[Carrie Spinks]

Hi Everyone,

Just a further consideration leading on from Lesley valid mention of outbreak management.

During periods of outbreak (or individual infectious isolation cases) where alcohol hand rubs/gels are less efficient and best practice is to hand wash such as Norovirus or C. Difficile – the need for staff paper hand towels, soap and clinical waste in the bathrooms (point of care) should be considered.

This can be very difficult to suddenly establish, maintain and ensure staff compliance in an outbreak.

Kind regards

Carrie

CARRIE SPINKS
Clinical Nurse Consultant – Infection Control

| RSL ANZAC Village |4 Colooli Road Narrabeen NSW 2101 | E: carrie.spinks@rsllifecare.org.au | T: 02 8978 4826 | M: 0420 940 748 | F: 02 9982 6604 | http://www.rsllifecare.org.au |

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—–Original Message—–

Hi Lisa,
In addition to comments from Michael and Richard, I would like to add that planners and architects must come to understand the very real tension between providing a home like environment and infection risk. While a residential care environment can be made to look and feel homelike. It will never lose the high institutional infection risk including respiratory or gastro outbreaks and outbreak related deaths.

We would all agree with them that we do not have paper towels for personal use in our home ensuite. But then remind them that this is because our domestic homes do not accommodate 20+ vulnerable residents all receiving intimate personal care, washing and, toileting delivered by numerous staff moving from one care recipient to the next. The aspirational goal of providing a home ‘like’ environment never trumps real risk management measures that minimise institutional infection risk.
Cheers,
Lesley
Lesley Lewis
Regional Infection Control Consultant | Hume Region Infection Control Resource and Consulting Service

—–Original Message—–

Hi Lisa,
Your concern is very valid. Your Healthcare facility (not a house) would not be compliant with the Australian building code Part D – Infection Prevention and Control, D.0002 – Building Elements, Revision 7.0, 01 March 2016 which specify:
“HAND DRYING
Single use cloth or paper towels will be provided at all hand basins. Locate towel dispensers adjacent to the splashback to prevent splash contamination. Dispensers should be smooth-surfaced and easy to clean to prevent dust or soil contamination.
Paper towel may be used in public amenities and beverage bays.
Hot air hand dryers are not recommended for installation in clinical areas of healthcare facilities. High speed hand dryers may be considered in non-clinical areas, such as public toilets.”

Kind Regards,
Richard
Richard Bartolo
Manager Infection Prevention
Western Health
Gordon Street, Footscray VIC 3011
Ph. 03 8345 6113
Email. richard.bartolo@wh.org.au
Web. http://www.westernhealth.org.au

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—–Original Message—–

Hello Everyone,

I am an ICP working fir a large metropolitan health service in Victoria. We currently have as part of our health service, 4 residential aged care facilities.

We are currently in the planning stages with architects of a new public residential aged care facility. The question around hand towels in ensuites has been raised.

The concern by planners is that not having paper towels in ensuites, will avail them with more space for storage for residents in this space. They state you would not have paper towels in your home ensuite.

Our concern is , though a home, this is also a clinical space and for safe and best practice, staff require access to a wash basin and paper towels to perform hand hygiene if their hands are soiled.

I would like to know how others are managing in this space.

Kind regards,
Lisa

Lisa Mathieu Campbell
Acting Associate Director
Infection Prevention & Control Services
Eastern Health
Victoria

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[Carrie Spinks]

Hi Karen,

I find the Australian Aged Care Home Antimicrobial Stewardship Policy a useful tool to assist with review parameters for AB prescribing in RACF:
https://irp-cdn.multiscreensite.com/d820f98f/files/uploaded/AMS%20Policy_Sept%2018.pdf

In fact I find all the NCAS (National Centre for Antimicrobial Stewardship) tools very useful.
https://www.ncas-australia.org/

Although it does not answer your first enquiry, it does your second.

Hope this is helpful.
Kind regards

Carrie

CARRIE SPINKS
Clinical Nurse Consultant Infection Control

| RSL ANZAC Village | 4 Colooli Road Narrabeen NSW 2101 | E: carrie.spinks@rsllifecare.org.au | T: 02 8978 4826 | M: 0420 940 748 | F: 02 9982 6604 | http://www.rsllifecare.org.au |

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From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Team Leader RN Wynyard
Sent: Tuesday, September 10, 2019 11:13 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: [ACIPC_Infexion_Connexion] RE Prophylactic Long term Antibiotic usage in RACF

Hi all

I just have a question regarding GP s who prescribe Antibiotics prophylactically to minimise recurrent infections. Some have had prophylactic antibiotics prescribed for recurrent UTIs for example ( more than 4-5 in previous 12 month period)
Some of our Residents have been on Prophylactic Antibiotics for > 6 months.
Predominantly for either recurrent UTI or Respiratory Tract infections (exacerbation of COPD)
Around 50 % (sometimes higher depending on others prescribed) of our Monthly data statistic in regards to Antibiotics prescribed consists of those who are on ongoing prophylactic antibiotics

Should these Residents have a specimen sent to pathology for M S & C at any time to confirm whether they have become Resistant during the 6 months plus they have been prescribed them ?
Should a GP at minimum be reviewing this in regards to ceasing at any specified time ?

Kind Regards
Karen Panzich TLRN / Infection Control Coordinator
Wynyard Care Centre
Tasmania

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