[Cath Murphy]

Thanks Michael

That is a very interesting link. As you suggest it seems difficult or perhaps tricky to distinguish between instrument and surface disinfection. The site has a lot of helpful info but it doesn’t seem to address the use of surface disinfectants in non-clinical settings let’s say for example in theme parks, gyms or other community settings.

Cheers

Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

Hi Cath

You have to ask the question “is this a therapeutic good?” to decide if it needs to be listed on the ARTG by TGA. For disinfectants, it’s about claims made about the disinfectant.

See the TGA website here: https://www.tga.gov.au/regulation-disinfectants-and-sterilants

In my opinion this is a bit of a minefield in which the actual disinfectant sponsors and manufacturers get confused in, so that makes it hard for health professionals to determine what is necessary.

Any disinfectant with claims should be TGA approved for any application, but there are some exclusions at the bottom of the page (refer to the actual regulation for completeness).

Hope this helps in some way. If in doubt, best advice is to contact the TGA.

Cheers
Michael

Michael Wishart
Infection Control Coordinator

A 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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Dear ACIPC Members

I am seeking information and responses to a series of questions regarding UV disinfection. I am not sure what the TGA’s regulatory requirements are and would be grateful for any advice.

Advance thanks.

When does a device require TGA approval?

What are the TGA requirement for UV disinfection?

Can a disinfection device be used outside of healthcare facilities without TGA approval?

Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

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[Cath Murphy]

Hi Katherine

There has been some amazing new research done on air turbulence in operating theatres where a HEPA/ Ultraviolet air recirculation system (HUAIRS) is in use. I saw it presented at an Australian Orthopaedic Association Conference in Adelaide 3 weeks ago.

The results may not yet be published but they are disturbing given that there were very large increases in turbulence even when just one person entered the OR. Air turbulence is an invisible issue and as such one we may not have ever given it enough consideration. Some of the issues raised in the research may be able to be generalised to support your argument.

I am happy to put you in contact with the researcher if you think that it would help. In the interim here are a couple of general papers on air and spread.

Yours sincerely

Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

Greetings!

I am seeking information on the use of oscillating, portable fans for patient cooling in ICU settings. Our units are very enthusiastic to purchase said items, however we are not keen due to the risk of turbulent airflow, aerosolization of pathogens etc. The ICU teams are requesting documentation/studies/evidence to support our stance – a brief look has failed to find anything but we are wondering, before I dig deeper, if anyone had had to respond to this issue and was able to share this information.

Katherine McKay
Clinical Nurse Consultant
Hand Hygiene Portfolio
Infection Prevention and Control Services
Box Hill Hospital
Eastern Health

P: (03) 9895 3480
E: katherine.mckay@easternhealth.org.au

http://www.easternhealth.org.au
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[Cath Murphy]

Thanks GH. That’s valuable additional information.

All of IC Today materials are underwritten by medical device manufacturers or medical industry. Many research initiatives published in peer review literature are also funded by medical industry. Neither degrades the value of their content and as you say we should also always be aware of author associations and funding sources.

It’s the reality these days that much of the R&D investment is borne by medical industry as there are very few research funding options otherwise available. Medical industry also has much to offer us in terms of fast and efficient communication. As well they are valuable supporters of our profession and pay large amounts of money to be part of events like our upcoming ACIPC Annual Meeting.

The real solutions to infection control require all stakeholders to be working together – clinicians, government, professional associations, academia, consumers and medical industry with common goals and aspirations. We would be nave to think otherwise.

Yours sincerely

Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

Hi All,

For those following this thread the following information is available and in the public domain.

The two main reference in the IC Today article that relate to the use of the nasal antiseptic (Nozin) for decolonisation of staff and patients are as follows:

* SteedLL et al. Reduction of nasal Staphylococcus aureus carriage in health care professionals by treatment with a nonantibiotic, alcohol-based nasal antiseptic. American Journal of Infection Control 42 (2014) 841-6

Full paper – http://www.ajicjournal.org/article/S0196-6553(14)00651-8/pdf

* Perioperative participation of orthopedic patients and surgical staff in a nasal decolonization intervention to reduce Staphylococcus spp surgical site infections. Am J Infect Control. 2017 May 1;45(5):554-556
Full paper – http://www.ajicjournal.org/article/S0196-6553(17)30006-8/pdf

http://www.infectioncontroltoday.com/~/media/Files/Medical/Whitepapers/2017/10/20170922-ND-broadening-application-CP-.pdf

From the manufacturer/supplier web page:

* The product is FDA approved (OTC Drug Regulation) and it contains the following ingredients:

* Ingredients for Nozin Nasal Sanitizer antiseptic

* Active Ingredients:
Alcohol (62% antiseptic)
* Inactive Ingredients:
jojoba, orange oil, coconut oil, lauric acid, benzalkonium chloride, vitamin E
https://www.nozin.com/

Regards

Glenys

Glenys Harrington
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
E: infexion@ozemail.com.au
[Description: ICC Diagram ICCversion]

Hi Matthias

I was loathe to use trade names on this site. However, I will to respond. There is a growing body of US evidence around a product called Nozin. More details are at nozinpro.com

When I was at APIC in June 2017 there was a lot of interest in the product in healthcare and other settings.

Thanks for your view on the existing literature Matthias, I always enjoy your responses.

Yours sincerely

Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

Hi Cath, hi Michael,

I am curious about the remark below concerning ethanol for nasal decolonisation. The last time I looked (which is a while ago), the results achieved were not convincing.

From a physiological and/or conceptual point of view, while alcohol is a fantastic antiseptic/disinfectant for superficial skin, it is usually deemed unsuitable for mucous membranes (which the inside of the nose consists of), due to its more aggressive nature than aqueous antiseptics.

Best regards, Matthias.

—
Matthias Maiwald, MD, FRCPA
Senior Consultant in Microbiology
Adj. Assoc. Prof., Natl. Univ. Singapore
Department of Pathology and Laboratory Medicine
KK Women’s and Children’s Hospital
100 Bukit Timah Road
Singapore 229899
Tel. +65 6394 8725 (Office)
Tel. +65 6394 1389 (Laboratory)
Fax +65 6394 1387

Hi Cath

Just a comment: the povidone iodine nasal cream commonly used pre-op in the US is not yet available in Australia, as far as I am aware. I wish it was, as getting traditional pre-admission nasal decolonisation (5 days of mupuricin or the like) done in a private hospital is not easy!

Cheers
Michael

Michael Wishart
Infection Control Coordinator

A 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0]
P Please consider the environment before printing this email

Dear All

I am interested in learning more about the adoption and use of nasal decolonisation in Australia and New Zealand. In the US this appears to be being used sometimes in place of Contact Precautions. There is a download from IC Today to that effect plus some recent papers. Happy to share if anyone wants it, please email me. So would any of you be able to comment on these questions and if and how you use nasal decolonisation in your organisations please. Thanks in advance.

a) other than ethanol and povidone iodine (e.g.: 3M and others) what else is used for nasal decolonisation right before surgery?
b) which are the most commonly used products?
c) what are the surgery profiles where these are used? (e.g.: ortho, open heart, hernia repair etc)
d) what is the adoption rate for using something like this? Is it universal or a % of surgeons opt to do it?

Yours sincerely

Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

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[Cath Murphy]

Hi Matthias

I was loathe to use trade names on this site. However, I will to respond. There is a growing body of US evidence around a product called Nozin. More details are at nozinpro.com

When I was at APIC in June 2017 there was a lot of interest in the product in healthcare and other settings.

Thanks for your view on the existing literature Matthias, I always enjoy your responses.

Yours sincerely

Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

Hi Cath, hi Michael,

I am curious about the remark below concerning ethanol for nasal decolonisation. The last time I looked (which is a while ago), the results achieved were not convincing.

From a physiological and/or conceptual point of view, while alcohol is a fantastic antiseptic/disinfectant for superficial skin, it is usually deemed unsuitable for mucous membranes (which the inside of the nose consists of), due to its more aggressive nature than aqueous antiseptics.

Best regards, Matthias.

—
Matthias Maiwald, MD, FRCPA
Senior Consultant in Microbiology
Adj. Assoc. Prof., Natl. Univ. Singapore
Department of Pathology and Laboratory Medicine
KK Women’s and Children’s Hospital
100 Bukit Timah Road
Singapore 229899
Tel. +65 6394 8725 (Office)
Tel. +65 6394 1389 (Laboratory)
Fax +65 6394 1387

Hi Cath

Just a comment: the povidone iodine nasal cream commonly used pre-op in the US is not yet available in Australia, as far as I am aware. I wish it was, as getting traditional pre-admission nasal decolonisation (5 days of mupuricin or the like) done in a private hospital is not easy!

Cheers
Michael

Michael Wishart
Infection Control Coordinator

A 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0]
P Please consider the environment before printing this email

Dear All

I am interested in learning more about the adoption and use of nasal decolonisation in Australia and New Zealand. In the US this appears to be being used sometimes in place of Contact Precautions. There is a download from IC Today to that effect plus some recent papers. Happy to share if anyone wants it, please email me. So would any of you be able to comment on these questions and if and how you use nasal decolonisation in your organisations please. Thanks in advance.

a) other than ethanol and povidone iodine (e.g.: 3M and others) what else is used for nasal decolonisation right before surgery?
b) which are the most commonly used products?
c) what are the surgery profiles where these are used? (e.g.: ortho, open heart, hernia repair etc)
d) what is the adoption rate for using something like this? Is it universal or a % of surgeons opt to do it?

Yours sincerely

Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

______________________________________________________________________
This email and any attachments to it (the “Email”) 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. If you are not the intended recipient of the Email, please notify the sender immediately by return email, delete the Email, and do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
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[Cath Murphy]

Hi Terry and All

A little relatedI have been working on a project in relation to ultra-clean OR particularly in relation to implants and as an adjunct to all the other standard approaches asepsis, surgical skill, environmental cleaning and surgical hand asepsis.

This is an incredibly interesting paper from AJIC that infers our current approaches can be improved. It is particularly encouraging to see Australia mentioned. The paper is worth a read in my opinion anyway.

Yours sincerely

Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry McAuley
Sent: Friday, 6 October 2017 08:33
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Mixing of endoscopy and ophthalmology procedures in a HEPA filtered Operating Room

Thanks Michael,

I’ve suggested a waiting period between cases based on the time taken to achieve a full air exchange in the OR and of course cleaning thoroughly between cases (as they should already be).

Kind Regards
Terry McAuley
Director
STEAM Consulting Pty Ltd
M: 0438109692

Sent from my Samsung Mobile on the Telstra Mobile Network

——– Original message ——–
From: Michael Wishart <Michael.Wishart@SVHA.ORG.AU>
Date: 6/10/17 7:46 am (GMT+10:00)
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Mixing of endoscopy and ophthalmology procedures in a HEPA filtered Operating Room

Hi Terry

We had this question many years ago at St Elsewheres when we opened a new imaging procedure room that was used for vascular grafts. Because the imaging was so good, a gastroenterologist wanted to do so specific colonoscopy procedures requiring imaging in it. The vascular surgeons kicked up a big stink, but the ID/micro people supported it with the appropriate cleaning between cases and use of the procedure room (it was HEPA filtered) for both types of cases.

Similar concept. Not sure if there would be a need to be a waiting period to ensure appropriate air changes before ophthalmic procedures that followed endoscopies (eg possible aerosolized viruses?).

Cheers
Michael

Michael Wishart
Infection Control Coordinator

A 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry McAuley
Sent: Thursday, 5 October 2017 5:54 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Mixing of endoscopy and ophthalmology procedures in a HEPA filtered Operating Room
Importance: High

Hi Everyone,

I have been asked if there is any evidence available that would indicate that you should not perform ophthalmic procedures in a correctly ventilated Operating Room after the OR has been used for endoscopy procedures.

I havent been able to locate anything suggesting that this is an issue however before making a recommendation I thought I would ask the Brain Bank if they have ever researched this question and if so have they found an answer?

Kind Regards
Terry McAuley
Sterilisation & Infection Prevention and Control Consultant
STEAM Consulting Pty Ltd ACN 604 439 698
Mob: +61 (0)438 109 692
E: terry@steamconsulting.com.au
W: http://www.steamconsulting.com.au
A: PO BOX 779
Endeavour Hills
VIC Australia 3802

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[Cath Murphy]

There are lots of research papers out there discussing pro and cons of each approach. Patient non-compliance was a big factor in night-before body washes as patient’s didn’t remember or just didn’t do it.

I think the majority of research has been around CHG with true sensitivity very very very rare despite folks trying to position CHG as the new “latex allergy”. CHG also preferred for its residual effect. Triclosan has been subject to FDA safety notice this year – worth googling probably.

I will try and find the papers and my summary and will happily share it with you in separate email if you would like.

Yours sincerely

Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

Dear Brains Trust,
We are currently reviewing our pre-operative information that we provide our patients prior to their elective surgical procedure, more specifically colo-rectal surgery.

We are particularly interested in what other facilities who undertake this type of surgery advise their patients regarding antiseptic body washes.

Specifically:

* when are you asking your patients to perform the wash (eg day of surgery only, the night before and day of surgery)?
* the type of antiseptic body wash (eg chlorhexidine, no antiseptic wash, triclosan) you advise your patients to use?
* substitutes if patients identify as having an allergy to your recommended body wash?

Happy to discuss off-line if preferred.

Kind regards,
Barb

Barbara May
CNC Infection Prevention and Control |Port Macquarie Base Hospital |Mid North Coast Local Health District
PO Box 2466, PORT MACQUARIE NSW 2444 | Tel 02 5524 2061| Fax 02 5524 2061| Mob 0402890677

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[Cath Murphy]

Vicki

In my mind the best source of advice for all things IV is the US INS Infusion Therapy Standards of Practice. Can you access the Standards? If not PM me and I can direct you. Standard 84 makes multiple recommendations that will be helpful for you.

It would be so useful if ACSQHC endorsed or adopted these Standards rather than leaving blanks in guidance. The NZ draft IV Standards are largely based on these US INS Standards also.

Perhaps the AVAS group could also endorse them?

Gorski, L. A., L. Hadaway, M.E. Hagle, M. McGoldrick, M Orr, and D. Doellman. 2016. “Infusion nursing standards of practice.” J Infus Nurs 39 (1S):1-256.

Yours sincerely

Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

Hi All,

Would appreciate any assistance with this issue…

Do you know of any policy that describes how long a prefilled IV medication can hang for?

I had it in mind that ALL IV infusions should be replaced at 24 hours to reduce risk of infection (even if it’s a prefilled bag) but I can’t find this documented anywhere.
e.g. patient in ICU using a prefilled morphine bag, bag is stable for >24 hours, and the dose is low enough that it would last 3 days. Nurses have been changing every 24 hours but someone asked me today if they *had to*.

Thanks

Vicki

Vicki Denyer

Infection Prevention & Control Clinical Nurse Consultant
Lismore Base Hospital

Infection Prevention & Control is Everyone’s Business

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[Cath Murphy]

Dear All

I agree with Michael’s rationale and agree there are cases of occupational transmission of serious bloodborne illness from mucousal splashes reported in the literature. So from an OCH&S obligation the HCW should comply.

This is one of those frustrating issues that come up from time to time and they drive me crazy. They are like the ? of eating in theatres/ anaesthetists wearing masks/ OT staff changing attire etc. Why IC professionals continually have to fight these causes is exhausting and sad but back to the science….whilst Michael provides a meta-analysis it is a few years old and it is based on very few reports probably because the issue hasn’t been well studied not that the issue isn’t important.

I would also draw attention to the increasing use of air-purifying systems in the US and other countries. Some of the data related to validation studies are very compelling and show how CFU counts of bacteria rise (sometimes to extremes) when speaking (behind masks) happens. Obviously showing causation between high counts/ speaking and actual wound infection is difficult given to the many confounders (# of people in the room/ traffic/ movement/ +/- measures like laminar flow/ skin prep etc etc) but surely it just makes sense for people in the OR to wear masks for everyone’s sake.

Off track..but I recall being asked this exact question by a group of anaesthetists at a scientific meeting in the late 1990s and after responding seriously and scientifically I then added “mask wearing depends on how good looking you are and in your case I would”…as you can imagine it went down like a lead balloon but it silenced the question asker.

I seriously wish you good luck in fighting these battles and I wish the people we served relaised the very serious and very real issues we fight daily and perhaps then they would stop creating distractions like this.

With respect
Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

Hi Fran

This topic has received a fair bit of attention over the years, and yes, your doctors are correct: there is no compelling evidence to suggest surgical face masks reduce surgical site infection rates. See this meta-analysis conclusion: https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0064347/

Having said that, my own rationale for staff wearing surgical face masks during procedures is for protection of their mucous membranes from splashing of potentially infectious material. In my view, the ‘strike resistance’ for surgical face masks is of high importance, and has little to do with preventing contamination of the surgical wound.

To suggest staff in a room during a procedure don’t wear masks would in my opinion be asking for trouble. From a occupational health and safety perspective, I would always recommend everyone in a room during a surgical procedure should be wearing a surgical face mask, and eye protection as well.

In my view, anyway.

Cheers
Michael

Michael Wishart
Infection Control Coordinator

A 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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Afternoon All,

I require some assistance please.

We’ve had interesting discussions amongst some of Visiting Medical Officers regarding the effectiveness of wearing surgical masks in the operating room to decrease the likelihood of postoperative surgical site infections. The practice of wearing masks is believed to minimize the transmission of oro-and nasopharyngeal bacteria from Theatre Operating staff to patient’s wounds. However a couple of individuals believe there is not enough evidence to support this and therefore don’t think it is necessary to wear surgical masks while operating.

I’m aware of the requirements as per the ACORN Standards and the National Infection Control Guidelines (2016 Draft version), which our Staff complies by, however I cannot find current best practice or evidence to provide to those two individuals.

Any suggestions please? And if you’re willing to share, what is the Policy in regards this matter at your facilities?

Kind Regards

Franciska Ferreira
Infection Prevention & Control/Wound Management Consultant
Burnside War Memorial Hospital
120 Kensington Road, Toorak Gardens, SA 5056
t: 08 8202 7231 f: 08 8407 8573 e: fferreira@burnsidehospital.asn.au
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[Cath Murphy]

Hi Cate

This is an interesting issue. Whilst the guidelines say exactly what you have reproduced below I think the emphasis should be on single-use high-quality transducer cover rather than using a condom. My reasoning is based on two things. Firstly, to minimise risk I think it is best to use equipment specifically manufactured for a specific purpose ie. use a transducer cover that is purpose manufactured vs a condom which is manufactured for contraceptive purposes not infection control although there are obvious IC benefits and one could argue either side.

Secondly, the issue of U/S reprocessing was on the agenda at the recent APIC meeting in Portland and it seems that US ICPs are moving much more towards improved higher-levelled reprocessing than was previously performed. This has come about by greater appreciation for the potential risk of transmission of conditions such as HPV and also the availability of relatively inexpensive quality systems of reprocessing that are suitable for US probes.

As a fall-back position perhaps the manufacturer of the US transducer could recommend a cover that they know through testing works well with their probe. It’s an interesting position that ASUM has adopted regarding condom use and I wonder what evidence they used to support it.

Hope this helps
Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

Hi everyone,
Seeking advice on ultrasound transducer covers. The Guidelines for Reprocessing Ultrasound Transducers regarding transducer/probe covers state All intracavity transducers should be covered with a single-use high-quality transducer cover. This may include some , but not all brands of condom, specific transducer covers or surgical drapes.
Can you tell me how I determine which brands of condoms are suitable? Is there a criteria to assist?
thanks

Cate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
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e … cate.coffey@nt.gov.au http://www.nt.gov.au/health

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[Cath Murphy]

I have enjoyed watching this thread evolve and have a few questions for consideration of ICPs seeing staff present with skin issues.

Firstly are you able to determine when staff started experiencing issues? If so, was it in anyway related to a change in glove providers and perhaps even adoption of a glove less expensive but also lower quality than some of the high quality nitrile gloves that are available.

The second important question is are these issues allergy and/or chemical accelerator related? If so I would highly recommend a chemical accelerator free quality glove.

Over the past decade particularly I have edited several documents on glove quality/ manufacturing and choice as well as skin issues relating to glove use. If anyone is interested I am very happy to provide links to those documents.

Yours sincerely

Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Vicki Denyer
Sent: Friday, 23 June 2017 12:10
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Oatmeal nitrile gloves

Hi Rita , like wise ( referring to Kate Hipsley email response) with us at our hospital- this glove was originally used for staff who had skin irritant / breakdown of skin integrity.
Feedback from these staff enforce how well their skin responded to this type of glove. We currently have this glove across whole LHD

Vicki
Vicki Denyer

Infection Prevention & Control Clinical Nurse Consultant
Lismore Base Hospital
Ph: 02 66 202385
Fax: 02 66 202287

Infection Prevention & Control is Everyones Business

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Kate Hipsley
Sent: Friday, 23 June 2017 8:30 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Oatmeal nitrile gloves

Dear Rita, this product is our go to glove when staff experience skin issues and where their medical advice is to try an alternate glove. The possible risks you mentioned in my opinion would be negated by the fact that the HCWs skin is usually in a better state (or at least not deteriorating further) after using the gloves.
Happy to discuss our experience offline if you wish.
Kate Hipsley
NSW Ambulance
0428238789

On 22 Jun 2017, at 13:17, Rita Roy <Rita.Roy@HEALTH.NSW.GOV.AU> wrote:
Dear All,
Has any of your facilities used oatmeal nitrile gloves? If so, are you aware of any efficacy issues or risks associated with the usage of theses gloves? Is there any interaction that can occur with alcohol based hand rubs/gels/foams and any residue left from the gloves on hands after removal? Any information would be appreciated.
Many thanks,
Rita

Rita Roy

Clinical Nurse Consultant | Infection Control
Hornsby Ku ring gai Health Service, Palmerston Road, Hornsby NSW 2076
Tel (02) 9477 9232 | Fax (02) 9477 9013 Rita.Roy@health.nsw.gov.au
http://www.health.nsw.gov.au

Click here to visit the Infection Prevention and Control page on the Intranet
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[Cath Murphy]

Dear Terry

Thank you for access to the publication and congratulations on getting it published. I wonder if Australia will ever make progress in this area.

I also wonder if you think that the same strategies would work equally in countries like Australia and NZ where we still have no legislation mandating use of safety-engineered devices. It would be interesting to repeat the study in ANZ.

Is this paper the basis of what you will be preventing at APIC or will it be different?

Yours sincerely

Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
121 Dunlin Drive
Burleigh Waters 4220
QLD, Australia

E: Cath@infectioncontrolplus.com.au
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From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry Grimmond
Sent: Wednesday, 17 May 2017 10:47
To: AICALIST@AICALIST.ORG.AU
Subject: Free access to Sharps Injuries article

Hi Michael,

JAOHP has granted free access to the attached publication on strategies to reduce sharps injuries it may be of interest to AICAlist colleagues.
Its url is http://www.aohp.org/aohp/Portals/0/Documents/NewsAndEvents/Press%20Release/2017PRStrategiesfreecopy%20.pdf

Best regards, Terry

Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist
Grimmond and Associates
Ph (NZ): +64 7 855 3212
Mob (NZ): +64 274 365 140
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[Cath Murphy]

Janet

PS. Looking at the edition of AJIC which came out this week there are several papers on HH monitoring and an editorial by Pittet (which unsurprisingly promotes WHO’s direct observer method). All makes for interesting reading and discussion.

Cheers
Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
Burleigh Waters 4220
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

Hi all

We currently participate in the Hand Hygiene Australia 5 moments of hand hygiene auditing. It is planned to continue with this.

One of our units is interested in trialling some of the automated hand hygiene auditing and / or promoting systems which are available.

Could you please let me know if any of you have experience with any of these, and if so, what your findings and experience were.

Many thanks

Janet Wallace

Clinical Nurse Consultant

Infection Control – Infection Management and Prevention Service (IMPS)

Children’s Health Queensland Hospital and Health Service

Level 12

Lady Cilento Children’s Hospital, South Brisbane QLD 4101

T: 07 3068 3989 / mobile 0408 236 266

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[Cath Murphy]

Hi Janet

Mary-Louise McLAws, UNSW has had extensive local experience with these so I would contact her as a starting point. She is our national expert on them and she published on this in collaboration with Westmead Children’s Hospital I think.

There are also several published papers in AJIC and ICHE which discuss various methods and outcomes. See this website for info
http://www.ehcohealth.org/category/the-evidence/

Connie Steed and Elaine Larson are both based in the US and together they spearheaded use of these systems. I could connect you if that would be helpful.

Also there are a number of papers being presented at APIC 2017 on automated monitoring of HH. I am happy to bring back and share any info I gain from those presentations.

Cheers
Cath

Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
Burleigh Waters 4220
QLD, Australia

E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.au

Hi all

We currently participate in the Hand Hygiene Australia 5 moments of hand hygiene auditing. It is planned to continue with this.

One of our units is interested in trialling some of the automated hand hygiene auditing and / or promoting systems which are available.

Could you please let me know if any of you have experience with any of these, and if so, what your findings and experience were.

Many thanks

Janet Wallace

Clinical Nurse Consultant

Infection Control – Infection Management and Prevention Service (IMPS)

Children’s Health Queensland Hospital and Health Service

Level 12

Lady Cilento Children’s Hospital, South Brisbane QLD 4101

T: 07 3068 3989 / mobile 0408 236 266

E: janet.wallace@health.qld.gov.au

W: http://www.childrens.health.qld.gov.au

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[Cath Murphy]

Dear Jayne

A common sense approach would seem like the obvious way to go. That said we now more so than perhaps at any other time understand a lot more of the significant contribution environmental surfaces play in HAI risk. There was an article specifically on the risk of floors published I think within the last 2 months in AJIC. Try and get it if you have trouble let me know.

Also FYI and others who may not understand the detail legislation is typically never written for minute detail like this in infection control. Legislation broadly affects infection control through OCH&S requirements that involve IC. The problem with legislation is that there must always be a penalty which is enforceable and that usually requires ongoing monitoring – think policing. Infection control breaches are not typically of the nature of other criminal offences.

In my working life I have seen legislation specific to infection control only in NSW (in response to early 1990s pt-to-pt HIV transmission) and that was through a series of Regulations. QLD has some legislation for IC as well I think. Obviously there are also respective pieces of legislation for licencing of skin pentration/ tattooing etc. More typically IC recommendations come as Guidelines which provide overarching principles and are enforceable in that in a court of law an individual or organisation deemed to have breached them would have to show just cause as to why they deviated from the standard of the “common man”.

Also in Australia we know that compliance with national Guidelines and Standards is enshrined within the Standard 3 accreditation framework and that penalties ie. restrictions in practice can be enforced if there is deviation from those requirements. In the private sector, hospital licences to operate can be revoked by the licensing authority if breaches occur. Usually it is the state/ territory govt who are the licensing authority.

There are also professional requirements that registered HCWs have under their respective professional regulations (that is where the NSW IC requirements sit)

So in short, for a mop or any other specific IC recommendation it is unlikely that there will be “law” but good sense and use of evidence should prevail as always. I would also personally add keeping an eye on evolving technologies ie. waterless surface disinfection/ decontamination is a good idea in this instance. Others will disagree with me on that as they have in the past.

I hope this helps you and other understand how all the different directives create and contribute to our somewhat complicated Australian IC framework.

Other legal requirements relate to how products/ medications/ solutions etc get registered with the TGA.

Good luck with your mop and bucket.

Cheers
Cath

Cathryn Murphy MPH PhD CIC
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—–Original Message—–

Hi Jayne

I would also be very interested to hear some comments as we have had similar issues/queries raised here as well.

As you say common sense should prevail but any guidelines would be very useful.

Kind regards
Mary

Mary Willimann CICP-E| Manager Infection Control St John of God Subiaco Hospital
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—–Original Message—–

Dear knowledge Bank,

This might sound like an odd question but one of our sites has just been had accreditation and they observed a cleaner mopping 4 bathrooms before they change mop heads and water. Bearing in mind they only mop the bathroom floor as the rest of the room is carpeted.!!! ( that’s another story). Our policy states to change after 3-4 rooms unless grossly soiled/contaminated.

Is there legislation ( I cannot find it in NSW Health or CEC guidelines)dictating how frequently mop heads and water are changed between patient rooms i.e. NON infectious patient rooms.

Common sense should prevail as changing for each room would not only be logistical nightmare but also have WH&S risks, time and cost constraints..

Happy to hear comments 🙂 Thank you in advance.

Jayne

Jayne O’Connor RN,BSc.Inf.Cont.
IPC Co-Ordinator
Sydney Adventist Hospital
185 Fox Valley Rd.,
Wahroonga 2076

Tel DD: (02) 9487 9732

[Description: 5 moments hand hygiene]

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[Cath Murphy]

Agree completely with you ML.

Also often distressed by pushback from clinicians and even IPs who use the phrase “evidence-based” as a cop out for adopting measures that make biological or even plausible sense. It’s not like the global infection control community has endless time, money or intellectual capacity to create the evidence yet it’s an easy cop-out.

Look at other professions/ industries like law/ aviation/ mining/ food preparation where specific important matters are mandated not on evidence but on good common sense and reasonable consideration of potential for harm/ risk mitigation and/ or remediation. Yet in healthcare we so often flim-flam and procrastinate or put up an immediate brick wall to any hint of mandating and meanwhile poor practice, events which should be never and patient harm are tolerated.

Politics and finance are major drivers of infection prevention practice at every level but increasing I hope our profession can become more open to leading efforts to prevent infection rather than making excuses about why we should or shouldn’t support specific aspects.

Many may find this comment offensive or inflammatory and I am sorry of you interpret it as such – my intention is to provoke further thought and deeper consideration of how we can make sustainable improvements.

Respectfully

Cath

Cathryn Murphy MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
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Michael
There are several evidential factors that should make HCWs accept annual vaccination:
1. flu can be transmitted at least 24 hours before symptoms,
2. flu can be present even when a case is asymptomatic
3. flu can be easily transmitted while symptomatic during just tidal breathing
4. Flu particles can travel 2.6 metres
There is evidence to back up all of these that makes mandatory vaccination every HCW’s patient safety duty.

M-L
Professor Epidemiology Healthcare Associated Infection and Infectious Disease Control

Sent from my iPhone

On 8 Feb 2017, at 9:19 pm, Michael Wishart <Michael.Wishart@SVHA.ORG.AU> wrote:
[Posted on behalf of Giulietta Pontivivo – Moderator]

Hi Michael

The draft update of the MoH NSW Occupational Assessment, Screening and Vaccination Against Specific Infectious Diseases PD stipulates “HCW’s in Category A high risk groups will be mandated to be vaccinate before 31st may each year. If unvaccinated the HCW maybe deployed permanently to other low risk working environments”.

Personally I would have liked to see all HCW’s in category A be mandated to have a seasonal flu vaccine. Given that in NSW there were over 270 HC facilities that experienced influenza outbreaks last year with low rates of HCW influenza vaccination in such facilities then mandatory vaccination must be seen as a patient safety requirement.

Regards Giulietta

Giulietta Pontivivo CICP RN/RM/MPH| NM Infection Prevention Management and Staff Health Services- St Vincent’s Hospital (Unit Level 6, DeLacy Building), 390 Victoria Street Darlinghurst NSW 2010
Contact Details: t: 61 2 8382 3284 | f: 61 2 8382 3892 |M-0457 533 452 e: Giulietta.Pontivivo@svha.org.au

There has been an interesting discussion of the 2010 SHEA position paper on mandated influenza vaccination in the US on the Controversies in Hospital Infection Control blog (http://haicontroversies.blogspot.com.au/). The key blog posts are from Jan 29th, Feb 5th and Feb 6th.

For those who do not regularly follow this blog, it is an interesting debate. It is a discussion on evidence vs opinion for prescription of practice.

I agree with the original blog author: it is fine to state opinion and plausibility to recommend something, but if we want to mandate something, there needs to be clear evidence.

Would be interested to hear other ICP’s opinion on this topic.

Cheers
Michael

Michael Wishart
Infection Control Coordinator

A 627 Rode Road, Chermside QLD 4032
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