[Che Jarvis]

Hi Meryl,

I agree with Michael, & Julie on the potential risk for transmission of droplet based organisms.

Our HCF only utilises inhalers as single patient use, & even our spacers are for single patient use & are purchased by the patient’s/parents.

Regards,

Che Jarvis
Acting CNC Infection Control| Nepean Hospital
Level 2, South Block
Tel 02 4734 2228 | Fax | Mob | che.jarvis@health.nsw.gov.au
http://www.health.nsw.gov.au
[http://www0.health.nsw.gov.au/images/communications/e-signatures/images/NSW-Health-Nepean-Blue-Mountains-LHD.jpg]
________________________________

Hi Meryl,

I agree with Michael regarding potential risks of droplet contamination of respiratory viruses within the inhaler if used between patients.

In our HCF the inhalers we use are labelled as single patient use so they are only approved for more than one episode of use on one patient only. We do not reuse these items for different patients. They are cleaned with a neutral detergent when required although we do ask that staff check the manufacturers instructions as some are not designed to be cleaned or dismantled & have a life expectancy similar to a puffer.

Regards

Julie Hunt

Clinical Nurse Consultant
Infection Prevention & Control
Royal North Shore Hospital
Reserve Rd St Leonards 2065
Tel 02 99264339 or 99264490

Good morning everyone,

I have been approached our ED to find out the risks of cross-infection through use of an inhaler with a spacer. To put this into context, the use of spacers is restricted to individual patients, but the inhalers are currently used for multiple patients. My concerns are as follows:

Children in ED are usually undifferentiated as and such we do not know what infection they have or what kind of additional transmission-based precautions might be required.

The valve in the spacer is a valve not a filter thus there is the possibility of contamination of the inhaler through the valve of the spacer.

The inhaler sits at the patients bedside before moving to the medication room and then on to another patients room, being handled by children, parents and nursing staff along the way.
Thus far I have not been able to find any literature on this but was wondering if anyone could inform me what their local practice is and the rationale behind it.

Many thanks in advance,

Meryl

Meryl Jones
Clinical Nurse
Infection Management and Prevention Service

Childrens Health Queensland Hospital and Health Service
Level 12
Lady Cilento Childrens Hospital, South Brisbane QLD 4101

T: 07 3068 4145.
E: meryl.jones@health.qld.gov.au
W: http://www.childrens.health.qld.gov.au

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[Che Jarvis]

Hi Ruth,

here at Nepean we are just looking into a number of policies particularly as we are encroaching on flu season.

There are a number of practice changes we are looking at including:

1) Locked ward with video intercom to be buzzed in, to minimise unecessary traffic.

2) A sign in book for visitors, & one for staff to track visitors to the ward, with a declaration of wellness.

3) Age restrictions for children (Slightly controvertial) & would need to be flexible.

4) Increased use of surgical masks for people displaying any viral type signs or symptoms.

This is all just prelimanary at this stage.

Regards,

Che Jarvis
Acting CNC Infection Control| Nepean Hospital
Level 2, South Block
Tel 02 4734 2228 | Fax | Mob | che.jarvis@health.nsw.gov.au
http://www.health.nsw.gov.au
[http://www0.health.nsw.gov.au/images/communications/e-signatures/images/NSW-Health-Nepean-Blue-Mountains-LHD.jpg]
________________________________

Would any member be prepared to share any protocols or policies they have for visitor restrictions specifically for a haematology or bone marrow transplant ward or unit with immunosuppressed patients. We are particularly interested in any no children (at all policies). This has arisen as a result of a recent Pertussis outbreak.

Kind regards

Ruth

Ruth Barratt RN, BSc, MAdvPrac (Hons)
Clinical NurseSpecialist Infection Prevention and Control
Community Liaison Infection Prevention
: ruth.barratt@cdhb.health.nz
: + 64 3 3640 083 or ext.80083
: 0275 263175
Level 5, Riverside Building
Christchurch Hospital | Private Bag 4710, Christchurch
Clean Hands Save Lives!

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