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Hi everyone
I’ve had a request to install a hose in the sluice room of new ICU to clean bedpans etc. I have issues with this as the potential for aerosolising and splashing MRO’s would increaseAny thoughts you could share?
[cid:image001.png@01D18357.A5F5D540]
Cate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517737
e … cate.coffey@nt.gov.au http://www.nt.gov.au/healthOur Vision: Better health outcomes for all Central Australians
Our Values: Community at the Centre | Equity and Integrity | We are Accountable | We are Relevant Today and Ready for Tomorrow | We are Committed to High Quality Care | We Value our PartnershipsCentral Australia Health Service is a Smoke Free Workplace
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Hi Cate
As a matter of principle we have refused the installation of hoses in dirty utility rooms in all our new developments, and have removed hoses from existing dirty utilities. The rationale for this is the high risk of environmental contamination and health care worker exposure. We have addressed the problem of bedpans not being effectively cleaned by pan sanitisers by prospectively installing pan washer/disinfectors that have a detergent cycle. We have also had a planned program of replacement of old pan sanitisers with new.
Where we identify issues with pan cleanliness we engaged the supplier/manufacturer to review the situation and ensure the equipment is functioning appropriately and delivering clean and disinfected pans as per equipment purpose.
We have had to remind staff that pans should not be left on top of the washer/disinfected as this “cooks” the faeces onto the pan and makes it difficult to clean.
We undertake regular dirty utility room and pan audits and have identified that pans are being cleaned by the washer disinfectors in the absence of hoses in the room.
I hope this helps.
Beth
Beth Bint
Clinical Nurse Consultant | Infection Management and Control Service
Level 1 Lawson House, Wollongong Hospital 2500, NSW
Tel. 02 4222 5838 |Mob. 0475 943 952 Fax. 02 4222 5367 | beth.bint@sesiahs.health.nsw.gov.au[cid:image001.jpg@01D18378.1BB66EF0]
Hi everyone
I’ve had a request to install a hose in the sluice room of new ICU to clean bedpans etc. I have issues with this as the potential for aerosolising and splashing MRO’s would increaseAny thoughts you could share?
[cid:image001.png@01D18357.A5F5D540]
Cate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517737
e … cate.coffey@nt.gov.au http://www.nt.gov.au/healthOur Vision: Better health outcomes for all Central Australians
Our Values: Community at the Centre | Equity and Integrity | We are Accountable | We are Relevant Today and Ready for Tomorrow | We are Committed to High Quality Care | We Value our PartnershipsCentral Australia Health Service is a Smoke Free Workplace
The information in this e-mail is intended solely for the addressee named. It may contain legally privileged or confidential information that is subject to copyright. If you are not the intended recipient you must not use, disclose copy or distribute this communication. If you have received this message in error, please delete the e-mail and notify the sender. No representation is made that this e-mail is free of viruses. Virus scanning is recommended and is the responsibility of the recipient.
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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[Posted on behalf of Lindy Ryan – Moderator]
Dear Cate
I would support Beth’s response that sluice hoses DO provide a risk from aerosolising faecal & urine remnants and in contaminating the whole environment by their spray pressure mechanism (so it doesn’t matter how well they are cleaned by the pan washer disinfector if they are stored clean in a heavily contaminated environment. )
I was involved in an MRGN outbreak review in an ICU several years ago when we likely traced it back to the poor quality of bed pan cleaning in machines that did not have a detergent cycle (they were NOT clean as faecal marks were still obvious ) AND the return of the sluice hose being fixed and reinstalled for use for staff after a long time of it not working ( they were most happy that it was finally fixed they indicated to me when it was first discovered ).
All other variable risks indicators such as environmental & pt Cleaning, HH compliance & AMS, bed occupancy , pt risk groups and staffing level remained largely unchanged in the review to what may have had an impact on the outbreak. (interestingly the source pt with the MRGN used bed pans had been cleaned in this particular dirty utility room and the subsequent other cases identified had also all been located in this ICU section at one time or another & had used bed pans post this source pt admission. No pts who had only resided in the other ICU were affected )Given this factor of the sluice hose recommissioning & use prior to outbreak was initially the most obvious red flag to action first – (also dirty ‘clean’ pans yuk!) so it was removed & the room entirely cleaned and disinfected before reopening (and a new pan washer disinfector with detergent requested be purchased ) and of course by mere hawthorn effect or fear of infection control now residing in their ICU to investigate (so I believe all the other variables likely smartened up)….. the outbreak was contained once this one item was removed and environment cleaned…mmm
I further agree with Beth that The sluice hoses also pose and occupational exposure risk to staff if they aren’t wearing full PPE when using this from the aerosolising faecal matter.
I think the great email that Glenys sent out to us all on this forum on toilet flush and aerosolising is a great visual example of what we cant see but is happening and you don’t really want to wear it and take it home with you when you see what it is doing (thanks Glenys for the visual…it is ensconced in my brain permanently )!A High-Speed Super Zoomed Video Of What Happens To A Toilet When You Flush
http://www.fastcoexist.com/3021884/a-high-speed-super-zoomed-video-of-what-happens-to-a-toilet-when-you-flushhope my input of use/ interest
kind regards & good luck with hose !
kind regards
Lindy
Lindy Ryan
Infection prevention & Control Clinical Nurse Consultant (CNC) | Coffs Harbour Health Campus
Pacific Hwy Coffs Harbour NSW 2450
Tel (02) 6656 7770 | lindy.ryan@ncahs.health.nsw.gov.au
http://www.health.nsw.gov.au[http://internal.health.nsw.gov.au/communications/e-signatures/images/NSW-Health-Mid-North-Coast-LHD.jpg]
Hi everyone
I’ve had a request to install a hose in the sluice room of new ICU to clean bedpans etc. I have issues with this as the potential for aerosolising and splashing MRO’s would increaseAny thoughts you could share?
[cid:image001.png@01D18357.A5F5D540]
Cate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517737
e … cate.coffey@nt.gov.au http://www.nt.gov.au/healthOur Vision: Better health outcomes for all Central Australians
Our Values: Community at the Centre | Equity and Integrity | We are Accountable | We are Relevant Today and Ready for Tomorrow | We are Committed to High Quality Care | We Value our PartnershipsCentral Australia Health Service is a Smoke Free Workplace
The information in this e-mail is intended solely for the addressee named. It may contain legally privileged or confidential information that is subject to copyright. If you are not the intended recipient you must not use, disclose copy or distribute this communication. If you have received this message in error, please delete the e-mail and notify the sender. No representation is made that this e-mail is free of viruses. Virus scanning is recommended and is the responsibility of the recipient.
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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Hi Cate,
In terms of setting up a new facility it is wise to avoid the use of
sprayers (also called aerated spray wands) in patient toilet facilities.These are hoses with a nozzle which are installed at the back of the toilet
and used to rinse out bed pans in the toilet bowl in anteroom toilet/shower
facilities (single/multi-bed rooms) and in hoppers ( wall-mounted sinks,
with deep basins, large drains, and spray arms that flush like toilets) in
dirty utility rooms (see images attached).Sprayers seem to have been common in parts of Canada and the US (mentioned
in some of Carlings publications) and have contributed in outbreaks of
C.difficile in Canada Preliminary Findings with C.difficile Outbreak in
Cape Breton District Health Authority (CBDHA), 21 April 2011, Department of
Health and Wellness, Nova Scotia – see attached.At the time and in Quebec it seems that some healthcare facilities had
neither automated bedpan washers or macerators for processing bedpans. Where
such reprocessing machines were not available oxo-biodegradable plastic
hygienic bags (bed pan liners) were used, not sure if this is still the
case.A June 2009 Quebec report (Comparative Analysis of Bedpan Processing
Equipment) by the Agence dvaluation des technologies et des modes
dintervention en sant (AETMIS now INESSS) recommended that staff must not
empty bedpans into sinks or toilets and must no longer use spray wands. The
report includes options in terms of appropriate reprocessing methods for bed
pans and a cost analysis of each option see attached.Some years ago when reviewing plans to upgraded and retro-fit wards at a
healthcare facility I worked at we were asked to approve the use of sprayers
in patient ensuites to rinse out bed pans in the toilet bowl. The request
came from a USA director of nursing who was planning to remove the automated
bedpan washers from the wards as they were located outside patient rooms and
were very noisy.Because of the risk of environmental contamination they were not approved by
infection control and automated bedpan washers were installed in designated
ward dirty utility rooms (1-2 per ward) which in the upgrade were located
away from patient bedrooms.Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
ABN 47533508426
Of Cate Coffey
Hi everyone
Ive had a request to install a hose in the sluice room of new ICU to clean
bedpans etc. I have issues with this as the potential for aerosolising and
splashing MROs would increaseAny thoughts you could share?
Cate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517737
e … cate.coffey@nt.gov.au http://www.nt.gov.au/health
Our Vision: Better health outcomes for all Central Australians
Our Values: Community at the Centre | Equity and Integrity | We are
Accountable | We are Relevant Today and Ready for Tomorrow | We are
Committed to High Quality Care | We Value our PartnershipsCentral Australia Health Service is a Smoke Free Workplace
The information in this e-mail is intended solely for the addressee named.
It may contain legally privileged or confidential information that is
subject to copyright. If you are not the intended recipient you must not
use, disclose copy or distribute this communication. If you have received
this message in error, please delete the e-mail and notify the sender. No
representation is made that this e-mail is free of viruses. Virus scanning
is recommended and is the responsibility of the recipient.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 –
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the quotes) to listserv@aicalist.org.auMESSAGES 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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