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Diane Hobday

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  • in reply to: Use of T spray 11 (posted on behalf of a fellow ICP) #70749
    Diane Hobday
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    Diane Hobday

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    Hi Rita

    As noted by Terry, you can only use T-spray on surfaces that are not endocavity transducers (semi-critical medical devices). The TGA has a warning about following manufacturers guidelines, as they may not meet Australian requirements:

    http://www.tga.gov.au/hp/iris-articles-2008-55.htm

    cheers
    Diane

    Diane Hobday
    Accreditation Manager – DIAS

    National Association of Testing Authorities, Australia
    Level 1, 675 Victoria Street
    Abbotsford VIC 3067

    http://www.nata.com.au

    Hi All,

    Phillips recommends the use of T-spray 11 disinfectant cleaner on their Phillips ultrasound machine as it is one of the products approved for use by the manufacturer on that equipment. Is anyone else using this? MSDS says it’s an ammonium chloride ( 4 types).

    Rita Roy

    Clinical Nurse Consultant | Infection Control
    Hornsby Ku ring gai Health Service, Palmerston Road, Hornsby NSW 2077
    Tel (02) 9477 9232 | Fax (02) 9477 9013 | Mob 0422 930 370 | Rita.Roy@health.nsw.gov.au
    http://www.health.nsw.gov.au

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    in reply to: Request #70333
    Diane Hobday
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    Diane Hobday

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    Hello Joe-Anne

    I have heard rumours of that safety alert for nearly 18 months now, and had come to the conclusion that it is not coming. Do you have any idea when it may be released?

    Thanks
    Diane

    Diane Hobday
    Accreditation Manager – DIAS

    National Association of Testing Authorities, Australia
    Level 1, 675 Victoria Street
    Abbotsford VIC 3067

    http://www.nata.com.au

    Hi Vicki
    NSW Ministry of Health are currently reviewing the compliance of the product with AS4187 and will be issuing a Safety Alert for NSW healthcare facilities. I would hold off any purchases until the Safety Alert is released

    Thanks

    Joe-Anne Bendall

    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| 7 Fax 93827510 |
    Mobile 0418984255 | * Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

    I was just inquiring as to whether there are any hospitals currently using the Tristel wipes system within their facility & whether they would be willing to contact me to discuss this product/process please

    Vicki Denyer

    Clinical Nurse Consultant | Infection Prevention & Control Unit
    Lismore Base Hospital
    Tel 02 6620 2385 | vicki.denyer@ncahs.health.nsw.gov.au

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    in reply to: ASUM guidelines and US probe cleaning #70020
    Diane Hobday
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    Diane Hobday

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    Hello

    All intracavity probes *must* be disinfected using a high level disinfectant included on the ARTG as such – in essence, one of the four methods listed in the ASUM guidelines.

    This disinfection is in addition to the use of covers. Covers should never be considered an alternative to appropriate cleaning and disinfection.

    For external intact skin a less stringent process, in addition to a cover, can be used because these do not require ‘high level’ disinfection. (see TGO 54 for more information about what does and does not require high level disinfection)

    I hope this helps.

    Cheers
    Diane

    Diane Hobday

    Accreditation Manager – DIAS
    National Association of Testing Authorities, Australia
    1/675 Victoria Street
    Abbotsford VIC 3067

    03 9274 8200
    http://www.nata.com.au

    Dear All,

    I am seeking some assistance with interpreting the ASUM guidelines and their requirements for US probe cleaning.

    We are using the Trophon for all intracavity probes and wiping over all other probes used for routine imaging, biopsy guidance etc with a disinfectant wipe. The current wipe in use is not one of the four recommended disinfection methods referred to in their guidelines.
    We use probes covers routinely for all interventional procedures or on mucous membranes, wounds etc.

    Am I correct in interpreting the ASUM guidelines – that all probes regardless of cover usage must be cleaned in one of the four ways stated by ASUM. Can anyone throw some more light on this issue for me please.

    We have received full Imaging reaccreditation and our current practise was not raised as an issue.

    Regards

    Phillipa Parsons
    Infection Prevention and Control Clinical Coordinator
    Cabrini Health
    183 Wattletree Rd
    Malvern Vic 3144
    03 9508 1577
    0400 369 741

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    in reply to: storage of tissues #69839
    Diane Hobday
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    Diane Hobday

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    Hi Terry

    It may be easier to check the requirements for storing drugs – see what they can be kept with: the hospital pharmacy will have their regs on storage. I’m fairly certain that a vaccine fridge (for example) can’t be used for anything other than vaccines… it may be that scheduled drugs have similar constraints.

    Di

    Diane Hobday

    Accreditation Manager – DIAS
    National Association of Testing Authorities, Australia
    1/675 Victoria Street
    Abbotsford VIC 3067

    03 9274 8200
    http://www.nata.com.au

    —–Original Message—–

    Thanks Julie,

    I had found all the TGA and subsequent TGO 86 material however this is more to do with harvested tissue to be used on other patients i.e. corneal grafts etc.

    This tissue is the patient’s own tissue [skin] stored for later regrafting and also material that is being stored pending use for research purposes, therefore I do not believe they are covered by this Act and TGO86.

    My query boils down to – can you or can you not store human tissue [or specimens] in the same fridge as drugs? If not – where is a suitable reference to be found.

    Regards
    Terry McAuley
    Sterilisation & Infection Control Consultant STEAM Consulting
    E: terry@steamconsulting.com.au
    W: http://www.steamconsulting.com.au
    A: PO BOX 779
    Endeavour Hills
    VIC Australia 3802

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    Hi Terry,

    There is some information on the storage of tissue in:
    Therapeutic Goods Act 1089
    Section 10
    Standards for Human skin

    It doesn’t go into specific types of refrigeration, only temperatures and duration and that collected human skin must be sampled for bioburden, using a validated sampling technique prior to being packaged and, when packaged, must be packaged within at least one moisture impermeable barrier using an aseptic technique and stored in accordance with conditions and duration specified and justified by validation data or documented evidence from the relevant scientific literature

    Regards

    Julie

    Julie Hunt
    Clinical Nurse Consultant | Infection Prevention and Control Royal North Shore Hospital, Reserve Rd, St Leonards 2065 Tel 02 99264339 or 99264490 juhunt@nsccahs.health.nsw.gov.au

    >>> Michael Wishart 11/03/2013 2:15 pm >>>
    Hi Terry

    We looked at storage of human skin recently, as we were using a fridge that was used to store lab specimens. Provided you have a temperature monitored and maintained fridge with appropriate alarms and checks, and provided the tissue is labelled with name and date of collection / expiry, and sealed into its own container, we couldn’t find any guidelines that specified what else could be storied in the fridge with it.

    We have changed our practice here, though, and now store these tissues in a blood fridge, as that has is attached to a monitored alarm system. Whereas the pathology fridge just beeps to itself in the pathology room where no one can hear it.

    If anyone has actual tissue storage guidelines that specify more clearly where these tissues can be stored I would be interested as well.

    Cheers
    Michael

    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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    Hi everyone,

    I have recently come across a practice of storing human tissue i.e. skin in the same fridge as drugs.

    I was wondering if anyone could point me to the reference where it clearly states that this is not an acceptable practice? A quick internet search hasn’t been helpful.

    Thanks in anticipation.

    Regards
    Terry McAuley
    Sterilisation & Infection Control Consultant STEAM Consulting
    E: terry@steamconsulting.com.au
    W: http://www.steamconsulting.com.au
    A: PO BOX 779
    Endeavour Hills
    VIC Australia 3802

    CONFIDENTIAL 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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    in reply to: Re: storage of tissues #69827
    Diane Hobday
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    Author:
    Diane Hobday

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    Hi Terry

    My instinct is to say “No” – that neither the drug nor path fridges would be acceptable, even with biohazard bagging. Give the Donor Tissue Bank a call – they will give you definitive information about how to deal with this – I have no doubt that others have the same issue to overcome.

    Cheers
    Di

    Diane Hobday

    Accreditation Manager – DIAS
    National Association of Testing Authorities, Australia
    1/675 Victoria Street
    Abbotsford VIC 3067

    03 9274 8200
    http://www.nata.com.au

    Thanks for the responses Michael and Diane,

    The context where this is occurring is a Day Surgery environment – so there is no Pathology or Blood fridge available – the only refrigerators are either the food fridge and the drug fridge. Both are temperature moitored.

    The client is reluctant to purchase a separate refrigerator purely for the storage of human tissue, as the volume of this material is no more than half a dozen specimen jars at a time.

    Clearly the food fridge is not an option, however as drugs are considered ‘clean’ my query is, is it acceptable to store something ‘dirty’ in the drug fridge?

    The tissue is stored in a labelled specimen jar inside a sealed biohazard bag.

    Further thoughts will be gratefully received.

    Regards
    Terry McAuley
    Sterilisation & Infection Control Consultant
    STEAM Consulting
    E: terry@steamconsulting.com.au
    W: http://www.steamconsulting.com.au
    A: PO BOX 779
    Endeavour Hills
    VIC Australia 3802

    CONFIDENTIAL 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.

    Hi all

    I can’t find anything specific in any of the Standards – what Terry says is covering most bases (because a blood fridge has better monitoring than a path fridge).

    If you want a definitive answer I would encourage you to contact the Donor Tissue Bank of Victoria at the Victorian Institute of Forensic Medicine (VIFM). They are a state-of-the-art public tissue bank, and will be able to give you advice about best practice and applicable standards.

    C

    Diane Hobday

    Accreditation Manager – DIAS
    National Association of Testing Authorities, Australia
    1/675 Victoria Street
    Abbotsford VIC 3067

    03 9274 8200
    http://www.nata.com.au

    Hi Terry

    We looked at storage of human skin recently, as we were using a fridge that was used to store lab specimens. Provided you have a temperature monitored and maintained fridge with appropriate alarms and checks, and provided the tissue is labelled with name and date of collection / expiry, and sealed into its own container, we couldn’t find any guidelines that specified what else could be storied in the fridge with it.

    We have changed our practice here, though, and now store these tissues in a blood fridge, as that has is attached to a monitored alarm system. Whereas the pathology fridge just beeps to itself in the pathology room where no one can hear it.

    If anyone has actual tissue storage guidelines that specify more clearly where these tissues can be stored I would be interested as well.

    Cheers
    Michael

    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
    Please consider the environment before printing this email

    Hi everyone,

    I have recently come across a practice of storing human tissue i.e. skin in the same fridge as drugs.

    I was wondering if anyone could point me to the reference where it clearly states that this is not an acceptable practice? A quick internet search hasn’t been helpful.

    Thanks in anticipation.

    Regards
    Terry McAuley
    Sterilisation & Infection Control Consultant
    STEAM Consulting
    E: terry@steamconsulting.com.au
    W: http://www.steamconsulting.com.au
    A: PO BOX 779
    Endeavour Hills
    VIC Australia 3802

    CONFIDENTIAL 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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    in reply to: storage of tissues #69823
    Diane Hobday
    Participant

    Author:
    Diane Hobday

    Position:

    Organisation:

    State:

    Hi all

    I can’t find anything specific in any of the Standards – what Terry says is covering most bases (because a blood fridge has better monitoring than a path fridge).

    If you want a definitive answer I would encourage you to contact the Donor Tissue Bank of Victoria at the Victorian Institute of Forensic Medicine (VIFM). They are a state-of-the-art public tissue bank, and will be able to give you advice about best practice and applicable standards.

    C

    Diane Hobday

    Accreditation Manager – DIAS
    National Association of Testing Authorities, Australia
    1/675 Victoria Street
    Abbotsford VIC 3067

    03 9274 8200
    http://www.nata.com.au

    Hi Terry

    We looked at storage of human skin recently, as we were using a fridge that was used to store lab specimens. Provided you have a temperature monitored and maintained fridge with appropriate alarms and checks, and provided the tissue is labelled with name and date of collection / expiry, and sealed into its own container, we couldn’t find any guidelines that specified what else could be storied in the fridge with it.

    We have changed our practice here, though, and now store these tissues in a blood fridge, as that has is attached to a monitored alarm system. Whereas the pathology fridge just beeps to itself in the pathology room where no one can hear it.

    If anyone has actual tissue storage guidelines that specify more clearly where these tissues can be stored I would be interested as well.

    Cheers
    Michael

    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
    Please consider the environment before printing this email

    Hi everyone,

    I have recently come across a practice of storing human tissue i.e. skin in the same fridge as drugs.

    I was wondering if anyone could point me to the reference where it clearly states that this is not an acceptable practice? A quick internet search hasn’t been helpful.

    Thanks in anticipation.

    Regards
    Terry McAuley
    Sterilisation & Infection Control Consultant
    STEAM Consulting
    E: terry@steamconsulting.com.au
    W: http://www.steamconsulting.com.au
    A: PO BOX 779
    Endeavour Hills
    VIC Australia 3802

    CONFIDENTIAL 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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    in reply to: TOE Probe covers #69704
    Diane Hobday
    Participant

    Author:
    Diane Hobday

    Position:

    Organisation:

    State:

    Hi
    As noted yesterday RICPRAC has a should on covers, not a must. RICPRAC also mentions the 38 micron covers. High-level disinfection is required for endocavity transducers in all states and goes back to TGO54 definitions and requirements. It is my understanding that the reason covers are suggested for ultrasound probes is that they do not detract from image quality, and as the probes cannot usually be thermally disinfected, the additional protection is encouraged.
    If there is another reason, Im keen to hear about it!
    Cheers
    Diane Hobday

    Accreditation Manager – DIAS
    National Association of Testing Authorities, Australia
    1/675 Victoria Street
    Abbotsford VIC 3067

    03 9274 8200
    http://www.nata.com.au

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Maree Sommerville
    Sent: Monday, 4 February 2013 6:04 PM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: TOE Probe covers

    The Victorian Government has not issued such a directive but did refer to high level disinfection (see link) way back in 2008.
    http://www.health.vic.gov.au/hospitalcirculars/circ08/circ0108.htm
    For the use of covers, ASUM (Australian Society for Ultrasound Medicine) recommend 38 microns. This is echoed in the ASA (Australian Sonographers Association). The policies are available on-line from both these organisations. The literature they use mostly refers to gynaecological/obstetric use of intracavity ultrasound.
    What is the rationale to cover TOE probes when we do not cover gastroscopes bronchoscopes or duodenoscopes? Is it used to facilitate the sound wave? There are risks, given that the cover has to go past teeth and may break on the way down, thus causing a possible obstruction. I would think the most important action would be cleaning and sterilisation/disinfection and storage afterwards.
    Happy to be further educated.
    Good luck with it all.
    Maree Sommerville
    Infection Control Coordinator
    Mercy Hospital for Women
    ________________________________
    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Barbara Elliott
    Sent: Monday, 4 February 2013 1:40 PM
    To: AICALIST@AICALIST.ORG.AU
    Subject: TOE Probe covers

    Does anyone have information on the use of probe covers in diagnostic ultrasound, specifically for TOE probes and where to obtain these?

    The WA Health dept has released an Operational directive for Prevention of Cross Infection in Ultrasound and states that all intracavity ultrasound transducers must be covered before insertion. We have been unable to find a suitable cover for the TOE probes and the one we have used does not allow adequate visualisation during the procedure.

    Do other states have this requirement?

    Kind regards,

    Barbara Elliott I Coordinator Infection Prevention & Control I St John of God Subiaco Hospital

    Level 3, 12 Salvado Road SUBIACO WA 6008
    P: 08 9382 6871 F: 08 9382 6785 M: 0413706384 E: barbara.elliott@sjog.org.au
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    in reply to: TOE Probe covers #69699
    Diane Hobday
    Participant

    Author:
    Diane Hobday

    Position:

    Organisation:

    State:

    Hi Barbara
    Not sure about all other states without going in to check each one, but Victoria has a ‘should’ on covers for all transducers:
    “Transvaginal, transrectal and transoesophageal ultrasound probes…should be covered for the procedure with a disposable impermeable cover.”

    Ref RICPRAC Infection Prevention & Control Manual, 3rd Ed 2008, p 22 of section 9.1: Cleaning Disinfection and Sterilisation of Reusable Medical
    Equipment

    It may be worthwhile contacting a Victorian cardiology practice.

    I’m fairly certain that most states have something similar.
    Cheers
    Diane Hobday

    Accreditation Manager – DIAS
    National Association of Testing Authorities, Australia
    1/675 Victoria Street
    Abbotsford VIC 3067

    03 9274 8200
    http://www.nata.com.au

    Does anyone have information on the use of probe covers in diagnostic ultrasound, specifically for TOE probes and where to obtain these?

    The WA Health dept has released an Operational directive for Prevention of Cross Infection in Ultrasound and states that all intracavity ultrasound transducers must be covered before insertion. We have been unable to find a suitable cover for the TOE probes and the one we have used does not allow adequate visualisation during the procedure.

    Do other states have this requirement?

    Kind regards,

    Barbara Elliott I Coordinator Infection Prevention & Control I St John of God Subiaco Hospital

    Level 3, 12 Salvado Road SUBIACO WA 6008
    P: 08 9382 6871 F: 08 9382 6785 M: 0413706384 E: barbara.elliott@sjog.org.au
    [cid:BOQYKCOCVCTH.IMAGE_8.jpg]

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