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Glenys Harrington

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  • Glenys Harrington
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    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi John,

    Are you saying you have had no clusters or outbreaks of VRE since the implementation 1000 ppm sodium hypochlorite for all environmental cleaning in all clinical areas ten years ago?

    Also does the cleaning schedule include the use of 1000 ppm sodium hypochlorite on non-critical medical devices?

    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—–

    Hi Richard,
    I am interested as to why you need to use a concentration of greater than 1000 ppm for terminal cleaning/disinfection.

    At Austin Health we have been using a cleaning disinfection solution with 1000 ppm sodium hypochlorite for over ten years as a standardised cleaning agent for all environmental cleaning in all clinical areas. We have not encountered substantial OH&S issues as long as staff use appropriate PPE and are trained in safe chemical handling. We couple this standardised cleaning system with monthly VRE environmental surveillance. Our surveillance usually does not yield VRE detections , but when we identify VRE on an item such as a commode chair we inform the clinical area to re-clean all the commode chair. We have found the standard application of 1000 ppm is effective.

    Kind regards,

    John Greenough
    Manager – Infection Control Department

    03 9496 6625

    Level 7, Harold Stokes Building
    145 Studley Road, Heidelberg
    PO Box 5555, Victoria, 3084

    http://www.austin.org.au

    —–Original Message—–

    Hi Richard

    Well, where should I start? This, admittedly, if from quite a few years ago, but anything above 1000ppm available chlorine was problematic for my staff at the time. We initially tried 10000ppm available chlorine, and saw severe cases of skin problems, and some respiratory sensitisation. And the surfaces showed a very rapid decline… even stainless steel benches showed rapid wear! So we moved down to 5000pmm and saw less respiratory sensitisation, still had multiple cases of skin problems, and still had surface wear. This was over a period of several years, mind you. So, after that, I abandoned sodium hypochlorite unless I had absolutely no alternative, and then only at level 1000ppm or less.

    There are other disinfectants now available, although bleach remains easy to obtain and cheap, making it desirable from a cost perspective. But I would strongly argue that wide use of bleach is a definite hazard to staff that is very hard to control.

    My opinion, at any rate.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032 T +61 7 3326 3068 | F +61 7 3607 2226 E michael.wishart@svha.org.au | W https://clicktime.symantec.com/39g5xiNNWMD9XxxzMLsFgPw7Vc?uhttps%3A%2F%2Fwww.svphn.org.au

    —–Original Message—–

    Hi Everyone,
    We are looking at higher concentration dilution of sodium hypochlorite (10% bleach solution) (1:10 solution 1 part bleach for every 9 parts water) for terminal cleaning. This concentration is 5 times the currently used dose 5000 ppm vs 1000ppm. The higher concentrations of chlorine are deemed respiratory sensitizers which have the potential to trigger reactions in some staff. Has anyone had issues?

    Kind Regards,

    Richard

    Richard Bartolo
    Manager Infection Prevention

    Western Health
    Gordon Street, Footscray VIC 3011
    Ph. 03 8345 6113
    Mob. 0438 560 441
    Email. richard.bartolo@wh.org.au
    Web. https://clicktime.symantec.com/3T9CBetsUTQQ1UEyZRZusdP7Vc?uwww.westernhealth.org.au

    This was sent from my iPhone.
    Kind Regards,

    Richard Bartolo
    Manager Infection Prevention

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    in reply to: Routine Chlorhexidine washes in ICU #75650
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi Kristin,

    Lots of information in the peer review literature – some suggested reading
    below

    . Curtis J. Donskey MD et al. Effect of chlorhexidine bathing in
    preventing infections and reducing skin burden and environmental
    contamination: A review of the literature. American Journal of Infection
    Control 44 (2016) e17-e21

    . Susan S. Huang, M.D.Targeted versus Universal Decolonization to
    Prevent ICU Infection. N Engl J Med. 2013 Jun 13;368(24):2255-65

    *Bleasdale SC, Trick WE, Gonzalez IM, Lyles RD, Hayden MK, and
    Weinstein RA (2007).
    Effectiveness of chlorhexidine bathing to reduce catheter-associated
    bloodstream infections in medical intensive care unit patients
    External Web Site Icon. Archives
    of Internal Medicine, 167(19):2073-9.

    *Climo MW, Septowitz KA, Zucotti G, Fraser VJ, Warren DK, Perl TM,
    Speck K, Jernigan JA, Robles JR, Wong ES (2009).
    The Effect of daily bathing
    with Chlorhexidine on the Acquisition of Methicillin-resistant
    Staphylococcus aureus, Vancomycin-resistant Enterococci and
    Healthcare-associated Bloodstream Infections: Results of a
    Quasi-experimental Multicenter Trial
    External Web Site Icon. Critical
    Care Medicine, 37(6):1858-65.

    *Popovich K, Hota B, Hayes R, Weinstein R, Hayden M (2009).
    Effectiveness of routine
    Patient Cleansing with Chlorhexidine Gluconate for Infection Prevention in
    the Medical Intensive Care Unit
    External Web Site Icon. Infection Control and Hospital Epidemiology,
    30(10):959-963.

    *Huang SS, Septimus E, Hayden MK, Kleinman K, Sturtevant J, Avery TR,
    Moody J, Hickok J, Lankiewicz J, Gombosev A, Kaganov RE, Haffenreffer K,
    Jernigan JA, Perlin JB, Platt R, Weinstein RA; Agency for Healthcare
    Research and Quality (AHRQ) DEcIDE Network and Healthcare-Associated
    Infections Program, and the CDC Prevention Epicenters. Effect of body
    surface decolonisation on bacteriuria and candiduria in intensive care
    units: an analysis of a cluster-randomised trial. Lancet Infect Dis. 2016
    Jan;16(1):70-9. doi: 10.1016/S1473-3099(15)00238-8. Epub 2015 Nov
    27.PMID:26631833

    Regards

    Glenys

    Glenys Harrington

    Consultant

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    Kristin Ryan-Agnew (Northern NSW LHD)

    Dear colleagues,

    With a recent spike in HAI MRO’s in our ICU unit, best practice literature
    suggests routine 2% chlorhexidine body washes.

    I would love your thoughts and experiences with this proposal.

    Kind regard

    Kristin

    Kristin Ryan-Agnew

    Kristin Ryan-Agnew (MPH/Grad Cert IP&C)

    Infection Prevention & Control Clinical Nurse Consultant

    The Tweed Hospital

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    in reply to: Re: Cleaning floors in operating suites #75601
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi Lesley,

    Your research projects sounds very interesting.

    Are you able to share the publication or the reference for the publication?

    Would be very useful to share with clinical staff as this topic seems to be raised on a routine, regular basis.

    Regards

    Glenys

    Glenys Harrington

    Consultant

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    Hi Mandy, Support your recommendation I did a research project on show covers many years ago, and found no value in use, as per your comments, What is on the floor stays there unless we provide a vector to carry contaminates ( ie pillows table attachments placed on the floor)

    Change is slow and old practices entrenched without evidence.

    Kind Regards

    Lesley Alway

    Director

    Strategic Health Resources.

    Post Graduate Education Services.

    0408 324 727

    03 94390534

    Director Australian Health Design Council

    Logowithtxt_AHDC

    Hi all

    We have mostly removed shoe covers in our operating theatres and procedural areas. The reasons for this are:

    1.No-one washes their hands after they put them on! .. then they touch EVERYTHING!
    2.There was no hand hygiene sink located adjacent to the change room so they could wash their hands either!. We did eventually put ABHR up in this location, but it had become a habit!
    3.The floor is dirty any-how, leaving the only real purpose of the shoe cover to protect the individuals shoes from contamination during the case. This is a reasonable reason to wear shoe covers, but staff are encouraged to have dedicated shoes.
    4.We have a dress codes for the operating theatres, including dedicated shoes or compliant with WHS requirements (enclosed, non-slip) plus able to be wiped over in the event blood or body fluid contamination
    5.For the most part, most procedures are low risk of gross contamination to shoes, with a couple of notable exceptions (trauma etc). It is better to contain the blood/fluid before it makes it to the floor! This is better from an infection control perspective plus will reduce theatre turn around.

    Reference information can be sourced from Standard Statement 5 Of the Perioperative attire standard in the current ACORN Standards (Ed 15)

    By reducing the number of staff who wear the shoe covers, will hopefully result in a reduction of this problem.

    Re the slips, is the correct product being used on the floors and is it the correct floor covering? We found an issue with product compatibly for the type of flooring we used- the cleaning agent left a film which created a hazard when wet. However, after we investigated further it was discovered that the laminate used in the new build was not to the correct standard. I am unsure of the full details, but it eventually got rectified!

    Kind regards

    Mandy Davidson

    RN; GCert Inf Pre & Cont; MPHTM; Cert III Sterilisation; Cert IV TAE; Immunisation cred; CICP-A

    Clinical Nurse Consultant 4187 Implementation project

    Infection Prevention & Control

    cid:image001.png@01D3A192.E1513890

    T

    07 4433 1873 | 0402 987 432

    E

    Mandy.Davidson@health.qld.gov.au

    W

    http://www.health.qld.gov.au/townsville

    Townsville Hospital and Health Service

    100 Angus Smith Drive, Douglas, QLD 4814

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    Townsville Hospital and Health Service acknowledges the Traditional Owners of the land, and pays respect to Elders past, present and future.

    We are currently having problems with shoe covers in theatre too. The cleaners are sweeping up pieces of white plastic type material which are coming from the shoe covers. The type we are using are obviously not designed for all day wear and bits are wearing off over the course of the day. We are looking at other products that may be a bit stronger and can last a full day of wear intact

    cid:image003.jpg@01D2E9BF.C675F410

    Cathy Mowat

    Clinical Nurse Consultant

    Infection Prevention and Control

    Central Gippsland Health

    T. 03 5143 8518

    E. cathy.mowat@cghs.com.au

    Central Gippsland Health is located on the traditional land of the Gunai Kurnai people

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    Are the shoe covers leaving behind a film? as we had a similar issue & subsequently changed our shoe covers ect

    Emma Trippe
    Infection Control Consultant

    Calvary Riverina Hospital
    Hardy Avenue Wagga Wagga NSW 2650
    P: 02 6932 1628
    E: Emma.Trippe@calvarycare.org.au
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    [Posted on behalf of member Moderator]

    Hi everyone

    We seem to have an issue within our operating theatre regarding the product we use on the floors VMOs complaining they slip easily and the manager wants to try something else instead

    Any help would be appreciated

    Regards, Jenny

    Jenny Garland

    Acting Quality Risk and Safety Manager

    Infection control officer

    Mater Health Service North Queensland

    E mail:Jenny.garland@matertsv.org.au

    Phone 47274173

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    in reply to: Reverie Harp – patient contact? #75494
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi Michael,

    Found the following cleaning instructions online (see below and attached):

    . Cleaning The Reverie Harp If you are using your Reverie Harp in a
    hospital setting and need to keep it disinfected you can wipe down the
    instrument and strings with the alcohol based disinfectant wipes commonly
    found in hospitals.

    I would also include patient/client/resident HH before and after each use

    Glenys

    Glenys Harrington

    Consultant

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    Michael Wishart

    Hi all

    Our pastoral care team want to use a Reverie Harp as part of working with
    patients https://www.robertsmusic.net/harps/

    It would potentially be taken into patient rooms, and patients would hold it
    or it would be placed on their bed for them to play.

    Any suggestions about how we would manage this form an infection prevention
    and control perspective? Does anyone use anything like this in their
    facilities already? Any suggestions on how it could be cleaned between
    patients?

    Thanks for any advice.

    Cheers

    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032

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

    E michael.wishart@svha.org.au |

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

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    in reply to: Environmental swabbing of shared patient equipment #75454
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi Nadene,

    These publications may be of interest/use.

    Contaminated Portable Equipment Is a Potential Vector for Dissemination of
    Pathogens in the Intensive Care Unit Infect Control Hosp Epidemiol
    2017;38:1247-1249

    Do wheelchairs spread pathogenic bacteria within hospital walls?
    World Journal of Microbiology and
    Biotechnology, 30(2), 385-387, 2014

    Havill NL, Havill HL, Mangione E, Dumigan DG, Boyce JM. Cleanliness of
    portable medical equipment disinfected by nursing staff. Am J Infect
    Control. 2011;39:602-4.

    Ide N, Frogner BK, LeRouge CM, et al What’s on your keyboard? A systematic
    review of the contamination of peripheral computer devices in healthcare
    settings BMJ Open 2019;9:e026437. doi: 10.1136/bmjopen-2018-026437

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    Walker, Nadene
    equipment

    Hi All,

    Does anyone have any recent research on the incidence of microorganisms on
    shared patient equipment?

    Thank you, regards, Nadene

    Nadene Walker

    Clinical Nurse Specialist

    Infection Prevention and Control

    WA Country Health Service – Great Southern

    Albany Health Campus

    Warden Ave Albany WA 6330

    PO Box 252 Albany WA 6331

    P (08) 98922211 F (08) 98426037

    M: 0428 086 062 (Business hours)

    nadene.walker@health.wa.gov.au

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    Healthier country communities through partnership and innovation

    “I respectfully acknowledge the past and present traditional owners of this
    land, Noongar country, that we are working on.”

    5may2019_tb

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    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi Pam,

    Generally in Australia 1000ppm Sodium Hypochlorite is recommended and used
    however you will find in the USA Sodium Hypochlorite 5000ppm is general
    what is used.

    In outbreak control reports (i.e. multiple strategies) you will find both
    concentrations of Sodium Hypochlorite noted.

    If your including spores in your query find below an extract from the recent
    “ASID/ACIPC position statement – Infection control for patients with
    Clostridium difficile infection in healthcare facilities” which explains
    further the use of chlorine based agent.

    . “If using a chlorine based agent (i.e. household bleach) high
    levels of chlorine (5000 mg/L free chlorine) have been shown to have
    consistent efficacy against C difficile spores however lower dilutions of
    chlorine (1000 and 3000 mg/L free chlorine) show varying capacity to
    eradicate spores. Sporicidal agent contact times recommended by the
    manufacturer/supplier need to be practical for healthcare n settings. Long
    contact times (the time the surface needs to remain wet) of 10-30 min may be
    an occupational health and safety hazard and are not practical for a
    healthcare setting”.

    Rhonda L. Stuart et al. ASID/ACIPC position statement – Infection control
    for patients with Clostridium difficile infection in healthcare facilities

    https://www.idhjournal.com.au/article/S2468-0451(18)30143-3/fulltext

    I hope this is helpful.

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    Pamela Ann Boon
    grade disinfectants

    Good morning everyone,

    I am comparing two Sodium Hypochlorite products for hard surface
    cleaning/disinfection (floors etc).

    They have widely different recommended ppm dilutions for reconstitution as
    hospital grade disinfection (one is 1000ppm, the other is 5000ppm).

    Does anyone have any suggestions where I can locate advice on approximate
    ppm Sodium Hypochlorite dilution for microbial kill?

    Thanks so much,

    Kind regards,

    Pam

    Pamela Boon | Clinical Nurse Manager

    Infection Prevention and Management Unit

    Royal Darwin Palmerston Hospitals | Top End Health Service

    Northern Territory Government

    LG Floor, Royal Darwin Hospital, Rocklands Drive, Tiwi

    GPO Box 41326, Casuarina, NT 0811

    p …08 892 28045

    f … 08 892 28889

    e … Pamela.Boon@nt.gov.au
    w. http://www.nt.gov.au/health

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    in reply to: Health Service Cleaning surveyors. #75421
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi Matt,

    My experience when these audits were in place (large acute care facility/community hospital/aged care facility) was that the audit training was internal.

    The audit tool was fairly self-explanatory as it included a scoring system so easy to follow.

    Initially the audits were multidisciplinary however because it was labour intensive (one of the problems) it was usually just done by an experienced environmental services manager or the corporate person overseeing the service.

    There was also an annual external audit undertaken. This was conducted by a private company/contractors, some of whom were ICPs.

    I do know of a facility that is still doing these audits so if you need an ICP contact drop me an email infexion@ozemail.com.au

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    Hi All,

    Going back a few years Victoria introduced cleaning standards and trained people (IPC and Hotel Services Staff) to audit their own and other facilities. Just wondering if this is still a thing, and if so who overseas the standards and the training?? Thanks in advance.

    Cheers Matt

    Matt Mason RN, CICP-E, FCRANAplus, BN, M Rural Health, M Advanced Practice (IC)

    Lecturer
    School of Nursing, Midwifery & Paramedicine
    USC

    Ph +61 7 5456 5191

    mmason1@usc.edu.au

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    in reply to: Exercise Heart Rate Monitors for Children #75410
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi Donna,

    Such information should be sourced directly from the medical product/device manufacturer/s as they are required by TGA to provide recommended instructions for use(IFU) which must include cleaning instructions and be inclusive of the recommended cleaning/disinfecting agents.

    Healthcare facilities should:

    Identify and follow the device manufacturers cleaning and decontamination instructions as failure may be considered off-label use

    Ensure any detergents and/or disinfectants used are compatible with the device manufacturers instructions for use (IFU)

    Ensure staff are training in the appropriate use of the cleaning and disinfection agents and

    If the manufacturers instructions for use (IFU) are inadequate, report to the Australian Government, Therapeutics Goods Administration (TGA), Medical Device Incident Reporting & Investigation Scheme (IRIS) https://www.tga.gov.au/medical-device-incident-reporting-investigation-scheme-iris and the manufacturer.

    Hope this is helpful.

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    Hello, does anyone know of an exercise heart rate monitor for children that can be used to ascertain their fitness level? I am looking for something that can be easily cleaned.

    Currently the service is looking at strap-on chest monitors made of a stretchy fabric material, which would in the very least will require machine washing. Something I am very reluctant to add to my list of risks at this stage.

    If anyone can suggest a suitable product, could you please inbox me? Thankyou

    Kind Regards,

    Donna Schmidt
    Clinical Nurse Consultant Infection Control – Primary & Community Health

    Rosemeadow Community Health Centre

    5 Thomas Rose Drive, Rosemeadow, NSW, 2560
    Tel (02) 4633 4113 | Fax (02) 4633 4111 | Mob 0438 925 816

    donnamarie.schmidt@health.nsw.gov.au

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    Hi guys,

    Can you please post this to the list.

    Thanks,

    Helen.

    Helen Scott

    A/CNC Infection Prevention & Control

    Clinical Governance Unit

    North West Hospital and Health Service | Queensland Government

    p: 07 4744 4021 | m: 0429 474 493

    a: PO Box 27 Mount Isa Qld 4825

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    in reply to: FW: Issues with Influenza Vaccination leakage #75391
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi Sue,

    You may have already done this but if not your issues/problems should be
    reported to the TGA using the “Medicine or defective vaccine report” form at
    the following link:

    https://www.tga.gov.au/medicine-or-vaccine-defect-report

    As per TGA – The report is to “report defects that you think have arisen
    during manufacture, storage or handling of medicines. These sorts of
    problems are usually found in a single batch or a single pack of a product.
    These problems may require investigation by the Therapeutic Goods
    Administration (TGA) Laboratories”.

    Your particular issues/problems may relate to a specific batch.

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    Susan Gonelli
    leakage

    Hi All,

    I would like to ask if anyone else is having issues with the AfluriaQuad
    Influenza vaccine and BD Eclipse needles. We have had a number of leur lock
    mechanism breakages as well as vaccine leaking requiring a 2nd dose. We
    have also had a needle stick injury post vaccination when the needle and
    syringe fell apart as the safety mechanism was being activated. I also have
    been informed that another organisation have had 3 needle stick injuries
    within their IC department using the same combination of vaccine and BD
    Eclipse needles. I have attached a photo of the broken syringe / needle
    combination.

    This issue has been reported to TGA, BD and Seqirus

    Regards

    Sue Gonelli CNC – Pre Employment Immunisation Coordinator

    Employee Exposure Management and Immunisation Service – PO Box 52, Frankston
    Vic 3199

    Direct 9788 4568 Fax 9784 2347 Switchboard 03 9784 7777

    Penisula Health

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    in reply to: Discharge bed cleaning #75216
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi Pam,

    This recently published review by Evonne Curran et al in the Journal of
    Infection Prevention will help you with guidance in relation to cleaning and
    disinfection.

    . Curran et al. Chemical disinfectants: controversies regarding
    their use in low risk healthcare environments (part 1). Journal of Infection
    Prevention. First Published March 5, 2019. Accessed online 11/3/2019.
    https://journals.sagepub.com/doi/pdf/10.1177/1757177419828139

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    Pamela Ann Boon

    Good morning,

    We are reviewing bed cleaning procedures and products in our hospitals.

    In regards to discharge bed cleaning, can anybody share;

    . Do you use detergent

    . Do you use detergent & disinfectant – if YES what product do you
    use

    Thanks so much.

    Cheers from Pam

    Pamela Boon | Clinical Nurse Manager

    Infection Prevention and Management Unit

    Royal Darwin Palmerston Hospitals | Top End Health Service

    Northern Territory Government

    LG Floor, Royal Darwin Hospital, Rocklands Drive, Tiwi

    GPO Box 41326, Casuarina, NT 0811

    p …08 892 28045

    f … 08 892 28889

    e … Pamela.Boon@nt.gov.au
    w. http://www.nt.gov.au/health

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    in reply to: wall paper in clinical areas – any advice #75168
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi Lindy,

    This article (abstract below) may be of interest/use. The types of wall
    finishes tested included latex-based paint, enamel paint, vinyl,
    micro-perforated vinyl (with paper backing) and textured wallpaper.

    Do you know the specific (generic) type of wallpaper that is proposed? For
    example vinyl wallpaper may unintentionally form vapour barriers which can
    create an environment where mould is likely to grow.

    Am J Infect Control. 2006
    Jun;34(5):258-63.

    Assessment of materials commonly utilized in health care: implications for
    bacterial survival and transmission.

    Lankford MG1,
    Collins S,
    Youngberg L,
    Rooney DM,
    Warren JR,
    Noskin GA.

    Author information

    Abstract

    BACKGROUND:

    Contaminated environmental surfaces, equipment, and health care workers’
    hands have been linked to outbreaks of infection or colonization because of
    vancomycin-resistant enterococci (VRE) and Pseudomonas aeruginosa (PSAE).
    Upholstery, walls, and flooring may enhance bacterial survival, providing
    infectious reservoirs.

    OBJECTIVES:

    Investigate recovery of VRE and PSAE, determine efficacy of disinfection,
    and evaluate VRE transmission from surfaces.

    METHODS:

    Upholstery, flooring, and wall coverings were inoculated with VRE and PSAE
    and assessed for recovery at 24 hours, 72 hours, and 7 days. Inoculated
    surfaces were cleaned utilizing manufacturers’ recommendations of natural,
    commercial, or hospital-approved products and methods, and samples were
    obtained. To assess potential for transmission, volunteers touched
    VRE-inoculated surfaces and imprinted palms onto contact-impression plates.

    RESULTS:

    Twenty-four hours following inoculation, all surfaces had recovery of VRE;
    13 (92.9%) of 14 surfaces had persistent PSAE. After cleaning, VRE was
    recovered from 7 (50%) surfaces, PSAE from 5 (35.7%) surfaces. After
    inoculation followed by palmar contact, VRE was recovered from all surfaces
    touched.

    CONCLUSION:

    Bacteria commonly encountered in hospitals are capable of prolonged survival
    and may promote cross transmission. Selection of surfaces for health care
    environments should include product application and complexity of
    manufacturers’ recommendations for disinfection. Recovery of organisms on
    surfaces and hands emphasizes importance of hand hygiene compliance prior to
    patient contact.

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    Lindy Ryan (Mid North Coast LHD)
    advice

    Hello brains trust

    It seems our local health services and state health infrastructure are
    intending to put wall paper in clinical areas in part of our new builds
    .such as birthing unit.

    My infection control sense is really twitching with concerns as they don’t
    see any infection control issues at this time without more rationale re
    risks that would sway them to reconsider doing this (as they believe it
    will give them the homey feeling they are after in their new model of care)
    .

    So …in the spirit of trying to be informed and with the times in
    understanding & working proactively to support these new model of care
    needs ..can anyone else provide any advice of their experience with this
    being installed and any pros and cons .I am screaming ‘no don’t ‘ inside
    for a number of reasons (we have a warm humid climate here on the coast in
    summer) . so I am hoping for any wise words or publications , commentary
    from this group around the use of wallpaper in clinical areas if anyone has
    any to help us with

    Many thanks as always

    Kind regards

    Lindy

    Lindy Ryan

    District Infection Prevention & Control CNC | Clinical Governance &
    Information Services MNCLHD

    Level 1 Coffs Specialist Centre, Pacific Hwy, Coffs Harbour
    Office 66911984 or Mob 0419 990 693 |

    lindy.ryan@ncahs.health.nsw.gov.au
    http://www.health.nsw.gov.au

    http://internal.health.nsw.gov.au/communications/e-signatures/images/NSW-Hea
    lth-Mid-North-Coast-LHD.jpg

    “Wise and humane management of the patient is the best safeguard against
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    in reply to: wall paper in clinical areas – any advice #75146
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi Lindy,

    The simple answer is that wall paper cannot be cleaned nor when necessary
    disinfected which may be required in a birthing suite.

    I think if the supplier or manufacturer of the wall paper was asked they
    will advise that the wall paper will not tolerate water nor chemical
    disinfectants such as sodium hypochlorite (i.e. household bleach).

    Your architects may not be familiar with current Australasian Health
    Facility Guidelines

    Section – 04 SURFACES AND FINISHES

    04.01 General

    “All surfaces in patient care areas should be smooth and impervious, and
    easily cleanable. Unnecessary horizontal, textured, moisture-retaining
    surfaces or inaccessible areas where moisture or soil can accumulate should
    be avoided”

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    Lindy Ryan (Mid North Coast LHD)
    advice

    Hello brains trust

    It seems our local health services and state health infrastructure are
    intending to put wall paper in clinical areas in part of our new builds
    .such as birthing unit.

    My infection control sense is really twitching with concerns as they don’t
    see any infection control issues at this time without more rationale re
    risks that would sway them to reconsider doing this (as they believe it
    will give them the homey feeling they are after in their new model of care)
    .

    So …in the spirit of trying to be informed and with the times in
    understanding & working proactively to support these new model of care
    needs ..can anyone else provide any advice of their experience with this
    being installed and any pros and cons .I am screaming ‘no don’t ‘ inside
    for a number of reasons (we have a warm humid climate here on the coast in
    summer) . so I am hoping for any wise words or publications , commentary
    from this group around the use of wallpaper in clinical areas if anyone has
    any to help us with

    Many thanks as always

    Kind regards

    Lindy

    Lindy Ryan

    District Infection Prevention & Control CNC | Clinical Governance &
    Information Services MNCLHD

    Level 1 Coffs Specialist Centre, Pacific Hwy, Coffs Harbour
    Office 66911984 or Mob 0419 990 693 |

    lindy.ryan@ncahs.health.nsw.gov.au
    http://www.health.nsw.gov.au

    http://internal.health.nsw.gov.au/communications/e-signatures/images/NSW-Hea
    lth-Mid-North-Coast-LHD.jpg

    “Wise and humane management of the patient is the best safeguard against
    infection”

    (Florence Nightingale Circa 1860)

    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.

    Views expressed in this message are those of the individual sender, and are
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    in reply to: Re: FW: Laundry Audits #75032
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi Marija

    Thanks for the extract from the standard.

    I disagree with the premise that an audit is required.

    The wording is review, hence there are many way this can be done without a
    formal audit process, checklists are what come to mind for me.

    In addition such reviews should be the responsibility of the service manager
    not audit weary infection prevention and control staff don’t you think?

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    Juraja, Marija (Health)

    As per my understanding of the new standard with regard to last points in
    red. I believe that the overall goverenance for this sists with Executive
    and including the contractual obligations placed onto the company that is
    providing that service. We should be auditing internal compliance with
    provision and storage of clean linen and its removal. My thoughts J

    Action 3.12

    Review processes for linen handling

    Review the movement, supply and handling of clean and used linen in the
    health service organisation to minimise infection risks associated with
    linen for both patients and the workforce. This includes linen used for
    patient care, environmental linen (for example, privacy screens), and linen
    used by the workforce (for example, theatre scrubs, uniforms). Consider how
    to:

    Minimise excess handling

    Ensure effective containment and storage

    Optimise traffic flows to minimise contamination of
    clean linen

    Reprocess used linen (methods used, and whether this
    is done by the health service organisation or an external service).

    Ensure that any external services are part of the systems for quality
    improvement and contracts review addressed in the Clinical Governance
    Standard.

    Kind 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

    Conumers

    Fefe Lawson

    Hi All

    My understanding for accreditation and food safety requirements is that you
    should have certification from 3rd party providers.

    Fefe Lawson

    Director Governance and Corporate Services

    Karitane

    0419100366

    Sent from my Samsung Galaxy smartphone.

    ——– Original message ——–

    Dear All,

    Such requests from accreditors in relation to 3rd party laundry service
    providers should be reported to ACSQHC.

    Such requests are setting an unfortunate precedent in which the healthcare
    facility has no jurisdiction over such providers.

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    De Sousa, Fiona M (THS)

    Hi All,

    In some of my previous roles auditing the laundry provider on a regular
    (annual / second yearly) basis was required and specifically asked for by
    accreditors. I have also worked in facilities where the provision of
    compliance documentation from the laundry was considered sufficient by
    accreditors.

    In my current facility an annual audit is carried out of our 3rd party
    provider but is not the responsibility of IPC.

    Kind regards,

    Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit

    Launceston General Hospital, Level 2, Launceston TAS 7250

    phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email:
    fiona.de.sousa@ths.tas.gov.au |

    intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control

    IPCU – ‘By working together we promote a culture of safety to reduce
    preventable infections and transmission of multi-resistant organisms’

    Michael Wishart

    Hi Marija

    I certainly agree. Similar to sterile stock we purchase (we don’t audit them
    on AS 4187 compliance, we get documentation they meet requirement), we
    should have copies of the external laundry provider’s certifications as part
    of the contract.

    There is one external infection control audit group I know of that does
    request these audits are down by the facility, though. And, I will admit, it
    gives the ICP an opportunity to visit the laundry annually, which I have
    found to be useful in order to understand the laundry process and meet the
    key stakeholders.

    Maybe rather than a formal audit, ICP’s could request to visit the external
    laundry for a tour?

    Cheers

    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032

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

    E michael.wishart@svha.org.au |

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

    cid:image001.jpg@01D46C86.4CDB6090

    2019 conference email signature

    Marija (Health)

    Hi All,

    I agree and yes it should be built into the contract ( and something I check
    when the contracts are due for renewal) for the linen services provided for
    the organisation and something that can be requested by your Hotel Services
    Manager.

    This is not for us to audit (we have enough as it is to do), but for the
    service to provide their evidence if required and for us to ensure that
    linen managed on site is managed within the guidelines/standards.

    My thoughts.

    Kind 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

    Conumers

    Glenys Harrington

    Dear all,

    I have heard some hospitals teams are being asked during accreditation about
    their linen service compliance with Australian and NZ Linen standard
    4146:2000.

    While this would be appropriate for internal laundry services I would be
    interested to know of any regulatory requirement for annual/other auditing
    requirements by hospital staff (infection control/hospital service) when the
    provider is a 3rd party provider (external)?

    Surely compliance with relevant standards/regulations is included contracts
    with 3rd party providers and hence such providers themselves could be
    compelled can provide evidence if requested?

    It does not seem like a good use of busy infection control/other hospitals
    personnel resources to be conducting audits (annual or otherwise) on 3rd
    party providers whom they have no direct jurisdiction over?

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    De Sousa, Fiona M (THS)

    Hi All,

    We are currently looking at alternative tools for auditing 3rd party
    laundry premises. Does anyone have a tool they would be willing to share?

    Kind regards,

    Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit

    Launceston General Hospital, Level 2, Launceston TAS 7250

    phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email:
    fiona.de.sousa@ths.tas.gov.au |

    intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control

    IPCU – ‘By working together we promote a culture of safety to reduce
    preventable infections and transmission of multi-resistant organisms’

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    in reply to: Re: FW: Laundry Audits #75029
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Dear All,

    Such requests from accreditors in relation to 3rd party laundry service
    providers should be reported to ACSQHC.

    Such requests are setting an unfortunate precedent in which the healthcare
    facility has no jurisdiction over such providers.

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    De Sousa, Fiona M (THS)

    Hi All,

    In some of my previous roles auditing the laundry provider on a regular
    (annual / second yearly) basis was required and specifically asked for by
    accreditors. I have also worked in facilities where the provision of
    compliance documentation from the laundry was considered sufficient by
    accreditors.

    In my current facility an annual audit is carried out of our 3rd party
    provider but is not the responsibility of IPC.

    Kind regards,

    Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit

    Launceston General Hospital, Level 2, Launceston TAS 7250

    phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email:
    fiona.de.sousa@ths.tas.gov.au |

    intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control

    IPCU – ‘By working together we promote a culture of safety to reduce
    preventable infections and transmission of multi-resistant organisms’

    Michael Wishart

    Hi Marija

    I certainly agree. Similar to sterile stock we purchase (we don’t audit them
    on AS 4187 compliance, we get documentation they meet requirement), we
    should have copies of the external laundry provider’s certifications as part
    of the contract.

    There is one external infection control audit group I know of that does
    request these audits are down by the facility, though. And, I will admit, it
    gives the ICP an opportunity to visit the laundry annually, which I have
    found to be useful in order to understand the laundry process and meet the
    key stakeholders.

    Maybe rather than a formal audit, ICP’s could request to visit the external
    laundry for a tour?

    Cheers

    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032

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

    E michael.wishart@svha.org.au |

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

    cid:image001.jpg@01D46C86.4CDB6090

    2019 conference email signature

    Marija (Health)

    Hi All,

    I agree and yes it should be built into the contract ( and something I check
    when the contracts are due for renewal) for the linen services provided for
    the organisation and something that can be requested by your Hotel Services
    Manager.

    This is not for us to audit (we have enough as it is to do), but for the
    service to provide their evidence if required and for us to ensure that
    linen managed on site is managed within the guidelines/standards.

    My thoughts.

    Kind 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

    Conumers

    Glenys Harrington

    Dear all,

    I have heard some hospitals teams are being asked during accreditation about
    their linen service compliance with Australian and NZ Linen standard
    4146:2000.

    While this would be appropriate for internal laundry services I would be
    interested to know of any regulatory requirement for annual/other auditing
    requirements by hospital staff (infection control/hospital service) when the
    provider is a 3rd party provider (external)?

    Surely compliance with relevant standards/regulations is included contracts
    with 3rd party providers and hence such providers themselves could be
    compelled can provide evidence if requested?

    It does not seem like a good use of busy infection control/other hospitals
    personnel resources to be conducting audits (annual or otherwise) on 3rd
    party providers whom they have no direct jurisdiction over?

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    De Sousa, Fiona M (THS)

    Hi All,

    We are currently looking at alternative tools for auditing 3rd party
    laundry premises. Does anyone have a tool they would be willing to share?

    Kind regards,

    Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit

    Launceston General Hospital, Level 2, Launceston TAS 7250

    phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email:
    fiona.de.sousa@ths.tas.gov.au |

    intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control

    IPCU – ‘By working together we promote a culture of safety to reduce
    preventable infections and transmission of multi-resistant organisms’

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    in reply to: FW: Laundry Audits #75010
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Dear all,

    I have heard some hospitals teams are being asked during accreditation about
    their linen service compliance with Australian and NZ Linen standard
    4146:2000.

    While this would be appropriate for internal laundry services I would be
    interested to know of any regulatory requirement for annual/other auditing
    requirements by hospital staff (infection control/hospital service) when the
    provider is a 3rd party provider (external)?

    Surely compliance with relevant standards/regulations is included contracts
    with 3rd party providers and hence such providers themselves could be
    compelled can provide evidence if requested?

    It does not seem like a good use of busy infection control/other hospitals
    personnel resources to be conducting audits (annual or otherwise) on 3rd
    party providers whom they have no direct jurisdiction over?

    Regards

    Glenys

    Glenys Harrington

    Infection Control Consultancy (ICC)

    P.O. Box 6385

    Melbourne

    Australia, 3004

    M: +61 404816434

    E: infexion@ozemail.com.au

    De Sousa, Fiona M (THS)

    Hi All,

    We are currently looking at alternative tools for auditing 3rd party
    laundry premises. Does anyone have a tool they would be willing to share?

    Kind regards,

    Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit

    Launceston General Hospital, Level 2, Launceston TAS 7250

    phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email:
    fiona.de.sousa@ths.tas.gov.au |

    intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control

    IPCU – ‘By working together we promote a culture of safety to reduce
    preventable infections and transmission of multi-resistant organisms’

    _____

    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
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    If you have received the transmission in error, please immediately contact
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    its return at our cost. No liability is accepted for any unauthorised use of
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