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Thanks Terry
I like all ACIPC members I’m sure are very appreciative of the large amount of work you’ve done on our behalf. Thank you. A/S work is always tedious and you can never please everybody. Whilst the intent is always honourable it does seem very ludicrous and money-making in that to comply with the new AS 4187 as it stands in terms of normative references individual health service organisations (HSO) including hospitals public and private, day procedure centres and I imagine small single operators like GPs, dentists, Podiatrist etc will have to have access to at least 10 ISO Standards to which AS4187 refers. My experience has been that a single ISO Standard is always in excess of $100 AUD, in fact one I had to buy was almost $240. That’s an awful lot of additional money that ultimately will fall back onto patients. High price to pay.
Is there any opportunity at this late stage for the College or other concerned agencies to protest or is it inevitable? I appreciate that as part of A/S process you are limited in your ability to comment but please continue to advocate strongly from a common sense point of view as you always have.
Thanks and cheers
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]Hi Cath,
As the ACIPC representative on Committee HE023 responsible for AS/NZS4187 I can tell you that the committee is meeting on August 18th and 19th to discuss and resolve the comments received on the second public review draft of the document. After this next meeting I should be able to let ACIPC know a projected publication date [fingers crossed]. All being well, with all comments effectively resolved and no further technical or editorial work being required of the committee, I believe that the new edition of the Standard should be available before the end of 2014 or at least early 2015.
As for your query regarding the referencing of the ISO and EN Standards as normative documents and the need to have access to copies of those Standards applicable to each facility, this issue was raised many times. It is not my intent to represent or communicate an official Standards Australia position etc, however it is my understanding that organisations will need to arrange for access to those referenced documents.
I too have concerns similar to yours.
Regards
Terry McAuley
Sterilisation & Infection Prevention and Control Consultant
STEAM Consulting
E: terry@steamconsulting.com.au
W: http://www.steamconsulting.com.au
A: PO BOX 779
Endeavour Hills
VIC Australia 3802CONFIDENTIAL COMMUNICATION: The information contained in this message may contain confidential information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or duplication of this transmission is strictly prohibited. If you have received this communication in error, please notify us by telephone or email immediately and return the original message to us or destroy all printed and electronic copies. Nothing in this transmission constitutes an agreement of any kind unless otherwise expressly indicated.
The draft version seems to refer to multiple AS, AS/NZ and ISO Standards as NORMATIVE documents ie. they are an integral part of the Standard but are not replicated within the Standard. These are all very expensive as single documents. Is it Standards Australia’s intent that where these are referred to that Aussie and Kiwi hospitals will have to purchase each separate standard. Surely not…And if not how do on the ground clinicians access that information esp if in private hospitals or long term care facilities where organisational licences to Aust Standards or ISO don’t exist?
Without being cynical I predict major implementation problems with this approach.
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]Hi Cath,
The college has had significant input through representation on the 4187 Standard, as well as providing two submissions to the draft documents in the past 12 months.
The last response being only 6 weeks ago.
Most recommendations that the college submitted have been included but the final outcome from this last round won’t be known for at least another few weeks.
I can’t give you any other information regarding when the final document will be launched, apart from this being hopefully the last round of consultation.Kind Regards
Marija Juraja
RN, Grad Cert IC, CICP
Immediate Past President, ACIPC
[cid:image001.jpg@01CFAFCA.1430F0C0]Could someone please give me a brief overview of where Standards Australia are up to with the review of AS 4187? I have accessed materials available to members on the College website but am keen to know how close we may be to a final version and if it is publically available information, how much of the College’s recommendations were considered in the final version?
Hope someone can help as preparing for implementation is critically important.
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
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Hi Terry
Interesting question and interesting set of responses.I have sent it along to Bill Rutala to see his opinion. Will keep you posted on any reply.
Out of interest have you seen any illness among pts that could correlate with this org (I note the at risk group you mention)?
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]Hi Everyone,
I have had a recent spate where a number of my endoscopy procedure centre clients have reported culturing of “Pseudomonas species” or Gram negative bacilli after the monthly water testing of the Automated Endoscope Reprocessors.
Upon further investigation, the organism has been identified as Cupriavidis pauculus. This organism is often associated with ultra filtration systems and although it has low pathogenicity it is a risk to immunocompromised patients.
Despite repeated water line disinfections, filter changes, disinfectant dumps etc this bug keeps cropping up over and over again. We find that we have cleared it in the next test after filter changes etc etc but then a month later – we get a positive result again.
Whilst in low numbers, it is causing some concern regarding potential risks to patients. In all cases we are not growing the organism form the endoscopes.
I am wondering if anyone else has been experiencing the same issues?
If so – what did you do about it both in terms of managing the machines and the risks to patients?
If you have cultured this organism, did you manage to identify the cause of the problem?
Happy to chat offline.
Regards
Terry McAuley
Sterilisation & Infection Prevention and Control Consultant
STEAM Consulting
E: terry@steamconsulting.com.au
W: http://www.steamconsulting.com.au
A: PO BOX 779
Endeavour Hills
VIC Australia 3802CONFIDENTIAL COMMUNICATION: The information contained in this message may contain confidential information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or duplication of this transmission is strictly prohibited. If you have received this communication in error, please notify us by telephone or email immediately and return the original message to us or destroy all printed and electronic copies. Nothing in this transmission constitutes an agreement of any kind unless otherwise expressly indicated.
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Typically when companies (esp US) offer Webinars if Aussies register and don’t attend given the horrid time differences it is usual to be able to access a recording afterwards. Good luck.
CHi Marie
It is EST (US), not Australian EST. Thus it will be at 2am tomorrow morning AEST I think.
I only twigged to this myself yesterday when trying to book a room to view this, and checked the website for details. Definitely EST as in New York time!
It would be great if anyone will be watching the Webinar to let the list know if it will be made available to download or view on the web. I will be sleeping at 2am AEST. 😉
Cheers
MichaelMichael Wishart
Infection Control Coordinator
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
Please consider the environment before printing this email[cid:image001.png@01CF28B1.938CBBB0]
We have been trying to access the Webinar Post-Insertion Vascular access Device care scheduled for 12.00 EST which is 09.00 PST. The message kept saying the webinar is not yet open to attendees come back at scheduled time. I’m not sure why this is happening given that it is way passed 09.00 PST. Is there any way we can get a recording of the webinar when it’s finished?
I have also emailed the support email at: webinair@saxecommunications.com and am awaiting a reply
Thanks for your help
[cid:image001.jpg@01CF289E.7C821F40]
Marie Murphy PhD, BSc (Hons), RN
Learning & Development
Manager
Bethesda Hospital________________________________
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Tel +61 8 9340 6499 | Fax +61 8 9340 6398
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Marie
Out of interest have you taken into account the day behind date of US Pacific time? I am assuming that the Webinar is being run out of the US?
Cath
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]We have been trying to access the Webinar Post-Insertion Vascular access Device care scheduled for 12.00 EST which is 09.00 PST. The message kept saying the webinar is not yet open to attendees come back at scheduled time. I’m not sure why this is happening given that it is way passed 09.00 PST. Is there any way we can get a recording of the webinar when it’s finished?
I have also emailed the support email at: webinair@saxecommunications.com and am awaiting a reply
Thanks for your help
[cid:image001.jpg@01CF289E.7C821F40]
Marie Murphy PhD, BSc (Hons), RN
Learning & Development
Manager
Bethesda Hospital________________________________
25 Queenslea Drive | Claremont | WA | 6010
Tel +61 8 9340 6499 | Fax +61 8 9340 6398
Pager 038Email
Web
________________________________
This email including attached files are confidential and intended only for the person or entity to which it is addressed and may contain confidential information. If you are not the intended recipient please notify the sender immediately and delete the e-mail from your system furthermore use, redistribution or copying is not authorised. any views or opinions presented in this email are solely those of the author and do not necessarily represent those of Bethesda Hospital Inc. It is the recipients responsibility to check for the presence of viruses. Bethesda Hospital Inc accepts no liability for any damage caused by receipt of this email.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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Whilst an interesting piece from the CEC ACIPC subscribers should also be reminded that the CEC has authority only in NSW, not nationally and therefore outside of NSW their notices are in no way mandatory.
As an experienced writer of state policy and regulation and guidelines I am always sceptical about what the political motive/ knee-jerk reaction may be behind issuance of documents such as this. What happened somewhere to cause this to be written?
Perhaps what they best reflect is the need for infection prevention guidance to be written in a way that it keeps up with technological and research advancements and for ICPs to be closely engaged when any new product or system is introduced into an organisation as pounds to peanuts some ingenious HCW somewhere will find a new, unimaginable way to use the product and often that way can cause harm or risk.
You gotta love a field that is constantly changing….
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]Dear all,
Please find attached the recently published notice from the Clinical Excellence Commission titled:
“Use of Chemical Impregnated Disinfection Wipe Systems for Reusable Medical Devices” 001/14
This notice speaks to all chemical disinfection wipe systems including, the much discussed, Chlorine Dioxide Based 3 Step Wipe System.
I trust the group find this document useful.
Yours Sincerely
Scott Pabst
National Sales Manager
AshMed Pty Ltd
Ph. 0435 843 950
E. scott@ashmed.com.auMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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Joe, Michael and CO
HI and thanks. How do you monitor that cleaning is done as recommended? Also have you, or anyone else ever done a “time in motion” study to assess the return on investment for some of the articles.
During my brief return to the clinical setting I saw irregular journeys from the ward to CSSD where senior nurses transported venepuncture tourniquets and then had arguments with CSSD over how they were to be reprocessed. Alternatively I also saw several “washed/ cleaned” single pt items hanging indiscriminately in various places clean ute rooms, dirty ute rooms, storage rooms, pt’s bathrooms etc.
As Michael Wishart and Brett Mitchell have indicated, given the global lack of compliance with cleaning (and nationally as Deb Macbeth and I showed for the Gold Coast and Elizabeth Gillespie showed for Monash) and lack of compliance for HH are we not just being delusional to think that these things will actually be cleaned in a feasible, economic, thorough and standardised way. Which I guess is one of the reasons that services where used items and linen etc are taken off site and reprocessed according to standard procedures.
Personally whilst I appreciate the bean counter approach and recognise bean counters are as powerful as banks and airline check-in staff in that they can make your life great or miserable, my sense is that we should be removing ambiguity, looking at better systems and clarifying roles for many things in IP. Those tasks are complex, difficult and time consuming so perhaps for some specific pieces of pt equipment single-use is the better option.
If any of you are curious about the ambiguity issues read recent work from Gurses, Pronovost et al. I was fascinated by their call for pt safety to start working more like the nuclear power profession. Perhaps time for we oldies to be shaken about by the new and curious amongst us.
—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Joe-Anne Bendall
Sent: Thursday, 9 January 2014 10:27 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Single Use vs Reusable Pt EquipmentHi Cath
Great debate to start the New Year
I think each hospital has different risks. For example, here we can allocate MRO pts their own BP machine, tourniquet etc. The equipment is cleaned when the patient is discharged as part of the terminal cleaning process. With the focus on the health $, I am not sure we could sustain the costs associated with the costs for purchase, storage and disposal of single use items.We are currently developing a local health district policy for the cleaning of shared patient care equipment. This should help with reducing the risks of sharing equipment.
Thanks
Joe-Anne Bendall
(Monday/Thursday/Friday)
Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
SYDNEY NSW 2000
|| ph +61 2 9382 7199 |page 22070 via switch 9382 7111|( Fax
|| 93827510 |(
Mobile 0418984255 | | Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Cath Murphy
Sent: Thursday, 9 January 2014 11:05 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Single Use vs Reusable Pt EquipmentThanks Irene and Terrie
Whilst I appreciate Terrie’s position coming from his role with a provider of reusable waste equipment my question was more specifically about equipment used on patients for clinical care so things like BP cuffs, ECG leads and tourniquets. The various responses are interesting and please keep them coming as debate and expression are good for us as is an appreciation for the past (and yes I qualify and feel “oldie” as well 🙂 Cheers CathRegards
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—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Wilkinson, Irene (Health)
Sent: Thursday, 9 January 2014 9:24 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Single Use vs Reusable Pt EquipmentHi all,
as a fellow “oldie” I agree with Terry’s assessment of the trends over the years. I also support the final point about the issues involved in the decision making process. What has always puzzled me is how to accurately measure the environmental impact of either disposable or re-usable items?Irene Wilkinson
Manager, Infection Control Service,
Communicable Disease Control Branch
SA Health
11 Hindmarsh Square,
Adelaide SA 5000
Ph: 08 7425 7170
________________________________________
From: ACIPC Infexion Connexion [AICALIST@AICALIST.ORG.AU] On Behalf Of Terry Grimmond [tg@GANDASSOC.COM]
Sent: 08 January 2014 13:03
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Single Use vs Reusable Pt EquipmentHi Cath,
I had not heard of a movement back to single use items so I will be interested to hear members’ responses on this topic. For oldies like me it has been interesting to see the disposable/reusable “cycle” over the decades.* in the 60’s we reused needles, glass syringes, gowns, etc, to reduce procurement costs;
* in the 70’s the cost of labour to process reusables (and modern technology enabling economic production of disposables) moved us to disposables;
* In the 80’s and 90’s waste disposal costs together with environmental impact of disposables, caused many to move to reusables again;
* Now with staff shortages, in-house processing of reusables is being re-examined (NB. processing by external contractors can still be economical, e.g. reprocessing single-use medical devices saves USA hospitals $300m annually.
As you point out, there have been relatively few evidence-based articles implicating disease transmission with either protocol.
The decision to use disposables or reusables must be evidence-based encompassing patient and staff safety, labour costs, procurement costs, and environmental impact. I look forward to members’ commentsBest 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: tg@gandassoc.com
“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 08, 2014 12:53 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Single Use vs Reusable Pt EquipmentHappy new year all
As you may know there’s a subtle movement in Australia towards more widespread adoption of single-use items such as venepuncture tourniquets, lower limb surgical tourniquets, BP cuffs and ECG leads. Tom Gottlieb recently did some elegant research on venepuncture tourniquets and AT ACIPC 2013 Karen Vickery presented new perspectives on biofilm on reusable equipment. Single-use items have been adopted widely in the US for some years and recommendations to that effect are included in many Standards published by relevant professional associations eg AORN.
Whilst appreciating that demonstrating causality between reusable equipment and transmission of colonising organisms or infection is difficult either is biologically plausible. There are also issues of non-cleaning, lack of clarity about who’s role it actually is to clean reusable equipment, how frequently they need to be cleaned or reprocessed etc. These issues have plagued us for at least 3 decades that I know of and likely longer. I’m wondering what others in Australia and beyond think about single-use pt care items
So my questions are:
1. Has any ACIPC colleague successfully built a business case to convert their facility to single-use pt equipment? If so who was involved in that process?;
2. Which pieces of pt equipment do folks think are most in need of single-use alternative options?;
3. Other than price, storage, supply and environmental/waste issues and lack of detailed science what other factors would need to be addressed to help convince you or your organisation’s decision makers to invest in specific single-use equipment?.
I’d be grateful for any discussion here or as PMs on the email address below. If anyone is interested in my further work around this issue please email me.
Regards
CathDr Cathryn Murphy RN MPH PhD CIC
Executive Director
Infection Control Plus Pty Ltd
Cath@infectioncontrolplus.com.auAdjunct Professor
Griffith University, School of Nursing and Midwifery
Ph: +61 428 154 154 http://www.infectioncontrolplus.com.auMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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Thanks Irene and Terrie
Whilst I appreciate Terrie’s position coming from his role with a provider of reusable waste equipment my question was more specifically about equipment used on patients for clinical care so things like BP cuffs, ECG leads and tourniquets. The various responses are interesting and please keep them coming as debate and expression are good for us as is an appreciation for the past (and yes I qualify and feel “oldie” as well 🙂
Cheers
CathRegards
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—–Original Message—–
Hi all,
as a fellow “oldie” I agree with Terry’s assessment of the trends over the years. I also support the final point about the issues involved in the decision making process. What has always puzzled me is how to accurately measure the environmental impact of either disposable or re-usable items?Irene Wilkinson
Manager, Infection Control Service,
Communicable Disease Control Branch
SA Health
11 Hindmarsh Square,
Adelaide SA 5000
________________________________________Hi Cath,
I had not heard of a movement back to single use items so I will be interested to hear members’ responses on this topic. For oldies like me it has been interesting to see the disposable/reusable “cycle” over the decades.* in the 60’s we reused needles, glass syringes, gowns, etc, to reduce procurement costs;
* in the 70’s the cost of labour to process reusables (and modern technology enabling economic production of disposables) moved us to disposables;
* In the 80’s and 90’s waste disposal costs together with environmental impact of disposables, caused many to move to reusables again;
* Now with staff shortages, in-house processing of reusables is being re-examined (NB. processing by external contractors can still be economical, e.g. reprocessing single-use medical devices saves USA hospitals $300m annually.
As you point out, there have been relatively few evidence-based articles implicating disease transmission with either protocol.
The decision to use disposables or reusables must be evidence-based encompassing patient and staff safety, labour costs, procurement costs, and environmental impact. I look forward to members’ commentsBest 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: tg@gandassoc.com
“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.”Happy new year all
As you may know there’s a subtle movement in Australia towards more widespread adoption of single-use items such as venepuncture tourniquets, lower limb surgical tourniquets, BP cuffs and ECG leads. Tom Gottlieb recently did some elegant research on venepuncture tourniquets and AT ACIPC 2013 Karen Vickery presented new perspectives on biofilm on reusable equipment. Single-use items have been adopted widely in the US for some years and recommendations to that effect are included in many Standards published by relevant professional associations eg AORN.
Whilst appreciating that demonstrating causality between reusable equipment and transmission of colonising organisms or infection is difficult either is biologically plausible. There are also issues of non-cleaning, lack of clarity about who’s role it actually is to clean reusable equipment, how frequently they need to be cleaned or reprocessed etc. These issues have plagued us for at least 3 decades that I know of and likely longer. I’m wondering what others in Australia and beyond think about single-use pt care items
So my questions are:
1. Has any ACIPC colleague successfully built a business case to convert their facility to single-use pt equipment? If so who was involved in that process?;
2. Which pieces of pt equipment do folks think are most in need of single-use alternative options?;
3. Other than price, storage, supply and environmental/waste issues and lack of detailed science what other factors would need to be addressed to help convince you or your organisation’s decision makers to invest in specific single-use equipment?.
I’d be grateful for any discussion here or as PMs on the email address below. If anyone is interested in my further work around this issue please email me.
Regards
CathDr Cathryn Murphy RN MPH PhD CIC
Executive Director
Infection Control Plus Pty Ltd
Cath@infectioncontrolplus.com.auAdjunct Professor
Griffith University, School of Nursing and MidwiferyMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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USA CDC has a great resource available at http://www.cdc.gov/HAI/organisms/norovirus.html
I’ve not read it recently regarding the mask issue but I suspect it will be evidence-based in all of its recommendations. Hope it helps.
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—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Christine Dufty
Sent: Monday, 28 October 2013 7:53 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: NorovirusWhy a P2 mask, thats seems like overkill?
Christine A. Dufty
Infection Control Manager
West Wimmera Health Service
Mob: 0409 443 418
Ph: (03) 5391 4 216—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of TERRI CRIPPS
Sent: 25 October 2013 4:53 PM
To: AICALIST@AICALIST.ORG.AU
Subject: NorovirusHi everyone,
Always on a Friday afternoon!
We have had a great debate here about what sort of precautions Norovirus requires and what sort of isolation room they need to be nursed in.
The NSW Ministry of Health Infection Control policy PD2007_036 states:
Contact and Airborne precautions.
P2 mask when there is potential for aerosol dissemination e.g. patient vomiting or toileting (diarrhoea), disposing of faeces.
Airborne = negative pressure room if available and P2 mask
Contact = gown/apron, gloves
Ensure consistent environmental cleaning and disinfection.
I have always advised the staff that contact and DROPLET precautions are required if the patient is vomiting or has profuse/explosive diarrhoea. I have also advised that a surgical mask is sufficient (if worn correctly). Our little ones dont vomit and expel faeces as far as adults do too.
We do not have the luxury of having a negative pressure room for them to be nursed in either as we do not have that many.
I think CDC simply suggests single rooms and contact precautions.
Just thought I would ask the other experts out there what they think about this topic?
Also if I advise staff to follow the contact and droplet precautions and surgical mask route, am I going against policy?
Any help on this matter would be appreciated. Happy to admit I am wrong!
Terri Cripps | Clinical Nurse Consultant Infection Control | Sydney Childrens Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 |8 : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140Description: Description: http://www.chw.edu.au/site/signature/schn.jpg
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Terri
You have three options as I see it.
1. Dont use the video
2. Use the video and use it as an extra learning point and
3. Definitely write to CDC and bring it to their attention.It’s very easy for detail to be overlooked, the trick is using it to an infection prevention advantage. You can do that terri I know. 🙂
Cheers
Cath
Cathryn Murphy PhD
Executive Director
Infection Control Plus Pty Ltd
Ph: +61 428 154 154
http://www.infectioncontrolplus.com.au—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Orrell, Terri
Sent: Tuesday, 24 September 2013 9:49 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: New Dialysis Infection Prevention ResourcesHi Michael
Don’t think I would use this video as there are two breaches there – nail polish and jewellery being worn by clinical staff.
Very surprised this hasn’t been noted.
Regards
TerriTerri Orrell | Clinical Nurse Consultant
Infection Control | Peel Health Campus
110 Lakes Road, Mandurah WA 6010
t: 08 9531 8570 | f: 08 9531 8598
e: OrrellT@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
Sent: Tuesday, 24 September 2013 6:22 AM
To: AICALIST@AICALIST.ORG.AU
Subject: [ACIPC_Infexion_Connexion] CDC: New Dialysis Infection Prevention ResourcesThought this may be of interest to those with or involved in haemodialysis.
Cheers
MichaelSubject: Fwd: New Dialysis Infection Prevention Resources
Infections are a leading cause of death in hemodialysis patients. Receiving safe care and avoiding infectious complications are of utmost importance to patients. Reducing infections requires diligence from both providers and patients.
CDC is providing three new resources for preventing infections in dialysis patients: a Provider Training Video and accompanying Provider Poster and Patient Pocket Guide. Please visit CDCs Dialysis Safety website to see these exciting new materials.Provider Training Video: Preventing Bloodstream Infections in Outpatient Hemodialysis Patients: Best Practices for Dialysis Staff http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTMwOTIzLjIzMjk1ODMxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDEzMDkyMy4yMzI5NTgzMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3Nzg4MzI4JmVtYWlsaWQ9bWljaGFlbC53aXNoYXJ0QGludGVybm9kZS5vbi5uZXQmdXNlcmlkPW1pY2hhZWwud2lzaGFydEBpbnRlcm5vZGUub24ubmV0JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&103&&&http://youtu.be/_0zhY0JMGCA
The video is intended to be used by outpatient hemodialysis facilities as an educational tool to help remind their frontline staff, including technicians and nurses, about infection prevention measures. It can be used as an orientation video for new staff and as an annual in-service training tool to remind staff of proper protocols.Provider Poster: Put Together the Pieces to Prevent Infections in Dialysis Patients http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTMwOTIzLjIzMjk1ODMxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDEzMDkyMy4yMzI5NTgzMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3Nzg4MzI4JmVtYWlsaWQ9bWljaGFlbC53aXNoYXJ0QGludGVybm9kZS5vbi5uZXQmdXNlcmlkPW1pY2hhZWwud2lzaGFydEBpbnRlcm5vZGUub24ubmV0JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&104&&&http://www.cdc.gov/dialysis/PDFs/Dialysis-provider_poster.pdf
The poster can be posted in staff lounges or on the treatment floor to serve as a reminder of the messages in the video and other important ways to prevent infections.Patient Pocket Guide: 6 Tips to Prevent Dialysis Infections http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTMwOTIzLjIzMjk1ODMxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDEzMDkyMy4yMzI5NTgzMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3Nzg4MzI4JmVtYWlsaWQ9bWljaGFlbC53aXNoYXJ0QGludGVybm9kZS5vbi5uZXQmdXNlcmlkPW1pY2hhZWwud2lzaGFydEBpbnRlcm5vZGUub24ubmV0JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&105&&&http://www.cdc.gov/dialysis/PDFs/Dialysis-Patient-PocketGuide.pdf
The patient pocket guide is intended to educate patients on ways they can help prevent infections and can be shared as part of an information packet or reviewed with them by clinical staff.The poster and pocket guide are available for order through the CDC-INFO warehouse. The DVD will be available for order this week.
Please visit CDCs Dialysis Safety website for additional infection prevention resources, including a free continuing education (CE) activity and several observation tools, checklist tools, and protocols.
http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTMwOTIzLjIzMjk1ODMxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDEzMDkyMy4yMzI5NTgzMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3Nzg4MzI4JmVtYWlsaWQ9bWljaGFlbC53aXNoYXJ0QGludGVybm9kZS5vbi5uZXQmdXNlcmlkPW1pY2hhZWwud2lzaGFydEBpbnRlcm5vZGUub24ubmV0JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&107&&&http://www.cdc.gov/dialysis/Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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So there is a handy little ap called SNIP which lets you take screen snips of any screen if you can see a realread version perhaps you could SNIP a section as well.
Cheers
CathFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Maree Sommerville
Sent: Wednesday, 4 September 2013 8:36 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Infection control considerations for haematology and cancer pts. – service, building , ward layout/ flow for inpt services/accommodations scheduleGreat tip.
It costs $168 US dollars but they have a facility that allows you to read the whole document with a RealRead (a javascript program).
Cannot print it out but worth looking at.
Below is the link. RealRead link is at the bottom of the pagehttp://www.fgiguidelines.org/guidelines2010.php
Maree Sommerville
Infection Control Coordinator
Mercy Hospital for Women
________________________________
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Cath Murphy
Sent: Wednesday, 4 September 2013 5:16 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Infection control considerations for haematology and cancer pts. – service, building , ward layout/ flow for inpt services/accommodations scheduleLindy
Are you able to locate the most recent edition of the US Guidelines FOR DESIGN AND CONSTRUCTION OF
Health Care Facilities: The Facility Guidelines Institute.
Depending on the extent of your build/ reno this may be a very wise investment although not inexpensive. It certainly was for the team at Gold Coast Hospital. Also my understanding from years of dealing with US ICPs is that this document in each updated version is their absolute go-to document for reno and construction. It goes well beyond the scope and general detail of CDC Guideline.
Good luck
Cath
Cathryn Murphy PhD
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 Lindy Ryan
Sent: Tuesday, 3 September 2013 18:41 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Infection control considerations for haematology and cancer pts. – service, building , ward layout/ flow for inpt services/accommodations scheduleDear Colleagues
Just wondering if anyone can guide me toward any useful information regarding infection control recommendations/ advice for inpatient haematology / cancer ward locations/ layout/ flows (also includes transplant pts.).
I can only locate the CDC information around outpatient oncology settings which isnt really helpful in regard to physical location, layout and flows and I was unable to find any helpful information on the Australasian health care facility guidelines for this highest risk area either.
Any ideas or links really appreciated
Thanks you in advance
Regards
Lindy
Lindy Ryan
Infection control CNC
Nepean Hospital NBMLHD
Phone 4734 2228
Email lindy.ryan@swahs.health.nsw.gov.auInfection Prevention and control is everyones business
Clean hands safest care.take a moment & practice the five moments___________________________________
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Lindy
Are you able to locate the most recent edition of the US “Guidelines FOR DESIGN AND CONSTRUCTION OF
Health Care Facilities: The Facility Guidelines Institute”.
Depending on the extent of your build/ reno this may be a very wise investment although not inexpensive. It certainly was for the team at Gold Coast Hospital. Also my understanding from years of dealing with US ICPs is that this document in each updated version is their absolute “go-to” document for reno and construction. It goes well beyond the scope and general detail of CDC Guideline.
Good luck
Cath
Cathryn Murphy PhD
Executive Director
Infection Control Plus Pty Ltd
http://www.infectioncontrolplus.com.au
[Description: twitter logo][Description: FB logo][Description: icp icon]Dear Colleagues
Just wondering if anyone can guide me toward any useful information regarding infection control recommendations/ advice for inpatient haematology / cancer ward locations/ layout/ flows (also includes transplant pts.).
I can only locate the CDC information around outpatient oncology settings which isn’t really helpful in regard to physical location, layout and flows and I was unable to find any helpful information on the Australasian health care facility guidelines for this highest risk area either.
Any ideas or links really appreciated
Thanks you in advance
Regards
Lindy
Lindy Ryan
Infection control CNC
Nepean Hospital NBMLHD
Phone 4734 2228
Email lindy.ryan@swahs.health.nsw.gov.auInfection Prevention and control is everyones business
Clean hands – safest care….take a moment & practice the five moments___________________________________
Unless you are the intended recipient any unauthorised use, dissemination,further distribution or reproduction of this communication in any form whatsoever, is strictly prohibited.
If this communication has been sent to you in error, please notify the sender by return e-mail and delete and/or destroy your copy of this communication (including attachments).
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Unless otherwise expressed, it is not represented, warranted or guaranteed that the integrity of this communication has been maintained nor that the communication is free of virus, errors or interference.
09/03/13 – 18:41:01
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Tim
Thanks. These syringes are well used in the US as I am sure you would know and appreciate. They are considered part of the CDC recommendations. This is a small study and the methodology not without limitation. That said it’s always exciting to look at new technologies and further explore their potential for improving patient safety.
Do you think the reduction was due more to standardised care ie. frequent flushing, less handling or something else ? dressing, insertion technique, skin antisepsis? Proving causality and the flip side showing protection is always controversial.
I’m keen to know why you especially found this paper compelling? Also how similar to Australian healthcare settings do you think Italian settings would be? These are the sorts of questions I always have to stop and ask when reviewing reports from the literature.
For the record, I too think that these pre-filled syringes are the way to go and I just wished that as clinicians adopted new technologies we also had capacity, skill and time to invest in undertaking and reporting the much needed research to silence those opponents.
Cheers
Cath
Cathryn Murphy PhD
Executive Director
Infection Control Plus Pty Ltd
http://www.infectioncontrolplus.com.au
[Description: twitter logo][Description: FB logo][Description: icp icon]FYI
For those who are interested in CLABSI reduction through the use of pre-filled flush syringes.
A recent publication in The Journal of Hospital Infection this past May, focuses on the potential for complication reduction when moving from a manually filled flush syringe to a pre-filled flush syringe and ultimately showed a 60% CRBSI reduction when utilizing a pre-filled flush syringe for maintenance.Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant, Central Venous Access & Parenteral Nutrition Service
Conjoint Lecturer, South West Sydney Clinical School | Faculty of Medicine | University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital, Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel (+61) 2 8738 3603 | Fax (+61) 2 8738 3551 | Mob +61 (0)409 463 428 | Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au
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Michael
CDC does not typically drill down to the minutia level of applications. Under FDA and OSHA legislation I am sure that the assumptions rightly or wrongly are that manufacturers label as per their submission for registration and testing and that clinicians follow label instructions. Australia is no different.
Below is an interesting point about intraoperative skin prep and solution of choice.
There are also many in-press publications about CHG bathing pre-operatively as an additional measure.
We have to remain on top of all this research and public policy and it’s very time consuming and not easy without formal training in reading and understanding scientific papers. Our lot in life I guess.
JUNE 2013 UPDATED
8B. Perform intraoperative skin preparation with an appropriate antiseptic agent. (Category IA)
8B.1.a. Use chlorhexidine gluconate-alcohol in preference of aqueous iodophor skin preparation, unless contraindicated. (Category IA)
8B.1.b. No recommendation can be made regarding the safety and effectiveness of chlorhexidine gluconate-alcohol as compared to iodophor-alcohol skin preparation.(No recommendation/unresolved issue)Cheers
CathThanks Cath, very interesting. But this appears to be about pre-op antiseptic body wash rather than pre-op skin antisepsis. Is there any proposed change to the HICPAC guidelines about skin antisepsis? Presume they will at least have a statement about following antiseptic manufacturer’s instructions for application?
Cheers
MichaelMichael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
Please consider the environment before printing this emailMichael and all
In my research I am currently reviewing the draft US CDC Surgical Site Infection Guidelines which are due to be released in Nov 2013. They include comprehensive review of literature and rigorous grading of evidence for every recommendation. Guidance in this issue like many areas of infection prevention often becomes outdated due to new technologies and formulations. Misinterpretation, multi-resistant attitudes and holding onto sacred cows continue to plague effective clinical practice. The CDC draft statement regarding skin antisepsis suggests that multi applications may be one such sacred cow. The draft recommendation below is subject to normal HICPAC consultation processes.
Always interesting to see how public policy evolves, usually much slower and less responsive than technology and adoption of trends and fads. All of this keeps our role exciting and very necessary.
JUNE 2013 NEW
8A. Require patients to shower or bathe (full body-including scalp) on at least the night before the operative day (Category IB)
8A.1. No recommendation can be made regarding the safety and effectiveness of specific body cleansing products, the optimal timing or number of product applications. (No recommendation/unresolved issue)Cath
Cathryn Murphy PhD
Executive Director
Infection Control Plus Pty Ltd
http://www.infectioncontrolplus.com.au
[Description: twitter logo][Description: FB logo][Description: icp icon]Hi all
Can I ask a question which may seem naive to those with a recent theatre background? When applying antiseptic solution as part of a surgical skin preparation prior to a procedure, is it best practice to apply two ‘coats’ of antiseptic solution, one immediately on top of the other, using different swabs?
I can see not real benefit in doing this from an antiseptic action viewpoint (apart from mechanical friction) Can also not see this mentioned in a cursory review of any SSI prevention best practice guidelines.
Any comments? Any references to get me up-to-date if I need to be updated?
Thanks
MichaelMichael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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Michael and all
In my research I am currently reviewing the draft US CDC Surgical Site Infection Guidelines which are due to be released in Nov 2013. They include comprehensive review of literature and rigorous grading of evidence for every recommendation. Guidance in this issue like many areas of infection prevention often becomes outdated due to new technologies and formulations. Misinterpretation, multi-resistant attitudes and holding onto sacred cows continue to plague effective clinical practice. The CDC draft statement regarding skin antisepsis suggests that multi applications may be one such sacred cow. The draft recommendation below is subject to normal HICPAC consultation processes.
Always interesting to see how public policy evolves, usually much slower and less responsive than technology and adoption of trends and fads. All of this keeps our role exciting and very necessary.
JUNE 2013 NEW
8A. Require patients to shower or bathe (full body-including scalp) on at least the night before the operative day (Category IB)
8A.1. No recommendation can be made regarding the safety and effectiveness of specific body cleansing products, the optimal timing or number of product applications. (No recommendation/unresolved issue)Cath
Cathryn Murphy PhD
Executive Director
Infection Control Plus Pty Ltd
http://www.infectioncontrolplus.com.au
[Description: twitter logo][Description: FB logo][Description: icp icon]Hi all
Can I ask a question which may seem naive to those with a recent theatre background? When applying antiseptic solution as part of a surgical skin preparation prior to a procedure, is it best practice to apply two ‘coats’ of antiseptic solution, one immediately on top of the other, using different swabs?
I can see not real benefit in doing this from an antiseptic action viewpoint (apart from mechanical friction) Can also not see this mentioned in a cursory review of any SSI prevention best practice guidelines.
Any comments? Any references to get me up-to-date if I need to be updated?
Thanks
MichaelMichael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
Please consider the environment before printing this emailWARNING : This email contains information, which is CONFIDENTIAL, and that maybe subject to LEGAL PRIVILEGE. This e-mail and any attachments to it (the “Communication”) is confidential and is for the use only of the intended recipient, and may not duplicated or used by any other party without the express consent of the sender. The Communication may contain copyright material of St Vincent’s Health & Aged Care(“SVHAC”), or any of its related entities or of third parties. If you are not the intended recipient of the Communication, please notify the sender immediately by return e-mail, delete the Communication, and do not read, copy, print, retransmit, store or act in reliance on the Communication. Any views expressed in the Communication are those of the individual sender only, unless expressly stated to be those of SVHAC. SVHAC does not guarantee the integrity of the Communication, or that it is free from errors, viruses or interference. Thank-you.
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Michael
Skin preparation research and product is rapidly evolving as is our understanding of it’s role and the additional benefit of daily CHG bathing. This topic was discussed and presented in great depth at APIC 2013 and on re-listening recently to recordings of APIC sessions I took home several messages including:
1. AORN in their Standards use evidence to base preparation instructions;
2. CDC is about to release a new SSI guideline which addresses this topic and much else
3. Ultimately, clinicians need to follow manufacturers’ specific directions for their specific product
In short I don’t think there is an evidence-based “one-stop” answer to your question.
Interesting science published around this in the last 12 months in AJIC, ICHE and NEJM esp.
Cheers
CathCathryn Murphy PhD
Executive Director
Infection Control Plus Pty Ltd
http://www.infectioncontrolplus.com.au
[Description: twitter logo][Description: FB logo][Description: icp icon]Hi all
Can I ask a question which may seem naive to those with a recent theatre background? When applying antiseptic solution as part of a surgical skin preparation prior to a procedure, is it best practice to apply two ‘coats’ of antiseptic solution, one immediately on top of the other, using different swabs?
I can see not real benefit in doing this from an antiseptic action viewpoint (apart from mechanical friction) Can also not see this mentioned in a cursory review of any SSI prevention best practice guidelines.
Any comments? Any references to get me up-to-date if I need to be updated?
Thanks
MichaelMichael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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