Transmission based precautions in paediatrics

[Willimann, Mary]

Hi Everyone

I am hoping that you might be able to assist with possible guidelines/policies relating to the implementation of transmission based precautions in paediatric patients. Having recently moved to a paediatric environment I am curious to see if transmission based precautions should be applied differently/modified as children possibly have unique needs when it comes to infection prevention. For example, should droplet and contact precautions be applied to children with respiratory viruses due to the fact that children tend to put everything in their mouths and are not as good as adults with respiratory etiquette?

I understand that standard precautions must always be applied and that a risk management approach still needs to occur but would be very grateful for any advice and/or direction!

Many thanks
Mary

Mary Willimann CICP | Infection Prevention and Control Coordinator
Child and Adolescent Health Service, Roberts Road Subiaco WA 6008
T: (08) 9340 7822 | 0466 350 206
E: mary.willimann@health.wa.gov.au
Delivering a Healthy WA

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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[Thomson, Rachel EA]

Hi Mary,

I have been particularly busy, so I haven’t noticed if you have had many replies to you question. I personally find this a tricky area, but thought I would share our organisation’s approach.

We have extended the ‘privilege’ of PPE to all visitors, including parents visiting ill children. That is, we make provision for all to people entering the care zone to wear PPE. We ask our nursing staff to educate parents/carers in the role/purpose and use of PPE. We do not mandate wearing of PPE for principle care-givers for pathogens such as MRSA, VRE etc. but encourage these individuals to consider protecting their own health with use of masks and appropriate HH when the child has an acute respiratory illness, such as Influenza. For pathogens/ clinical syndromes such as;
Adenovirus (respiratory syndrome only)
Bronchiolitis
Croup
Human metapneumovirus
RSV
Rhinovirus

We make provision that only during direct contact with the child that staff need to wear PPE (mask, gown, gloves). We have adopted the principle that where the primary care giver could be at risk from infection with the pathogen that protection should be afforded to these parents/carers. We also recognise that parents/carers rooming in cannot spend all day in PPE, nor can they sleep in such equipment.

In short, we do not have a perfect solution, but very much have adopted an approach that parents/carers have a right to be protected, need to be educated in the use of PPE if they are going to use it.

Hope this helps?

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi Everyone

I am hoping that you might be able to assist with possible guidelines/policies relating to the implementation of transmission based precautions in paediatric patients. Having recently moved to a paediatric environment I am curious to see if transmission based precautions should be applied differently/modified as children possibly have unique needs when it comes to infection prevention. For example, should droplet and contact precautions be applied to children with respiratory viruses due to the fact that children tend to put everything in their mouths and are not as good as adults with respiratory etiquette?

I understand that standard precautions must always be applied and that a risk management approach still needs to occur but would be very grateful for any advice and/or direction!

Many thanks
Mary

Mary Willimann CICP | Infection Prevention and Control Coordinator
Child and Adolescent Health Service, Roberts Road Subiaco WA 6008
T: (08) 9340 7822 | 0466 350 206
E: mary.willimann@health.wa.gov.au
Delivering a Healthy WA

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

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.

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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[Glenys Harrington]

Hi Rachel,

Wouldn’t the primary care giver have already been exposed?

Probably more important to focus on good respiratory hygiene and hand
hygiene.

Also less work load for nurses in terms of training primary care givers and
visitors in PPE when it may not be needed.

Regards

Glenys

Glenys Harrington

Consultant

Infection Control Consultancy (ICC)

PO Box 5202

Middle Park

Victoria, 3206

Australia

M: +61 404 816 434

infexion@ozemail.com.au

ABN 47533508426

Of Thomson, Rachel EA (DHHS)
paediatrics

Hi Mary,

I have been particularly busy, so I haven’t noticed if you have had many
replies to you question. I personally find this a tricky area, but thought
I would share our organisation’s approach.

We have extended the ‘privilege’ of PPE to all visitors, including parents
visiting ill children. That is, we make provision for all to people
entering the care zone to wear PPE. We ask our nursing staff to educate
parents/carers in the role/purpose and use of PPE. We do not mandate
wearing of PPE for principle care-givers for pathogens such as MRSA, VRE
etc. but encourage these individuals to consider protecting their own health
with use of masks and appropriate HH when the child has an acute respiratory
illness, such as Influenza. For pathogens/ clinical syndromes such as;

Adenovirus (respiratory syndrome only)

Bronchiolitis

Croup

Human metapneumovirus

RSV

Rhinovirus

We make provision that only during direct contact with the child that staff
need to wear PPE (mask, gown, gloves). We have adopted the principle that
where the primary care giver could be at risk from infection with the
pathogen that protection should be afforded to these parents/carers. We
also recognise that parents/carers rooming in cannot spend all day in PPE,
nor can they sleep in such equipment.

In short, we do not have a perfect solution, but very much have adopted an
approach that parents/carers have a right to be protected, need to be
educated in the use of PPE if they are going to use it.

Hope this helps?

Kind regards

Rachel

………………………….

Rachel Thomson

Nurse Unit Manager

Infection Prevention & Control Unit

Royal Hobart Hospital

Tasmanian Health Organisation-South

(: 03 62227882/8658

rachel.thomson@dhhs.tas.gov.au

Level 4, H Block

48 Liverpool Street

Hobart, 7000

Of Willimann, Mary

Hi Everyone

I am hoping that you might be able to assist with possible
guidelines/policies relating to the implementation of transmission based
precautions in paediatric patients. Having recently moved to a paediatric
environment I am curious to see if transmission based precautions should be
applied differently/modified as children possibly have unique needs when it
comes to infection prevention. For example, should droplet and contact
precautions be applied to children with respiratory viruses due to the fact
that children tend to put everything in their mouths and are not as good as
adults with respiratory etiquette?

I understand that standard precautions must always be applied and that a
risk management approach still needs to occur but would be very grateful for
any advice and/or direction!

Many thanks

Mary

Mary Willimann CICP | Infection Prevention and Control Coordinator

Child and Adolescent Health Service, Roberts Road Subiaco WA 6008

T: (08) 9340 7822 | 0466 350 206

E: mary.willimann@health.wa.gov.au

Delivering a Healthy WA

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

_____

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by
legal professional privilege, and is intended only for the person or persons
to whom it is addressed. If you are not such a person, you are warned that
any disclosure, copying or dissemination of the information is unauthorised.
If you have received the transmission in error, please immediately contact
this office by telephone, fax or email, to inform us of the error and to
enable arrangements to be made for the destruction of the transmission, or
its return at our cost. No liability is accepted for any unauthorised use of
the information contained in this transmission.

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

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

[Thomson, Rachel EA]

Hi Glenys,

In many circumstances the answer is yes for children and infants, I certainly don’t disagree with you. However, in our experience, rather than having a child in a room at home, which may even be a separate room, we place child and parent/care giver in very close proximity. Invariably, we seat the parent/caregiver next to the bed. In shared rooms, this is even more problematic, and the parent/ caregiver is obliged to sit very close. Our focus has been to include our parents/caregivers in our consideration for the use of PPE rather than assume that they have been exposed and then ensure that this is the case.

We certainly do focus on respiratory and hand hygiene; it is simply that we include our parents/care givers in the considerations we make, and framework we have developed here at the RHH over time.

Cheers
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi Rachel,

Wouldn’t the primary care giver have already been exposed?

Probably more important to focus on good respiratory hygiene and hand hygiene.

Also less work load for nurses in terms of training primary care givers and visitors in PPE when it may not be needed.

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

Hi Mary,

I have been particularly busy, so I haven’t noticed if you have had many replies to you question. I personally find this a tricky area, but thought I would share our organisation’s approach.

We have extended the ‘privilege’ of PPE to all visitors, including parents visiting ill children. That is, we make provision for all to people entering the care zone to wear PPE. We ask our nursing staff to educate parents/carers in the role/purpose and use of PPE. We do not mandate wearing of PPE for principle care-givers for pathogens such as MRSA, VRE etc. but encourage these individuals to consider protecting their own health with use of masks and appropriate HH when the child has an acute respiratory illness, such as Influenza. For pathogens/ clinical syndromes such as;
Adenovirus (respiratory syndrome only)
Bronchiolitis
Croup
Human metapneumovirus
RSV
Rhinovirus

We make provision that only during direct contact with the child that staff need to wear PPE (mask, gown, gloves). We have adopted the principle that where the primary care giver could be at risk from infection with the pathogen that protection should be afforded to these parents/carers. We also recognise that parents/carers rooming in cannot spend all day in PPE, nor can they sleep in such equipment.

In short, we do not have a perfect solution, but very much have adopted an approach that parents/carers have a right to be protected, need to be educated in the use of PPE if they are going to use it.

Hope this helps?

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi Everyone

I am hoping that you might be able to assist with possible guidelines/policies relating to the implementation of transmission based precautions in paediatric patients. Having recently moved to a paediatric environment I am curious to see if transmission based precautions should be applied differently/modified as children possibly have unique needs when it comes to infection prevention. For example, should droplet and contact precautions be applied to children with respiratory viruses due to the fact that children tend to put everything in their mouths and are not as good as adults with respiratory etiquette?

I understand that standard precautions must always be applied and that a risk management approach still needs to occur but would be very grateful for any advice and/or direction!

Many thanks
Mary

Mary Willimann CICP | Infection Prevention and Control Coordinator
Child and Adolescent Health Service, Roberts Road Subiaco WA 6008
T: (08) 9340 7822 | 0466 350 206
E: mary.willimann@health.wa.gov.au
Delivering a Healthy WA

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

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
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

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

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.

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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[Glenys Harrington]

Hi Rachel,

The shared and close placement of these children is increasing the risk not
only to the carer and visitors but to other child/children who are sharing
the room .

The real fix is that you need more segregation (distancing) and more single
rooms.

To bring this to the attention of hospital executive staff I would write an
incident report each time this co-sharing is required detailing the
associated potential risks.

Probably not a risk an organisation should be taking outside of a
respiratory outbreak setting when there are large numbers of presentations

Regards

Glenys

Glenys Harrington

Consultant

Infection Control Consultancy (ICC)

PO Box 5202

Middle Park

Victoria, 3206

Australia

M: +61 404 816 434

infexion@ozemail.com.au

ABN 47533508426

Of Thomson, Rachel EA (DHHS)
paediatrics

Hi Glenys,

In many circumstances the answer is yes for children and infants, I
certainly don’t disagree with you. However, in our experience, rather than
having a child in a room at home, which may even be a separate room, we
place child and parent/care giver in very close proximity. Invariably, we
seat the parent/caregiver next to the bed. In shared rooms, this is even
more problematic, and the parent/ caregiver is obliged to sit very close.
Our focus has been to include our parents/caregivers in our consideration
for the use of PPE rather than assume that they have been exposed and then
ensure that this is the case.

We certainly do focus on respiratory and hand hygiene; it is simply that we
include our parents/care givers in the considerations we make, and framework
we have developed here at the RHH over time.

Cheers

Rachel

………………………….

Rachel Thomson

Nurse Unit Manager

Infection Prevention & Control Unit

Royal Hobart Hospital

Tasmanian Health Organisation-South

(: 03 62227882/8658

rachel.thomson@dhhs.tas.gov.au

Level 4, H Block

48 Liverpool Street

Hobart, 7000

Of Glenys Harrington

Hi Rachel,

Wouldn’t the primary care giver have already been exposed?

Probably more important to focus on good respiratory hygiene and hand
hygiene.

Also less work load for nurses in terms of training primary care givers and
visitors in PPE when it may not be needed.

Regards

Glenys

Glenys Harrington

Consultant

Infection Control Consultancy (ICC)

PO Box 5202

Middle Park

Victoria, 3206

Australia

M: +61 404 816 434

infexion@ozemail.com.au

ABN 47533508426

Of Thomson, Rachel EA (DHHS)
paediatrics

Hi Mary,

I have been particularly busy, so I haven’t noticed if you have had many
replies to you question. I personally find this a tricky area, but thought
I would share our organisation’s approach.

We have extended the ‘privilege’ of PPE to all visitors, including parents
visiting ill children. That is, we make provision for all to people
entering the care zone to wear PPE. We ask our nursing staff to educate
parents/carers in the role/purpose and use of PPE. We do not mandate
wearing of PPE for principle care-givers for pathogens such as MRSA, VRE
etc. but encourage these individuals to consider protecting their own health
with use of masks and appropriate HH when the child has an acute respiratory
illness, such as Influenza. For pathogens/ clinical syndromes such as;

Adenovirus (respiratory syndrome only)

Bronchiolitis

Croup

Human metapneumovirus

RSV

Rhinovirus

We make provision that only during direct contact with the child that staff
need to wear PPE (mask, gown, gloves). We have adopted the principle that
where the primary care giver could be at risk from infection with the
pathogen that protection should be afforded to these parents/carers. We
also recognise that parents/carers rooming in cannot spend all day in PPE,
nor can they sleep in such equipment.

In short, we do not have a perfect solution, but very much have adopted an
approach that parents/carers have a right to be protected, need to be
educated in the use of PPE if they are going to use it.

Hope this helps?

Kind regards

Rachel

………………………….

Rachel Thomson

Nurse Unit Manager

Infection Prevention & Control Unit

Royal Hobart Hospital

Tasmanian Health Organisation-South

(: 03 62227882/8658

rachel.thomson@dhhs.tas.gov.au

Level 4, H Block

48 Liverpool Street

Hobart, 7000

Of Willimann, Mary

Hi Everyone

I am hoping that you might be able to assist with possible
guidelines/policies relating to the implementation of transmission based
precautions in paediatric patients. Having recently moved to a paediatric
environment I am curious to see if transmission based precautions should be
applied differently/modified as children possibly have unique needs when it
comes to infection prevention. For example, should droplet and contact
precautions be applied to children with respiratory viruses due to the fact
that children tend to put everything in their mouths and are not as good as
adults with respiratory etiquette?

I understand that standard precautions must always be applied and that a
risk management approach still needs to occur but would be very grateful for
any advice and/or direction!

Many thanks

Mary

Mary Willimann CICP | Infection Prevention and Control Coordinator

Child and Adolescent Health Service, Roberts Road Subiaco WA 6008

T: (08) 9340 7822 | 0466 350 206

E: mary.willimann@health.wa.gov.au

Delivering a Healthy WA

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
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You can unsubscribe from this list be sending ‘signoff aicalist’ (without
the quotes) to listserv@aicalist.org.au

_____

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by
legal professional privilege, and is intended only for the person or persons
to whom it is addressed. If you are not such a person, you are warned that
any disclosure, copying or dissemination of the information is unauthorised.
If you have received the transmission in error, please immediately contact
this office by telephone, fax or email, to inform us of the error and to
enable arrangements to be made for the destruction of the transmission, or
its return at our cost. No liability is accepted for any unauthorised use of
the information contained in this transmission.

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
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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 –
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Replies to this message will be directed back to the list. To create a new
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To send a message to the list administrator send an email to
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You can unsubscribe from this list be sending ‘signoff aicalist’ (without
the quotes) to listserv@aicalist.org.au

_____

CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by
legal professional privilege, and is intended only for the person or persons
to whom it is addressed. If you are not such a person, you are warned that
any disclosure, copying or dissemination of the information is unauthorised.
If you have received the transmission in error, please immediately contact
this office by telephone, fax or email, to inform us of the error and to
enable arrangements to be made for the destruction of the transmission, or
its return at our cost. No liability is accepted for any unauthorised use of
the information contained in this transmission.

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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[Thomson, Rachel EA]

Agreed!

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi Rachel,

The shared and close placement of these children is increasing the risk not only to the carer and visitors but to other child/children who are sharing the room .

The real fix is that you need more segregation (distancing) and more single rooms.

To bring this to the attention of hospital executive staff I would write an incident report each time this co-sharing is required detailing the associated potential risks.

Probably not a risk an organisation should be taking outside of a respiratory outbreak setting when there are large numbers of presentations

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

Hi Glenys,

In many circumstances the answer is yes for children and infants, I certainly don’t disagree with you. However, in our experience, rather than having a child in a room at home, which may even be a separate room, we place child and parent/care giver in very close proximity. Invariably, we seat the parent/caregiver next to the bed. In shared rooms, this is even more problematic, and the parent/ caregiver is obliged to sit very close. Our focus has been to include our parents/caregivers in our consideration for the use of PPE rather than assume that they have been exposed and then ensure that this is the case.

We certainly do focus on respiratory and hand hygiene; it is simply that we include our parents/care givers in the considerations we make, and framework we have developed here at the RHH over time.

Cheers
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi Rachel,

Wouldn’t the primary care giver have already been exposed?

Probably more important to focus on good respiratory hygiene and hand hygiene.

Also less work load for nurses in terms of training primary care givers and visitors in PPE when it may not be needed.

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

Hi Mary,

I have been particularly busy, so I haven’t noticed if you have had many replies to you question. I personally find this a tricky area, but thought I would share our organisation’s approach.

We have extended the ‘privilege’ of PPE to all visitors, including parents visiting ill children. That is, we make provision for all to people entering the care zone to wear PPE. We ask our nursing staff to educate parents/carers in the role/purpose and use of PPE. We do not mandate wearing of PPE for principle care-givers for pathogens such as MRSA, VRE etc. but encourage these individuals to consider protecting their own health with use of masks and appropriate HH when the child has an acute respiratory illness, such as Influenza. For pathogens/ clinical syndromes such as;
Adenovirus (respiratory syndrome only)
Bronchiolitis
Croup
Human metapneumovirus
RSV
Rhinovirus

We make provision that only during direct contact with the child that staff need to wear PPE (mask, gown, gloves). We have adopted the principle that where the primary care giver could be at risk from infection with the pathogen that protection should be afforded to these parents/carers. We also recognise that parents/carers rooming in cannot spend all day in PPE, nor can they sleep in such equipment.

In short, we do not have a perfect solution, but very much have adopted an approach that parents/carers have a right to be protected, need to be educated in the use of PPE if they are going to use it.

Hope this helps?

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi Everyone

I am hoping that you might be able to assist with possible guidelines/policies relating to the implementation of transmission based precautions in paediatric patients. Having recently moved to a paediatric environment I am curious to see if transmission based precautions should be applied differently/modified as children possibly have unique needs when it comes to infection prevention. For example, should droplet and contact precautions be applied to children with respiratory viruses due to the fact that children tend to put everything in their mouths and are not as good as adults with respiratory etiquette?

I understand that standard precautions must always be applied and that a risk management approach still needs to occur but would be very grateful for any advice and/or direction!

Many thanks
Mary

Mary Willimann CICP | Infection Prevention and Control Coordinator
Child and Adolescent Health Service, Roberts Road Subiaco WA 6008
T: (08) 9340 7822 | 0466 350 206
E: mary.willimann@health.wa.gov.au
Delivering a Healthy WA

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[Willimann, Mary]

Hi Rachel and Glenys

Thanks very much for your input and advice – you have made some very useful points so very much appreciated. I guess it’s to try and always use a risk management approach and lots of common sense!

Many thanks
Mary

Mary Willimann CICP | Infection Prevention and Control Coordinator
Child and Adolescent Health Service, Roberts Road Subiaco WA 6008
T: (08) 9340 8281 | 0466 350 206
E: mary.willimann@health.wa.gov.au
Delivering a Healthy WA

Agreed!

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi Rachel,

The shared and close placement of these children is increasing the risk not only to the carer and visitors but to other child/children who are sharing the room .

The real fix is that you need more segregation (distancing) and more single rooms.

To bring this to the attention of hospital executive staff I would write an incident report each time this co-sharing is required detailing the associated potential risks.

Probably not a risk an organisation should be taking outside of a respiratory outbreak setting when there are large numbers of presentations

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

Hi Glenys,

In many circumstances the answer is yes for children and infants, I certainly don’t disagree with you. However, in our experience, rather than having a child in a room at home, which may even be a separate room, we place child and parent/care giver in very close proximity. Invariably, we seat the parent/caregiver next to the bed. In shared rooms, this is even more problematic, and the parent/ caregiver is obliged to sit very close. Our focus has been to include our parents/caregivers in our consideration for the use of PPE rather than assume that they have been exposed and then ensure that this is the case.

We certainly do focus on respiratory and hand hygiene; it is simply that we include our parents/care givers in the considerations we make, and framework we have developed here at the RHH over time.

Cheers
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi Rachel,

Wouldn’t the primary care giver have already been exposed?

Probably more important to focus on good respiratory hygiene and hand hygiene.

Also less work load for nurses in terms of training primary care givers and visitors in PPE when it may not be needed.

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

Hi Mary,

I have been particularly busy, so I haven’t noticed if you have had many replies to you question. I personally find this a tricky area, but thought I would share our organisation’s approach.

We have extended the ‘privilege’ of PPE to all visitors, including parents visiting ill children. That is, we make provision for all to people entering the care zone to wear PPE. We ask our nursing staff to educate parents/carers in the role/purpose and use of PPE. We do not mandate wearing of PPE for principle care-givers for pathogens such as MRSA, VRE etc. but encourage these individuals to consider protecting their own health with use of masks and appropriate HH when the child has an acute respiratory illness, such as Influenza. For pathogens/ clinical syndromes such as;
Adenovirus (respiratory syndrome only)
Bronchiolitis
Croup
Human metapneumovirus
RSV
Rhinovirus

We make provision that only during direct contact with the child that staff need to wear PPE (mask, gown, gloves). We have adopted the principle that where the primary care giver could be at risk from infection with the pathogen that protection should be afforded to these parents/carers. We also recognise that parents/carers rooming in cannot spend all day in PPE, nor can they sleep in such equipment.

In short, we do not have a perfect solution, but very much have adopted an approach that parents/carers have a right to be protected, need to be educated in the use of PPE if they are going to use it.

Hope this helps?

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi Everyone

I am hoping that you might be able to assist with possible guidelines/policies relating to the implementation of transmission based precautions in paediatric patients. Having recently moved to a paediatric environment I am curious to see if transmission based precautions should be applied differently/modified as children possibly have unique needs when it comes to infection prevention. For example, should droplet and contact precautions be applied to children with respiratory viruses due to the fact that children tend to put everything in their mouths and are not as good as adults with respiratory etiquette?

I understand that standard precautions must always be applied and that a risk management approach still needs to occur but would be very grateful for any advice and/or direction!

Many thanks
Mary

Mary Willimann CICP | Infection Prevention and Control Coordinator
Child and Adolescent Health Service, Roberts Road Subiaco WA 6008
T: (08) 9340 7822 | 0466 350 206
E: mary.willimann@health.wa.gov.au
Delivering a Healthy WA

MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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[Glenys Harrington]

Hi Mary and Rachel,

The attached publication will be helpful in working through the issues
discussed in this thread – as you will see there is little evidence to
support the use of PPE for visitors/carers.

. L. Silvia Munoz-Price et al. Isolation Precautions for Visitors
Infection Control & Hospital Epidemiology / Volume 36 / Issue 07 / July
2015, pp 747 – 758

Regards

Glenys

Glenys Harrington

Consultant

Infection Control Consultancy (ICC)

PO Box 5202

Middle Park

Victoria, 3206

Australia

M: +61 404 816 434

infexion@ozemail.com.au

ABN 47533508426

Of Glenys Harrington
paediatrics

Hi Rachel,

The shared and close placement of these children is increasing the risk not
only to the carer and visitors but to other child/children who are sharing
the room .

The real fix is that you need more segregation (distancing) and more single
rooms.

To bring this to the attention of hospital executive staff I would write an
incident report each time this co-sharing is required detailing the
associated potential risks.

Probably not a risk an organisation should be taking outside of a
respiratory outbreak setting when there are large numbers of presentations

Regards

Glenys

Glenys Harrington

Consultant

Infection Control Consultancy (ICC)

PO Box 5202

Middle Park

Victoria, 3206

Australia

M: +61 404 816 434

infexion@ozemail.com.au

ABN 47533508426

Of Thomson, Rachel EA (DHHS)
paediatrics

Hi Glenys,

In many circumstances the answer is yes for children and infants, I
certainly don’t disagree with you. However, in our experience, rather than
having a child in a room at home, which may even be a separate room, we
place child and parent/care giver in very close proximity. Invariably, we
seat the parent/caregiver next to the bed. In shared rooms, this is even
more problematic, and the parent/ caregiver is obliged to sit very close.
Our focus has been to include our parents/caregivers in our consideration
for the use of PPE rather than assume that they have been exposed and then
ensure that this is the case.

We certainly do focus on respiratory and hand hygiene; it is simply that we
include our parents/care givers in the considerations we make, and framework
we have developed here at the RHH over time.

Cheers

Rachel

………………………….

Rachel Thomson

Nurse Unit Manager

Infection Prevention & Control Unit

Royal Hobart Hospital

Tasmanian Health Organisation-South

(: 03 62227882/8658

rachel.thomson@dhhs.tas.gov.au

Level 4, H Block

48 Liverpool Street

Hobart, 7000

Of Glenys Harrington

Hi Rachel,

Wouldn’t the primary care giver have already been exposed?

Probably more important to focus on good respiratory hygiene and hand
hygiene.

Also less work load for nurses in terms of training primary care givers and
visitors in PPE when it may not be needed.

Regards

Glenys

Glenys Harrington

Consultant

Infection Control Consultancy (ICC)

PO Box 5202

Middle Park

Victoria, 3206

Australia

M: +61 404 816 434

infexion@ozemail.com.au

ABN 47533508426

Of Thomson, Rachel EA (DHHS)
paediatrics

Hi Mary,

I have been particularly busy, so I haven’t noticed if you have had many
replies to you question. I personally find this a tricky area, but thought
I would share our organisation’s approach.

We have extended the ‘privilege’ of PPE to all visitors, including parents
visiting ill children. That is, we make provision for all to people
entering the care zone to wear PPE. We ask our nursing staff to educate
parents/carers in the role/purpose and use of PPE. We do not mandate
wearing of PPE for principle care-givers for pathogens such as MRSA, VRE
etc. but encourage these individuals to consider protecting their own health
with use of masks and appropriate HH when the child has an acute respiratory
illness, such as Influenza. For pathogens/ clinical syndromes such as;

Adenovirus (respiratory syndrome only)

Bronchiolitis

Croup

Human metapneumovirus

RSV

Rhinovirus

We make provision that only during direct contact with the child that staff
need to wear PPE (mask, gown, gloves). We have adopted the principle that
where the primary care giver could be at risk from infection with the
pathogen that protection should be afforded to these parents/carers. We
also recognise that parents/carers rooming in cannot spend all day in PPE,
nor can they sleep in such equipment.

In short, we do not have a perfect solution, but very much have adopted an
approach that parents/carers have a right to be protected, need to be
educated in the use of PPE if they are going to use it.

Hope this helps?

Kind regards

Rachel

………………………….

Rachel Thomson

Nurse Unit Manager

Infection Prevention & Control Unit

Royal Hobart Hospital

Tasmanian Health Organisation-South

(: 03 62227882/8658

rachel.thomson@dhhs.tas.gov.au

Level 4, H Block

48 Liverpool Street

Hobart, 7000

Of Willimann, Mary

Hi Everyone

I am hoping that you might be able to assist with possible
guidelines/policies relating to the implementation of transmission based
precautions in paediatric patients. Having recently moved to a paediatric
environment I am curious to see if transmission based precautions should be
applied differently/modified as children possibly have unique needs when it
comes to infection prevention. For example, should droplet and contact
precautions be applied to children with respiratory viruses due to the fact
that children tend to put everything in their mouths and are not as good as
adults with respiratory etiquette?

I understand that standard precautions must always be applied and that a
risk management approach still needs to occur but would be very grateful for
any advice and/or direction!

Many thanks

Mary

Mary Willimann CICP | Infection Prevention and Control Coordinator

Child and Adolescent Health Service, Roberts Road Subiaco WA 6008

T: (08) 9340 7822 | 0466 350 206

E: mary.willimann@health.wa.gov.au

Delivering a Healthy WA

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