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Hi Sonja,
I would recommend you refer to both the ASID/AICA position statement – Infection control guidelines for patients with Clostridium difficile infection in healthcare settings (link here http://www.publish.csiro.au/hi/HI11011 ) and to the Hand hygiene Australia website (link here http://www.hha.org.au/About/ABHRS/abhr-limitations.aspx ) which provide guidance re hand hygiene requirements for C. difficile.
While alcohol is not effective against C. difficile spores it is effective against the vegetative form of the bacteria. Spores are a survival mechanism of this organism for when times get tough (so to speak).
HHA recommends that “gloves should be used during the care of patients with CDI, to minimise spore contamination, and if hands become soiled, or gloves have not been used, then hands must be washed with soap and water.”Regards,
Donna
………………………………………………………………………..
Donna Cameron | Infection Control Consultant
Microbiological Diagnostic Unit
Public Health Laboratory | Department of Microbiology & Immunology
The University of Melbourne, Building 248, Level 1, 792 Elizabeth Street, Melbourne, 3010, VIC
Telephone +61 3 8344 3574 | Fax +61 3 8344 7833
Website http://www.mduphl.unimelb.edu.au/
[cid:image001.jpg@01D0A504.C7427D20]
This email and any attachments may contain personal information or information that is otherwise confidential or the subject of copyright. Any use, disclosure or copying of any part of it is prohibited. The University does not warrant that this email or any attachments are free from viruses or defects. Please check any attachments for viruses and defects before opening them. If this email is received in error please delete it and notify us by return email.Hello all,
I’m interested in how healthcare facilities go about Clostridium positive patients and Hand Hygiene products. As ABHR is not efficient with C-diff, we advise staff to mainly use water and soap for their 5 moments of hand hygiene rather ABHR, especially when leaving patient and patient environment. Also emphasising daily cleaning of high touch areas with sporicidal product.
Now it came to my attention, that ward manager completely removing ABHR from C-diff positive patients environment and expect staff to only use water hand soap for their HH. This is an issue on our ICU ward and I’m currently working on a practical advice/solution.
I’m greatly appreciating any practical help/advice.
Regards
SonjaSonja Wegert | Infection Control Practitioner (ICP)
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hospital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517977
e … sonja.Wegert@nt.gov.au http://www.nt.gov.au/healthMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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Hi Heather,
All Victorian public hospitals contribute data to VICNISS, including SSI data where relevant. VICNISS implemented this change several years ago for a number of surgery types. Perhaps if you contacted VICNISS directly they may be able to provide you with feedback.
I suspect that infection data won’t be greatly affected by the change as the majority of infections, including deep/organ space joint infections, occur within a couple of months of the surgery. In my experience, very few infections, if any, first occurred later than 90 days post surgery. The other problem with a very long follow up period is how attributable the infection really is to the original surgery. Could an infection of an implant have been seeded from another infection site source?
Regards,
Donna
………………………………………………………………………..
Donna Cameron | Infection Control Consultant
Microbiological Diagnostic Unit
Public Health Laboratory | Department of Microbiology & Immunology
The University of Melbourne, Building 248, Level 1, 792 Elizabeth Street, Melbourne, 3010, VIC
Telephone +61 3 8344 3574 | Fax +61 3 8344 7833
Website http://www.mduphl.unimelb.edu.au/
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This email and any attachments may contain personal information or information that is otherwise confidential or the subject of copyright. Any use, disclosure or copying of any part of it is prohibited. The University does not warrant that this email or any attachments are free from viruses or defects. Please check any attachments for viruses and defects before opening them. If this email is received in error please delete it and notify us by return email.Dear Colleagues
The CDC changed the definition of a hospital acquired surgical site infection of a joint replacement from 1 year to 90 days.
Have all hospitals adopted this new protocol?
I would also be interested to know what brought about this change, and is this generally considered a positive change.Kind regards
Heather
Heather Warfield
Infection Prevention & Control
Surgical site surveillance
Canberra Hospital
building 10, level 4———————————————————————–
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Hi Sam,
This is also a link that was sent out on Infexion Connexion a couple of years ago about hand dryers vs towel.
Regards,
Donna
………………………………………………………………………..
Donna Cameron | Infection Control Consultant
Microbiological Diagnostic Unit
Public Health Laboratory | Department of Microbiology & Immunology
The University of Melbourne, Building 248, Level 1, 792 Elizabeth Street, Melbourne, 3010, VIC
Telephone +61 3 8344 3574 | Fax +61 3 8344 7833
Website http://www.mduphl.unimelb.edu.au/
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Hi Sam
Jon Otter blogged on this recently.
https://reflectionsipc.com/2016/04/20/are-hand-dryers-safe-for-clinical-settings/
Cheers
Regards
Philip Russo| PhD Scholar
School of Public Health | Institute of Health and Biomedical Innovation
Queensland University of Technology | 60 Musk Ave, Kelvin Grove, QLD 4059 | Australia
CRE-RHAI
Good Afternoon,
I am seeking information about the use of air blowing hand driers in ACF. A local ACF has approached me for assistance is having them removed due to the aerosols generated. I understand that paper towel is the preferred drying option, however there is nowhere i can find anything that states air blown hand driers are inappropriate.
Can anyone help me please?
Thank you.
Kind regardsSam Kelly
Public Health Officer | Infection Control| Communicable Disease Control
Health Protection Service | Population Health| ACTHealth
25 Mulley Street Holder ACT | Locked Bag 5005 Weston Creek ACT 2611
T 02 6205 1376 | M0409 986 167 | Esam.kelly@act.gov.au| Website |———————————————————————–
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Hi Cate,
I would recommend you refer to the Victorian Guidelines for the classification and design of isolation rooms in health care facilities (https://www2.health.vic.gov.au/about/publications/policiesandguidelines/Guidelines%20for%20the%20classification%20and%20design%20of%20isolation%20rooms%20in%20health%20care%20facilities%20Victorian%20Advisory%20Committee%20on%20Infection%20Control%202007)https://www2.health.vic.gov.au/about/publications/policiesandguidelines/Guidelines%20for%20the%20classification%20and%20design%20of%20isolation%20rooms%20in%20health%20care%20facilities%20Victorian%20Advisory%20Committee%20on%20Infection%20Control%202007https://www2.health.vic.gov.au/about/publications/policiesandguidelines/Guidelines%20for%20the%20classification%20and%20design%20of%20isolation%20rooms%20in%20health%20care%20facilities%20Victorian%20Advisory%20Committee%20on%20Infection%20Control%202007
There is no requirement for HEPA filters on either the supply or exhaust air (see pages 9-10). If your negative pressure rooms will be used by very immunosuppressed patients (e.g. in a haematology unit) then you may want to consider having a HEPA on the supply air. The facility I worked in previously (Austin Health) did fit 2 neg pressure rooms with HEPA filter supply air in the Olivia Newton John Cancer and Wellness Centre because of the patient population.
The guideline does state “HEPA filters should be installed on exhausts only if the requirements of AS1668.2 cannot be met due to physical limitations of an exiting building. If HEPA filters are installed, high efficiency deep bed filters shall be installed to protect the HEPA.” In other words HEPA filters are only required if the exhaust air cannot be located far enough away for supply air intakes. Deep bed filters are essential if HEPA filters are installed on the exhaust air as the HEPA filters become clogged very quickly with all the lint and dust drawn through them (a neg pressure room is the dust and lint sink for a ward!).
Experience with negative pressure rooms that have exhaust air HEPA filters has taught me to try to avoid this at all cost!
Regards,
Donna………………………………………………………………………..
Donna Cameron | Infection Control Consultant
Microbiological Diagnostic Unit
Public Health Laboratory | Department of Microbiology & Immunology
The University of Melbourne, Building 248, Level 1, 792 Elizabeth Street, Melbourne, 3010, VIC
Telephone +61 3 8344 3574 | Fax +61 3 8344 7833
Website http://www.mduphl.unimelb.edu.au/
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________________________________Hi everyone,
Can anyone clarify whether HEPA filters go on the supply line or exhaust line in Negative pressure rooms? Or both?The International Health Facility Guidelines says both esp if there are immunosuppressed and infectious pts, however has a table which states not required for supply air.
ThanksCate 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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Hi Ruth,
It actually isn’t a requirement in either the 2013 ACSQHC CRE guideline (http://www.safetyandquality.gov.au/wp-content/uploads/2013/12/MRGN-Guide-Enterobacteriaceae-PDF-1.89MB.pdf ) or the recently released Victorian guideline on carbapenemase-producing Enterobacteriaceae (https://www2.health.vic.gov.au/public-health/infectious-diseases/infection-control-guidelines/carbapenemase-producing-enterobacteriaceae-management) to screen all patients for CRE/CPE with a recent travel history only. The recommendation is, as you appear to already be doing, to screen all patients directly transferred from overseas hospitals and all patients who have had an overnight admission to a hospital or residential care facility in the previous 12 months.
The ACSQHC CRE guideline is in the process of being updated and should be released soon, but I am not aware that the screening requirements will change to include anyone who has travelled overseas in the previous 12 months.
I am also not aware of any hospitals in Victoria that would be undertaking this level of screening as they would also not have the ability to pre-emptively isolate that many patients until cleared either (and it also not required by the Vic CPE guideline). It is a huge undertaking to attempt to screen all patients who have a recent overseas travel history. If they really want to go down that path then it would be better to risk assess which countries present the greatest risk of acquiring CPE from just travelling to them and/or choose which hospital admissions it is more relevant to (e.g. pre TRUS biopsies etc).
Regards,
Donna
………………………………………………………………………..
Donna Cameron | Infection Control Consultant
Microbiological Diagnostic Unit
Public Health Laboratory | Department of Microbiology & Immunology
The University of Melbourne, Building 248, Level 1, 792 Elizabeth Street, Melbourne, 3010, VIC
Telephone +61 3 8344 3574 | Fax +61 3 8344 7833
Website http://www.mduphl.unimelb.edu.au/
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This email and any attachments may contain personal information or information that is otherwise confidential or the subject of copyright. Any use, disclosure or copying of any part of it is prohibited. The University does not warrant that this email or any attachments are free from viruses or defects. Please check any attachments for viruses and defects before opening them. If this email is received in error please delete it and notify us by return email.Hello to my Australian colleagues,
We have recently experienced a CRE outbreak involving 4 patients that was not associated with any overseas hospitalisation or travel . A laboratory colleague who recently attend a conference in Melbourne advises that it is the norm now in Australian acute hospitals to screen all patients who have travelled overseas for CPO/CRE as per the ACSQH 2013 guidelines for CRE. We are coming under pressure to introduce this.
We currently screen all patients who have had an overseas hospital stay within the previous 12 months but if we were to screen all travellers as well, we would not be able to isolate them pending screening results and I am not sure how cost effective the screening would be versus positive results.I am interested to know if most Australian acute hospitals actually do this extended screening and if so how you were able to get buy in from the nursing staff.
Cheers
Ruth
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Ruth Barratt RN, BSc, MAdvPrac (Hons)
Clinical NurseSpecialist Infection Prevention and Control
Community Liaison Infection Prevention
*: ruth.barratt@cdhb.health.nz
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[1098272744j4O36h]: 0275 263175
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