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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
Bennett, Noleen
Hello all
The Victorian DHHS Infection Control cell recently provided the following
advice about showering COVID positive patients/residentsScientific 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.1SARS-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.21.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
Tanya Hempshall (DHHS)
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.auDHHS-M-COVID-19-IMT-Outreach-Team@dhhsvicgovau.onmicrosoft.com
Department of Health and Human Services | 50 Lonsdale St, Melbourne VIC 3000
> On Behalf Of Christine Giles
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:
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Hi Everyone,
Just to clarify further my assessment on a selection of N95 masks:
What I was doing when assessing these masks was a user seal check (fit check) not a fit test.
Staff should perform a user seal check (fit check) every time they put on an N95 to check the N95 mask-to-face seal.
My understanding is that if you cant get a good user seal check (fit check) on yourself after following all the instructions from the manufacturer then that particular mask does not fit. Hence if it fails a user seal check (fit check) it will also fails a fit test.
While a user seal check (fit check) is person specific I noticed that most of the masks I was assessing were all very large and would be too big for me. Hence they would also be too big for someone who was smaller than me, particularly someone with a small narrow face.
Hence, if an N95 mask fails a user seal check (fit check) there is no point in doing a fit test until you find a different mask (model or size) for the user that can pass a user seal check (fit check).
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Great assessment, Glenys. Your findings underline the necessity of proper fit testing – and not just fit checking – when using respirators.
Here’s a great article on fit testing: https://www.mja.com.au/journal/2020/fit-testing-n95p2-masks-protect-health-care-workers#:~:textThe%20Australian%20Standard%20AS%2FNZS,fit%2Dtesting%20(9).
Cheers
Crystal Polson
Infection Control Coordinator
University of Melbourne
On Mon, Aug 31, 2020 at 10:43 PM Glenys Harrington <infexion@ozemail.com.au > wrote:
Hi All,
With the change in guidelines in relation to the use of N95s in VIC I have been assisting a HCF to identify a suitable N95 masks.
As a start I have reviewed a number of N95 masks on the market to see if they pass a seal check (fit check) on myself.
A user seal check should be done every time a N95 mask is to be worn to ensure an adequate seal is achieved.
In the last 2 weeks I have obtained and reviewed six N95 masks. Four have been supplied to healthcare facilities from stockpiles (i.e. hospitals and/or aged care facilities), one masks was supplied by a manufacture and one mask was provided by a distributor.
Of the 6 masks only 1 passed a seal check (fit check) on myself.
Happy to share my assessment to date which includes details and images of failure issues I noted see attached.
In addition I have attached two recent articles (MAGAZINE OF THE AUSTRALIAN SOCIETY OF ANAESTHETISTS, SEPTEMBER 2020 and JAMA Intern Med. Published online August 11, 2020. doi:10.1001/jamainternmed.2020.4221) in relation to this issue which may also be of interest/assistance if you are reviewing such masks.
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
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Hi All,
Further to Loris question below if you reusing single use disposable face shields (particularly in Victoria) what type of cleaning and disinfection agent/s are you finding are the best in terms of keeping the view clear?
Please note I do not support the reuse of face shields in particulate cleaning and placing bags. The risk with reuse of a face shield is that with shields with components that cannot be cleaned and disinfected (foam/elastic) when placed in any type of bag the internal surface of the bag may become contaminated. This may result in hand contamination when reusing the face shield on subsequent occasions.
The Aged care guidelines Coronavirus (COVID-19), Plan for the Victorian Aged Care Sector, Version 3.0, 1 July 2020 note the following:
PPE
*Single use disposable items cannot be reused
*Face shields should be changed every 4 hrsThank you in anticipation
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Dear Colleagues,
Our organisation has purchased cleanable face shields which have been issued to each staff member.
Some staff have complained that these style of face shields are not acceptable as an equivalent to safety glasses for droplet precautions as there is a 1cm wide gap at the top of the face shield between the perspex of the face shield and the headband. Unlike the single use face shields that have a foam headband which fills in this gap.
Are there any Australian or International standards on face shields.
Would a gap at the top make the face shield unable to be used as PPE?
Thank you in advance for your help.
Lori
Lori McLeod-Mills
National Quality Governance Officer
Healthcare Imaging Services
lori.mcleod@healthcareimaging.com.au
0414 542 483
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Hi Sarah,
See the following document and links re: advice in relation to staff
working across multiple sites in RACF.*Attached _Guiding Principles for residential aged care – keeping
Victorian residents and workers safe Date of document: 22 July 2020
*Statement clarifying implementation of Guiding Principles for
residential aged care – keeping Victoria residents and workers safehttps://mailchi.mp/agedcareupdates/statement-clarifying-implementation-of-gu
iding-principles-for-residential-aged-care-keeping-victoria-residents-and-wo
rkers-safe?e=c28bbe0954regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
McCarthy
Hi Sarah – the DHHS have put out “Movement of healthcare workers and health
service employees during coronavirus (COVID-19) pandemic – 8 August 2020Jenny
Jenny McCarthy | Infection Prevention and Control Coordinator
Maryvale Private Hospital
286 Maryvale Rd, Morwell VIC 3840
P.O. Box 348, Morwell, VIC, 3840
t +61 (0)3 51321235 f +61 (0)3 51339505Maryvale Private Hospital acknowledges the traditional owners of country,
the Gunaikurnai nation, and recognises their continuing connection to land,
waters and culture.
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Hi Team,
I am after some advice regarding staff working across multiple sites in
RACF.We are Victorian based, and lucky enough to be in an area of no known active
cases but am cautious at the idea of ‘sharing’ staff.Does the department currently have any recommendations out, or is it up to
each facility to determine the risk?Kind regards,
Sarah Bulzomi
Infection Control Officer (Wednesdays)Robinvale District Health Services
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Hi Karen and Lucas,
There is no requirement to COVID test all admission from the community or hospital just contact and droplet precautions for isolation 14 days.
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Hi Lucas
Totally agree with Karen. You must also take into consideration that it can take up to 10 days for symptoms to appear after last contact. That is why we test at day 11 with 72 hours for results to come back. Hence 14 days isolation.
Tough times for you guys at the moment but if you follow the guidelines it will get under control much quicker.
Kind regards,
Sharon Deen
Infection Control Nurse
Phone:08 9531 8570This message has originated outside of the organisation and you should therefore take precaution when opening links or attachments that may be contained within.
_____
HI Lucas,
All entering should be COVID19 tested but you must also follow you state health guidelines. Any slips may cause harm to your patients and team AND a huge political and media backlash. Tread carefully. Good luck.
Kind regards
Karen
Karen Booth
RN BHSCN GAICD
President APNA
Australian Primary Health Care Nurses Association
M: 0411 898 884
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.auGood evening all
Just curious what your thoughts and current policies are regarding new admissions to aged care facilities and quarantine.
At present in our facility we are quarantining new admissions from the community or hospital for 14 days. This is following a recommendation from our local PHN.
Are others following a similar policy? What are your thoughts on perhaps COVID testing new admissions and ceasing quarantine on return of negative testing?
Thank you
Lucas Lloyd
Clinical Operations Manager
Chaffey Aged Care, Merbein, VIC
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Hi josh,
I posted information below back in April, may be of interest/use
This short video from Bradford Teaching Hospitals, Tissue Viability Team re: advice for staff on preventing pressure ulcers while wearing PPE (April 2020) may be of interest/use.
https://www.youtube.com/watch?v1XJCbdpMCNc&featureyoutu.be
regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
E: infexion@ozemail.com.au—–Original Message—–
Hello IPC professionals,
Wondering if anyone has any resources or evidence in pressure area care with mask use?
Staff are beginning to find irritation on the bridge of their noses and are wanting help.
Thanks,
Josh Puglia
Infection Prevention & Control Nurse | Hand Hygiene Coordinator The Royal Womens Hospital | Locked Bag 300 | Cnr Grattan St & Flemington Rd, Parkville VIC 3052
P: +61 3 8345 2791 | Pager 52793
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Hi Leanne and Mary,
Can you confirm the citation for the following Health Technical Advice
*RESPONSE TO HUMIDITY CONTROL EVENTS IN STERILE STORE & PERIOPERATIVE
AREAS Health Technical Advice. HTA-2019-001I don’t see it in the document? Would need in order to use as a reference.
Thanks
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Atkinson
parametersHi Pam, have you seen the document ‘Response to humidity control events in
sterile store and perioperative areas’
https://www.vhhsba.vic.gov.au/sites/default/files/2020-05/VHHSBA-Health-Tech
nical-Advice-HTA-2019-001-Humidity-Control-Event-020200219.pdf . This
document has all the information you are looking for. Items processed in
CSD and items processed commercially all need to be kept within the 35-70%
range.Kind regards
Leeanne
Leeanne Atkinson
Coordinator
Infection Control
East Grampians Health Service
PO Box 155, Ararat, Victoria, 3377
Phone : (03) 5352 9332
Email : leeanne.atkinson@eghs.net.au
Web : http://www.eghs.net.auWe proudly acknowledge the Traditional Owners of the land on which our
services are located and pay our respects to Elders, past, present and
future.PLEASE CONSIDER THE ENVIRONMENT BEFORE YOU PRINT THIS EMAIL
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Thank you for your cooperation.> On Behalf Of Pamela Ann Boon
parameters*** Please Note – This email has come from an email source external to EGHS
***Hi everyone, hope you are all going ok.
Does anyone know if there a difference in acceptable humidity parameters
when storing:1.Items processed in CSD – ie in kimgard and paper packs
2.Items processed commerciallyI know AS4187 states 35% to 70% for sterile stock storage areas.
Thanks so much everyone.
Cheers from Pam
Pamela Boon | Infection Prevention Senior Management Consultant
Top End Health Service | Department of Health
Northern Territory Government
2nd Floor, Building 4, Royal Darwin Hospital, Rocklands Drive, Tiwi
GPO Box 41326, Casuarina, NT 0811
p …08 892
f …
e … Pamela.Boon@nt.gov.au
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Hi All,
I don’t mind the idea and I’m sure the dentist is well intentioned.
Incidentally, I have found that with the masks I’m purchasing from
pharmacies etc (Mandatory in Melbourne while out of your home at present)
are insufficient in length and width (is too small) to keep the inverted
ends of the mask in place. Hence, will not be applicable to all surgical
mask.You will see on the video I have requested the following information from
Dr. Rabeeh Bahrampourian:*Hi Dr. Rabeeh Bahrampourian can you provide me with the reference to
your comment in the video that the “effectiveness of the surgical mask drops
to 56% because of the gap at the side of a surgical mask” and the evidence
that folding in the mask at the corners improves the effectiveness of the
mask. Many thanks in anticipation. Glenys Harrington Consultant, Infection
Control Consultancy (ICC), P.O. Box 6385, Melbourne, Australia, 3004, M: +61
404816434, E: infexion@ozemail.com.auGlenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Wishart
Hi Elizabeth
The technique itself looks OK, particularly with that specific brand and
type of mask. You would have to test it on other brands and types to see if
the same technique could be used.BUT. I’m not convinced that using this technique is a good idea or even
necessary, for a number of reasons, including:1.It assumes that a loose fitting mask is a risk. If you are using a
level 2 or 3 surgical mask appropriately to prevent droplet transmission,
there is no evidence to suggest the seal at the sides is so important.
2.You are, in my opinion, fanning the flames for the aerosol route of
transmission being important with routine contact, not just droplet spread.
3.Using a level 2 or 3 surgical mask with a seal is sending a false
assurance about spread from aerosols, as these masks are not designed to
prevent inhalation of aerosols like a correctly fitted P2/N95 masks.I will be quite interested in other members’ view on this.
Cheers
Michael
Michael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
St Vincent’s Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD
4169
M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
E michael.wishart@svha.org.au |> On Behalf Of Elizabeth Carroll
Hello all: I have seen this video on utube which shows how to modify a
surgical mask by folding it to achieve a tighter fit.Is there any benefit in modifying the masks in this way?
Is there any problem with doing this – assuming of course that it’s a fresh
mas), and also ensuring that that doffing is as per normal infection
control procedure?I was considering sharing this with my Managers and incorporating into our
procedures (in residential and home aged care).Any thoughts?
Elizabeth Carroll | Executive Manager Residential & Chief Clinical Officer
p 07 3223 4444 d 07 3223 4491 f 07 3223 4411 m 0468 522 131
Level 3, 19 Lang Parade, Milton Q 4064 | PO Box 771, Toowong BC Q 4066
______________________________________________________________________
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are not the intended recipient of the Email, please notify the sender
immediately by return email, delete the Email, and do not copy, print,
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Thanks Maree,
Yes agree a validation study would be ideal.
Understand the elderly may not have a fever (up to 20-30%), also many are on routine Panadol osteo.
We have a signs and symptoms checklists in place which also includes a cognitive assessment and residents are assessed three times per day.
It is evident that at this facility the no contact thermometers are inaccurate, they were introduced in a setting of not being able to get sheaths for the tympanic thermometers.
Have now sourced sheaths and converted back to using tympanic thermometers in light of the incidents below.
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Hello Glenys,
I have heard there were issues regarding the infrared temperatures.
They have swung on to the market and are everywhere.
Ripe for a validation study!
Two things are possible:
*Infrared thermometers are inconsistent and do not report accurately
*Older people may not always present with a temperature when they have an infection (and in the examples you give, they may not have had one in the NH)Safer Care Victoria has produced a tool asking staff to report daily typical and non-typical symptoms. This then triggers a response.
For your interest the link is below.
Aged care services in Victoria have begun reporting this to SCV via a VICNISS portal this week.
I am sure there are better articles on aged care and infection but the below link is a simple and quick 2 minute read.
https://khn.org/news/seniors-with-covid-19-show-unusual-symptoms-doctors-say/
Maree
Maree Sommerville
Infection Control Consultant
VICNISS Coordinating Centre
Doherty Institute | Level 2792 Elizabeth St Melbourne VIC 3000
T: +61 3 9342 9362 | F: +61 3 9342 9355 | http://www.vicniss.org.auThe Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.auHi Kelly,
Thank for responding.
Are you using the no contact thermometers on you patients or just screening at the entrance to your facility?
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Hi all,
We are currently using the infrared contactless thermometers for several reasons for quite a while we couldnt get the probe covers for the tympanic thermometers as they were in very short supply. We have found them good as long as they are used correctly. They do not work well at the entrance screening points however, as the cold air coming into the building means they have to be constantly recalibrated. They also do not work well on cold skin. The infra net thermometers we are using are TGA approved and have been supplied by DHHS.
Cheers,
Kelly
I acknowledge the traditional owners of the land on which we work and live, and respect their ongoing custodianship of the land. I pay respect to Aboriginal people, and Elders past and present.
Kelly Barton
Infection Prevention & Control Officer
RN BHSc (Nursing). Grad Cert (Infection Control)(Advanced Acute Care). Nurse Immuniser. Cert IV T&A
P Reduce, re-use, recycle. Please consider the environment before printing this e-mail.
Dear all,
I note previous concerns about the accuracy of no touch infrared thermometers below.
Has there been any recommendations in relation NOT using these thermometers in clinical areas?
Think we are missing COVID-19 cases in aged care settings because of the use of such thermometers in this setting.
Have had 2 recent confirmed COVID-19 residents who were afebrile at the facility but febrile on arrival at the hospital.
Im looking for any specific directive that may have come out?
Many thanks in anticipation.
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Hi Sue
We looked at contactless infrared contactless thermometers, but the actual temperature measurements provided were not considered accurate enough by our physicians.
We use mainly infrared ear thermometers in our adult patients, with a probe cover, and wipe with a detergent wipe between uses.
One of the advantages of an ear thermometer is that it does not come into contact with mucous membranes, and therefore the question about high level disinfection between patients is avoided.
But I know there are physicians who will not rely upon infrared ear thermometer readings, although we find they tend to be quite accurate, provided they are taken correctly and the ear used is not inflamed.
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 |
Hi all,
Does anyone use contactless infrared thermometers?
In the current environment it may seem prudent to use them.
We use Covidien thermometers and go through 100 probe covers a day on one ward.
It would be good to reduce the level of plastic discarded too.
Regards,
Sue
Sue King
Nurse Unit Manager/Infection Prevention and controlDonvale Rehabilitation Hospital
Tully WardPhone:
03 9841 1272
Fax:
03 9842 7276
Email:
Web:
Address:
1119 Doncaster Road, Donvale Vic 3111
Hi Debra,
We use probe covers or the thermometers dont work anyway. I have always wiped them down with the cleaning wipe supplied to wipe down the rest of the obs machine. Its standard practice to clean between each patient. I would of thought if proper cleaning has been used with wipes rated to kill the microorganism and use of covers sufficient for general use with dedicated equipment wherever possible for people in isolation.
Regards Angela Carvosso
RN Warwick Health Services
Sent from Mail for Windows 10
Hi all,
Has anyone else been asked if oral thermometers should undergo HLD to comply with 4187, as the probe comes in contact with a mucous membrane?
There is heightened awareness around COVID 19 transmission and it was raised that a probe cover is not considered sufficient protection without HLD for other sitesIf you could please let me know what processes do others use for cleaning of oral thermometer probes between each patient?
Kind regards,
Debra Lee
Clinical Nurse Consultant
Infection Management and Prevention Service
West Block Ground floor
Redcliffe Hospital
Redcliffe, Qld 4020debra.lee@health.qld.gov.au
metronorth.health.qld.gov.au(Make Prevention Your Intention)
follow us on social media
Metro North Hospital and Health Service
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Hi Kelly,
Thank for responding.
Are you using the no contact thermometers on you patients or just screening at the entrance to your facility?
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Hi all,
We are currently using the infrared contactless thermometers for several reasons for quite a while we couldnt get the probe covers for the tympanic thermometers as they were in very short supply. We have found them good as long as they are used correctly. They do not work well at the entrance screening points however, as the cold air coming into the building means they have to be constantly recalibrated. They also do not work well on cold skin. The infra net thermometers we are using are TGA approved and have been supplied by DHHS.
Cheers,
Kelly
I acknowledge the traditional owners of the land on which we work and live, and respect their ongoing custodianship of the land. I pay respect to Aboriginal people, and Elders past and present.
Kelly Barton
Infection Prevention & Control Officer
RN BHSc (Nursing). Grad Cert (Infection Control)(Advanced Acute Care). Nurse Immuniser. Cert IV T&A
P Reduce, re-use, recycle. Please consider the environment before printing this e-mail.
Dear all,
I note previous concerns about the accuracy of no touch infrared thermometers below.
Has there been any recommendations in relation NOT using these thermometers in clinical areas?
Think we are missing COVID-19 cases in aged care settings because of the use of such thermometers in this setting.
Have had 2 recent confirmed COVID-19 residents who were afebrile at the facility but febrile on arrival at the hospital.
Im looking for any specific directive that may have come out?
Many thanks in anticipation.
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Hi Sue
We looked at contactless infrared contactless thermometers, but the actual temperature measurements provided were not considered accurate enough by our physicians.
We use mainly infrared ear thermometers in our adult patients, with a probe cover, and wipe with a detergent wipe between uses.
One of the advantages of an ear thermometer is that it does not come into contact with mucous membranes, and therefore the question about high level disinfection between patients is avoided.
But I know there are physicians who will not rely upon infrared ear thermometer readings, although we find they tend to be quite accurate, provided they are taken correctly and the ear used is not inflamed.
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 |
Hi all,
Does anyone use contactless infrared thermometers?
In the current environment it may seem prudent to use them.
We use Covidien thermometers and go through 100 probe covers a day on one ward.
It would be good to reduce the level of plastic discarded too.
Regards,
Sue
Sue King
Nurse Unit Manager/Infection Prevention and controlDonvale Rehabilitation Hospital
Tully WardPhone:
03 9841 1272
Fax:
03 9842 7276
Email:
Web:
Address:
1119 Doncaster Road, Donvale Vic 3111
Hi Debra,
We use probe covers or the thermometers dont work anyway. I have always wiped them down with the cleaning wipe supplied to wipe down the rest of the obs machine. Its standard practice to clean between each patient. I would of thought if proper cleaning has been used with wipes rated to kill the microorganism and use of covers sufficient for general use with dedicated equipment wherever possible for people in isolation.
Regards Angela Carvosso
RN Warwick Health Services
Sent from Mail for Windows 10
Hi all,
Has anyone else been asked if oral thermometers should undergo HLD to comply with 4187, as the probe comes in contact with a mucous membrane?
There is heightened awareness around COVID 19 transmission and it was raised that a probe cover is not considered sufficient protection without HLD for other sitesIf you could please let me know what processes do others use for cleaning of oral thermometer probes between each patient?
Kind regards,
Debra Lee
Clinical Nurse Consultant
Infection Management and Prevention Service
West Block Ground floor
Redcliffe Hospital
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Hi Phil,
Thanks for forwarding the update.
Is there a reason why there is a variation in the possible infectious period
between the “Identification of potential source contacts” and a “Close
contact definition”? See extracts below.Are you able you clarify?
Page 14
“Identification of potential source contacts
For most cases, infection is likely to have been acquired 5-7 days prior to
the first reported case becoming symptomatic (i.e. the median incubation
period of the disease) but may be from anyone who has had contact between 14
days and 24 hours before the first reported case became symptomatic (i.e.
the longest and shortest possible incubation periods). These individuals may
be unidentified cases and the transmission source for the first reported
case. Follow-up should occur for any person who in that period had…..”Page 20
“Close contact definition
A close contact is defined as requiring:
. face-to-face contact in any setting with a confirmed or probable case, for
greater than 15 minutes cumulative over the course of a week, in the period
extending from 48 hours before onset of symptoms in the confirmed or
probable case, or. sharing of a closed space with a confirmed or probable case for a
prolonged period (e.g. more than 2 hours) in the period extending from 48
hours before onset of symptoms in the confirmed or probable case”Many thanks in anticipation
Rgards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Russo
Guidelines for Public Health UnitsDear members
The COVID-19 CDNA National Guidelines for Public Health Units v3.0 has just
been published:https://www1.health.gov.au/internet/main/publishing.nsf/Content/cdna-song-no
vel-coronavirus.htmThe main endorsed changes in this iteration include:
– Revised definition of a probable case (pg 10)
– Revised advice in enhanced testing (pg 11)
– Addition of information on identification of potential source
contacts (pg 14)– Addition of guidance on outbreak investigation and management in
high-risk settings (pg 24-29)For details of all changes, see the revised document. Changes from the last
version have been highlighted.Philip Russo PhD MClinEpid BN, FACIPC
ACIPC President
P +61 3 6281 9239
W
acipc.org.auA 228 Liverpool Street, Hobart TAS 7000, Australia
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Hi Jenny,
DHHS information for Victoria – see attched. I have highlighted the relevant
information.Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
McCarthy
Hi Rachel – as Cathy said the Victorian government is doing a screening
process to get a snapshot of what is going on in the community before they
start to ease restrictions. From my research today it seems there is no need
for them to isolate until they get their test results – thanks to all who
have repliedJenny
Maryvale Private Hospital acknowledges the traditional owners of country,
the Gunaikurnai nation, and recognises their continuing connection to land,
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system) and kindly notify the sender by reply e-mail.Thomson, Rachel EA
Hi Jenny,
I wonder why this HCW was accepted for testing if they were symptom free?
Maybe each jurisdiction are doing their own thing in this regard. In
Tasmania, this person would not have met testing criteria if no symptoms and
no other risk factors for COVID-19If this HCW has symptoms or are a confirmed close contact of a COVID-19 case
or have other risk factors for COVID-19 then they should wait until their
results are available.Interested to understand more about the decision to test this HCW.
Kind regards
Rachel
………………………….
Rachel Thomson
Nurse Unit Manager
Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 6166 7882/ 6166 8658
Level 4, H Block
48 Liverpool Street
Hobart, 7000
> On Behalf Of Jenny McCarthy
Hi all
I have a staff member who is feeling quite well but decided to be tested for
COVID-19 at one of the shopping centre testing areas they have set up. She
assumed she would have a result within 2 days but has been told it may be up
to a week. One of my colleagues has told her she cannot return to work until
she has her result – does this sound right to everyone?Thanks in advance for your expertise and comments
Jenny
Maryvale Private Hospital acknowledges the traditional owners of country,
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Hi Sue,
Will depend on the ventilation and the air exchanges in the area.
contact me directly of needed
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
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
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.auHi 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 hospitalsDonvale Rehabilitation Hospital
Tully WardPhone:
03 9841 1272
Fax:
03 9842 7276
Email:
Web:
Address:
1119 Doncaster Road, Donvale Vic 3111
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 |
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
Newcastle Endoscopy Centre
Ph. 02 4947 6007
http://www.curagroup.com.au/newcastle-endoscopy-centre
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Dear Emily,
The are issues with reprocessing spacers.
They should not be rinsed after washing with detergent as the residual soap on the inside lining of the spacer minimise static electricity in the spacer.
Static electricity causes the medicine to get trapped to the walls of the spacer, instead of entering the lungs.
See highlighted points in the instructions from the Australian Asthma Council as an example – below
Good video from Asthma UK
https://www.youtube.com/watch?v-3tZ-vYok3Q
Cleaning your spacer – Australian Asthma Council
Clean your spacer about once a month and after you have recovered from any cold or respiratory infection. Your spacer may become a bit cloudy over time, but it shouldnt be mouldy or brown.
To clean your spacer:
* Dismantle your spacer, if necessary
*
* Wash all the parts in clean warm water with liquid dishwashing detergent
* Allow the parts to air dry without rinsing drying with a cloth or paper towel can result in static building up on the inside of the spacer, which makes the medication stick to the sides
*
* Wipe the mouthpiece clean of detergent, if needed
*
* When completely dry, reassemble if necessary
New spacers (e.g. Able Spacer Universal, Breath-A-Tech, Volumatic) also need to be washed before you use them for the first time. If a new spacer has to be used immediately, you can prime the spacer by firing at least multiple (at least 10) puffs into it to begin with to help reduce the static build-up inside. You can then take your medication dose as usual.
Spacers made from antistatic polymers (e.g. Able A2A, AeroChamber Plus, Breathe Eazy, La Petite E-Chamber, La Grande E-Chamber, OptiChamber Diamond) do not need to be primed or washed before first use, nor do disposable cardboard spacers.
Your spacer should be checked by your pharmacist, nurse or asthma educator every 612 months to check the structure is intact (e.g. no cracks) and the valve is working properly.
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Hi,
If the manufacturers instructions deems them to be reusable and the instructions are given for the cleaning and reprocessing they can be reprocessed. However, CSD cannot reprocess single use items. Spacers are considered single patient use therefore cannot be reprocessed.
Regards
Kerrin Maher RN BN
Nurse Unit Manager | Central Sterilising Department
QEll Jubilee Hospital | Metro South Health
Kessels Road QLD 4108
t. 07 31826151e. kerrin.maher@health.qld.gov.au
Emily send to CSSD for high level disinfection in instrument washers.
Cheers
Les Alway
Strategic Health Resources
Lesley Alway
Strategic Health Resources
0408324727
On 28 Mar 2020, at 11:22 am, Emily Stewart <estewart@fsph.org.au > wrote:
Hi
I am a very fresh Infection Control Coordinator. Only 18 months into the role from a Surgical Nursing Background.
I have had such a huge learning experience in this last two months!!
I was not sure how to word this question, and am a little shy to post on the ACIPCLIST.
Our ED NUM has asked if there are any products to disinfect spacers , so they can become shared equipment within our facility.
As there is such a shortage and people still have asthma attacks.
I have discussed with our pharmacist, regarding the cleaning process, but alas he only gave me information on how to clean them for continued one person use.
Your guidance or help in the matter would be greatly appreciated.
Thank you
Kind Regards
Emily Stewart Infection Control Coordinator RN
Tel: 07 43311168 Fax: 07 41512180
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Hi Belinda,
The paper I posted was in relation to aerosol and surface contamination of HCoV-19 (SARS-2)- as per below:
Aerosol and surface stability of HCoV-19 (SARS-CoV-6 2) compared to SARS-CoV-1
medRxiv preprint doi: https://doi.org/10.1101/2020.03.09.20033217
*”HCoV-19 (SARS-2) has caused >88,000 reported illnesses with a current case-fatality ratio of ~2%. Here, we investigate the stability of viable HCoV-19 on surfaces and in aerosols in comparison with SARS35 CoV-1. Overall, stability is very similar between HCoV-19 and SARS-CoV-1. We found that viable virus could be detected in aerosols up to 3 hours post aerosolization, up to 4 hours on copper, up to 24 hours on cardboard and up to 2-3 days on plastic and stainless steel. HCoV-19 and SARS-CoV-1 exhibited similar half-lives in aerosols, with median estimates around 2.7 hours. Both viruses show relatively long viability on stainless steel and polypropylene compared to copper or cardboard: the median half-life estimate for HCoV-19 is around 13 hours on steel and around 16 hours on polypropylene. Our results indicate that aerosol and fomite transmission of HCoV-19 is plausible, as the virus can remain viable in aerosols for multiple hours and on surfaces up to days.
I have a conflict of interest in terms of the use of hydrogen peroxide as I consult to a company that markets such a product for cleaning and disinfecting to the healthcare industry in Australia, hence Im not able to comment in this private members forum on a specific products.
Happy to be contacted directly to discuss further if needed contact details below.
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Dear Glenys
Thanks for the information. Is there a dilution ratio for the use hydrogen peroxide when cleaning surfaces?
Warm regards
Belinda Ellis, CNS
MQ Health General Practice
On Sat, 14 Mar 2020 at 5:51 pm, <marjenes@optusnet.com.au > wrote:
Glenys I noted 10 minutes is being recommended by our official feed but its way less than that as you and I know
Regards,
Margaret Jennings
Marjen Education Serviceswebsite. http://www.marjenes.com.au
email. marjenes@optusnet.com.aumob. 0404 088 754
Dear All,
This publication (in press yesterday) notes the following in the summary:
*The analysis of 22 studies reveals that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62-71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute.
Kampf G, et al. Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents, Journal of Hospital Infection, https:// doi.org/10.1016/j.jhin.2020.01.022 .
May be of interest/use.
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
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Virus-free. http://www.avg.com
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—
Kind regards, Belinda
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