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Thanks Michael Wishart for your common sensical approach. I agree with you wholeheartedly and like you fear yet more mixed infection control messages that adopting ring-fencing would cause.
Cheers
Cathryn Murphy MPH PhD CIC
Chief Executive Officer
Infection Control Plus Pty Ltd
PO Box 3079
Burleigh Town 4220E: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W: infectioncontrolplus.com.auHi Rita
In my opinion you are opening Pandora’s fabled box if you take this path of ‘ring-fencing’ You are basically saying that contact precautions are not sufficient. I have seen this attempted and it made no difference in a large hospital already endemic with MROs. And one of the spinoffs can be suboptimal care for orthopaedic patients who are excluded from orthopaedic wards.
In my opinion, anyway. Someone may have some studies to support either position. Just be careful the path you take, in my experience.
Cheers
MichaelMichael Wishart
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226P Please consider the environment before printing this email
Sent by Outlook for Android on a Galaxy S5
On Mon, May 30, 2016 at 10:14 PM -0700, “Rita Roy” <Rita.Roy@HEALTH.NSW.GOV.AU> wrote:
Dear All,
Does any hospital have a guideline for admission of patients to orthopaedic wards? More specifically, are there any criteria that you might be following, for example: no patients with MROs, wounds, ulcers, etc. to be allowed admission into orthopaedic wards, even if the presentation is related to orthopaedics?
Many thanks in advance,
Rita
Rita RoyClinical 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.auClick here to visit the Infection Prevention and Control page on the Intranet
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Dear Cate and colleagues
What an interesting topic. It seems that the only issue raised is wipeable surfaces. Can I please take this opportunity to raise thinking, and likely debate about the adjunct method of disinfection – no waterless disinfection.
As many of you may realise there are now several different types of either hydrogen or xenon-based waterless disinfection system. These systems are now almost routine in US hospitals and are being adopted in the UK and other parts of the world as they become available.
There is good evidence for their effectiveness and contribution to reducing transmission risk and infection. They are NOT an alternative to but an ADJUNCT to cleaning. As a healthcare consumer my hope is that they soon become routine in Australian hospitals.
Happy to talk more about them to anyone who may be interested. I know that summary papers and other research papers have previously been shared here and I am also happy to share those again.
Warm regards
CathCathryn Murphy RN MPH PhD
Executive Director
Infection Control Plus Pty Ltd
PO Box 3079
Burleigh Town 4219
Queensland
AUSTRALIAE: Cath@infectioncontrolplus.com.au
http://www.infectioncontrolplus.com.au
Hi everyone,
I have request by builders to put jumbo toilet roll holders – that hold large round rolls- in ensuite rooms on a new ICU build. My thoughts are no it is an infection control risk but I thought I would ask my more experience learned colleagues in case you have done this?.
Yep sure am covering the big issues today!!!Cate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517737
e … cate.coffey@nt.gov.au http://www.nt.gov.au/healthOur Vision: Better health outcomes for all Central Australians
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Hi Louise
My understanding is that TGA and equivalent regulatory bodies in the US (FDA) and parts of Europe have an agreement between them to monitor these types of events. FDA has an impressive registry of all sorts of reports including incidents from devices etc.
Also any sponsors of devices or equipment ie. manufacturers or distributors are typically well informed of problems with their devices and are typically diligent in taking remedial action regardless of TGA involvement. It is in their better interest to mitigate risk.
Of course this all depends on the classification of a device/ machine according to TGA requirements as not every device used in healthcare is automatically required to be registered.
When I see informal notices like this on listservers like ACIPCs I think of them as early informal notifications. As well its always good to keep a watching on eye on reports from literature and grey sources.
Hope this helps Louise.
Cheers
CathPLEASE NOTE OUR NEW MAILING ADDRESS:
Cathryn Murphy RN MPH PhD
Executive Director
Infection Control Plus Pty Ltd
PO Box 3079
Burleigh Town 4219
Queensland
AUSTRALIAE: Cath@infectioncontrolplus.com.au
Ph: +61 428 154154http://www.infectioncontrolplus.com.au
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Hobbs, Louise
Sent: Thursday, 28 April 2016 15:47 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: FW: Mycobacterium chimaera update: A must listen from ECCMID [WARNING: SPF validation unavailable]Thank you for sharing this information Glenys
Does anyone know how the TGA recognises and responds to these types of overseas reports of equipment cleaning failures which have resulted in a number of adverse event outcomes and subsequently offers advice response to the Australian community? Is this the responsibility of another national body?
Regards
Louise Hobbs PhD | Manager Infection Prevention and Surveillance Service
Melbourne Health | Royal Melbourne Hospital – City Campus | Level 9 Royal Melbourne Hospital
Grattan Street, Parkville Victoria 3052
T: + 61 3 9342 8328 | F: + 61 3 9342 7277 | e: louise.hobbs@mh.org.au
[Flu-Vax-2015-banner-300px]From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Glenys Harrington
Sent: Thursday, 28 April 2016 2:34 PM
To: AICALIST@AICALIST.ORG.AU
Subject: [ACIPC_Infexion_Connexion] FW: Mycobacterium chimaera update: A must listen from ECCMID [WARNING: SPF validation unavailable]Dear All,
For those following the Mycobacterium chimaera heater-cooler units you may find some of the answers you need in the following blog from the Controversies in Hospital Infection Prevention below.
The link to the presentation by Dr. Jakko van Ingen at ECCMID is well worth looking at – see link below.
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 47533508426From: noreply+feedproxy@google.com [mailto:noreply+feedproxy@google.com]
Sent: 15 April, 2016 4:21 PM
To: infexion@ozemail.com.au
Subject: Controversies in Hospital Infection PreventionControversies in Hospital Infection Prevention
________________________________
Mycobacterium chimaera update: A must listen from ECCMID
Posted: 14 Apr 2016 06:33 PM PDT
[https://2.bp.blogspot.com/-nSG7E3FIOUI/VxA6EVJ7aOI/AAAAAAAABPc/yxCsKjr02FI703yFHoldb2azHpKcIXGSQCLcB/s640/cover%2Bphoto%2Bfor%2Bblog.jpg]Weve posted several times about the horrible M. chimaera outbreak linked to heater-cooler units (HCUs) used during cardiac bypass surgery. As weve addressed the problem here at Iowa, weve become increasingly frustrated (and dumbfounded) at the lack of available information about the clinical and epidemiological features of the outbreak itself, and at the general lack of urgency about this ongoing and grave risk to patients.
Fortunately, Dr. Jakko van Ingen gave an excellent talk at ECCMID that answers several important questions weve had about this outbreak, confirming some of the things weve heard (in confidence, I assume for political or legal reasons) on various conference calls and email strings. I urge you to take 30 minutes of your time to listen to his talk, all the way to the end of the Q&A period.
Aside from being an extremely entertaining speaker, Jakko addresses several key questions, including:
Is this a clonal outbreak? YES. Slide 29 reports whole genome sequencing data that clusters the isolates from Sorin 3T units and infected patients (within just 2-3 SNPs), and further discussion (during Q&A session) confirms that isolates from other European countries are also in this cluster.
Were the HCUs already contaminated prior to being shipped to end users? YES. Listen carefully to the last question and answer.
Does this particular outbreak primarily involve one make/model of HCU? YES. While nontuberculous mycobacteria have been isolated from other types of HCUs, the specific M. chimaera cluster in this case involves Sorin 3T units.
Is the invasive, disseminated, high crude mortality form of the illness restricted to those patients with implants (e.g. valves, grafts)? YES. The life-threatening disseminated infection appears to require some prosthetic material to which the organism can adhere, protecting itself (via biofilm formation) from host defense. According to Dr. van Ingen, case finding in the Netherlands is now limited to those with implants, and does not include standard non-valve, non-implant CABG patients.
Is it possible to mount an effective, rapid national response to this urgent problem? YES. Slide 18 details the Dutch response, which involved discontinuing all non-urgent cardiac surgery until HCUs were placed outside of ORs (which was done within 48 hours). As we learned here when we did the same thing, it is amazing what you can accomplish when you are left with no other option.
Is opening up a Sorin 3T HCU a frightening experience? YES. Im sure Ill have nightmares about these water-stained, biofilm-befouled devices for a long time (see below for one image from Garvey, et al).
[https://3.bp.blogspot.com/-nrOmoURm3NQ/VxA6HaCEksI/AAAAAAAABPk/fpT7TpyENfcB4jxnEW8LZ1_qKBzRIO7LQCKgB/s640/Screen%2BShot%2B2016-04-14%2Bat%2B7.32.56%2BPM.png]What are the implications?
HCUs are not safe to operate in an OR. The air exhausting from the HCU ventilation fan must be physically separated from the air in the OR, and the easiest way to do that is to remove them from the OR (and maintain the OR at positive pressure, of course).
Everyone using Sorin 3T HCUs should assume that they may have exposed patients to M. chimaera, until more is known about the details of the point-source. Contaminated units cannot be disinfected even with the more intensive protocols currently recommended. In addition, only a few labs are capable of properly performing NTM cultures of water samples, so negative water cultures are of limited value and could be falsely reassuring.
A much more active national patient and provider notification is needed. Our experience is similar to that of others: identified cases would never have been found had it not been for aggressive and active case-finding. There are undoubtedly others currently being treated with immunosuppression for sarcoidosis or some other granulomatous process of uncertain etiology who actually have undiagnosed disseminated M. chimaera disease.
Below I’ve pasted an epidemic curve, an underestimate as it involves only those cases reported to FDA from US (blue bars) and abroad (red). This outbreak isn’t over, not by a long shot, and the fact that there are still hospitals performing cardiac surgery with their Sorin 3T HCUs inside of the OR is extremely distressing.
[https://1.bp.blogspot.com/-C2f_g5YW_rM/VxA-j-6qAhI/AAAAAAAABP8/9EgqZ6WlqZcrrCfOjH_F-Bo3m34JiCndwCLcB/s640/Screen%2BShot%2B2016-04-14%2Bat%2B8.05.55%2BPM.png]You are subscribed to email updates from Controversies in Hospital Infection Prevention.
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Hi Kristie
A/Prof Mitchell raises some good points in relation to the CDC study and which should be considered in future studies. I have always been concerned that ICPs who read the CDC study results will assume that the system used in that study is in some way superior to other brands and types of non-liquid surface disinfection. Please note that there is a plethora of research using other systems and brands and the evidence is increasing very quickly.
I have close relationships with a large group of US ICPs who manage large corporate IC programs across the country. They report using various systems with various results. When talking to them they discuss the importance still of routine cleaning and terminal cleaning before disinfection. They also discussed issues regarding implementation (storage, designated users, capital outlay/ return on investment, cycle time, impact on operating time/ access to patient rooms etc).
Personally, I expect and hope that non-liquid surface disinfection will become the routine standard in Australian in and out patient settings. My early work with Dr Macbethh from 2011 was the first Australian publication to show the inadequacy of routine cleaning and I would suspect that the typical healthcare setting would yield similar results even now unless there has been serious campaigning to raise awareness of the envionrmental burden.
I have a database of many published papers on non-liquid disinfection and am happy to share with you offline if needed.
Good luck with your decisions and I hope members support Brett’s important research around this issue.
Regards
Cath
Cathryn Murphy RN MPH PhD CIC
Executive Director
Infection Control Plus.
Cath@infectioncontrolplus.com.auHi Kristie
Here is a link to a CDC funding study on this point. https://idsa.confex.com/idsa/2015/webprogram/Paper53062.html
There are a few questions that in my mind remain unanswered and or request some further discussion:
* Was this intervention cost effective?
* There were reductions in arms B, C and D, in comparison to A (reference group), just because something isn’t statistically significant, it doesn’t mean it isn’t clinically relevant. For example, arm C (bleach only) showed a reduction
* Is a quaternary ammonium a suitable reference group, especially in Australia?
* It is a shame one of the arms was not just detergent
I am certainly not wanting to be critical of this study. This was a large complex study and the first of its kind in many instances. Those involved are to be congratulated. We need more of these types of studies conducted, not only in the cleaning area, but also IP&C more generally. I raise these questions in the interest of sparking some debate and ensuring we take a considered approach before jumping wholeheartedly into UV. These are questions you are likely to face. There are also a number of implementation issues that remain central to any cleaning intervention. This is one thing the REACH study (randomised stepped wedge cluster control study in 11 Australian hospitals) is seeking to explore, in addition to effectiveness and cost effectiveness of a cleaning bundle. http://reach.cre-rhai.org.au/
Thanks
BrettAssociate Professor Brett Mitchell
Associate Professor of Nursing, RN, BN, PhD, M.Adv.Prac, CICP, MRCNA
Faculty of Nursing and Health and Director Lifestyle Research Centre, CooranbongAvondale College Ltd trading as Avondale College of Higher Education
http://www.avondale.edu.au | http://www.designedforlife.me
185 Fox Valley Road, Wahroonga NSW 2076 AustraliaHello,
We are interested in hearing from sites who currently use UV light as a part of their cleaning package to decontaminate the environment and the equipment to a high level of efficacy.
If you could please make contact with me if you use UV light, we have some questions we’d like to ask.
Thank you.
Kind regards,
Kristie
Kristie Popkiss
Infection Prevention and Management Lead SERCO – Fiona Stanley Hospital
M 0437 358 042
CD012 Main Hospital
Barry Marshall Drive, Murdoch WA 6160
kristie.popkiss@serco-ap.com.au kristie.popkiss@health.wa.gov.auNext Organisation Wide Survey June 2016
Standard 3
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Hi Jo
There is something really interesting that we have observed. Doctors willing share info such as HAI rates or definitions/ methodologies used. None of these would be confidential would they if we consider that no individual is identified by them and also assuming no-surgeon specific data is shared. Eg. Would the number of cases of C diff in a hospital over a given period be considered confidential?
So why is it that Australian ICPs are so less willing to share data or will only share after checking with a higher authority and getting permission?
My sense is that US ICPs in particular have a long history of data sharing thru NNIS and then NHSN. As a result they most often willingly share all sorts of data witth peers and this enables them to better understand the impact of their work and also to contribute to the evidence. I cant help but wonder how we could build a similar collaborative, research/ sharing community among Australian ICPs.
It is a good point to note that this list is mainly for discussion of issues and information sharing not for recruiting study participants yet there is currently no other way to target all Australian ICPs. Even College membership which I assume is larger than subscribers to this ListServ is an under estimation.
Cheers
CathFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Joe-Anne Bendall
Sent: Saturday, 9 April 2016 10:22 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: ACIPC 2014 Sharps injury SurveyI agree with the discussion so far as we are all bound by a Code of Conduct, particularly unauthorised use of confidential information.
Thank you (Please note change of email address)
Joe-Anne Bendall
Joe-Anne Bendall
Clinical Nurse Consultant Infection Prevention and Control
(Including vaccination and screening)
Monday Friday 0800 – 1630
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
SYDNEY NSW 2000
| ph +61 2 9382 7199 |page 22070 via switch 9382 7111| 7 Fax 93827510 |
Mobile 0418984255 | Joe-Anne.Bendall@HEALTH.NSW.GOV.AUFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Wilkinson, Irene (Health)
Sent: Friday, 8 April 2016 2:58 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: ACIPC 2014 Sharps injury SurveyGood comments Cath. I have a few comments to add to yours (and perhaps stimulate some discussion).
I believe the use of the AICAlist by researchers to recruit participants could be problematic for a number of reasons:
1. No-one knows how representative the membership is of all healthcare settings, which could introduce bias into the data.
2. I would think the majority of list subscribers are interested in participating in a forum for discussion, and could be somewhat irritated by the intrusion of requests to perform surveys, unless they pertain specifically to the college business?
3. Many respondents would need to obtain permission to supply data pertaining to their institution, so a formal request by letter would be more likely to get a positive response from management.
Kind regards,
Irene
Irene Wilkinson BSc(Hons) MPH
Manager, Infection Control Service
Communicable Disease Control Branch
System Peformance and Service Delivery
SA Health
Government of South AustraliaPh: (08) 7425 7170 | Fax: (08) 8226 2594 | Email: Irene.Wilkinson@sa.gov.au
http://www.sahealth.sa.gov.au/infectionprevention
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
This e-mail may contain confidential information, which also may be legally privileged. Only the intended recipient(s) may access, use, distribute or copy this e-mail. If this e-mail is received in error, please inform the sender by return e-mail and delete the original. If there are doubts about the validity of this message, please contact the sender by telephone. It is the recipient’s responsibility to check the e-mail and any attached files for viruses.From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Dr Cathryn Murphy
Sent: Friday, 8 April 2016 12:00 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: ACIPC 2014 Sharps injury SurveyDear Terry
I hope that you get the answers you are after. Perhaps if you provided very explicit details of every way you intend to use the data people may be more willing to respond. Given your commercial background potential respondents may need guaranteed assurance that you are not going to use this data for any specific commercial purpose or to inform any one medical device manufacturer. The information you gain will be valuable to medical device manufacturers and policy makers alike. Would you consider guaranteeing simultaneous release of aggregate data to the public domain? Again, this may reassure potential contributors.
At a more strategic level the ongoing problem of low response rates and difficulty identifying and contacting those specifically responsible for infection prevention in Australian healthcare organisations is problematic. In 1997 when I did my PhD I achieved a remarkable 76% or thereabouts response rates. The last few surveys I have seen use this list in the last 2 years as a proxy gateway to ICPs have achieved very poor response rates in comparison. In fact most would not rate as publishable and the data is inherently limited in value and generalisability.
I would welcome discussion and opportunity to better understand what impedes Aussie ICPs from contributing and what individual researchers and ACIPC could do, or do better to help improve overall response rates. Compared to international surveys we perform very badly in terms of response and it is retarding Australias ability to rightly showcase great work done here.
Regards and good luck
CathPLEASE NOTE OUR NEW MAILING ADDRESS:
Cathryn Murphy RN MPH PhD
Executive Director
Infection Control Plus Pty Ltd
PO Box 3079
Burleigh Town 4219
Queensland
AUSTRALIAE: Cath@infectioncontrolplus.com.au
Ph: +61 428 154154http://www.infectioncontrolplus.com.au
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry Grimmond
Sent: Friday, 8 April 2016 7:41 AM
To: AICALIST@AICALIST.ORG.AU
Subject: ACIPC 2014 Sharps injury SurveyDear members
ACIPC Sharps Injury Survey we need your participation
Our aim is 150 hospitals and 50 non-hospital healthcare facilities. With 41 responses received to date, we need your participation!
The Survey
Just 11 Qs on your 2014 data; open till May 31st 2016. Click on https://www.surveymonkey.com/r/C5KPSJL or ACIPC website boxPoints to remember:
You may first want to ask Finance/Human Resources for answers to Qs7 – 9.
All data is confidential and no facility will be named
Data from ALL HCF is needed (hosp, aged care, community, ambulance, GP, etc)
If a Q is not applicable to your facility write NA
If more than one hospital in your group, please submit each hospital separately, or email Terry Grimmond for an Excel multiple-facility version.
More detail? Contact Terry Grimmond at terry@terrygrimmond.com
Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist
Grimmond and Associates
Ph (NZ): +64 7 855 3212
Mob (NZ): +64 274 365 140
E: terry@terrygrimmond.com
[Twitter_logo_blue]: @terrygrimmond
W: http://terrygrimmond.com
[cid:image002.gif@01D1917A.D15B8A50]
“This email (including any attachments) is intended only for the use of the individual or entity named above and may contain information that is confidential and privileged. If you are not the intended recipient, you are reminded that any dissemination, distribution or copying of this email or attachments is prohibited. If you have received this email in error, please notify me immediately by return email or telephone and destroy the original message. Thank you.”From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Professor Ramon Shaban, ACIPC President
Sent: Wednesday, February 24, 2016 7:23 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Media Release – Measles and VaccinationColleagues
For your information and noting.Kind regards,
Ramon[ACIPC_Logo_Colour_RGB_Hi_Res.jpg]
Professor Ramon Z Shaban
PRESIDENTAustralasian College for Infection Prevention and Control
GPO Box 3254, Brisbane Qld 4001
Tel: +61 7 3735 6463 Mobile: 0478 312 668Email: president@acipc.org.au
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Dear Terry
I hope that you get the answers you are after. Perhaps if you provided very explicit details of every way you intend to use the data people may be more willing to respond. Given your commercial background potential respondents may need guaranteed assurance that you are not going to use this data for any specific commercial purpose or to inform any one medical device manufacturer. The information you gain will be valuable to medical device manufacturers and policy makers alike. Would you consider guaranteeing simultaneous release of aggregate data to the public domain? Again, this may reassure potential contributors.
At a more strategic level the ongoing problem of low response rates and difficulty identifying and contacting those specifically responsible for infection prevention in Australian healthcare organisations is problematic. In 1997 when I did my PhD I achieved a remarkable 76% or thereabouts response rates. The last few surveys I have seen use this list in the last 2 years as a proxy gateway to ICPs have achieved very poor response rates in comparison. In fact most would not rate as publishable and the data is inherently limited in value and generalisability.
I would welcome discussion and opportunity to better understand what impedes Aussie ICPs from contributing and what individual researchers and ACIPC could do, or do better to help improve overall response rates. Compared to international surveys we perform very badly in terms of response and it is retarding Australias ability to rightly showcase great work done here.
Regards and good luck
CathPLEASE NOTE OUR NEW MAILING ADDRESS:
Cathryn Murphy RN MPH PhD
Executive Director
Infection Control Plus Pty Ltd
PO Box 3079
Burleigh Town 4219
Queensland
AUSTRALIAE: Cath@infectioncontrolplus.com.au
Ph: +61 428 154154http://www.infectioncontrolplus.com.au
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry Grimmond
Sent: Friday, 8 April 2016 7:41 AM
To: AICALIST@AICALIST.ORG.AU
Subject: ACIPC 2014 Sharps injury SurveyDear members
ACIPC Sharps Injury Survey we need your participation
Our aim is 150 hospitals and 50 non-hospital healthcare facilities. With 41 responses received to date, we need your participation!
The Survey
Just 11 Qs on your 2014 data; open till May 31st 2016. Click on https://www.surveymonkey.com/r/C5KPSJL or ACIPC website boxPoints to remember:
You may first want to ask Finance/Human Resources for answers to Qs7 – 9.
All data is confidential and no facility will be named
Data from ALL HCF is needed (hosp, aged care, community, ambulance, GP, etc)
If a Q is not applicable to your facility write NA
If more than one hospital in your group, please submit each hospital separately, or email Terry Grimmond for an Excel multiple-facility version.
More detail? Contact Terry Grimmond at terry@terrygrimmond.com
Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist
Grimmond and Associates
Ph (NZ): +64 7 855 3212
Mob (NZ): +64 274 365 140
E: terry@terrygrimmond.com
[Twitter_logo_blue]: @terrygrimmond
W: http://terrygrimmond.com
[cid:image002.gif@01D1917A.D15B8A50]
“This email (including any attachments) is intended only for the use of the individual or entity named above and may contain information that is confidential and privileged. If you are not the intended recipient, you are reminded that any dissemination, distribution or copying of this email or attachments is prohibited. If you have received this email in error, please notify me immediately by return email or telephone and destroy the original message. Thank you.”From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Professor Ramon Shaban, ACIPC President
Sent: Wednesday, February 24, 2016 7:23 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Media Release – Measles and VaccinationColleagues
For your information and noting.Kind regards,
Ramon[ACIPC_Logo_Colour_RGB_Hi_Res.jpg]
Professor Ramon Z Shaban
PRESIDENTAustralasian College for Infection Prevention and Control
GPO Box 3254, Brisbane Qld 4001
Tel: +61 7 3735 6463 Mobile: 0478 312 668Email: president@acipc.org.au
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Hi Jane
I read the responses to your question with great interest. There are some good ideas. I would encourage you to be very very innovative in what you introduce. Make your system fun, make the reward something that is valued and perhaps look even to award criteria outside of healthcare so you can find a pattern or an idea that could be adapted. There are numerous fields where 100% compliance is the Gold Standard and I would even encourage you to not make awards if you get a consistent rate far short of 100% or you don’t get substantial sustained compliance, otherwise who knows if the results were by chance only and who would reward chance? I know there is fabulous Aussie research coming out about over estimation by human auditors compared to non-human observations.For examples of other industries look for food awards (5-hats etc), aviation safety or airline of the year, hotel of the year or even burger of the year. I hope that this idea makes sense and doesn’t infer all I do is travel and eat burgers (far from the truth). There are also ranking systems for universities and US hospitals which could give you some innovative ideas. If you would like to talk about this offline I am happy to help you. Otherwise good luck and hopefully you will proud enough of whatever you develop to share it here.
Regards
CathCath Murphy RN PhD CIC
Executive Director
Infection Control Plus Pty Ltd—–Original Message—–
Dear Colleagues,
Just wondering if anyone has an annual hand hygiene award that is awarded to ward/department, and if so what are your criteria for selecting the winners?
We are about to award for the first time in our annual awards, but want the selection to be correct as it is not just about improvement but consistency of improvement, we don’t want to put staff off improving on hand hygiene compliance who have had good results but maybe have not been consistent!! Does that make sense???Anyway happy to hear your advise:)
Kind regards
JayneJayne OConnor RN, BSc.Inf.Cont.
IPC Co ordinator
Sydney Adventist Hospital
185 Fox valley Rd,
Wahroonga 2076If you are not the intended recipient you are hereby notified that any dissemination, distribution or reproduction of this message is prohibited. If you have received this message in error please notify the sender immediately, then destroy the original message.
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Without Prejudice
Dear Members
I was saddened to read the recent Press Release regarding the College’s position on Children In Detention. In my 25 plus years as a member and once President of AICA and as a 7 year board member and 2010 APIC President alignment of a professional body with any non-infection prevention political issue appears unprecedented.
Regardless of where members stand personally on this contentious issue it is arrogant and perhaps even incorrect for the President to assume unilateral support of his position by all members.
Further, whilst the AMA acts as the primary industrial relations agency for medical practitioners and as such rightly has an opinion on this issue the College purpose as stated in its Constitution makes no mention of political commentary as a goal.
Informally, I have canvassed views from at least two other senior College members who are offended by the College’s action. I would request that in future the Executive and College leadership do not assume members’ positions on non infection prevention matters and instead focus solely on working within the scope of the Constitution representing members well on infection prevention matters.
Regards
Cathryn Murphy
Executive Director
Infection Control Plus Pty LtdCathryn Murphy RN PhD
Executive Director
PO Box 106
West Burleigh QLD 4219
Queensland, AUSTRALIA+61 428 154154
E: Cath@infectioncontrolplus.com.au——– Original message ——–
[Posted on behalf of ACIPC President – Moderator]
Colleagues
Please note the attached media release from the College.Kind regards,
Ramon[ACIPC_Logo_Colour_RGB_Hi_Res.jpg]
Professor Ramon Z Shaban
PRESIDENTAustralasian College for Infection Prevention and Control
GPO Box 3254, Brisbane Qld 4001
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Dear Glenys
Thank you for highlighting this resource and for further raising the issue of disinfection. As you will appreciate my interest came from observation and familiarity with USA ultrasound (U/S) disinfection practice. In June 2015 I had the good fortune to moderate a panel of experts at APIC 2015 where the issues of HPV transmission and U/S decontamination were explored in great detail. Later as I prepared for a series of presentations to the American U/S community and also Infection Control Today I recognised that there were many anomalies between what is routinely done in the USA compared to Australia. Craig Meyer’s work, and his findings on traditional methods of disinfection such as those we routinely use in Australia, should prompt an urgent review by clinicians and relevant organisations and individuals charged with development of guidelines, policies and/ or protocols in this area.
FYI I also delivered a Webinar to ASUM and I am happy to share copies of my slides from any of those presentations with others if they are interested. In return I would hope only for appropriate attribution. I also have a good bank of research articles should anyone have an interest. Please email outside of this group if interested.
Like you, I am passionate about helping other IPs recognise problems, innovate and improve quality. It seems that there are enough IC&P problems to allow us and others with IC&P longevity to do that for our entire careers and still leave plenty of mysteries for subsequent IPs. I will be emailing Dr Basseal separately to offer assistance in ASUM’s directive development.
Wishing all ACIPC members a successful and healthy 2016.
Sincerely
CathCathryn Murphy RN MPH PhD
Executive Director
Infection Control Plus Pty Ltd
PO Box 106
West Burleigh 4219
Queensland
AUSTRALIAE: Cath@infectioncontrolplus.com.au
http://www.infectioncontrolplus.com.au
Dear All,
I recently viewed the Infection Control Today Webinar titled: “Infection Control in Ultrasound: Mitigating cross contamination risk”. The webinar provided an excellent overview of the topic and Dr Cathryn Murphy PhD (Australia) was one of the panelists. http://www.infectioncontroltoday.com/webinars/2015/11/infection-control-in-ultrasound.aspx?cmpidLI1-6&scLI1-6
In the webinar Dr Craig Meyers, Professor of Microbiology and Immunology at Penn State College of Medicine discussed the following:
* Human Papillomavirus HPV16
* By way of background HPV types 16 and 18, are responsible for most HPV-caused cancers such as cervical, anogenital and oropharyngeal cancers
* Human Papillomavirus HPV16 and susceptibility of commonly used disinfectants
* The possibility of fomite or non-sexual transmission of HPV16
* The efficacy of an automated ultrasound probe disinfector against high-risk human papillomavirus.
Interestingly both Glutaraldehyde and Cidex OPA (0.55% ortho-phthalaldehyde) are not virucidal against Human Papillomavirus HPV16 and HPV18. See the following attachments:
* Myers J et al. Susceptibility of high-risk human papillomavirus type 16 to clinical disinfectants. J Antimicrob Chemother 2014; 69: 1546-1550.
* Myers C et al. The efficacy of an automated ultrasound probe disinfector against high-risk human papillomavirus. SHEA Spring 2015: Science Guiding Prevention, May 14-15 2015, Orlando, Florida, USA
I had a quick look at the Australasian Society for Ultrasound in Medicine (ASUM) web page:
In their Policies and Statements B2 “Statement on the Disinfection of Transducers” May 1996 (Reaffirmed September 2015) there are no specific guidelines/recommendations in relation to high level disinfectant selection and use in situations where Human Papillomavirus may be a risk. http://www.asum.com.au/newsite/Files/Documents/Policies/2015.09.03%20B2%20disinfection%20final.pdf
Also of interest was a conference presentation (ASUM Annual Meeting 2015) by Dr Jocelyne Basseal titled “Disinfection of ultrasound transducers; Results from an ASUM survey” This was an anonymous survey of ASUM members to assess current practices in relation to transducer disinfection and basic hygiene for external and intracavity probes.
They received 105 responses from across Australia and NZ.
While the presentation was encouraging in terms of a future strategies to improve infection prevention and control in the area of sonography I was surprised at some of the current practices for both external and intracavity probes including:
* Topping up of ultrasound gel(41%) (i.e. reusing the same container over and over again without cleaning will results in contamination with organisms such as pseudomonas (personal ICP experience)
* Using non-sterile gel for intracavity biopsy procedures(5%) (see TGA and FDA contaminated ultrasound gel recall http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm299409.htm https://www.tga.gov.au/alert/l-gel-ultrasound-transmission-gel-recall )
* cleaning “only” for intracavity transducers (2.5%), i.e. no high level disinfection
* cleaning ultrasound machine keyboard daily (60%), cleaning machine keyboard week (approx. 30%), i.e. they should be cleaned between each patient
* no ultrasound induction training on employment (43%)
* no training from the manufacturer (approx. 58%), and so on……
This survey also begs the question what infection prevention and control training sonographers are receiving in university Medical Sonography courses?
As Glutaraldehyde and Cidex OPA (0.55% ortho-phthalaldehyde) are commonly used disinfecting agents in health facilities it may be timely to review current practices and procedures relating not only to intracavity ultrasound practices and procedures in relation to high-risk Human Papillomaviruses but intracavity ultrasound practices in general at your Health Facility.
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
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Glenys et al
Thank you for this really interesting commentary which again highlights the challenge of new technologies and our need for constant vigilance. As you are aware for many years Australia and I think parts of Canada have been outliers in terms of recommending regular sampling of scopes.
APIC is currently writing an article for their Infection Preventionist magazine on duodenoscopes and have asked me to draft a few words on Australia’s approach to routine culturing as per GENCA Guidelines. APIC is particularly keen to share with their members the practical ways in which routine culturing is undertaken. I feel compelled to provide a broad overview and examples of different organisation’s practices and especially any difficulties w/ complying w/ sampling. I understand how 2 large SE QLD hospitals did it. I am familiar w/ the GENCA Guidelines and CHRISP protocols but I wondered if any on this list would be willing to offer insights. Dot points would be fine. I suspect that issues like:
– time taken for results
– lack of additional circulating scopes
– access to micro labs
– standardised procedure
– action in the event of positive culture
– clearance/ repeat reprocessing and culturing
– ? need for Lookback, suspension of duodenoscopic services until clearanceetc
may all be potentially problematic.Would list members who are willing to help me please post here ASAP as I am past the APIC deadline, or email me directly. Copies of local policy would be especially helpful .I am very happy to attribute anyone who provides insight (or have them remain anonymous as desired) and thank you in advance. I am also happy to share the final draft w/ any list members who may be interested.
Regards
CathDr Cathryn Murphy RN MPH PhD CIC
Executive Director
Infection Control Plus Pty Ltd
Cath@infectioncontrolplus.com.au
http://www.infectioncontrolplus.com.au
[Description: twitter logo][Description: FB logo][Description: icp icon]Dear all,
Find below the FDA notification of the New Reprocessing Instructions for the Olympus TJF-Q180V duodenoscopes.
Attached is the Olympus letter to customers which details the new reprocessing instructions including;
* supplementary flushing instructions
* additional recess flushing and forceps elevator raising /lowering steps during pre-cleaning
* manual cleaning
* manual disinfection and endoscope rinsing and alcohol flushing.
Olympus advise that “these new reprocessing procedures should be implemented as soon as possible” and that “the new cleaning procedure requires the use of a small bristle cleaning brush (MAJ_1888) which Olympus anticipates shipping no later than May 8, 2015”
The key differences include the following:
Pre cleaning
* During immersion, raise and lower the elevator 3 times
Manual cleaning* Additional brushing of the forceps elevator recess area using an additional brush (MAJ-1888 brush)
* Additional flushing of forceps elevator recess area
* Additional raising and lowering the forceps elevator
Manual high level disinfection* Additional manual flushing steps and increased flushing volume of the endoscope channel and forceps recess area
* Additional raising and lowering of the forceps elevator
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[MedWatch logo][MedWatch – The FDA Safety Information and Adverse Event Reporting Program]
Duodenoscope Model TJF-Q180V by Olympus: FDA Safety Communication – New Reprocessing Instructions Validated
* Implement the new manual cleaning and high level disinfection procedures for the Olympus TJF-Q180V duodenoscope in accordance with the manufacturer’s reprocessing instructions.
* Train appropriate staff on Olympus’ new reprocessing instructions and implement them as soon as possible.
* Contact Olympus directly with specific questions and concerns or to schedule a site visit with their Endoscopy Support Specialists Technical Assistance Center (TAC), 1-800-848-9024, option 1 Monday – Friday between 7AM EST – 8 PM EST.Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program:
* Complete and submit the report Online: http://www.fda.gov/MedWatch/report
* Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178Read the MedWatch Safety Alert, inclusing links to the FDA Safety Communication at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm440098.htm
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So sorry to hear that Terry. I have been wondering of late why and how SSI prevention seems to have dropped from our priority lists as AMS, BSI, HH, S diff, S aureus BSI and CLABSI prevention dance across our radars.
Regards
CathDr Cathryn Murphy RN MPH PhD CIC
Executive Director
Infection Control Plus Pty Ltd
Ph: +61 428 154 154
http://www.infectioncontrolplus.com.au
[Description: twitter logo][Description: FB logo][Description: icp icon]From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry Grimmond
Sent: Wednesday, 21 January 2015 8:21 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: ResourceThanks Cath very pertinent a close friend had hip replacement in Dec and after 3rd redo from infection, is on Vancomycin, has diarrhea, and is not faring well.
Regards, Terry
Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist
Grimmond and Associates
Ph (NZ): +64 7 855 3212
Mob (NZ): +64 274 365 140
E: terry@terrygrimmond.com
[Twitter_logo_blue]: @terrygrimmond
W: http://terrygrimmond.com
[cid:image002.gif@01D0356B.F4D3D300]
“This email (including any attachments) is intended only for the use of the individual or entity named above and may contain information that is confidential and privileged. If you are not the intended recipient, you are reminded that any dissemination, distribution or copying of this email or attachments is prohibited. If you have received this email in error, please notify me immediately by return email or telephone and destroy the original message. Thank you.”From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Cath Murphy
Sent: Wednesday, January 21, 2015 11:03 AM
To: AICALIST@AICALIST.ORG.AU
Subject: ResourceGreat post from CDC that members may find useful in education of families and patients.
Patients can get infections while receiving medical treatment in a healthcare facility. Learn six ways to be a safe patient and how protect yourself from infections at the hospital. http://1.usa.gov/1xRnyEy
Regards
CathDr Cathryn Murphy RN MPH PhD CIC
Executive Director
Infection Control Plus Pty Ltd
Ph: +61 428 154 154
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A remarkable achievement. Congratulations Claire. This is a fabulous recognition of an individual leader and our field. The visibility and promotion can only help us.
Its refreshing to see excellence acknowledged and celebrated by peers as for so long petty professional jealousies and tall poppy have marred our progression.
I wish you well Claire and thank you to whoever initiated the nomination process.
Regards
CathFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
Sent: Friday, 17 October 2014 6:04 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Claire Boardman: Australian of the Year nomineeThe ACIPC Executive Council is excited to announce that ACIPC inaugural president Claire Boardman has been nominated as a 2015 NT Finalist in the Australian of the Yeard Award.
Claire’s dedication to promoting infection control professional practice within Australia makes her a worthy recipient of this honour.http://www.australianoftheyear.org.au/honour-roll/#browse:view=fullView&recipientID=1212
All ACIPC members, along with the ACIPC Executive Council, should be proud to acknowledge Claire’s accomplishments. Well done, Claire!
Cheers
Michael Wishart
ACIPC Executive Council member
On behalf of ACIPC Executive Council
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Dear Gemma
An interesting question. My guess would be that WHO being a global agency provides advice that can be generic and accommodate the very many different types, combinations and compositions of PPE used for isolation. In contrast CDC is a USA-based agency with a very discrete primary audience, USA healthcare providers. Typically PPE used in the USA is well-defined, high quality and standardised.
The fact that much of the world including Australian ICPs often look to the CDC for best practice is in my mind a great thing, especially as Australia is closer to US practice than it is to less wealthy nations (part of WHO’s target audience).
There has been some research done around different types of potential contamination of clothing and face when removing PPE so you may want to read that. Overall the key messages would be:
1. Teach a system, one way and stick to it;
2. Ensure compliance with wearing PPE and removing it is improved. Current research shows that HCWs are generally worse at PPE selection d use than they are with hand hygiene compliance.
I have attached a couple of papers you may find interesting.
Good luck.
Regards
CathDr Cathryn Murphy RN MPH PhD CIC
Executive Director
Infection Control Plus Pty LtdAdjunct Professor
Griffith University, School of Nursing and Midwifery
http://www.infectioncontrolplus.com.au
[Description: twitter logo][Description: FB logo][Description: icp icon][Posted on behalf of Gemma Klintworth – Moderator]
Dear all,
We have recently realised that the CDC and WHO differ in recommendations regarding order of PPE removal.
Currently we teach the order as per CDC (and as adopted by NHMRC guidelines) but are curious as to why the recommendation is to remove gloves, then goggles and then gown, where as WHO recommends gloves and gown first (likely being the two dirtiest items) and then goggles.
Two varying posters are attached.
Any thoughts would be appreciated.
Kind regards,
Gemma
Gemma Klintworth
Infection Prevention Nurse Consultant
Infection Prevention and Healthcare Epidemiologyt 03 90762250 e G.Klintworth@alfred.org.au
m 0419 383 840Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia[cid:part2.04000504.07030802@internode.on.net]
Alfred Health incorporates The Alfred, Caulfield Hospital and Sandringham Hospital
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Great idea Terry I am also happy to participate in such a Webinar as this issue remains under reported and under researched in conferences and journals despite it remaining problematic.
Regards
CathDr Cathryn Murphy RN MPH PhD CIC
Executive Director
Infection Control Plus Pty LtdAdjunct Professor
Griffith University, School of Nursing and Midwifery
Ph: +61 428 154 154
http://www.infectioncontrolplus.com.au
[Description: twitter logo][Description: FB logo][Description: icp icon]From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry Grimmond
Sent: Tuesday, 26 August 2014 17:50 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: ACIPC webinars – what do you want?Hi Brett,
I would like to see a webinar on Sharps Injury Prevention in Australia, and I would be happy to participate as a speaker or panel which ever the board thought appropriate.Kind regards, Terry
Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist
Grimmond and Associates
Ph/Fx (NZ): +64 7 856 4042
Mob (NZ): +64 274 365 140
E: terry@terrygrimmond.com
[Twitter_logo_blue]: @terrygrimmond
W: http://terrygrimmond.com
[cid:image002.gif@01CFC166.B448D250]
“This email (including any attachments) is intended only for the use of the individual or entity named above and may contain information that is confidential and privileged. If you are not the intended recipient, you are reminded that any dissemination, distribution or copying of this email or attachments is prohibited. If you have received this email in error, please notify me immediately by return email or telephone and destroy the original message. Thank you.”From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Brett Mitchell
Sent: Tuesday, August 26, 2014 4:02 PM
To: AICALIST@AICALIST.ORG.AU
Subject: ACIPC webinars – what do you want?Hi everyone,
We just had an interesting national journal club meeting using Webinar. Thanks to Dr Andrew Stewardson who presented some great discussion. For those who are not familiar with webinar, you can watch the presentation live on your screen, listen to the presenter and ask questions either by typing in a question or verbally asking.
I am sure the College are interested to hear what topics you would like to see in future webinars, so I would encourage you to respond by replying or email the ACIPC secretariat (admin@acipc.org.au). There has been some great discussion in recent weeks on this list which may be of interest. It could also be a good way of sharing important research findings or way for people do discuss how they are dealing with complex issues those that are difficult to relay in an email.
Thanks
BrettDr Brett Mitchell
Senior Lecturer, RN, BN, PhD, M.Adv.Prac, CICP, MRCNA
Faculty of Nursing and Health
And
Lifestyle Research Centre, CooranbongExcellence in Christian Tertiary Education since 1897
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Thanks all – your responses have been overwhelming. I have what I need now I think. Many thanks for great networking and speedy response, greatly appreciated.
Cath Murphy PhD
Executive Director
Infection Control PlusI am urgently trying to access a PDF copy of the current Aged Care Standards used for AACQA accreditation. WWW search is proving difficult and I am wondering if there is a way to access the Standards in the public domain. My interest is specifically around the infection control requirements. I would be very grateful for advice how to access either through this forum or in personal email.
Thanks in advance
Cath Murphy PhD
Executive Director – Infection Control PlusCath@infectioncontrolplus.com.au
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