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Hi Ruth
I am currently looking at the risks associated with ESBL and the need to isolate.
Would you be able to send through the risk matrix that you use.
Kind regards
Sharon Deen
Infection Control Nurse[http://www.ramsayhealth.com/~/media/Images/email/email-RHC-logo]
Peel Health Campus
Infection Control
Phone:08 9531 8570
Fax:
08 9531 8409
Email:
DeenSharon@ramsayhealth.com.au
Web:
Address:
110 Lakes Road, Mandurah WA 6210
[http://www.ramsayhealth.com/~/media/Images/email/email-social-mediaPCP.jpg]
From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Ruth Barratt
Sent: Tuesday, 2 April 2019 5:57 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Gloves,gowns, contact precautions and colonised nmMRSAHi Cate,
Great you are looking at your local risk re. these issues.
I can share with you my NZ experience – in most of New Zealand North Island, Auckland and upper north of NZ which has a similar epidemiology picture to yours re MRSA e.g. overcrowding , high community rates of nmMRSA etc. Most NZ North Island hospitals removed contact precautions for nmMRSA patients many years ago and have not seen an increase in hospital transmission of MRSA which is actually mostly community acquired.* Re ESBL the common community ESBL- E.coli colonised patients are not isolated either unless they have a high risk factor for spread. Again the majority of the ESBLs are community acquired. In Christchurch over 5 years ago we introduced a risk matrix for isolation of ESBL based on organism e.g. ESBL Klebsiella is always in CP, and patient risk factors for spread. Again no change in hospital transmission. Of course it freed up single rooms, improved transfer times from ED and was better for the patients.
* Re. plastic aprons versus long sleeved plastic gowns. Most of the UK routinely use plastic aprons for these types of MRO CPs where there is minimal contamination anticipated. However it may be that one type of gown stocked on the wards is better than two.
* I also think Susan Jains recent journal article presents a good argument for no gloves for dry MRO patients very well.Cheers
RuthRuth Barratt RN, BSc, MAdvPrac (Hons)
PhD Candidate and Research Assistant
Centre for Infectious Diseases and Microbiology
Westmead Institute for Medical Research
University of Sydney
Email: ruth.barratt@sydney.edu.au
rbar5856@uni.sydney.edu.au
Mobile: 0468 352 335
ORCID ID:https://orcid.org/0000-0002-8930-6414From: ACIPC Infexion Connexion on behalf of Cate Coffey
Reply-To: ACIPC Infexion Connexion
Date: Monday, April 1, 2019 at 7:24 PM
To: “ACIPCLIST@ACIPC.ORG.AU”
Subject: Gloves,gowns, contact precautions and colonised nmMRSAHi everyone,
just after your thoughts on glove and gown use in contact precautions. We are currenlty reviewing the management of transmission based precautions in our facility. Our local profile of MROS’s include very almost no CPE, minimal MRSA, high rates of nmMRSA which is widespread in the community , increasing ESBL, minimal other gram negative MRO’s. We are reviewing the possiblilty of using standards precautions for patients who are colonised with nmMRSA. Clearance swabs are problematic as patientss often retrun to homes with overcrowding and high rates on nmMRSA. There is currently no PCR testing for MRSA/nmMRSA available in our jurisdiction, therefore 3 swabs are taken for culture.
We would also like to remove longsleeve plastic gowns and replace with plastic aprons for contact precautions unless there is a risk of blody fluid exposure. Gloves seem to poorly affect Hand Hygiene complance despite significant education and would like you views and experience on this.
The literature seems inconclusive but as this would be against NHMRC guidelines ,can you let me know if you have any advice regading the changes we would like to implement ?
Thanks everyoneCate 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
Our Values: Community at the Centre | Equity and Integrity | We are Accountable | We are Relevant Today and Ready for Tomorrow | We are Committed to High Quality Care | We Value our PartnershipsCentral Australia Health Service is a Smoke Free Workplace
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As far as I am aware there is no clearance protocol for clearance of ESBL.
Sharon Deen
Infection Control Nurse[http://www.ramsayhealth.com/~/media/Images/email/email-RHC-logo]
Peel Health Campus
Infection Control
Phone:08 9531 8570
Fax:
08 9531 8409
Email:
DeenSharon@ramsayhealth.com.au
Web:
Address:
110 Lakes Road, Mandurah WA 6210
[http://www.ramsayhealth.com/~/media/Images/email/email-social-mediaPCP.jpg]
Hello all,
I am wondering if anyone has a resource for education re ESBL, namely what constitutes as clearance of ESBL?
Many thanks
Katherine Fisher
Eurobodalla Infection Prevention Specialist
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Hi Michelle,
As per the WA guidelines, we collect 2 sets of MRSA screening swabs, nose, throat and any wounds.
This is at least 3 months after the last positive results.
Sharon Deen
Infection Control Nurse[http://www.ramsayhealth.com/~/media/Images/email/email-RHC-logo]
Peel Health Campus
Infection Control
Phone:08 9531 8570
Fax:
08 9531 8409
Email:
DeenSharon@ramsayhealth.com.au
Web:
Address:
110 Lakes Road, Mandurah WA 6210
[http://www.ramsayhealth.com/~/media/Images/email/email-social-mediaPCP.jpg]
Hi Everyone,
I was just wandering how many swabs do you need to collect for MRSA clearance.
Currently we are doing 2 negative MRSA results.Regards,
Michelle Gorman
Care Manager
Queanbeyan Residential Care Facility
7 Campbell Street
Queanbeyan NSW
2620
PH (02) 6297 1811Hello,
Our hospital has recently been looking into the way our toilets are cleaned throughout our hospital.
Do any of you use disposable toilet bowl brushes? If not, what cleaning process do you have for the brushes from room to room?
Any information appreciated.
Kind Regards,
Chelsea Kop | Clinical Services Manager, BSN, GDipNurs(Onc), MCN
Delmar Private Hospital
58 Quirk Street, Dee Why, NSW 2099
T +612 8978 5247 | M 0402772578 | F +612 9971 7299
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Just wondering what cohort of people would you screen?
I have had a look on CDC and there seems to be only advice for those who have tested positive and their contacts.
Cheers,
Sharon Deen
Infection Control Nurse[http://www.ramsayhealth.com/~/media/Images/email/email-RHC-logo.jpg]
Peel Health Campus
Infection Control
Phone:08 9531 8570
Fax:
08 9531 8409
Email:
DeenSharon@ramsayhealth.com.au
Web:
Address:
110 Lakes Road, Mandurah WA 6210
[http://www.ramsayhealth.com/~/media/Images/email/email-social-media2.jpg]
Dear All, just updating our MRO policy with reference to C.auris – which sites are we meant to screen ? I$B!G(Bve read a lot of literature but there is nothing specifically outling the testing sites.
I$B!G(Bm thinking;
Groin/ perineum &
Additional specimens should be obtained as follows: (if relevant)
$B!|(B Urine – voided or catheter urine
$B!|(B Skin lesions and wound swabs
$B!|(B Swabs of sites of catheters or other skin penetrating devicesAprreciate your advice
Emma Trippe
Infection Control Consultant
[cid:image001.png@01D475D3.A2307160]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.auHospitality | Healing | Stewardship | Respect
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Hi Fiona,
We screen all renal patients on a quarterly basis.
We screen all patients who have been admitted for an overnight stay outside WA then we manage them on contact precautions in isolation until the results are received.
VRE inpatients are managed in a single room with an ensuite on contact precautions.
Kind regards,
Sharon Deen
Infection Control Nurse[http://www.ramsayhealth.com/~/media/Images/email/email-RHC-logo.jpg]
Peel Health Campus
Infection Control
Phone:08 9531 8570
Fax:
08 9531 8409
Email:
DeenSharon@ramsayhealth.com.au
Web:
Address:
110 Lakes Road, Mandurah WA 6210
[http://www.ramsayhealth.com/~/media/Images/email/email-social-media2.jpg]
Dear Brains Trust,
Our facility recently underwent accreditation and there was surprise expressed at our ongoing screening of patients for VRE, with verbal reports that a number of hospitals no longer routinely screen for VRE.
I would like to know what people are doing in their facilities
* Do you screen or not screen?
* If you screen, what patient population is screened?
* If you have stopped screening – Why?
* If you have stopped screening what is the impact on VRE infection rates?
* How are VRE positive patients managed?Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control________________________________
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