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  • #69252
    Rebecca O’Donnell
    Participant

    Author:
    Rebecca O’Donnell

    Position:

    Organisation:

    State:

    Good morning,

    I would love some feedback regarding restrictions of visitors to Special care nurseries.

    Who do you restrict? Other siblings?

    I feel as long as Hand hygiene is performed and the visitor is well I personal feel that there is no real significant risk.

    Some of our staff feel that in the case of twins, one goes home and one stays in the nursery then the well twin shouldn’t visit as the baby might pose a threat to the babies in Special care (perhaps from a whooping cough point of view).

    Thanks,

    Rebecca O’Donnell | Infection 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.


    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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    #69253
    Jane Tomlinson
    Participant

    Author:
    Jane Tomlinson

    Position:

    Organisation:

    State:

    HI Rebecca
    Great question, I guess the risk lies with the capability for the
    department for screening of children who may be visiting the nursery to
    exclude signs of droplet or gastrointestinal infection? As you know
    influenza is infectious for two days prior to symptoms.

    Here at the RCH Bris we have see several cases of ‘hospital acquired’
    infection in at risk patients brought in by siblings, children will
    randomly vomit when they have norovirus and have limited personal
    hygiene.

    In fact 3 years ago we excluded all children under 14yrs from visiting
    in the inpatient baby area due to the repeated infections brought in
    this way. Yes this is difficult logistically for parents and siblings
    and less family centred care but we felt protecting the already
    compromised infants had to be foremost in our recommendations. We find
    that visitors/siblings minimise their infections and potential risks as
    they are so keen to visit with the sick patient and they don’t well
    understand the consequences to the sick patient.

    It is left up to the nurse in charge of the ward in special
    circumstances to adjust this on a case by case basis such as for those
    with multiple births.
    Also our baby room has ‘viewing’ windows for siblings to see the baby
    rather than directly visit.

    In my experience working at NICU and SCN who did not allow any visits
    from children under 14yrs this screening and control of visitors would
    then conceivably fall to the nurse at bedside and could potentially
    create some quite challenging interpersonal situations.

    Being creative I would wonder if you could incorporate a infectious
    symptoms screening tool for use at the bedside, could this require some
    discussion and or documentation with each group of visitors.

    regards
    Jane

    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
    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
    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
    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
    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
    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

    >>> “Rebecca O’Donnell” 7/08/12
    11:23 >>>

    Good morning,

    I would love some feedback regarding restrictions of visitors to
    Special care nurseries.

    Who do you restrict? Other siblings?

    I feel as long as Hand hygiene is performed and the visitor is well I
    personal feel that there is no real significant risk.

    Some of our staff feel that in the case of twins, one goes home and one
    stays in the nursery then the well twin shouldnt visit as the baby
    might pose a threat to the babies in Special care (perhaps from a
    whooping cough point of view).

    Thanks,

    Rebecca ODonnell | Infection Control Co-ordinator
    St Vincent’s Hospital Toowoomba | 22-36 Scott Street TOOWOOMBA 4350
    T07 4690 4042|F 07 46904400
    Erebecca.odonnell@stvincents.org.au (
    http://rebecca.o’donnell@stvincents.org.au )|W http://www.stvincents.org.au (
    http://www.stvincents.org.au/ )

    P Please consider the environment beforeprinting 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.

    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
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    This email, including any attachments sent with it, is confidential and for the sole use of the intended recipient(s). This confidentiality is not waived or lost, if you receive it and you are not the intended recipient(s), or if it is transmitted/received in error.
    Any unauthorised use, alteration, disclosure, distribution or review of this email is strictly prohibited. The information contained in this email, including any attachment sent with it, may be subject to a statutory duty of confidentiality if it relates to health service matters.
    If you are not the intended recipient(s), or if you have received this email in error, you are asked to immediately notify the sender by telephone collect on Australia +61 1800 198 175 or by return email. You should also delete this email, and any copies, from your computer system network and destroy any hard copies produced.
    If not an intended recipient of this email, you must not copy, distribute or take any action(s) that relies on it; any form of disclosure, modification, distribution and/or publication of this email is also prohibited.
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    #69254
    Rebecca O’Donnell
    Participant

    Author:
    Rebecca O’Donnell

    Position:

    Organisation:

    State:

    Jane I appreciate your input. You have certainly bought up some great points to discuss further. Yes a screening tool may be something to consider. Thank you for sharing your experiences and information.

    Again your time is very much appreciated.

    Kind regards,

    Rebecca ODonnell | Infection Control Co-ordinator
    St Vincent’s Hospital Toowoomba | 22-36 Scott Street TOOWOOMBA 4350
    T 07 4690 4042 | F 07 46904400
    E rebecca.odonnell@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.

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Jane Tomlinson
    Sent: Tuesday, 7 August 2012 1:18 PM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: Special care nursery

    HI Rebecca
    Great question, I guess the risk lies with the capability for the department for screening of children who may be visiting the nursery to exclude signs of droplet or gastrointestinal infection? As you know influenza is infectious for two days prior to symptoms.

    Here at the RCH Bris we have see several cases of ‘hospital acquired’ infection in at risk patients brought in by siblings, children will randomly vomit when they have norovirus and have limited personal hygiene.

    In fact 3 years ago we excluded all children under 14yrs from visiting in the inpatient baby area due to the repeated infections brought in this way. Yes this is difficult logistically for parents and siblings and less family centred care but we felt protecting the already compromised infants had to be foremost in our recommendations. We find that visitors/siblings minimise their infections and potential risks as they are so keen to visit with the sick patient and they don’t well understand the consequences to the sick patient.

    It is left up to the nurse in charge of the ward in special circumstances to adjust this on a case by case basis such as for those with multiple births.
    Also our baby room has ‘viewing’ windows for siblings to see the baby rather than directly visit.

    In my experience working at NICU and SCN who did not allow any visits from children under 14yrs this screening and control of visitors would then conceivably fall to the nurse at bedside and could potentially create some quite challenging interpersonal situations.

    Being creative I would wonder if you could incorporate a infectious symptoms screening tool for use at the bedside, could this require some discussion and or documentation with each group of visitors.

    regards
    Jane

    Jane Tomlinson RN
    Clinical Nurse Consultant
    Infection Management and Prevention Service
    Royal Children’s Hospital
    Children’s HealthQueensland
    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
    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
    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
    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
    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
    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

    >>> “Rebecca O’Donnell” 7/08/12 11:23 >>>
    Good morning,

    I would love some feedback regarding restrictions of visitors to Special care nurseries.

    Who do you restrict? Other siblings?

    I feel as long as Hand hygiene is performed and the visitor is well I personal feel that there is no real significant risk.

    Some of our staff feel that in the case of twins, one goes home and one stays in the nursery then the well twin shouldnt visit as the baby might pose a threat to the babies in Special care (perhaps from a whooping cough point of view).

    Thanks,

    Rebecca ODonnell | Infection Control Co-ordinator
    St Vincent’s Hospital Toowoomba | 22-36 Scott Street TOOWOOMBA 4350
    T 07 4690 4042 | F 07 46904400
    E rebecca.odonnell@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.

    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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    ********************************************************************************

    This email, including any attachments sent with it, is confidential and for the sole use of the intended recipient(s). This confidentiality is not waived or lost, if you receive it and you are not the intended recipient(s), or if it is transmitted/received in error.

    Any unauthorised use, alteration, disclosure, distribution or review of this email is strictly prohibited. The information contained in this email, including any attachment sent with it, may be subject to a statutory duty of confidentiality if it relates to health service matters.

    If you are not the intended recipient(s), or if you have received this email in error, you are asked to immediately notify the sender by telephone collect on Australia +61 1800 198 175 or by return email. You should also delete this email, and any copies, from your computer system network and destroy any hard copies produced.

    If not an intended recipient of this email, you must not copy, distribute or take any action(s) that relies on it; any form of disclosure, modification, distribution and/or publication of this email is also prohibited.

    Although Queensland Health takes all reasonable steps to ensure this email does not contain malicious software, Queensland Health does not accept responsibility for the consequences if any person’s computer inadvertently suffers any disruption to services, loss of information, harm or is infected with a virus, other malicious computer programme or code that may occur as a consequence of receiving this email.

    Unless stated otherwise, this email represents only the views of the sender and not the views of the Queensland Government.

    **********************************************************************************

    Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.

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    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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    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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    #69257
    Rebecca O’Donnell
    Participant

    Author:
    Rebecca O’Donnell

    Position:

    Organisation:

    State:

    Congrats your first time post worked!!

    Thanks Kate for your feedback and as Jane mentioned as well, there are complexities with this issue.

    My way of thinking is educate regarding illness and Hand Hygiene. Perhaps a screening tool would be helpful.

    Thanks for your input, it is very much appreciated.

    Kind regards,

    Rebecca O’Donnell | Infection 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,

    Hope this post works, first time posting!

    From working in paediatrics and neonatal ICU, and as an Infection Control Nurse, I see it from both sides. An additional challenge to those already mentioned is keeping young siblings from visiting other cots/ touching trolleys etc. It’s a hard ask to keep a young child contained to a cot space in a more open ICU setting, and as mentioned by Jane, hard to screen for symptoms when they will be either downplayed or infectious prior to actual symptoms presenting. I think having written guidelines that all of the staff are aware of and also information for parents explaining what is expected from the hospital (thus taking some of the “blame” away from the individual nurse at the bedside trying to restrict visiting) and the reasons why visiting of younger siblings might be restricted or not permitted can help. On the other side, it’s so important that younger siblings get to be a part of the new babies life, I’m not sure a complete ban is always necessary. Obviously during an outbreak or with ongoing issues things need to be reviewed and individual facilities face their own challenges that need individual solutions.
    From an NICU/ SC environment perspective, the aim is to try and keep things calm and quiet, and this is also a challenge if younger children are spending extended lengths of time there, it does get boring! So perhaps considering the guideline in a broader context of general aims of the unit might help?
    Not having worked for a few months now in the area, I can’t quite remember what is actually done in our facility however! Sorry!

    Kind regards

    Kate Herbert, Clinical Nurse
    Infection Prevention and Control
    Royal Hobart Hospital

    On Tue, Aug 7, 2012 at 3:00 PM, Rebecca O’Donnell <Rebecca.O'Donnell@stvincents.org.au> wrote:
    Jane I appreciate your input. You have certainly bought up some great points to discuss further. Yes a screening tool may be something to consider. Thank you for sharing your experiences and information.

    Again your time is very much appreciated.

    Kind regards,

    Rebecca O’Donnell | Infection 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 Rebecca
    Great question, I guess the risk lies with the capability for the department for screening of children who may be visiting the nursery to exclude signs of droplet or gastrointestinal infection? As you know influenza is infectious for two days prior to symptoms.

    Here at the RCH Bris we have see several cases of ‘hospital acquired’ infection in at risk patients brought in by siblings, children will randomly vomit when they have norovirus and have limited personal hygiene.

    In fact 3 years ago we excluded all children under 14yrs from visiting in the inpatient baby area due to the repeated infections brought in this way. Yes this is difficult logistically for parents and siblings and less family centred care but we felt protecting the already compromised infants had to be foremost in our recommendations. We find that visitors/siblings minimise their infections and potential risks as they are so keen to visit with the sick patient and they don’t well understand the consequences to the sick patient.

    It is left up to the nurse in charge of the ward in special circumstances to adjust this on a case by case basis such as for those with multiple births.
    Also our baby room has ‘viewing’ windows for siblings to see the baby rather than directly visit.

    In my experience working at NICU and SCN who did not allow any visits from children under 14yrs this screening and control of visitors would then conceivably fall to the nurse at bedside and could potentially create some quite challenging interpersonal situations.

    Being creative I would wonder if you could incorporate a infectious symptoms screening tool for use at the bedside, could this require some discussion and or documentation with each group of visitors.

    regards
    Jane

    Jane Tomlinson RN
    Clinical Nurse Consultant
    Infection Management and Prevention Service
    Royal Children’s Hospital
    Children’s HealthQueensland
    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
    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
    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
    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
    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
    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

    >>> “Rebecca O’Donnell” <Rebecca.O'Donnell@STVINCENTS.ORG.AU> 7/08/12 11:23 >>>
    Good morning,

    I would love some feedback regarding restrictions of visitors to Special care nurseries.

    Who do you restrict? Other siblings?

    I feel as long as Hand hygiene is performed and the visitor is well I personal feel that there is no real significant risk.

    Some of our staff feel that in the case of twins, one goes home and one stays in the nursery then the well twin shouldn’t visit as the baby might pose a threat to the babies in Special care (perhaps from a whooping cough point of view).

    Thanks,

    Rebecca O’Donnell | Infection 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.
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    #69259
    TERRI CRIPPS
    Participant

    Author:
    TERRI CRIPPS

    Position:

    Organisation:

    State:

    Hi,

    Having worked in Paediatrics, Special Care and Infection Control I, too, see it from both sides.

    Maybe there could be a designated short visiting time for siblings to visit the new baby which would limit the time the new baby was exposed to any potential disease while keeping the family happy, after a quick screening using the tool, from the nurse caring for the baby. Hand Hygiene can always be taught to older children and encouraged at the same time. The sibling then does not feel left out but it would be short so they can’t get too bored. This would require commitment from both the family and the staff. I agree it should be seen as a hospital wide guideline, then the families know the deal to begin with and the nurse is not targeted as being too strict.

    One problem I have is families wanting to bring in small babies to visit a child with an infectious disease. Not only immediate family but extended family and visitors as well. When we explain that the child in isolation is infectious and should not be visited by small babies and toddlers, they get upset. Then the staff give in and let them visit. And so the cycle of infection continues. Any tips?

    Thanks,

    Terri Cripps | Clinical Nurse Consultant Infection Control | Sydney Children’s Hospital
    ‘: (02) 9382 1876 | fax: (02) 9382 2084 |* : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140

    [cid:image001.jpg@01CD74CB.27A60FF0]
    [cid:image002.jpg@01CD74CB.27A60FF0]

    Congrats your first time post worked!!

    Thanks Kate for your feedback and as Jane mentioned as well, there are complexities with this issue.

    My way of thinking is educate regarding illness and Hand Hygiene. Perhaps a screening tool would be helpful.

    Thanks for your input, it is very much appreciated.

    Kind regards,

    Rebecca O’Donnell | Infection 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,

    Hope this post works, first time posting!

    From working in paediatrics and neonatal ICU, and as an Infection Control Nurse, I see it from both sides. An additional challenge to those already mentioned is keeping young siblings from visiting other cots/ touching trolleys etc. It’s a hard ask to keep a young child contained to a cot space in a more open ICU setting, and as mentioned by Jane, hard to screen for symptoms when they will be either downplayed or infectious prior to actual symptoms presenting. I think having written guidelines that all of the staff are aware of and also information for parents explaining what is expected from the hospital (thus taking some of the “blame” away from the individual nurse at the bedside trying to restrict visiting) and the reasons why visiting of younger siblings might be restricted or not permitted can help. On the other side, it’s so important that younger siblings get to be a part of the new babies life, I’m not sure a complete ban is always necessary. Obviously during an outbreak or with ongoing issues things need to be reviewed and individual facilities face their own challenges that need individual solutions.
    From an NICU/ SC environment perspective, the aim is to try and keep things calm and quiet, and this is also a challenge if younger children are spending extended lengths of time there, it does get boring! So perhaps considering the guideline in a broader context of general aims of the unit might help?
    Not having worked for a few months now in the area, I can’t quite remember what is actually done in our facility however! Sorry!

    Kind regards

    Kate Herbert, Clinical Nurse
    Infection Prevention and Control
    Royal Hobart Hospital

    On Tue, Aug 7, 2012 at 3:00 PM, Rebecca O’Donnell <Rebecca.O'Donnell@stvincents.org.au> wrote:
    Jane I appreciate your input. You have certainly bought up some great points to discuss further. Yes a screening tool may be something to consider. Thank you for sharing your experiences and information.

    Again your time is very much appreciated.

    Kind regards,

    Rebecca O’Donnell | Infection 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 Rebecca
    Great question, I guess the risk lies with the capability for the department for screening of children who may be visiting the nursery to exclude signs of droplet or gastrointestinal infection? As you know influenza is infectious for two days prior to symptoms.

    Here at the RCH Bris we have see several cases of ‘hospital acquired’ infection in at risk patients brought in by siblings, children will randomly vomit when they have norovirus and have limited personal hygiene.

    In fact 3 years ago we excluded all children under 14yrs from visiting in the inpatient baby area due to the repeated infections brought in this way. Yes this is difficult logistically for parents and siblings and less family centred care but we felt protecting the already compromised infants had to be foremost in our recommendations. We find that visitors/siblings minimise their infections and potential risks as they are so keen to visit with the sick patient and they don’t well understand the consequences to the sick patient.

    It is left up to the nurse in charge of the ward in special circumstances to adjust this on a case by case basis such as for those with multiple births.
    Also our baby room has ‘viewing’ windows for siblings to see the baby rather than directly visit.

    In my experience working at NICU and SCN who did not allow any visits from children under 14yrs this screening and control of visitors would then conceivably fall to the nurse at bedside and could potentially create some quite challenging interpersonal situations.

    Being creative I would wonder if you could incorporate a infectious symptoms screening tool for use at the bedside, could this require some discussion and or documentation with each group of visitors.

    regards
    Jane

    Jane Tomlinson RN
    Clinical Nurse Consultant
    Infection Management and Prevention Service
    Royal Children’s Hospital
    Children’s HealthQueensland
    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
    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
    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
    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
    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
    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

    >>> “Rebecca O’Donnell” <Rebecca.O'Donnell@STVINCENTS.ORG.AU> 7/08/12 11:23 >>>
    Good morning,

    I would love some feedback regarding restrictions of visitors to Special care nurseries.

    Who do you restrict? Other siblings?

    I feel as long as Hand hygiene is performed and the visitor is well I personal feel that there is no real significant risk.

    Some of our staff feel that in the case of twins, one goes home and one stays in the nursery then the well twin shouldn’t visit as the baby might pose a threat to the babies in Special care (perhaps from a whooping cough point of view).

    Thanks,

    Rebecca O’Donnell | Infection 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.

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    #69261
    Margaret Evans
    Participant

    Author:
    Margaret Evans

    Position:

    Organisation:

    State:

    Hi Rebecca
    I have included a couple of posters we have had for quite a number of years now. We do allow siblings to visit & do not appear to have a problem. Only once did we have RSV come into the unit but that could have been from staff or other adult visitors (this baby did not have siblings).

    I believe babies in NICU have more bugs of concern that those in the community. Hand hygiene can never be underestimated and parents, children or staff who are sick should be educated not to come into NICU or SCN.

    Margie Evans
    Infection Prevention & Control CNC
    Royal Hospital for Women
    LMB 2000
    Randwick 2031
    page 44075 or ph. 02 9382 6339

    Good morning,

    I would love some feedback regarding restrictions of visitors to Special care nurseries.

    Who do you restrict? Other siblings?

    I feel as long as Hand hygiene is performed and the visitor is well I personal feel that there is no real significant risk.

    Some of our staff feel that in the case of twins, one goes home and one stays in the nursery then the well twin shouldn’t visit as the baby might pose a threat to the babies in Special care (perhaps from a whooping cough point of view).

    Thanks,

    Rebecca O’Donnell | Infection 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.

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