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Another issue, probably greater than the potential risk of disease transmission, is cleaning. By adding a lid you have added two extra surfaces to clean and more hinges. Also, there is an assumption that people will actually lower the lid when flushing the toilet.
I think it would be good to actually try and quantify the risk of disease transmission – from what I have read it is a potential risk rather than an actual riskand things such as poor hand hygiene and environmental cleaning play much greater roles.Regards
Fiona Wilson I Clinical Nurse Consultant
Public Health Services I Department of Health and Human Services
3/25Argyle St Hobart, GPO Box 125 Hobart 7001
Phone (03) 6166 0601| Mobile 0439 014 634 | Fax (03) 6233 0553
Prevention is better than cureFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
Sent: Monday, 4 December 2017 4:39 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Toilet lidsOur hospital architect raised an interesting point. We had disabledaccess toilets installed in our new day oncology unit. With these toilets, they had to have a certain backrest fitted. We found that toilet lids wouldnt stay up on these toilets because of the back rest, but the oncology staff were adamant that the toilets in the unit had to have lids. So, even though the toilets are now non-compliant for disabled access, the back rest was removed as it was considered the risk of plume contain chemotherapeutic agents was greater than the risk of not having a back rest.
Just another piece in this puzzle to ponder.
Cheers
MichaelMichael Wishart
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0]
P Please consider the environment before printing this emailFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Juraja, Marija (Health)
Sent: Monday, 4 December 2017 3:22 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Toilet lidsHi Leah,
We have toilet lids in both our newly built hospital and our sister hospital TQEH on all toilets, including bariatric.
The rationale we used for retaining them was exactly that with regard to plume and risk of transmission.
The commode/shower chair we use allows for the chair to sit over the toilet without causing any issues to the lid.
Its being selective and trying out the chair and pan base to make sure they fit so that you can still use the lid once the chair is pulled away.
Several articles below that highlight the potential for cross contamination from the plume when flushing.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692156/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4666014/
https://www.ncbi.nlm.nih.gov/pubmed/23040490
https://www.ncbi.nlm.nih.gov/pubmed/22137761Kind Regards
Marija Juraja |Nurse Unit Manager CALHN Infection Prevention & Control Unit|
Division of Acute Medicine (RN, GCNS Inf Ctrl, CICP-E)
t: +61 8 7074 2810 (RAH) 8222 7588 (TQEH)| M: 0466 379 821|e:marija.juraja@sa.gov.au |
Adjunct Clinical Lecturer | University of South Australia | Division of Health Sciences
[cid:image002.jpg@01D36D17.DBECC900]From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terri Cripps (SCHN)
Sent: Monday, 4 December 2017 12:12 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Toilet lidsI think that the lack of toilet lids is due to them being attributed to increased falls in the toilet when the patient is opening and closing the lids. The act of opening and closing the lids cause the patient to become unsteady and lead to falls. So to reduce the falls risk, the lids have been removed.
It also is easier to get commodes over the toilet if there is no lid.
I agree with you all about the plume when flushing be of concern but it seems that falls outweigh infection prevention and control issues.
Interesting point of discussion.
Thanks,
Terri Cripps | Clinical Nurse Consultant – Infection Prevention and Control | SCHN Medical Diagnostics and HIV/Immunology
t: (02) 9382 1876 | f: (02) 9382 2084 | e: TERRI.Cripps@health.nsw.gov.au | w: http://www.schn.health.nsw.gov.au
p: 47140
[http://res.schn.health.nsw.gov.au/signatures/sch.gif]
High Street, Randwick 2031, NSW Australia
Please consider the environment before printing this email.From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Kelly Barton
Sent: Monday, 4 December 2017 11:49 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Toilet lidsI think the lack of toilet lids is very widespread. After advising staff to put the lid down to flush during an outbreak I was advised there were no lids. I have been taking note when I am in other facilities in the last few years and have found that most places I have seen do not have them. Considering what we now know about plume and MROs becoming more difficult to treat I am surprised this has not come up more often. Current design of over toilet chairs and equipment would make it difficult for lids to close for flushing.
I have seen toilet systems overseas where there is a vacuum system of evacuating contents with minimal water used. I would assumes that there would be less plume generated with these, but have not seen any research/study on them.
Keen to hear of other approaches also.
Kelly
Kelly Barton
Infection Prevention & Control Officer
Monday- Friday
P Reduce, re-use, recycle. Please consider the environment before printing this e-mail.Ph: 03 5751 9364
Mob: 0409 885 002Fax: 03 5751 9396
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Van Someren, Leah M (THS)
Sent: Monday, 4 December 2017 10:02 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Toilet lidsHi everyone,
We are currently building a 10 storey hospital here in Hobart. The redevelopment team have recommended against installing lids on the toilets.
The Infection Prevention and Control team have recommended that all toilets have lids. We have based this decision on the evidence of toilet plume and the potentially increased risk of transmitting pathogenic organisms through environmental contamination.
We are interested in the approach taken in other hospitals.
If you are working in a newly developed hospital that has recommended toilets lids on all toilets we would particularly like to hear from you including what influenced your decision making.
Furthermore, we have heard that there are a number of new hospitals built or being built around Australia where toilet lids are either not installed, or installed only in specific locations. If you are working in a facility that did not recommend installing toilet lids in all locations, can you please share your rationale for this?
Thank you in advance.
Leah
Leah Van Someren
Clinical Nurse Consultant
Infection Prevention and Control ServiceTHS- Southern Region
PH: 61662704
Mobile: 0417 986 084
Email: leah.vansomeren@ths.tas.gov.au
Intranet page: http://www.dhhs.tas.gov.au/intranet/stho/cccs/infection_prevention_and_controlLevel 3 I Marine Board Building I 1 Franklin Wharf I Hobart 7000
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Hello Helen,
The ePoster example slide, template and guidelines are available on the website at http://acipcconference.com.au/abstracts
This should have been sent to you as it was communicated (and link provided) to accepted authors in their notification email.
Regards
Fiona Wilson I Clinical Nurse Consultant
Public Health Services I Department of Health and Human Services
3/25Argyle St Hobart, GPO Box 125 Hobart 7001
Phone (03) 6166 0601| Mobile 0439 014 634 | Fax (03) 6233 0553
Prevention is better than cureHello all:
Can anyone share some examples of ePosters? I’ve had an abstract accepted as an ePoster presentation for the ACIPC 2016 conference and am looking at how the info is best displayed, but can’t find much on the way of completed examples on the Internet. There are plenty of tips etc, but I would like to look at how a one minute long PPT format ePoster might look.
Kind regards
Helen
Helen Lorenz RN BScN | Associate Clinical Service CALHN Coordinator Infection Prevention & Control Unit | Division of Acute Medicine The Queen Elizabeth Hospital | Central Adelaide Local Health Network Level 8 Tower Building | 28 Woodville Road, WOODVILLE SOUTH 5011 t: +61 8 8222 7588| p: 47758| f: +61 8 8222 6461 | DX: 465432 |e: Helen.Lorenz@sa.gov.au
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Glad you like them Kelly. The TIPCU resources are freely available at http://www.dhhs.tas.gov.au/publichealth/tasmanian_infection_prevention_and_control_unit
Fiona Wilson I Clinical Nurse Consultant
Public Health Services I Department of Health and Human Services
3/25Argyle St Hobart, GPO Box 125 Hobart 7001
Phone (03) 6166 0601| Mobile 0439 014 634 | Fax (03) 6233 0553
Prevention is better than cureFantastic resource Stephane – thanks for sharing!
Kelly
Kelly Barton
Infection Prevention & Control Officer
Monday- Friday
P Reduce, re-use, recycle. Please consider the environment before printing this e-mail.Hi Cath,
Annie Wells from the Tasmanian Department of Health and Human Services circulated this link last year. There is many videos and one concerns aseptic technique.
https://www.dhhs.tas.gov.au/publichealth/tasmanian_infection_prevention_and_control_unitKind regards,
Stphane
Dr Stphane Bouchoucha
Lecturer in Nursing
School of Nursing and Midwifery, Faculty of Health[Title: Deakin University Worldly Logo]
Deakin University
Building Y, 2.30
Melbourne Burwood Campus, 221 Burwood Highway, Melbourne, VIC 3125
+61 3 92517429
s.bouchoucha@deakin.edu.au
http://www.deakin.edu.au
Deakin University CRICOS Provider Code 00113BHi All,
Has anyone found a good aseptic training video?
CheersCath Wade
Clinical Nurse Consultant | Infection Prevention and Control
Level 1, 67 Holden Street Gosford Hospital
Catherine.Wade@health.nsw.gov.au or CCLHD-IPAC@health.nsw.gov.au
[cid:image001.jpg@01D1EE30.75931770][cid:image002.jpg@01D1EE30.75931770]This message is intended for the addressee named and may contain confidential information. If you are not the intended recipient, please delete it and notify the sender.
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CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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Hi, it will be ready in early May it is just being tested to make sure there are no glitches.
Fiona Wilson I Clinical Nurse Consultant
Public Health Services I Department of Health and Human Services
3/25Argyle St Hobart, GPO Box 125 Hobart 7001
Phone (03) 6166 0601| Mobile 0439 014 634 | Fax (03) 6233 0553
Prevention is better than cureFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Claire Boardman
Sent: Friday, 29 April 2016 1:24 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Registration for ACIPC 2016Hi Cath,
As per the ACIPC conference website you could contact:
Conference Managers
For all enquiries please contact the team at Conference Design:
mail@conferencedesign.com.au
+61 3 6231 2999They would be sure to know.
The abstract portal is open and working.
Regards,
ClaireClaire Boardman | Deputy Director, RHDAustralia
BAppSc, Grad Cert IC, CICP, MPH
M +61 418 956 110 | T +61 8 8946 8651 | claire.boardman @menzies.edu.au | http://www.rhdaustralia.org.au |
PO Box 41096, Casuarina NT 0811 | John Matthews Building (Bldg 58), Royal Darwin Hospital Campus, Rocklands Drive, Casuarina, NT
RHD Australia is an initiative based at Menzies School of Health Research and funded by the Australian Government Department of Health.In the spirit of respect, Menzies School of Health Research acknowledges the people and the Elders of the Aboriginal and Torres Strait Islander Nations who are the Traditional Owners of the land and seas of Australia.
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Dr Cathryn Murphy
Sent: Friday, 29 April 2016 11:26 AM
To: AICALIST@AICALIST.ORG.AU
Subject: [ACIPC_Infexion_Connexion] Registration for ACIPC 2016Is anyone aware of when members will be able to register online for the conference. The website seems to not yet be ready?
Cathryn Murphy RN MPH PhD
Executive Director
Infection Control Plus Pty Ltd
PO Box 3079
Burleigh Town 4219
Queensland
AUSTRALIAE: Cath@infectioncontrolplus.com.au
Ph: +61 428 154154http://www.infectioncontrolplus.com.au
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Glenys Harrington
Sent: Thursday, 28 April 2016 14:34 PM
To: AICALIST@AICALIST.ORG.AU
Subject: FW: Mycobacterium chimaera update: A must listen from ECCMIDDear All,
For those following the Mycobacterium chimaera heater-cooler units you may find some of the answers you need in the following blog from the Controversies in Hospital Infection Prevention below.
The link to the presentation by Dr. Jakko van Ingen at ECCMID is well worth looking at – see link below.
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426From: noreply+feedproxy@google.com [mailto:noreply+feedproxy@google.com]
Sent: 15 April, 2016 4:21 PM
To: infexion@ozemail.com.au
Subject: Controversies in Hospital Infection PreventionControversies in Hospital Infection Prevention
________________________________
Mycobacterium chimaera update: A must listen from ECCMID
Posted: 14 Apr 2016 06:33 PM PDT
[Image removed by sender.]Weve posted several times about the horrible M. chimaera outbreak linked to heater-cooler units (HCUs) used during cardiac bypass surgery. As weve addressed the problem here at Iowa, weve become increasingly frustrated (and dumbfounded) at the lack of available information about the clinical and epidemiological features of the outbreak itself, and at the general lack of urgency about this ongoing and grave risk to patients.
Fortunately, Dr. Jakko van Ingen gave an excellent talk at ECCMID that answers several important questions weve had about this outbreak, confirming some of the things weve heard (in confidence, I assume for political or legal reasons) on various conference calls and email strings. I urge you to take 30 minutes of your time to listen to his talk, all the way to the end of the Q&A period.
Aside from being an extremely entertaining speaker, Jakko addresses several key questions, including:
Is this a clonal outbreak? YES. Slide 29 reports whole genome sequencing data that clusters the isolates from Sorin 3T units and infected patients (within just 2-3 SNPs), and further discussion (during Q&A session) confirms that isolates from other European countries are also in this cluster.
Were the HCUs already contaminated prior to being shipped to end users? YES. Listen carefully to the last question and answer.
Does this particular outbreak primarily involve one make/model of HCU? YES. While nontuberculous mycobacteria have been isolated from other types of HCUs, the specific M. chimaera cluster in this case involves Sorin 3T units.
Is the invasive, disseminated, high crude mortality form of the illness restricted to those patients with implants (e.g. valves, grafts)? YES. The life-threatening disseminated infection appears to require some prosthetic material to which the organism can adhere, protecting itself (via biofilm formation) from host defense. According to Dr. van Ingen, case finding in the Netherlands is now limited to those with implants, and does not include standard non-valve, non-implant CABG patients.
Is it possible to mount an effective, rapid national response to this urgent problem? YES. Slide 18 details the Dutch response, which involved discontinuing all non-urgent cardiac surgery until HCUs were placed outside of ORs (which was done within 48 hours). As we learned here when we did the same thing, it is amazing what you can accomplish when you are left with no other option.
Is opening up a Sorin 3T HCU a frightening experience? YES. Im sure Ill have nightmares about these water-stained, biofilm-befouled devices for a long time (see below for one image from Garvey, et al).
[Image removed by sender.]What are the implications?
HCUs are not safe to operate in an OR. The air exhausting from the HCU ventilation fan must be physically separated from the air in the OR, and the easiest way to do that is to remove them from the OR (and maintain the OR at positive pressure, of course).
Everyone using Sorin 3T HCUs should assume that they may have exposed patients to M. chimaera, until more is known about the details of the point-source. Contaminated units cannot be disinfected even with the more intensive protocols currently recommended. In addition, only a few labs are capable of properly performing NTM cultures of water samples, so negative water cultures are of limited value and could be falsely reassuring.
A much more active national patient and provider notification is needed. Our experience is similar to that of others: identified cases would never have been found had it not been for aggressive and active case-finding. There are undoubtedly others currently being treated with immunosuppression for sarcoidosis or some other granulomatous process of uncertain etiology who actually have undiagnosed disseminated M. chimaera disease.
Below I’ve pasted an epidemic curve, an underestimate as it involves only those cases reported to FDA from US (blue bars) and abroad (red). This outbreak isn’t over, not by a long shot, and the fact that there are still hospitals performing cardiac surgery with their Sorin 3T HCUs inside of the OR is extremely distressing.
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Hello Helen, in the Tasmanian State-wide Hand Hygiene Policy we have stipulated that employees and volunteers are to be bare below the elbows when providing patient care that entails physical contact or when performing any procedure on the patient and when performing hand hygiene. We decided not to stipulate that all employees needed to be bare below the elbows and that it was only essential when providing physical care and doing hand hygiene.
See http://www.dhhs.tas.gov.au/publichealth/tasmanian_infection_prevention_and_control_unit/information_for_healthcare_workers for our policy and procedure.Regards
Fiona Wilson I Clinical Nurse Consultant
Public Health Services I Department of Health and Human Services
3/25Argyle St Hobart, GPO Box 125 Hobart 7001
Phone (03) 6166 0601| Mobile 0439 014 634 | Fax (03) 6233 0553
Prevention is better than cureFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Helen Newman
Sent: Monday, 29 February 2016 2:29 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Bare Below the Elbows policyHi all,
We are reviewing our Bare Below the Elbows policy and are seeking ideas on how other manage staff who cannot comply who work in areas not strictly direct patient care. We are trying to ensure we provide enough advice to managers trying to juggle the quandary of staff working indirectly with patients, for example sterile stock management etc who need to wear medical appliances.Do your current policies recommend either they cant work in these areas at all, or, provide some guidance around what type of activities they can and cant do, when they should do HH and how they should manage the appliance. As each situation will differ, these points need to be generic enough to inform us and managers for each risk assessment as they are done.
Any thoughts would be appreciated
Regards
HelenHelen Newman
Infection Prevention and Control CNC CICP| Infection Management and Control Service
Shellharbour and Kiama Hospitals
Tel 02 4295 2416 | Mobile 0475823959 | Fax 02 4295 2497 | Helen.Newman@sesiahs.health.nsw.gov.au
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Hello Chris, not sure that vaccination is recommended every 10 years. The Australian Immunisation handbook recommends that HCW have a booster if 10 years have elapsed since a previous dose (rather than every 10 years). Have not heard anything has changed re this (unless Victoria has made changes to recommendations – the Immunisation Brach will know).
CheersFiona Wilson I Clinical Nurse Consultant
Public Health Services I Department of Health and Human Services
3/25Argyle St Hobart, GPO Box 125 Hobart 7001
Phone (03) 6166 0601| Mobile 0439 014 634 | Fax (03) 6233 0553
Prevention is better than cureHello Everyone,
Just wondering if anyone else has heard that Midwives should have their Pertussis vaccination every 5 years as opposed to every 10 years?
There has been some talk about this but I can’t find any information to back it up.Thanks
Regards
ChrisChristine Braden
Manager Infection Control & Accreditation
Djerriwarrh Health Services
P.O Box 330
Bacchus Marsh 3340
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Hi Trish, I have been in a similar situation – proposed water fountain outside a radiotherapy bunker. At the time, I could not find anything specific that suggested fountains should not be installed in these type of areas. However, we (Infection Control) suggested it was unwise to install a feature near the entrance of such a facility due to 1) the patient population and b) risk of legionella bacteria – there have been cases related to fountains overseas. In addition, there are resources involved with ongoing maintenance of the fountain and the water. Upshot was, a sculpture was installed instead.
So – you need to look at what type of water feature your organisation is wanting to install and then look at what the risks and ongoing costs would be. And you could always suggest they install a sculpture by a local artist.
RegardsFiona Wilson I Clinical Nurse Consultant
Public Health Services I Department of Health and Human Services
3/25Argyle St Hobart, GPO Box 125 Hobart 7001
Phone (03) 6166 0601| Mobile 0439 014 634 | Fax (03) 6233 0553
Prevention is better than cureHi
Our Organisation is thinking about putting an outdoor water feature in a courtyard of our Cancer Centre. Does anyone have any guidelines specifically relating to water features especially installation and maintenance? I have already accessed AS/NZS 3666 :2011.
Thanks
TrishTrish Horne
CNC Infection Prevention and Control
Rural Inpatient and Community Services
THS-North West Region
1 Strahan Street
Burnie 7320
[cid:image001.png@01D0D4D8.EF4BA180]Standard 3 – Preventing and Controlling Healthcare Associated Infections________________________________
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Interesting article Sue. It does raise a few issues especially he use of public branding of non-conformists – they must wear a mask so everyone knows who they are – there are no public health benefits to this strategy of public identification that I can see. And it makes staff upset, angers the unions and invites public mistrust of healthcare workers. And I wonder what would have happened if it was a pivotal doctor or nurse who refused to wear a mask (or any HCW who could not be easily and quickly replaced)?? An alternative to the mask would be that vaccine refusers could be furloughed off work if there was a case/cases of influenza in their work area. Although I am not a big fan of mandatory vaccinations – not sure that penalising non vaccinators achieves anything other than making them (possibly) become even more determined not to be vaccinated.
Fiona Wilson I Clinical Nurse Consultant
Public Health Services I Department of Health and Human Services
3/25Argyle St Hobart, GPO Box 125 Hobart 7001
Phone (03) 6166 0601| Mobile 0439 014 634 | Fax (03) 6233 0553
Prevention is better than cureHi Kathy,
Just to add to the discussion, attached is an article from the New Zealand Herald this week discussing a hospitals vaccination policy for influenza,For your interest.
Regards,
SueSue Greig
Senior Project Officer
National HAI Prevention Program
Usual work days: Monday to WednesdayAustralian Commission on Safety and Quality in Health Care
GPO Box 5480 Sydney NSW 2001 | Level 5, 255 Elizabeth Street, Sydney NSW 2000
( direct (02) 9126 3565 | ( switchboard (02) 9126 3600 | 6 (02) 9126 3613 |
Email sue.greig@safetyandquality.gov.au | http://www.safetyandquality.gov.au
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[Commission-and-NSQHS-logos]HI Kathy,
Also an interesting piece in Healthcare Infection about this http://www.publish.csiro.au/paper/HI13041.htm and follow up letter to the editor in response to this publication http://www.publish.csiro.au/paper/HI14018.htm
Very topical.Thanks
BrettAssociate Professor Brett Mitchell
Associate Professor of Nursing, RN, BN, PhD, M.Adv.Prac, CICP, MRCNA
Faculty of Nursing and Health and Director Lifestyle Research Centre, CooranbongAvondale College Ltd trading as Avondale College of Higher Education
http://www.avondale.edu.au | http://www.designedforlife.me
185 Fox Valley Road, Wahroonga NSW 2076 AustraliaHi Kathy,
The attached recent publication may be if interest/use (you may have seen it already)
. Marci Drees et al. Carrots and Sticks: Achieving High Healthcare Personnel Influenza Vaccination Rates without a Mandate. Infect Control Hosp Epidemiol 2015;36(6):717-724
The authors achieved a 92% vaccination rate compared with vaccination rates of 57%-72% in the 3 years previous without mandating.
Their strategies included the following:
. Each of their forms (consent, declination and reason for declination) included a bar code, which was scanned by a newly created web-based application along with the HCP’s identification badge. This automatically updated the vaccination database with vaccinated, exempt or declined status.
. Every manager and vice president in the system began receiving weekly lists of their employees, notated as vaccinated, not vaccinated, or no response.
. Managers were required to follow up with employees who had not responded. In addition, managers were aware of which employees had not been vaccinated and, thus, were required to wear masks once the flu season began.
. Rather than relying on roving vaccinators, meetings, and distribution of vaccine for self-vaccination, the task force decided to adopt a “blitz” campaign during the first 2 weeks of the season. Beginning in early October, vaccination stations were set up across all shifts at entrances to hospitals and other outpatient/ancillary facilities.
. At each entrance, volunteer “clerks” (who ranged from administrative assistants to leadership personnel) scanned the HCP’s identification badge and the appropriate form (taking ~30 seconds), and then directed him/her to the next available vaccinator (volunteer nurses and pharmacists).
. After vaccination (or attesting to vaccination elsewhere), staff were given hanging badges, stating “I’m vaccinated because I care.”
. Wearing the hanging badges was not mandatory, but anyone not wearing an “I’m vaccinated” tag was required to mask while in patient care areas, regardless of their actual vaccination status.
. ~70% of all employees were vaccinated during the initial “blitz.”
. The policy used the existing disciplinary process for employees who either did not complete 1 of the 3 forms by November 30 (i.e., the mandatory declination), or who were not vaccinated and repeatedly failed to mask. While the discipline alone did not result in termination, it was considered in performance evaluations and could result in an employee being considered “below standard.” Employees in this status were ineligible for annual raises or any financial incentive.
Many of these strategies could be readily implement in Australian healthcare facility influenza vaccination programs.
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426Hi Kirsten,
Thanks for your response. Sending a text message is a great idea for contacting the casual and part timers, maybe not only asking for those who have had their jab elsewhere, but to remind them of when clinics are being held. We will definitely add that to our influenza vaccine planning for next year.Regards
KathyKathy Taylor- Infection Control Manager
The Wesley Hospital | 451 Coronation Drive, Auchenflower QLD 4066
t: 07 3232 7558 |m: 0427 607 812 | f: 07 3232 6043 |e: katherine.taylor@uchealth.com.auHi Kathy
Where I am is small and we have a significant part time/casual workforce. We found that MANY of our staff had been vaccinated elsewhere and weren’t letting us know. We sent out a text message to all our part time and casual nurses asking them to contact me if they had received their flu vax elsewhere. We increased our compliance by over 10%!
Kirsten Amos
Nurse Consultant
Infection Prevention and Control
Gippsland Southern Health ServicesThanks Cathy,
I agree that getting the managers to assist is the way to get buy-in, but I also like your idea of a prize draw – might hit up my exec for something good next year.Regards
KathyKathy Taylor- Infection Control Manager
The Wesley Hospital | 451 Coronation Drive, Auchenflower QLD 4066
t: 07 3232 7558 |m: 0427 607 812 | f: 07 3232 6043 |e: katherine.taylor@uchealth.com.auKatherine, we have had a lot of support from the executive team to achieve our current rate of 79%. We have broken down all staff into ward /departments lists and the managers were receiving weekly updates of progress within their department. As the number of vaccinated staff increased we then narrowed it down to those who have not been vaccinated. All unit managers were expected to assist us in ensuring that every staff member has either been vaccinated or has signed the declaration form formally declining the vaccine. We have around 950 staff on 2 sites for purposes of the influenza campaign. We have a major prize draw at the end of the season for staff who have been vaccinated. This has been in place for several years and alone didn’t assist that much in reaching our target. Last year we failed to reach 75% so the strategies this year really worked. It has, of course, come with the expense of great time and effort on the behalf of the infection control staff who are both nurse immunisers.
Cathy Mowat
Infection Control
Central Gippsland Health Service
Sale VictoriaDear AICALIST members,
From July last year any new starters at our hospital sign that they agree to have the vaccines that are recommended in the Australian Immunisation Handbook for their designation, and now our executive are toying with the idea of making influenza vaccination compulsory for all of our staff next year.With a lot of effort this year -lots of flu jab clinics, lollypops & bright stickers for ID swing tags on vaccination, “grab a snag & get a jab” BBQ lunch, free pizza lunch for wards/areas with compliance above 80% – we have a compliance rate of 72% of staff either vaccinated or who have signed an opt-out form declaring that they have been offered the influenza vaccine, but decline for whatever reason. I think this compliance rate is pretty good – certainly better than the compliance in previous years.
I would like to know what everyone else is doing out there. What has worked and what has not?
Is influenza vaccination compulsory at your facility? Is it something your exec team is considering?
What do you consider to be an acceptable vaccination rate in your healthcare facility?
Is there any penalty for staff who are not vaccinated, e.g. unimmunised staff wearing mask at work during winter?
Regards
KathyKathy Taylor- Infection Control Manager
The Wesley Hospital | 451 Coronation Drive, Auchenflower QLD 4066
t: 07 3232 7558 |m: 0427 607 812 | f: 07 3232 6043 |e: katherine.taylor@uchealth.com.au_________________________________________________________________
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Hi Trent, have seen this being done for SSI (similar issue as you have found – being done by orthopods based on a very small study). But not seen it done peri operatively. And not in Antibiotic Guidelines to the best of my knowledge as a method of perioperative prophylaxis. And based on my experience with the interosseous AB given for SSI – yes you will probably get pushback from the orthopods. They should certainly be recording it on the drug chart.
Cheers
Fiona Wilson I Clinical Nurse Consultant
Public Health Services I Department of Health and Human Services
3/25Argyle St Hobart, GPO Box 125 Hobart 7001
Phone (03) 6166 0601| Mobile 0439 014 634 | Fax (03) 6233 0553
Prevention is better than cure[Cross-posted from Oz-Bug with permission – Moderator. Copies of replies will be forwarded to Dr Yarwood.]
Hi all,
Our hard-working infection control team have come to us with an interesting issue. It at first glance seemed that some of our joint replacements weren’t being given prophylactic antibiotics. A bit of digging found out that they were, it just wasn’t being recorded.
The problem is that the orthopaedic surgeons are giving the antibiotics intra-osseously, without any systemic prophylaxis (given pre-incision, after tourniquet insertion), seemingly based on this study: http://dx.doi.org/10.1007/s11999-012-2469-2
I’ll be talking to the surgeons about this soon. My initial impressions are:
* Small study
* No clinical endpoints
* Some questions about the methods (confusion of ug/g vs ug/mL of fat or bone)
* Is a fat concentration of 175mg/g 2 minutes after completion of infusion biologically plausible (ie: could they be measuring extravasated infusion solution rather than tissue concentrations)
* What impact could there have been of rinsing the tissues in saline prior to sending them off for analysis in terms of outcomes?
In short, there’s lots of issues and I’m not terribly keen in the absence of some clinical outcome data. I expect there’ll be some pushback from our orthopods, though.
Has anyone else seen this in your hospitals?—
Trent Yarwood
Infectious Diseases Physician, Cairns
trentyarwood@gmail.com________________________________
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Hi Joe-anne, you could suggest to them that it is not an infection control issue……
Fiona Wilson I Clinical Nurse Consultant
Public Health Services I Department of Health and Human Services
3/25Argyle St Hobart, GPO Box 125 Hobart 7001
Phone (03) 6166 0601| Mobile 0439 014 634 | Fax (03) 6233 0553
Prevention is better than cureGood morning
Sometimes I get told about the most odd things!
There seems to be a growing trend of family/friends having a sleep in the patients bed when they go the theatre. When they are asked not to, staff are often abused.
Staff want to know how to address this growing problem. Has anyone dealt with this issue in their hospital?
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
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There has been quite a few articles in The Conversation but I would recommend the one by Allen Cheng in particular (second link).
http://theconversation.com/topics/ebola
http://theconversation.com/ebola-outbreak-is-cause-for-concern-but-theres-hope-yet-29948
Fiona Wilson I Clinical Nurse Consultant
Population Health Services I Department of Health and Human Services
3/25Argyle St Hobart, GPO Box 125 Hobart 7001
Phone (03) 6166 0601| Mobile 0439 014 634 | Fax (03) 6233 0553
PLEASE NOTE MY NEW PHONE NUMBER
Prevention is better than cureI came across this great article by Dr Tara C Smith (Epidemiologist) in the US, and thought it was very useful to share. We may not have any direct links to Ebola patients yet in Australia, but the West African outbreak is growing still, and it may only be a matter of time before we hear of possible cases in Australian healthcare workers assisting in control, or in travellers to Australia.
Dr Smith’s blog has more useful info on Ebola as well, including discussion on risks of airborne transmission. If you in a humorous mood, have a look at the handy diagram at the end of that blog post (warning: strong language)
http://scienceblogs.com/aetiology/2014/08/03/are-we-sure-ebola-isnt-airborne/
Cheers
MichaelMichael Wishart
Infection Control Coordinator
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@svha.org.au
w:www.holyspiritnorthside.org.au
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Thanks Matthias – should have looked at the archives first. The upshot was that it may be useful in the food industry but probably not so much in healthcare (especially for handwashing).
Regards
PS – my scepticism is intactFiona Wilson I CNC, Infection Control, TIPCU
Population Health Services I Department of Health and Human Services
Post GPO Box 125 Hobart Tas 7001 | Email tipcu@dhhs.tas.gov.au
Phone (03) 6222 7684 | Fax (03) 6233 0553
A fair and healthy TasmaniaDear Fiona,
There was an earlier thread about this in Infexion Connexion and also in OzBug where this was discussed. Not sure when, but it might have been about 1-2 years ago. The gist was, and my take on it was, that scepticism is warranted.
Best regards, Matthias.
—
Matthias Maiwald, MD, FRCPA
Consultant in Microbiology
Adj. Assoc. Prof., Natl. Univ. Singapore
Department of Pathology and Laboratory Medicine
KK Women’s and Children’s Hospital
100 Bukit Timah Road
Singapore 229899
Tel. +65 6394 8725 (Office)
Tel. +65 6394 1389 (Laboratory)
Fax +65 6394 1387I have received a query regarding electrolysed water for use as a sanitising and cleaning agent for hand washing, environmental cleaning as well as food rinsing/cleaning. Apparently there are facilities that use this product so am wondering if anyone has a) heard about it and b) uses it for hand hygiene and environmental cleaning etc.
Regards
Fiona Wilson I CNC, Infection Control, TIPCU
Population Health Services I Department of Health and Human Services
Post GPO Box 125 Hobart Tas 7001 | Email tipcu@dhhs.tas.gov.au
Phone (03) 6222 7684 | Fax (03) 6233 0553
A fair and healthy Tasmania________________________________
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Hello Jodie, I am not sure that this is really an infection control issue – if you would accept a drink and a biscuit at a friends house, why not from a client who you visit regularly?
Many older people can be socially isolated and sharing a cup of tea and a biscuit (especially with a frequent visitor) can be a way of reducing isolation, having a social chat and breaking down the ‘them and us’ barrier which is so prevalent in healthcare. Maybe we should see spending time with patients/clients as important as the ‘doing the procedure’ part.
RegardsFiona Wilson I CNC, Infection Control, TIPCU
Population Health Services I Department of Health and Human Services
Post GPO Box 125 Hobart Tas 7001 | Email tipcu@dhhs.tas.gov.au
Phone (03) 6222 7684 | Fax (03) 6233 0553
A fair and healthy TasmaniaHi All
Just wondering whether anyone has seen a guideline or has any thoughts regarding whether staff should accept food or drinks from clients homes if they are offered them.
I would have thought the staff member would need to assess the situation and politely decline if they didnt think it was safe. I personally would decline but just wondering if any one has had this issue raised before
Thanks
JodieJodie Burr
Acting Health Liaison
and
Infection Prevention and Control-Clinical Practice ConsultantDisability and Domiciliary Care Services
Department for Communities and Social Inclusion
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Hi Karen, you may want to have a look at what VICNISS do for SSI. Their program covers all of the public hospitals in Victoria irrespective of size. The procedures chosen by a hospital are dependent on how many are done per annum rather than how many beds there are (and I think the ‘general’ rule is >100 procedures/annum…. although saying that, the health service I worked at did do SSI surveillance on some procedures that had <100/annum).
Have a look at http://www.vicniss.org.au/Regards
Fiona Wilson I CNC, Infection Control, TIPCU
Population Health I Department of Health and Human Services
Post GPO Box 125 Hobart Tas 7001 | Email tipcu@dhhs.tas.gov.au
Phone (03) 6222 7684 | Fax (03) 6233 0553
A fair and healthy TasmaniaHi All,
We are seeking information on what other regional size (250+ beds) acute hospitals are doing that works well for SSI surveillance. We don’t do CABGs, nor 100 THRs/TKRs in a calendar year, nor participate in the ACHS clinical indicators program for BSI & LUSCS,
What we have done for many years is a ‘day-5 survey’: anyone who has a surgical wound and is still an inpatient on day 5 (DOS day 0) undergoes chart review against the SSI definitions. Although this has provided valuable data over the years, I suspect times have changed and the validity of someone being here on day 5 (although consistent) might not be sensitive to ever-shorter LOS. One of the obvious catches is if you go home on antibiotics on day 4 or present with infection on/after day 6 – you don’t count. This is a labour intensive spreadsheet based process with manual theatre list entry, (fairly reliable) electronic report for patient matching for day 5 (that is a step up in our world!), and trips to the wards as no electronic medical record.
We also do an annual telephone follow-up at 30 days of selected 100+ (annual total, not the quarter we do the survey for) procedures (e.g. LUSCS, lap chole, etc.) for a 3-month period.
Any suggestions, protocols, ideas most welcome
Thanks
Karen Turnbull
Acting Nurse Manager
Infection Prevention & Control Unit
Level 2, Launceston General Hospital
Charles Street 7250________________________________
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Hello Tain, laboratory design and use is regulated by the federal government and covers facility design and fittings, PPE, containment equipment and work practices.
Here are a couple of references you may like to look at:
Genetic Manipulation Advisory Committee (GMAC) guidelines
Australian Standards – AS/NZS 2243.(1 – 10) Safety in laboratoriesRegards
Fiona Wilson I CNC, Infection Control, TIPCU
Population Health I Department of Health and Human Services
Post GPO Box 125 Hobart Tas 7001 | Email tipcu@dhhs.tas.gov.au
Phone (03) 6222 7684 | Fax (03) 6233 0553
A fair and healthy TasmaniaGood morning Michael
I am wondering if the group can point me in the direction of any standards for pathology departments. Cleaning requirements for P3 labs. Anything in general would be of assistance. Also anything on forensic morgues too.
Thanks so muchTain Gardiner Clinical Nurse Manager
BN, MPH
Infection Prevention & Management Unit
Top End Health and Hospital Services
Rocklands Drive, Casuarina, NT 0811 PO Box 41326, Casuarina, NT 0811
p… (08) 892 28045 pager # 0239| f… (08) 892 28889 e…Tain.Gardiner@nt.gov.au[IIPW13_Microsite_TopLogoBanner_final-rev_notabs]
International Infection Prevention Week, October 20-26th 2013.
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