[Beth Bint]

Hi

We have worked hard to remove the culture of placing known MRO patients at the end of the list for all the reasons identified by Helen. One additional reason is that of descrimination. On occasions cases need to be cancelled due to unforeseen circumstances which means the MRO patient at the end of the list is the likely one to be cancelled. This can be repeated over many days. This practice has also been the case in our cardiac catherisation unit.

If all cases in procedural units are managed the same way with cleaning occuring after each case and appropriate management of reuseuable equipment, there is no imperative to schedule MRO patients any differently.

To further faciltity this process we use a all in one cleaning and dinsfection chlorine-based product so that cleaning and disfection requirements following a MRO patient do not require any additional time or resources.

Cheers
Beth

Beth Bint | Clinical Nurse Consultant Infection Prevention and Control,
Infection Management and Control Service (IMACS)
The Wollongong Hospital| ph +61 2 4222 5869 page 182 via switch+61 2 4222 5000| beth.bint@sesiahs.health.nsw.gov.au
________________________________

Hi, this is our policy taken from ACORN and HICMR:

INFECTION CONTROL RITUALS IN THE OPERATING THEATRE SUITE / INTERVENTIONAL
PROCEDURE ROOM
Order of Patients on the Operating List, eg. Dirty/Clean Cases
The most probable route of infection transmission between successive/sequential surgical
cases is from the air, instruments or environmental surfaces. If the ventilation system is
effective, air will not be a source of infection transmission. Furthermore, surfaces that do
not come into direct contact with the patient do not become contaminated. As a
consequence, the inanimate theatre environment has a negligible contribution to the
incident of post-operative infection. Therefore the order of patients on an operating list
should not be determined on the basis of risk of cross infection.

Cheers,
Helen.

Helen Scott,
Infection Control Co-ordinator,
Nepean Private Hospital, Penrith, NSW.

P Please consider the environment before printing this message

>>> Prue Wright 13/05/2011 7:13 am >>>
Hi Carien,

We wrote a policy last year specifically for OT and put together a kit for use when there is an MRO patient.

We acknowledge that more often than not, we could have a colonised patient that we are not aware of; but when a patient is identified we follow strict control measures.

VRE patients are put on the end of the list; and also MRSA if feasible.

We have an outside scout if we can, if not possible, then a stock trolley is placed near the door and the porters help out with handing in extra sponges etc.

The patient is recovered in OT if last on the list. Depending on the source of the MRO, and the clinical condition of the patient, recovery may have to be in the Recovery Unit. The bed is changed and cleaned during the procedure, and PPE is worn by porters and nursing staff caring for the patient.

With this policy there is no confusion as to what MRO requires special precautions and there is full awareness of the need for extra measures as the patient progresses through the hospital.

Prue Wright

Infection Control Co-ordinator
Hurstville Private

Hi,

We are currently looking into our practices regarding MRO patients in OT. I would like to know what other hospitals are doing re outside scout nurses and where and how do you recover pts post anaesthesia if they have a MRO.

Thank you,
Carien

Carien Coleman | Infection Control CNC
The Sunshine Coast Private Hospital
Syd Lingard Drive | BUDERIM QLD 4556
PO Box 5050 | Maroochydore BC QLD 4558
T: (07) 5430 3245 | F: (07) 5430 3436
E: carien.coleman@uchealth.com.au

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[Beth Bint]

Thank you to all who have responded.
I agree that it is not the responsibility of infection control to determine the type of leave taken.
I was keen to know that the recommendations that we make are consistent with systems across the country. We were also interested if different leave arrangements made a difference in staff compliance with disclosure and exclusion.

Thank you
Beth

Hi Beth,
At STV Melbourne we require symptomatic staff to remain away from work until 48 hours after last symptoms (mainly diarrhoea) has ceased. Historically in our residential facilities, management have required symptomatic staff to supply a clearance certificate from their G.P. As a rule staff use their own sick leave. If they do not have sufficient sick leave available then the manager of the area (NUM) is encouraged to make an arrangement with the H.R. Department. We do not routinely process staff sick leave as work cover as this may be more expensive in the long run as any claims may impact on insurance premiums.

But of course the Infection Control component of the advice is really limited to the staff remaining away from work with a 48 hour symptom free period. How staff are paid and by who is not an Infection Control issue is it? I would recommend that the managers of the areas affected need to make those decisions.

Kind regards.

John Greenough
Infection Control Consultant
St. Vincent’s Health
PO Box 2900
Fitzroy 3065
Telephone:
SVH (03) 9288 2020
SGHS (03) 9816 0632

Good afternoon

I am interested in knowing how various health services or facilities managed staff who become ill during a gastroenteritis (norovirus) outbreak.

How long are symptomatic staff recommended to stay off duty?
What type of leave do they take whilst symptomatic and recovering?
If it is deemed a work related illness, what are the parameters/definitions used for this?
Is there a variation in recommendations according to the type and place of employment in the health service?

Thank you
Beth

Beth Bint
CNC Infection Control
The Wollongong Hospital

M: 0458 230 562
e beth.bint@sesiahs.health.nsw.gov.au

Infection Management and Control Service (IMACS)
Level 1, Lawson House
The Wollongong Hospital
LMB 8808
SCMC NSW 2521

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