[Prue Wright]

Dear Kimberley,

Our Recovery Staff wear scrubs as the complex is part of OT. Day Surgery
staff do not wear scrubs as they do not go into OT. The unit is
separate.

People in scrubs outside the OT are not policed very well at the moment.
It would be interesting to see how other hospitals police their OT
staff.

Cheers

Ruth Dalrymple

Infection Control Coordinator

Hurstville Private Hospital

PS I have taken over from Prue Wright.

37 Gloucester Rd, Hurstville, NSW 2220, Australia
T +61 2 9579 7780 F +61 2 9579 7466
E Infection.Control@hurstvilleprivate.com.au
W healthecare.com.au

Behalf Of Phelan, Kimberley

We are currently reviewing our OR Attire Policy, our question is:

* Do your staff who work in Recovery/EDSU/Day Surgery Unit wear
scrubs?

* If they don’t wear scrubs how do you manage this?

* Do you all have a red line-defining the access to procedural
areas?

* How do you police staff who are wearing scrubs outside of the
theatre area, e.g. going to staff canteen?

Kimberley

Kimberley Phelan| CNS|Infection Prevention and Control|Health
Directorate|

Level 4, Building 10|Canberra Hospital and Health Services | Garran ACT
2605

Phone 02 61745615 | Fax 02 6244 4646 |Page 50339| Email
kimberley.phelan@act.gov.au

Infection is the final insult to our patients

care excellence collaboration integrity

CH_Logo_ACT_Health_Lockup_CMYK_HR

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[Prue Wright]

Hi All,

We have introduced Skinman which is an alcoholic based surgical scrub. It is very popular with the surgeons and scrub staff. Many of us have problems with dermatitis from traditional water based scrubbing, these have been resolved with the Skinman.

Prue Wright

Infection Control Coordinator

Hurstville Private Hospital

37 Gloucester Rd, Hurstville, NSW 2220, Australia
T +61 2 9579 7780 F +61 2 9579 7466
E Infection.Control@hurstvilleprivate.com.au W healthecare.com.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Tracy Sloane
Sent: Wednesday, 13 June 2012 9:19 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Surgical hand scrub

Hi All,

If you check out the latest edition of Healthcare Infections you will find an article about a study I did prior to TGA approval of a surgical hand rub (SHR) looking at HCW current scrub practices and their knowledge and attitudes about SHR. You might find the reference list helpful.

Cheers,

Tracy

Tracy Sloane

Senior Infection Control Consultant

Dandenong Hospital, Southern Health

T (03) 95548173 F (03) 95541905

E tracy.sloane@southernhealth.org.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Helen Scott
Sent: Tuesday, 12 June 2012 2:36 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Surgical hand scrub

Hi Jane,

The CDC have got a good article on this. It’s their MMWR and in October 2002, Vol 51, page 17 it discusses exactly this. I’m sure there’s a more up to date report somewhere. You could also try Skinman Soft, made by Orion.

Cheers,

Helen.

Helen Scott

Infection Control Co-ordinator

Nepean Private Hospital

Penrith, NSW.

0247 327333

Helen.Scott@healthscope.com.au

Please consider the environment before printing this message

>>> On 11/06/2012 at 5:50 am, in message , Jane Barnett wrote:

Hi

Weve got some staff who can only use the PCMX scrub product as they are sensitive to both chlorhex and betadine but BD have advised that they are withdrawing this product. Can I ask what other centres are doing for staff with allergies would plain soap and water washed followed by plain alcohol (without antiseptic additive) be sufficient for surgical procedures? Thoughts/ideas welcome.

Thanks

Jane Barnett

Clinical Nurse Specialist

Infection Prevention & Control

Christchurch Women’s Hospital

Private Bag 4711, Christchurch

Tel: 03 364 4510 (int 85510)

Fax: 03 364 4607

Infection Prevention and Control is Everyone’s Business

________________________________

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[Prue Wright]

Hi Katherine,

Good luck!

We have included nails jewellery etc in our uniform policy. It is hard to enforce, people resist. They will remove the offending items for a few days or even weeks, and then it sneaks back in. We keep trying!

Prue Wright
Infection Control Coordinator
Hurstville Private Hospital
37 Gloucester Rd, Hurstville, NSW 2220, Australia
T +61 2 9579 7780 F +61 2 9579 7466
E Infection.Control@hurstvilleprivate.com.auW healthecare.com.au

—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Katherine McKay
Sent: Tuesday, 22 May 2012 8:30 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Nail polish, artificial nails and jewellery

I am also interested in others experiences with artificial nails, nail polish and jewellery

I am currently undertaking an exploratory study on hand adornment and other elements of the Bare Below the Elbows (BBE) bundle – Barriers and enablers and it is proving to be a really interesting area.

BBE is currently not mandated in Victoria but there is an expectation that it will come.

I too would love to hear experiences of those who have been in a position to introduce BBE, monitor or enforce

Thanks!

Katherine McKay
Infection Control CNC
Eastern Health

0404809496 or 98713156
katherine.mckay@easternhealth.org.au

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[Prue Wright]

Hi all,

We use the Trophon, after a lot of deliberation. It is expensive to purchase; and initially had to be replaced under warranty several times. But it is working very well now; and extremely quick. We work hard and fast here(like everyone else!); and the surgeons do not tolerate any delay to the list.

We have an enrolled nurse dedicated to the processing of endoscopes, this includes the diagnostic probes. She is pedantic about procedure, so there is absolutely no doubt that correct processes are being carried out.

Prue Wright

Infection Control Co-ordinator

Hurstville Private

Ph: (02) 9579 7777

Fax: (02) 9570 8359

Mob: 0409 311 057

Email: InfectionControl@hurstvilleprivate.com.au

From: AICA Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Glenys Harrington
Sent: Thursday, 17 May 2012 3:29 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Ultrasound probe cleaning and disinfection

Maree,

An interesting observation made by your colleagues.

With the introduction of any new system/equipment it is important to evaluate any potential risks that may be associated with human error and where possible consider alternative engineering controls that have been designed to engineer out such risks.

Regards

Glenys

Glenys Harrington

Consultant

Infection Control Consultancy (ICC)

PO Box 5202

Middle Park

Victoria, 3206

Australia

H: +61 3 96902216

M: +61 404 816 434

infexion@ozemail.com.au

ABN 47533508426

From: AICA Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Maree Sommerville
Sent: Thursday, 17 May 2012 3:08 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: [AICA_Infexion_Connexion] Ultrasound probe cleaning and disinfection

My organisation made a decision very recently on this subject.

The 2 choices were the Tristel Wipe system and the Trophon system.

Both systems are listed on the ARTG and are readily searchable.

I prepared a paper to present to my committee in order for the committee to make a decision as to which is the best choice for us.

I can send an edited version of this paper upon request. I tried to be as unbiased as possible in order for my committee to make an impartial decision.

The decision made was for the Trophon and the rationale was because it was automated.

The weakness with the Tristel system is user fallibility.

There is no doubt the Tristel is easy and significantly cheaper. However it is harder to measure that correct contact time for the active ingredient to be effective. What happens in a busy unit with a doctor/ sonographer in a hurry to complete the list?

Trophon has significant ongoing cost implications with consumables and once the warranty is expired, ongoing service costs.

It is a tough decision. Cost of product versus a guarantee of user compliance with the process.

As one of my colleagues said if we cant get hand hygiene right among some staff, can we expect them to get this right!!!

Maree Sommerville

Infection Control Nurse Consultant

Mercy Hospital for Women

8458 4759

________________________________

From: AICA Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Fiona de Sousa
Sent: Thursday, 17 May 2012 1:09 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Ultrasound probe cleanign and disinfection

Hi All,

I have been asked to review a new cleaning and disinfection system for reprocessing transvaginal ultrasound probes especially those used in IVF related pregnancies where chemical residues are a high concern.

The system consists of three separate pre-packaged wipes (a cleaner, a disinfectant and a rinse wipe) which I believe is currently used in he UK. The active ingredient in the disinfectant wipe is chlorine dioxide in aqueous solution.

Has anyone got any experience with this type of system that they would be willing to share with me?

Kind Regards,

Fiona De Sousa

Infection Prevention & Control Coordinator

Sydney Adventist Hospital

Mobile: 0408 468 470

Office: (02) 9487 9732

Fax: (02) 9472 8053

Fiona.Desousa@sah.org.au

185 Fox Valley Road, Wahroonga, NSW, 2076

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[Prue Wright]

Hi Beth,

The problem I see is that the scrubbed personnel will have to walk past the patient’s bed through an area open to the general corridor; entering the OT through the same door as people going in and out. There is a potential for being collided with by porters and other staff entering or leaving the theatre.

The enclosed scrub area is a good feature; but there is only one way in and out; another potential for contamination.

It would be ideal to have a flow into the scrub area and then to the OT without backtracking or having to mix with general traffic.

Regards

Prue Wright

Infection Control Co-ordinator

Hurstville Private

Good Afternoon

We are currently undertaking the design of a new theatre suite. During this process discuss has arisen regarding the need for dedicate doorways to exit the scrub bays into the operating theatre, compared single doorway for entering and leaving the scrub bay and then using a shared corridor ‘entrance bay’ to enter the theatre. See table below for illustration of flow. Could you please advise if your theatres have this layout and if there have been any issues arise from this.

We would also be interested in opinions regarding the potential hazards associated with this design.

theatre

Opening doors

patient bed

anaesthetic bay

No door

Scrub sinks

theatre corridor

Thank you for your assistance

Beth

Beth Bint

Clinical Nurse Consultant | Infection Management and Control Service
Level 1 Lawson House, Wollongong Hospital 2500, NSW
Tel. 02 4222 5898 | Fax. 02 4222 5367 | beth.bint@sesiahs.health.nsw.gov.au

http://www.health.nsw.gov.au/images/communications/e-signatures/images/NSW-Health-Illawarra-Shoalhaven-LHD.jpg

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[Prue Wright]

Dear Beth,

Kimberley Clark provided that service four our facility at the start of the HINI outbreak it might be worth contacting your rep.

Regards,

Prue Wright

Infection Control Coordinator

Hurstville Private

From: AICA Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Beth Bint
Sent: Tuesday, 18 October 2011 11:03 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Fit testing service in NSW

Good morning all

A Medical student in the Illawarra Region is applying for an elective term overseas. One requirement for this placement is to be able to provide evidence of being fit tested for an N95 respirator, as detailed below.

Proof of N95 Mask fitting*
*Each student on a clinical placement is required to carry evidence that this standard has been met. It is expected that students from other universities will arrange to be fit
tested with a 3M product prior to arrival, and will submit documentation from a registered fit testing program along with their immunization record. We cannot assure timely access to fit testing if this has not been achieved prior to arrival; please do not jeopardize your clinical elective.

Unfortunately our Local Health District does not provide this service. I am hoping that someone in NSW or the ACT could advise me of a place where this Medical Student could access this service.

Thank you

Beth

Beth Bint

Clinical Nurse Consultant | Infection Managament and Control Service
Level 1 Lawson House, Wollongong Hospital 2500, NSW
Tel. 02 4222 5898 | Fax. 02 4222 5367 | beth.bint@sesiahs.health.nsw.gov.au

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[Prue Wright]

Hi Carien,

We wrote a policy last year specifically for OT and put together a “kit”
for use when there is an MRO patient.

We acknowledge that more often than not, we could have a colonised
patient that we are not aware of; but when a patient is identified we
follow strict control measures.

VRE patients are put on the end of the list; and also MRSA if feasible.

We have an “outside” scout if we can, if not possible, then a stock
trolley is placed near the door and the porters help out with handing in
extra sponges etc.

The patient is recovered in OT if last on the list. Depending on the
source of the MRO, and the clinical condition of the patient, recovery
may have to be in the Recovery Unit. The bed is changed and cleaned
during the procedure, and PPE is worn by porters and nursing staff
caring for the patient.

With this policy there is no confusion as to what MRO requires special
precautions and there is full awareness of the need for extra measures
as the patient progresses through the hospital.

Prue Wright

Infection Control Co-ordinator

Hurstville Private

Behalf Of Carien Coleman

Hi,

We are currently looking into our practices regarding MRO patients in
OT. I would like to know what other hospitals are doing re “outside
scout nurses” and where and how do you recover pts post anaesthesia if
they have a MRO.

Thank you,

Carien

Carien Coleman | Infection Control CNC

The Sunshine Coast Private Hospital

Syd Lingard Drive | BUDERIM QLD 4556

PO Box 5050 | Maroochydore BC QLD 4558

T: (07) 5430 3245 | F: (07) 5430 3436

E: carien.coleman@uchealth.com.au

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[Prue Wright]

Hi Pauline,

I usually draw up directly from the ampoule with a new syringe……but…..if you really think about it, the risk of contamination is going to be higher, unless the technique and motor skills of the person drawing up is pretty near perfect.

The best way is to use a blunt drawing up needle for drawing up the saline/water and then a fresh one for diluting the medication. In the “real” world this is least likely to happen.

In a “scrub” situation, the fluid is usually emptied into a galley pot, or the scrub will draw up from the ampoule and leave the drawing up needle in the ampoule to be discarded by the scout.

I have not seen any evidence or research.

Hope this is some help

Prue Wright

Infection Control Co-ordinator
Hurstville Private

Ph: (02) 9579 7777
Fax: (02) 9570 8359
Mob: 0409 311 057

Email: InfectionControl@hurstvilleprivate.com.au

—–Original Message—–
From: AICA Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Pauline Bass
Sent: Thursday, 5 May 2011 5:15 PM
To: AICALIST@AICALIST.ORG.AU
Subject: dRAWING UP FROM AMPOULES OF STERILE SALINE OR WATER

Hi

Quick few questions regarding drawing up from a (plastic) ampoule of sterile saline or water.

1) Would you recommend drawing up using a sterile needle and syringe or would you draw up using a sterile syringe only and

2) Does anyone know of any evidence or have any opinion that one method is preferential to the other for reducing risk of contamination of the syringe or fluid?

Regards

Pauline

Pauline Bass
Infection Prevention Nurse Consultant
Infection Prevention and Healthcare Epidemiology
Alfred Health

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[Prue Wright]

Dear Wendy,

We have only recently closed our medical ward, which I assume you would
have defined as “sub-acute”. We have an acute surgical ward and post
natal also. As post caesarian section patients are nursed on post
natal, they need to be classified as surgical.

When the medical ward was still open; patients with confirmed MROs were
treated with full precautions; just as they are in the surgical ward. We
could not risk HAIs in any of our patients, and are very aware of our
higher risk surgical areas.

So – in a nutshell – our policy for MRO management is across the board.

Hope this is some help

Regards

Prue Wright

Infection Control Coordinator
Hurstville Private

—–Original Message—–
Behalf Of Beckingham, Wendy

Dear Colleagues

I am wondering does anyone have a policy in the way you care for
patients with MRO’s in a acute versus subacute unit.

In saying this a definition to cover sub acute has also been difficult
to come by and am wondering if anyone can help this as well.

Wendy Beckingham
CNC Infection Control
The Canberra Hospital
pager 50390 or phone 43695

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[Prue Wright]

Hi Tain,

Our facility is not maintaining screw banks any longer. Stock is opened
as required and treated as any other implant.

We are only small though and do not do trauma – so this works for us

Prue Wright

Infection Control Co-ordinator

Hurstville Private

Behalf Of Tain Gardiner

Good afternoon all

I am wondering if you can supply me with supporting information in
regards to implant sets. i.e. screw banks in particular.

There is discussion with the reprocessing of screw banks that are
supposedly single use devices and then not having them available
anymore. This option is causing great concern.

I would appreciate any information facilities are doing please.

Regards

Tain Gardiner | Clinical Nurse Manager
Infection Prevention & Management, Royal Darwin Hospital | Department of
Health and Families
Rocklands Drive, Casuarina, NT 0811 | ‘Postal Address’ PO Box 41326,
Casuarina, NT 0811
p… (08) 89228045 pager # 239| f… (08) 8928889 | e…
Tain.Gardiner@nt.gov.au | http://www.nt.gov.au/health

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