[Matthias.Maiwald@KKH.COM.SG Subject: Re: Dermatitis in staff with probable cause Chlorhexidine In-Reply-To:]

Dear Group,

I think an answer to this question also depends on what kind of hand
hygiene is involved. If it is for standard hand hygiene in patient care (as
in 5 moments) and concerning an alcohol-based hand rub, then one might want
to try an alcohol product without chlorhexidine. For the occasional
handwashes when not using alcohol, plain soap without chlorhexidine would
be an option. Such an omission might also clarify if the problem is due to
chlorhexidine or not. Adverse reactions to chlorhexidine have been
described, but are apparently not very common. The standardised hand rub
formulations by the WHO have excellent antimicrobial activity (fulfill very
stringent standards) and do not contain chlorhexidine. One option would be
to get pharmacy to make a small personal supply of the WHO formulation for
the affected staff member. The availability of commercial products in
Australia that have (a) good antimicrobial activity, (b) good user
acceptability including emollient additives and (c) no chlorhexidine
appears to be very limited (there may not be any).

Best regards, Matthias.

—
Matthias Maiwald, MD, FRCPA, D(ABMM)
Consultant in Microbiology
Department of Pathology and Laboratory Medicine
KK Women’s and Children’s Hospital
100 Bukit Timah Road
Singapore 229899
Tel. +65 6394 1389
Fax +65 6394 1387

Glenys Harrington
To
Sent by: AICA AICALIST@AICALIST.ORG.AU
Infexion cc
Connexion
Re: Dermatitis in staff with
probable cause Chlorhexidine

29/06/2010 08:23
PM

Please respond to
AICA Infexion
Connexion

Margaret,

I have used the following process in conjunction with Pharmacy and Nurse
Managers(NMs) to minimise and standardise the number of HH products
throughout the hospital.

HCWs with skin problems were asked to have their skin problem assessed by
staff health service or their own GP – we advised staff that this was
important particularly in the event that the condition worsened/workcover
issues etc.

IC reviewed the HCWs HH practices (observation)- I often found staff were
over washing.

If HCW HH practices were OK (i.e. not over washing) HCWs were issued with 1
bottle of an alternative product for sensitive skin (a Triclosan product)
to
try for 1 week.

If after 1 week their skin condition had improved we arranged for the NM to
order a personal supply for HCW.

HCWs were instructed that to: a) use a new dispenser (may need to order
separately as not always distributed with HH product by
supplier/manufacturer) with each new bottle and b) ask other staff not to
used their product to minimise the risk of contamination of the
pump/dispenser.

If no improvement after 1 week they were referred via staff clinic to the
allergy clinic for assessment.

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)

PO Box 5202
Middle Park
Victoria, 3206
Australia

H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au

ABN 47533508426

—–Original Message—–
Of
Jennifer Benjamin
cause Chlorhexidine

Triclosan products are generally well tolerated and still has antimicrobial
properties

Jen Benjamin
Infection Control Consultant
Melbourne Pathology
M: 0402 000 590

“We take it personally”

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________________________________

Chlorhexidine

Hello all

I have had a couple of staff who are apparently sensitive to Chlorhexidine
products.

Dermatology review is difficult to access in the NT so my question is what
do other ICP recommend for hand hygiene in this case. I realise you can’t
endorse products but a few clues would be great!

Margaret Gleeson | Clinical Nurse Specialist, Hand Hygiene Compliance
Infection Prevention & Management Unit, Royal Darwin Hospital | Department
of Health and Families
Rocklands Drive, Tiwi, NT 0811| PO Box 41326, Casuarina, NT 0811
p… (08) 89227694 Pager # 238 | f… (08) 89228889|
e…margaret.gleeson@nt.gov.au | http://www.nt.gov.au/health

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