going to all single use items. An example is disposable curtains. Contrary to distributer claims these are not always able to be recycled and I see that we have a responsibility to consider the wider impact of our choices in products.
    To answer your specific questions Cath –

    * We have not put in a business case to go to all single use

    * I cannot think of any particular item that does not already have a single use alternative available e.g. BP cuffs, tourniquets etc. Perhaps a finger probe cover for the Dynamap

    * The environmental issue will always be a big one here in this facility.
    Cheers

    Ruth

    [IPC logo for email signature]

    Ruth Barratt RN, BSc, MAdvPrac (Hons)
    Clinical NurseSpecialist Infection Prevention and Control
    *: ruth.barratt@cdhb.health.nz
    *: + 64 3 3640 083 or ext.80083
    [1098272744j4O36h]: 0275 263175
    Level 5, Riverside Building
    Christchurch Hospital | Private Bag 4710, Christchurch
    Clean Hands Save Lives!

    Happy new year all

    As you may know there’s a subtle movement in Australia towards more widespread adoption of single-use items such as venepuncture tourniquets, lower limb surgical tourniquets, BP cuffs and ECG leads. Tom Gottlieb recently did some elegant research on venepuncture tourniquets and AT ACIPC 2013 Karen Vickery presented new perspectives on biofilm on reusable equipment. Single-use items have been adopted widely in the US for some years and recommendations to that effect are included in many Standards published by relevant professional associations eg AORN.

    Whilst appreciating that demonstrating causality between reusable equipment and transmission of colonising organisms or infection is difficult either is biologically plausible. There are also issues of non-cleaning, lack of clarity about who’s role it actually is to clean reusable equipment, how frequently they need to be cleaned or reprocessed etc. These issues have plagued us for at least 3 decades that I know of and likely longer. I’m wondering what others in Australia and beyond think about single-use pt care items

    So my questions are:

    1. Has any ACIPC colleague successfully built a business case to convert their facility to single-use pt equipment? If so who was involved in that process?;

    2. Which pieces of pt equipment do folks think are most in need of single-use alternative options?;

    3. Other than price, storage, supply and environmental/waste issues and lack of detailed science what other factors would need to be addressed to help convince you or your organisation’s decision makers to invest in specific single-use equipment?.

    I’d be grateful for any discussion here or as PMs on the email address below. If anyone is interested in my further work around this issue please email me.

    Regards
    Cath

    Dr Cathryn Murphy RN MPH PhD CIC
    Executive Director
    Infection Control Plus Pty Ltd
    Cath@infectioncontrolplus.com.au

    Adjunct Professor
    Griffith University, School of Nursing and Midwifery
    http://www.infectioncontrolplus.com.au
    [Description: twitter logo][Description: FB logo][Description: icp icon]

    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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    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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