[Donna Cameron]

Hi Vanessa,

It is currently part of the Victorian Stay at Home Directions (restricted areas) that everyone is required to wear a face covering. There are exemptions to this if you look at the document I have provided the link for (see Face covering requirements). Unless it is an OHS risk, I cannot see any exemptions that would allow them not to have to wear a face covering/mask. It is not just about protecting the residents of the facility but the other staff members who they will be in contact with as well.

If you wish to seek an exemption for them, you will need to contact the COVID Directions team at the Department of Health.

Regards,
Donna

Donna Cameron
Infection Control Consultant
Microbiological Diagnostic Unit Public Health Laboratory

T +61 (0)3 8344 3574
donna.cameron@unimelb.edu.au

The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au

________________________________

Hello Clever People
At our Residential Aged Care Facility we have an ongoing issue with chefs and kitchen hands not wearing their masks correctly whilst they are preparing resident meals.

Has anyone completed a risk assessment allowing those working in the kitchen and not having resident contact to not have to wear a mask?

I am getting tired of the ongoing non compliance and wonder if there maybe other facilities who have given them an exemption?

Many thanks
Vanessa Watkins
RN, Quality Manager & IPC Lead
Donwood Aged Care
Croydon, Vic
quality@donwood.com.au
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[Donna Cameron]

Hi Vanessa,

There is information about the sequence for PPE donning and doffing and where surgical masks and p2/N95s should be removed in the Australian Guidelines for the Prevention and Control of Infection in Healthcare found here Australian Guidelines for the Prevention and Control of Infection in Healthcare (2019) | NHMRC

See section 3.3 Personal protective equipment.

Regards,
Donna

Donna Cameron
Infection Control Consultant
Microbiological Diagnostic Unit Public Health Laboratory

T +61 (0)3 8344 3574
donna.cameron@unimelb.edu.au

The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au

________________________________

Hello All You Clever People
I am trying to provide a rationale re doffing mask after you have exited a residents room when the resident is in isolation.

The person insists that you remove ALL PPE whilst in the infectious room. In aged care there is no ante room for doffing so you are either in an infectious environment or outside the room.

I have tried to explain that you doff all PPE except for mask in the residents room and remove mask when outside their room.

Can anyone point me to a document that says this – or am I wrong?

Many thanks
Vanessa Watkins
RN, Quality Manager, IPC Lead
Donwood Aged Care
Croydon, Victoria

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[Donna Cameron]

Hi Glenda,

I would recommend you look at the following documents on the Victorian Department of Health’s website (here Department of Health and Human Services Victoria | Infection prevention control resources (dhhs.vic.gov.au):

* COVID-19 Infection prevention and control guidelines
* COVID-19 cleaning guidelines for workplaces (under cleaning tab)

Both provide very good advice regarding cleaning and disinfection after COVID-19 cases.

If you have any further queries, I recommend you contact the Infection Prevention and Control Advice and Response (IPCAR) team at the department via email COVID19InfectionControl@health.vic.gov.au .

Regards,
Donna

Donna Cameron
Infection Control Consultant
Microbiological Diagnostic Unit Public Health Laboratory

T +61 (0)3 8344 3574
donna.cameron@unimelb.edu.au

The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au

________________________________

Hi all,
I am seeking DDHS information on management of cleaning and disinfection after a COVID-19 case in a healthcare setting.

I have a copy of How to clean and disinfect after a COVID-19 case in non-healthcare settings -19 Sept 2020

It appears that the information given to dental practices is quite different from the information in this document.

Appreciate any current requirements that are being placed on healthcare settings.

kind regards
Glenda Farmer
Infection control
SmartDentist P/L
Victoria
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[Donna Cameron]

Hi Sara,

I suggest you send a query to the Infection Prevention and Control Advice & Response (IPCAR) Team at the department who are responsible for this guideline. Their email inbox for queries is COVID19InfectionControl@health.vic.gov.au

Regards,
Donna

Donna Cameron
Infection Control Consultant
Microbiological Diagnostic Unit Public Health Laboratory

T +61 (0)3 8344 3574
donna.cameron@unimelb.edu.au

The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au

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________________________________

Hi everyone,
I was wondering if there is anyone in this group that was part of the development of the DHHS COVID-19 Infection prevention and control guidelines – June edition?
I am seeking clarification regarding the cleaning requirements in section 9, specifically section 9.4 and 9.5 and which settings/clients these requirements relate to.
We are getting conflicting information from different authorities / bodies as to whether cleaning is sufficient, or whether we should be cleaning & disinfecting after outpatient client consults.
If anybody is able to assist, it would be greatly appreciated.
Thanks
Sara Nannery
OHS, Risk & IPC Coordinator
Sunbury Cobaw Community Health

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[Donna Cameron]

Hi Catherine,

I am assuming you dedicate slings to one resident at a time and they are not being shared between residents. If they are being shared they should really be laundered before use on another resident.

If not shared, there is no hard and fast rule for the frequency of laundering such items when used for the one resident. How frequently do you launder residents’ bed linen (I presume this is not daily either unless soiled)? Slings could be laundered less frequently. You may also need to take into account how long it takes for them to be laundered and returned in time for reuse (e.g. in-house vs off-site laundering service) or do you have sufficient extra slings that they can be rotated more frequently.

Regards,
Donna

Donna Cameron
Infection Control Consultant
T +61 (0) 3 8344 3574
donna.cameron@unimelb.edu.au
Microbiological Diagnostic Unit Public Health Laboratory
The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au

Hi Michael,
Could you please put this out as a question.
Can anyone tell me how often hoist slings should be washed, (apart from when they are obviously soiled) ?
With thanks,
Catherine Dunn
IPC Lead
Fairway Bayside Aged Care
195 Bluff Road
Sandringham. Vic 3191

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[Donna Cameron]

Hi Jenny,

Not that I have been in charge of running a COVID Screening clinic but I have attended a screening clinic a few times to have a test taken. The clinic I attended had the client/patient wipe down the chair they had been sitting on when they were called in to be tested. There were disinfectant wipes located around the waiting area for them to use and you were reminded by the nurse in the waiting area to use the wipes before going in to have your swab taken. There was also signage up requesting that you do that when called in.

Regards,
Donna

Donna Cameron
Infection Control Consultant
T +61 (0)3 8344 3574
donna.cameron@unimelb.edu.au

Microbiological Diagnostic Unit Public Health Laboratory

The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au

________________________________

Good Morning,

We have been asked to benchmark other Covid Screening clinics to see if they clean the chairs between each patient.

We have not routinely been doing this primarily due to the large volume of patients being seen however the clinic does receive a deep clean every evening.

Many thanks

Jenny Breen

Infection Prevention & Control CNC

Eastern Health

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[Donna Cameron]

[Donna Cameron]

[Donna Cameron]

Hi Erin,

You need to follow your state’s guidelines and regulations. I am unable to tell from your email which state you are in but further information regarding clinical waste for Victoria can be found at:

The Department of Health: Clinical and related waste – health.vic

The Victorian EPA: About clinical and related waste | Environment Protection Authority Victoria (epa.vic.gov.au) and
IWRG612.1: Clinical and related waste operational guidance | Environment Protection Authority Victoria (epa.vic.gov.au)

If the person is changing their own dressings then they can go into their home general waste. Usually, if the waste has been generated by a HCW undertaking healthcare in their home (e.g., a nurse changing dressings) then it may need to be taken back to the HCW’s organisation and disposed of as clinical waste.

Regards,
Donna

Donna Cameron
Infection Control Consultant
T +61 (0)3 8344 3574
donna.cameron@unimelb.edu.au

Microbiological Diagnostic Unit Public Health Laboratory

The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au

________________________________

Hi
I am reaching out to my IPC colleagues on where I can find current information on disposal of dressings (clinical waste) for a person who is MRSA positive and living in their own home. I have been unable to find guidelines or legislation sarround this.

Erin Sharp
Head of Care & Health
0404 895 224

esharp@grouphomes.com.au
headofcare@grouphomes.com.au

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[Donna Cameron]

[Donna Cameron]

Hi Kirsty,

There are the Australian Physiotherapy Association Australian guidelines for aquatic physiotherapists working in and/or managing hydrotherapy pools (which provides some infection control guidance). Found here: https://australian.physio/sites/default/files/tools/Aquatic_Physiotherapy_Guidelines.pdf

I would also contact your local public health unit or council to see if there are specific state regulations for the management of such facilities as well.

Regards,
Donna

Donna Cameron
Infection Control Consultant
donna.cameron@unimelb.edu.au

Microbiological Diagnostic Unit Public Health Laboratory

The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au

________________________________

Hi all
We are reviewing our management of our Hydrotherapy Pools and wondering if there is any IPC expert guidance in this area.
Would welcome any risk assessments from any of our colleagues.
Cheers
Kirsty

Kirsty Graham

Nurse Manager | CCLHD Infection Prevention and Control Unit
Clinical Safety, Quality and Governance Directorate
Level 4 (J4 POD D), Gosford, New South Wales 2250
Tel (02) 4320 3382 (Internal 93382)|Mobile 0407 749 034|Fax (02) 4320 2874 |Pager 18028 |
kirsty.graham@health.nsw.gov.au or CCLHD-IPAC@health.nsw.gov.au
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[Donna Cameron]

Hi Glenys,

It will be in the next version of the Vic DHHS COVID-19 guideline (V4) which should be uploaded to the website in the next 24 hours.

Regards,
Donna

Donna Cameron
Infection Control Consultant
donna.cameron@unimelb.edu.au

Microbiological Diagnostic Unit Public Health Laboratory

The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au

________________________________

Hi Noleen,

Has formal notification been issued to all healthcare facilities including aged care facilities as in Victoria?

Is the information available online at the DHHS VIC Coronavirus web page?

https://www.dhhs.vic.gov.au/coronavirus

I have had a look bit dont see it anywhere? Clean advice needs to be available in a public forum (i.e. DHHS VIC Coronavirus web page) not just a members forum.

Many thanks in anticipation.

Glenys

Glenys Harrington

Consultant

Infection Control Consultancy (ICC)

P.O. Box 6385

Melbourne

Australia, 3004

M: +61 404816434

E: infexion@ozemail.com.au

[Description: ICC Diagram ICCversion]

Hello all

The Victorian DHHS Infection Control cell recently provided the following advice about showering COVID positive patients/residents

Scientific Background

Shower water and aerosolised shower mist are a potential media of infection, as showering may produce bioaerosols. However, this has largely been proven in relation to specific pathogens such as legionella species and certain fungal species.1

SARS-CoV-2 has been isolated from wastewater in a shower siphon in quarantined households. It has been hypothesised that aerosolisation of virus from wastewater may be possible. However, this risk is largely theoretical and it is not known if virus found in wastewater is viable.2

1. Prussin AJ, Marr LC. Sources of airborne microorganisms in the built environment. Microbiome. 2015 Dec 1;3(1):78.
2. Dhla M, Wilbring G, Schulte B, Kmmerer BM, Diegmann C, Sib E, Richter E, Haag A, Engelhart S, Eis-Hbinger AM, Exner M. SARS-CoV-2 in environmental samples of quarantined households. medRxiv. 2020 Jan 1.

Interpretation

In the shower environment, the water stream may generate droplets that arise from the patients skin. It is plausible that infected patients may have skin contamination with SARS-CoV-2. Shower cubicles may have poor to limited ventilation and showering may wet masks being worn by healthcare workers potentially disrupting mask integrity.

Assessment & Guidance

* Showering of COVID-19 infected cases is not in itself a high-risk activity. The risks of infection transmission are largely theoretical.
* The risk of infection transmission can best be mitigated by using a gentle stream of water from a handheld shower head, which would reduce the risk of droplet aerosolisation.
* Healthcare workers should wear a mask and face shield. The mask should be replaced after the shower.
* Individuals who are able to shower independently or who require minimal assistance with shower set-up should be allowed to shower at an allocated time.

Regards,

Noleen

Noleen Bennett

Infection Control Consultant

1.VICNISS Coordinating Centre/ National Centre for Antimicrobial Stewardship

Peter Doherty Institute for Infections and Immunity

792 Elizabeth St Melbourne VIC 3000 T: + 61 3 93429333

2. Department of Nursing, Melbourne School of Health Sciences

The University of Melbourne

Thanks for the question

I need advice for this too. Some facilities asking if appropriate to use plastic aprons under PPE gown when showering clients and confirmation if both needed to be single use or if plastic apron underneath could be washed in washing machine.

Tanya Hempshall

DHHS COVID -19 Outreach Team Registered Nurse

COVID-19 Public Health Division

1300 651 160 | 0429131756 | tanya.hempshall@dhhs.vic.gov.au

DHHS-M-COVID-19-IMT-Outreach-Team@dhhsvicgovau.onmicrosoft.com

Department of Health and Human Services | 50 Lonsdale St, Melbourne VIC 3000

Could I please get some advice regarding

1. Showering or not showering covid residents in a RACF setting
2. Should Overshoes be worn during showering and does anyone have a system in place for donning and doffing with overshoes?

Thankyou

Chris

Chris Giles

0439 437 169

T: (02) 4736 9500 F: (02) 4736 9599

E: Christine.Giles@anglicare.org.au

W: http://www.anglicare.org.au

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[Donna Cameron]

Hi Sue,

In Victoria, the guidance re how long to leave a room after an aerosol generating procedure (AGP) has taken place (which is what I assume you are indicating by how long to leave the Cath lab vacant for) is 30 minutes. This is not predicated on the room being HEPA filtered. This is also National guidance. Victorian guidance on PPE (which also provides advice about how long to leave a room) can be found in the Healthcare worker PPE guidance for performing clinical procedures on the DHHS website here https://www.dhhs.vic.gov.au/health-services-and-general-practitioners-coronavirus-disease-covid-19

If an AGP has not taken place you do not need to leave the room to clear.

CDC also have a table that provides information about how long a room needs to be left determined by the number of air exchanges per hour, but as many facilities may not know this the general advice is to leave a room for 30 minutes. Link to table below FYI.

https://www.cdc.gov/infectioncontrol/guidelines/environmental/appendix/air.html

Regards,
Donna

Donna Cameron
Infection Control Consultant
T +61 (0) 3 8344 3574 (Monday, Wednesday & Friday); +61 (0) 3 9096 5233 (Tuesday & Thursday)
donna.cameron@unimelb.edu.au

Microbiological Diagnostic Unit Public Health Laboratory

The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au

________________________________

Hi all

Can anyone help me with the above issue?

The Lab is NOT Hepa filtered.

Kind Regards,

Sue

HI Sue,

I have been to several public hospitals in NSW in the last 2 weeks. The nurses were only in masks and gloves. What is your state Gov policy? Given you are only asking questions & temp checking, not swabbing, you should not need full kit.

Cheers

Karen

Karen Booth

RN BHSCN GAICD

President APNA

Australian Primary Health Care Nurses Association

M: 0411 898 884

karenbooth1@bigpond.com

Australian Primary Health Care Nurses Association (APNA)
Level 17/350 Queen Street, Melbourne VIC 3000
p: 1300 303 184 f: (03) 9322 9599
president@apna.asn.au | http://www.apna.asn.au

[cid:image001.png@01D61E6B.4D2172E0]

Hi Michael and all,

Thank you for the information this morning.

Do you know where I can find information in any guidelines regarding the minimal requirement of PPE for staff screening other staff entering a hospital?

Our staff are currently wearing gowns, gloves, goggles and a surgical mask at the entry points to the hospital.

This is seriously depleting PPE stock.

If anyone can help it would be most appreciated.

Regards,

Sue King
Nurse Unit Manager/ICp warringal private and donvale rehabilitation hospitals

[http://www.ramsayhealth.com/~/media/Images/email/email-RHC-logo]

Donvale Rehabilitation Hospital
Tully Ward

Phone:

03 9841 1272

Fax:

03 9842 7276

Email:

KingS@ramsayhealth.com.au

Web:

http://www.ramsayhealth.com

Address:

1119 Doncaster Road, Donvale Vic 3111

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For those who are looking for the advice from the Commission mentioned here, it is attached.

Cheers

Michael

Michael Wishart | Infection Control Coordinator, CICP-E

St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032

T +61 7 3326 3068 | F +61 7 3607 2226

E michael.wishart@svha.org.au |

W https://www.svphn.org.au

[cid:image001.jpg@01D61D4A.89A86BF0]

Hi team

Weve all no doubt implemented screening of patients since the beginning of this ride we find ourselves on, and now NSQHS has put out a questionnaire for patients presenting for elective surgery or investigations.

Can I please ask for some clarity on one of the questions, as we are the ones screening the patient pre-procedure at our facility?

Have you been told that you had COVID19? Should we not then ask how long ago was that notification and have you had two negative swabs since the initial diagnosis? If they are negative then I see no reason to prevent them from having the procedure/investigation.

Were you a close contact of a person who is known to have COVID19? Should we then ask, has this person returned a negative swab? Do we need to be concerned how long ago that negative swab was taken? (If only 2 days ago, should we wait at least 14days post this before the patient can then be re-screened again to check if any transmission has taken place)?

I appreciate your help and guidance with this query.

Kind Regards

Teresa Lewis

Infection Prevention & Control CNC

Tuesday 08:00 16:30

Infection Prevention is everybodys business, and it only takes 5 Moments

[cid:image002.png@01D61D37.CE6460E0]

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[Donna Cameron]

The Victorian Department of Health and Human Services has also put out guidance regarding rational use of PPE, based on a WHO document. Both of these documents can be downloaded from the Vic DHHS website (link below). Look under the ‘Resources for health professionals’ tab.

https://www.dhhs.vic.gov.au/health-services-and-general-practitioners-coronavirus-disease-covid-19

I would not recommend spraying masks and reusing them. They are made out of paper and I cannot imagine that their integrity could or would be guaranteed after doing so.

Regards,
Donna

Donna Cameron
Infection Control Consultant
T +61 (0) 3 8344 3574 (Monday, Wednesday & Friday); +61 (0) 3 9096 5233 (Tuesday & Thursday)
donna.cameron@unimelb.edu.au

Microbiological Diagnostic Unit Public Health Laboratory

The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au

________________________________

Hi all

FYI, the CEC has developed a mask utilisation priority during pandemic planning and response.

http://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0004/570577/Mask-utilisation-priority-during-pandemic-planning-and-response-March-2020.pdf

Kind regards

Meredith Southon

Meredith Southon RN MIPC QualNursImm

Clinical Nurse Consultant | Infection Prevention & Control | Staff Health | Murwillumbah District Hospital

PO Box 821, Murwillumbah NSW 2484
Tel 02 6672 0232 | Fax 02 6672 0226 | Meredith.Southon@health.nsw.gov.au

http://www.health.nsw.gov.au

[Description: http://internal.health.nsw.gov.au/communications/e-signatures/images/NSW-Health-Northern-NSW-LHD.jpg%5D

[cid:image003.jpg@01D5FE0F.C688DB40]

Dear All,

NSW Private Hospitals have been informed that the government stockpile of masks will not be available for private hospitals, also that unless a patient is medically unable to be cared for at the private hospital facility, they are not to transferred to a public hospital.

Whilst we are not out of supplies of masks, if we were to have many patients diagnosed with COVID-19, we would struggle with supply, particularly with surgical masks. We are not a surgical hospital, rather, medical, post surgical, rehab & palliative care.

During the SARS outbreak, masks were reportedly re-used, after spraying with a disinfectant and bagging for a nominated period of time. There has also been talk of hand made masks for low risk situations.

Im wondering what other facilities are experiencing?

Regards,

Susan

Susan Farrugia

Infection Control Coordinator

Arcadia Pittwater Private Hospital

Infectioncontrol@arcadiapittwater.com.au

[cid:image001.jpg@01D5E7F7.A43D0B20]

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[Donna Cameron]

Hi Cate,

Droplet and contact precautions, which includes use of eye protection, are recommended for routine care of COVID-19 patients as outlined in both the CDNA SoNG and Interim recommendations for the use of personal protective equipment (PPE) during hospital care of people with Coronavirus disease (COVID-19). The use of droplet and contact precautions is also recommended for cleaners when cleaning in COVID-19 patient rooms (which I assume is what housekeeping staff are?). I haven’t seen any guidance to suggest different PPE for different staff or when undertaking different activities in the rooms of patients with COVID-19, except for using P2 respirators for aerosol generating procedures or when there may be prolonged close contact.

Many facilities have a guideline/policy that catering staff don’t enter patient rooms when in transmission-based precautions or restrict which rooms they can enter (e.g. only enter contact transmission rooms, not droplet or airborne) so that they don’t have to don and doff PPE. Meals may be left outside the room and nursing staff take the meals into the patient.

Unless you can adequately train staff to don/doff their use of PPE may be more hazardous that not using any, particularly when removing PPE.

Regards,
Donna

Donna Cameron
Infection Control Consultant
T +61 (0) 3 8344 3574 (Monday, Wednesday & Friday); +61 (0) 3 9096 5233 (Tuesday & Thursday)
donna.cameron@unimelb.edu.au
Microbiological Diagnostic Unit Public Health Laboratory
The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au

HI everyone
Just wanting some clarity regarding the use of eye protection PP for COVID-19. Do housekeeping and catering staff required eye protection when they enter a room with COVID-19 transmission based precautions? Should t be the following :

* Airborne TBC for COVID-19 PPE includes;
* Long sleeved gown
* P2/N95 respirator (duck bill mask) – must be fit checked with each use
* Face shield or goggles if

-Taking respiratory specimens

-Patient has excessive coughing

-Patient has pneumonia

* Gloves (Hand hygiene before donning and after removing gloves)

See below from SoNg.

Coronavirus Disease 2019 (COVID-19)
CDNA National Guidelines for Public Health Units
States

For most inpatient contacts between healthcare staff and patients the following PPE is safe and appropriate and should be put on before entering the patient’s room:

o long-sleeved gown

o surgical mask

o face shield or goggles

o disposable nonsterile gloves when in contact with patient (hand hygiene before donning and after removing gloves)

Cate Coffey
Clinical Nurse Manager

Central Australia Health Service
Department of Health
Northern Territory Government

Infection Prevention and Control Unit
Alice Springs Hospital
PO Box 2234, Alice Springs, NT 0871

t. 08 8951 7737
http://www.health.nt.gov.au

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