[Jackie Miley]

Certainly Glenys

Here they are

Gurses AP, Siedi K, Vaidya V, Bochicchio G, Harris A, Hebden J, and Xiao Y
(2008) Systems ambiguity and guidance compliance: a qualitative study of
how intensive care units follow evidence based guidelines to reduce
healthcare-associated infections. *Quality and Safety in Healthcare *2008. *
17*:351-359.

Morton A, Cook D, Mengersen K, and Waterhouse M (2010) Limiting risk of
hospital adverse events: avoiding train wrecks is more important than
counting and reporting them. *Journal of Hospital Infection.* Volume
*76,*Issue 4 283-286

Kind regards
*Jackie *

*Jackie Miley* MSc, PG Cert Public Health, Cert Infection Control,
Dip Rn. Practice Educator

*Senior Lecturer* Infection Prevention and Control
*Subject Coordinator *MSc Infection Prevention and Control
Oxford Brookes University
Faculty of Health and Life Sciences
Room S1/12
Department of Biological and Medical Sciences
Gipsy Lane Campus
Headington
Oxford OX3 0BP
jmiley@brookes.ac.uk

*Coordinator – Audit and Surveillance Forum. Infection Prevention Society
UK*

*Have you seen?*
Publication of the IPS audit and surveillance competences

Jane McNeish, Catharine Pym, Sandra Beaumont, Jackie Miley
Journal of Infection Prevention July 2013 14: 122-124, first published on May
14, 2013 doi:10.1177/1757177413486736

On 12 January 2014 23:04, Glenys Harrington wrote:

> Hi Jackie,
>
>
>
> Is it possible for you to y include the full references details with your
> comments?
>
>
>
> Regards
>
>
>
> Glenys
>
>
>
> *Glenys Harrington*
>
> *Consultant*
>
> *Infection Control Consultancy (ICC)*
>
>
>
> *PO Box 5202*
>
> *Middle Park*
>
> *Victoria, 3206*
>
> *Australia*
>
> *H: +61 3 96902216 *
>
> *M: +61 404 816 434 *
>
> *infexion@ozemail.com.au *
>
> *ABN 47533508426*
>
>
>
> *[image: Description: ICC Diagram ICCversion]*
>
>
>
>
>
>
>
> *From:* ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] *On
> Behalf Of *Jackie Miley
> *Sent:* Thursday, 9 January 2014 2:46 PM
> *To:* AICALIST@AICALIST.ORG.AU
> *Subject:* Re: [ACIPC_Infexion_Connexion] Single Use vs Reusable Pt
> Equipment
>
>
>
> Dear All
> An interesting and useful dialogue. From my recent experience in the UK,
> financial penalties certainly focus the executive mind on outcomes.
> The Gurses et al paper has some interesting and informative perspectives
> to offer our “industry”!
> Shifting approaches without financial penalties appears to be problematic,
> though targets can lead to ‘train wrecks’ (Morton et al 2010) and there are
> lots of these.
> Reuse of single use items must surely be one of our more difficult battles
> Cheers
>
> Jackie Miley
>
> Project Coordinator Infection Prevention
> Infection Prevention and Epidemiology
>
> *The Alfred*
> 55 Commercial Road
> Melbourne VIC 3004
> PO Box 315 Prahran
> VIC 3181 Australia
>
> Melbourne 3000 Australia
>
>
>
>
>
> *Jackie *
>
>
>
> *Jackie Miley* MSc, PG Cert Public Health, Cert Infection Control,
> Dip Rn. Practice Educator
>
>
> *Senior Lecturer* Infection Prevention and Control
> *Subject Coordinator *MSc Infection Prevention and Control
>
> Oxford Brookes University
> Faculty of Health and Life Sciences
> Room S1/12
> Department of Biological and Medical Sciences
> Gipsy Lane Campus
> Headington
> Oxford OX3 0BP
> jmiley@brookes.ac.uk
>
> *Coordinator – Audit and Surveillance Forum. Infection Prevention
> Society UK*
>
> *Have you seen?*
> Publication of the IPS audit and surveillance competences
>
> Jane McNeish, Catharine Pym, Sandra Beaumont, Jackie Miley
>
> Journal of Infection Prevention July 2013 14: 122-124, first published on
> May 14, 2013 doi:10.1177/1757177413486736
>
>
>
>
>
> On 9 January 2014 11:26, Joe-Anne Bendall Joe-Anne.Bendall@sesiahs.health.nsw.gov.au> wrote:
>
> Hi Cath
> Great debate to start the New Year
> I think each hospital has different risks. For example, here we can
> allocate MRO pts their own BP machine, tourniquet etc. The equipment is
> cleaned when the patient is discharged as part of the terminal cleaning
> process. With the focus on the health $, I am not sure we could sustain the
> costs associated with the costs for purchase, storage and disposal of
> single use items.
>
> We are currently developing a local health district policy for the
> cleaning of shared patient care equipment. This should help with reducing
> the risks of sharing equipment.
>
>
> Thanks
>
> Joe-Anne Bendall
>
> (Monday/Thursday/Friday)
> Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and
> Control
> Sydney Hospital and Sydney Eye Hospital
> 8 Macquarie St
> SYDNEY NSW 2000
> || ph +61 2 9382 7199 |page 22070 via switch 9382 7111| ( Fax 93827510
> |(
> Mobile 0418984255 | | Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU
>
>
>
>
> —–Original Message—–
> From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On
> Behalf Of Cath Murphy
> Sent: Thursday, 9 January 2014 11:05 AM
> To: AICALIST@AICALIST.ORG.AU
> Subject: Re: Single Use vs Reusable Pt Equipment
>
> Thanks Irene and Terrie
> Whilst I appreciate Terrie’s position coming from his role with a provider
> of reusable waste equipment my question was more specifically about
> equipment used on patients for clinical care so things like BP cuffs, ECG
> leads and tourniquets. The various responses are interesting and please
> keep them coming as debate and expression are good for us as is an
> appreciation for the past (and yes I qualify and feel “oldie” as well 🙂
> Cheers Cath
>
> Regards
> Cath
>
> Dr Cathryn Murphy RN MPH PhD CIC
> Executive Director
> Infection Control Plus Pty Ltd
>
> Adjunct Professor
> Griffith University, School of Nursing and Midwifery
> Ph: +61 428 154 154
> http://www.infectioncontrolplus.com.au
>
>
>
>
> —–Original Message—–
> From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On
> Behalf Of Wilkinson, Irene (Health)
> Sent: Thursday, 9 January 2014 9:24 AM
> To: AICALIST@AICALIST.ORG.AU
> Subject: Re: Single Use vs Reusable Pt Equipment
>
> Hi all,
> as a fellow “oldie” I agree with Terry’s assessment of the trends over the
> years. I also support the final point about the issues involved in the
> decision making process. What has always puzzled me is how to accurately
> measure the environmental impact of either disposable or re-usable items?
>
>
> Irene Wilkinson
> Manager, Infection Control Service,
> Communicable Disease Control Branch
> SA Health
> 11 Hindmarsh Square,
> Adelaide SA 5000
> Ph: 08 7425 7170
> ________________________________________
> From: ACIPC Infexion Connexion [AICALIST@AICALIST.ORG.AU] On Behalf Of
> Terry Grimmond [tg@GANDASSOC.COM]
> Sent: 08 January 2014 13:03
> To: AICALIST@AICALIST.ORG.AU
> Subject: Re: Single Use vs Reusable Pt Equipment
>
> Hi Cath,
> I had not heard of a movement back to single use items so I will be
> interested to hear members’ responses on this topic. For oldies like me it
> has been interesting to see the disposable/reusable “cycle” over the
> decades.
>
> * in the 60’s we reused needles, glass syringes, gowns, etc, to
> reduce procurement costs;
>
> * in the 70’s the cost of labour to process reusables (and modern
> technology enabling economic production of disposables) moved us to
> disposables;
>
> * In the 80’s and 90’s waste disposal costs together with
> environmental impact of disposables, caused many to move to reusables again;
>
> * Now with staff shortages, in-house processing of reusables is
> being re-examined (NB. processing by external contractors can still be
> economical, e.g. reprocessing single-use medical devices saves USA
> hospitals $300m annually.
> As you point out, there have been relatively few evidence-based articles
> implicating disease transmission with either protocol.
> The decision to use disposables or reusables must be evidence-based
> encompassing patient and staff safety, labour costs, procurement costs, and
> environmental impact. I look forward to members’ comments
>
> Best regards, Terry
>
> Terry Grimmond FASM, BAgrSc, GrDpAdEd
> Consultant Microbiologist
> Grimmond and Associates
> Ph/Fx (NZ): +64 7 856 4042
> Mob (NZ): +64 274 365 140
> E: tg@gandassoc.com
> “This email (including any attachments) is intended only for the use of
> the individual or entity named above and may contain information that is
> confidential and privileged. If you are not the intended recipient, you are
> reminded that any dissemination, distribution or copying of this email or
> attachments is prohibited. If you have received this email in error, please
> notify me immediately by return email or telephone and destroy the original
> message. Thank you.”
>
>
> From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On
> Behalf Of Cath Murphy
> Sent: Wednesday, January 08, 2014 12:53 PM
> To: AICALIST@AICALIST.ORG.AU
> Subject: Single Use vs Reusable Pt Equipment
>
> Happy new year all
>
> As you may know there’s a subtle movement in Australia towards more
> widespread adoption of single-use items such as venepuncture tourniquets,
> lower limb surgical tourniquets, BP cuffs and ECG leads. Tom Gottlieb
> recently did some elegant research on venepuncture tourniquets and AT ACIPC
> 2013 Karen Vickery presented new perspectives on biofilm on reusable
> equipment. Single-use items have been adopted widely in the US for some
> years and recommendations to that effect are included in many Standards
> published by relevant professional associations eg AORN.
>
> Whilst appreciating that demonstrating causality between reusable
> equipment and transmission of colonising organisms or infection is
> difficult either is biologically plausible. There are also issues of
> non-cleaning, lack of clarity about who’s role it actually is to clean
> reusable equipment, how frequently they need to be cleaned or reprocessed
> etc. These issues have plagued us for at least 3 decades that I know of and
> likely longer. I’m wondering what others in Australia and beyond think
> about single-use pt care items
>
> So my questions are:
>
> 1. Has any ACIPC colleague successfully built a business case to
> convert their facility to single-use pt equipment? If so who was involved
> in that process?;
>
> 2. Which pieces of pt equipment do folks think are most in need of
> single-use alternative options?;
>
> 3. Other than price, storage, supply and environmental/waste issues
> and lack of detailed science what other factors would need to be addressed
> to help convince you or your organisation’s decision makers to invest in
> specific single-use equipment?.
>
> I’d be grateful for any discussion here or as PMs on the email address
> below. If anyone is interested in my further work around this issue please
> email me.
>
> Regards
> Cath
>
> Dr Cathryn Murphy RN MPH PhD CIC
> Executive Director
> Infection Control Plus Pty Ltd
> Cath@infectioncontrolplus.com.au
>
> Adjunct Professor
> Griffith University, School of Nursing and Midwifery
> Ph: +61 428 154 154<tel:%2B61%20428%20154%20154 >
> http://www.infectioncontrolplus.com.au
> https://www.facebook.com/infectioncontrolplus&gt; http://www.infectioncontrolplus.com.au/&gt;
>
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[Jackie Miley]

Dear All
An interesting and useful dialogue. From my recent experience in the UK,
financial penalties certainly focus the executive mind on outcomes.
The Gurses et al paper has some interesting and informative perspectives to
offer our “industry”!
Shifting approaches without financial penalties appears to be problematic,
though targets can lead to ‘train wrecks’ (Morton et al 2010) and there are
lots of these.
Reuse of single use items must surely be one of our more difficult battles
Cheers

Jackie Miley

Project Coordinator Infection Prevention
Infection Prevention and Epidemiology

*The Alfred*
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

Melbourne 3000 Australia

*Jackie *

*Jackie Miley* MSc, PG Cert Public Health, Cert Infection Control,
Dip Rn. Practice Educator

*Senior Lecturer* Infection Prevention and Control
*Subject Coordinator *MSc Infection Prevention and Control
Oxford Brookes University
Faculty of Health and Life Sciences
Room S1/12
Department of Biological and Medical Sciences
Gipsy Lane Campus
Headington
Oxford OX3 0BP
jmiley@brookes.ac.uk

*Coordinator – Audit and Surveillance Forum. Infection Prevention Society
UK*

*Have you seen?*
Publication of the IPS audit and surveillance competences

Jane McNeish, Catharine Pym, Sandra Beaumont, Jackie Miley
Journal of Infection Prevention July 2013 14: 122-124, first published on May
14, 2013 doi:10.1177/1757177413486736

On 9 January 2014 11:26, Joe-Anne Bendall wrote:

> Hi Cath
> Great debate to start the New Year
> I think each hospital has different risks. For example, here we can
> allocate MRO pts their own BP machine, tourniquet etc. The equipment is
> cleaned when the patient is discharged as part of the terminal cleaning
> process. With the focus on the health $, I am not sure we could sustain the
> costs associated with the costs for purchase, storage and disposal of
> single use items.
>
> We are currently developing a local health district policy for the
> cleaning of shared patient care equipment. This should help with reducing
> the risks of sharing equipment.
>
>
> Thanks
>
> Joe-Anne Bendall
>
> (Monday/Thursday/Friday)
> Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and
> Control
> Sydney Hospital and Sydney Eye Hospital
> 8 Macquarie St
> SYDNEY NSW 2000
> || ph +61 2 9382 7199 |page 22070 via switch 9382 7111| ( Fax 93827510
> |(
> Mobile 0418984255 | | Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU
>
>
>
> —–Original Message—–
> From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On
> Behalf Of Cath Murphy
> Sent: Thursday, 9 January 2014 11:05 AM
> To: AICALIST@AICALIST.ORG.AU
> Subject: Re: Single Use vs Reusable Pt Equipment
>
> Thanks Irene and Terrie
> Whilst I appreciate Terrie’s position coming from his role with a provider
> of reusable waste equipment my question was more specifically about
> equipment used on patients for clinical care so things like BP cuffs, ECG
> leads and tourniquets. The various responses are interesting and please
> keep them coming as debate and expression are good for us as is an
> appreciation for the past (and yes I qualify and feel “oldie” as well 🙂
> Cheers Cath
>
> Regards
> Cath
>
> Dr Cathryn Murphy RN MPH PhD CIC
> Executive Director
> Infection Control Plus Pty Ltd
>
> Adjunct Professor
> Griffith University, School of Nursing and Midwifery
> Ph: +61 428 154 154
> http://www.infectioncontrolplus.com.au
>
>
>
>
> —–Original Message—–
> From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On
> Behalf Of Wilkinson, Irene (Health)
> Sent: Thursday, 9 January 2014 9:24 AM
> To: AICALIST@AICALIST.ORG.AU
> Subject: Re: Single Use vs Reusable Pt Equipment
>
> Hi all,
> as a fellow “oldie” I agree with Terry’s assessment of the trends over the
> years. I also support the final point about the issues involved in the
> decision making process. What has always puzzled me is how to accurately
> measure the environmental impact of either disposable or re-usable items?
>
>
> Irene Wilkinson
> Manager, Infection Control Service,
> Communicable Disease Control Branch
> SA Health
> 11 Hindmarsh Square,
> Adelaide SA 5000
> Ph: 08 7425 7170
> ________________________________________
> From: ACIPC Infexion Connexion [AICALIST@AICALIST.ORG.AU] On Behalf Of
> Terry Grimmond [tg@GANDASSOC.COM]
> Sent: 08 January 2014 13:03
> To: AICALIST@AICALIST.ORG.AU
> Subject: Re: Single Use vs Reusable Pt Equipment
>
> Hi Cath,
> I had not heard of a movement back to single use items so I will be
> interested to hear members’ responses on this topic. For oldies like me it
> has been interesting to see the disposable/reusable “cycle” over the
> decades.
>
> * in the 60’s we reused needles, glass syringes, gowns, etc, to
> reduce procurement costs;
>
> * in the 70’s the cost of labour to process reusables (and modern
> technology enabling economic production of disposables) moved us to
> disposables;
>
> * In the 80’s and 90’s waste disposal costs together with
> environmental impact of disposables, caused many to move to reusables again;
>
> * Now with staff shortages, in-house processing of reusables is
> being re-examined (NB. processing by external contractors can still be
> economical, e.g. reprocessing single-use medical devices saves USA
> hospitals $300m annually.
> As you point out, there have been relatively few evidence-based articles
> implicating disease transmission with either protocol.
> The decision to use disposables or reusables must be evidence-based
> encompassing patient and staff safety, labour costs, procurement costs, and
> environmental impact. I look forward to members’ comments
>
> Best regards, Terry
>
> Terry Grimmond FASM, BAgrSc, GrDpAdEd
> Consultant Microbiologist
> Grimmond and Associates
> Ph/Fx (NZ): +64 7 856 4042
> Mob (NZ): +64 274 365 140
> E: tg@gandassoc.com
> “This email (including any attachments) is intended only for the use of
> the individual or entity named above and may contain information that is
> confidential and privileged. If you are not the intended recipient, you are
> reminded that any dissemination, distribution or copying of this email or
> attachments is prohibited. If you have received this email in error, please
> notify me immediately by return email or telephone and destroy the original
> message. Thank you.”
>
>
> From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On
> Behalf Of Cath Murphy
> Sent: Wednesday, January 08, 2014 12:53 PM
> To: AICALIST@AICALIST.ORG.AU
> Subject: Single Use vs Reusable Pt Equipment
>
> Happy new year all
>
> As you may know there’s a subtle movement in Australia towards more
> widespread adoption of single-use items such as venepuncture tourniquets,
> lower limb surgical tourniquets, BP cuffs and ECG leads. Tom Gottlieb
> recently did some elegant research on venepuncture tourniquets and AT ACIPC
> 2013 Karen Vickery presented new perspectives on biofilm on reusable
> equipment. Single-use items have been adopted widely in the US for some
> years and recommendations to that effect are included in many Standards
> published by relevant professional associations eg AORN.
>
> Whilst appreciating that demonstrating causality between reusable
> equipment and transmission of colonising organisms or infection is
> difficult either is biologically plausible. There are also issues of
> non-cleaning, lack of clarity about who’s role it actually is to clean
> reusable equipment, how frequently they need to be cleaned or reprocessed
> etc. These issues have plagued us for at least 3 decades that I know of and
> likely longer. I’m wondering what others in Australia and beyond think
> about single-use pt care items
>
> So my questions are:
>
> 1. Has any ACIPC colleague successfully built a business case to
> convert their facility to single-use pt equipment? If so who was involved
> in that process?;
>
> 2. Which pieces of pt equipment do folks think are most in need of
> single-use alternative options?;
>
> 3. Other than price, storage, supply and environmental/waste issues
> and lack of detailed science what other factors would need to be addressed
> to help convince you or your organisation’s decision makers to invest in
> specific single-use equipment?.
>
> I’d be grateful for any discussion here or as PMs on the email address
> below. If anyone is interested in my further work around this issue please
> email me.
>
> Regards
> Cath
>
> Dr Cathryn Murphy RN MPH PhD CIC
> Executive Director
> Infection Control Plus Pty Ltd
> Cath@infectioncontrolplus.com.au
>
> Adjunct Professor
> Griffith University, School of Nursing and Midwifery
> Ph: +61 428 154 154
> http://www.infectioncontrolplus.com.au
> https://www.facebook.com/infectioncontrolplus&gt; http://www.infectioncontrolplus.com.au/&gt;
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[Jackie Miley]

Michael,
I believe that using the solution according to manufacturers instructions,
and leaving the solution to ‘dry’ on the patient’s skin prior to incision
will facilitate optimal ‘kill’ time and negate the need to a second ‘pass’
with the solution.
Best wishes

*Jackie *

*Jackie Miley* MSc, PG Cert Public Health, Cert Infection Control,
Dip Rn. Practice Educator

Senior Lecturer Infection Prevention and Control
Subject Coordinator MSc Infection Prevention and Control

Oxford Brookes University
Faculty of Health and Life Sciences
Room S1/12
Department of Biological and Medical Sciences
Gipsy Lane Campus
Headington
Oxford OX3 0BP

jmiley@brookes.ac.uk

*Coordinator – Audit and Surveillance Forum. Infection Prevention Society
UK.*

On 19 July 2013 03:12, Tim Spencer wrote:

> Michael,****
>
> Seems to add unnecessary expense to me.. even if the swabs are low cost.**
> **
>
> If skin prepping is done correctly the first time, I see no need to
> double prep, although I do know a clinician who does before placing a
> PICC.****
>
> I do have a little literature (for VA), but its not as current as what
> you might be after.****
>
> Tim..****
>
> ** **
>
> *Timothy R. Spencer**, RN, APN, DipAppSci, Bach.Health, ICCert.
> **Clinical Nurse Consultant, * Central Venous Access & Parenteral
> Nutrition Service****
>
> *Conjoint Lecturer, *South West Sydney Clinical School | Faculty of
> Medicine |* *University of NSW
> Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital,
> Elizabeth Street, Liverpool, 2170, NSW, Australia
> Tel (+61) 2 8738 3603 | Fax (+61) 2 8738 3551 | Mob +61 (0)409 463 428 |
> Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au
> [image: 200 yeas logo white.jpg]****
>
> ** **
>
> *From:* ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] *On
> Behalf Of *Michael Wishart
> *Sent:* Friday, 19 July 2013 11:57 AM
> *To:* AICALIST@AICALIST.ORG.AU
> *Subject:* Surgical skin prepping****
>
> ** **
>
> Hi all****
>
> ** **
>
> Can I ask a question which may seem naive to those with a recent theatre
> background? When applying antiseptic solution as part of a surgical skin
> preparation prior to a procedure, is it best practice to apply two coats
> of antiseptic solution, one immediately on top of the other, using
> different swabs?****
>
> ** **
>
> I can see not real benefit in doing this from an antiseptic action
> viewpoint (apart from mechanical friction) Can also not see this mentioned
> in a cursory review of any SSI prevention best practice guidelines.****
>
> ** **
>
> Any comments? Any references to get me up-to-date if I need to be updated?
> ****
>
> ** **
>
> Thanks****
>
> Michael****
>
> ** **
>
> *Michael Wishart*****
>
> *CNC Infection Control*****
>
> *Holy Spirit Northside Private Hospital*****
>
> 627 Rode Road, Chermside, Qld 4032 ****
>
> *t:* (07) 3326 3068 | *f:* (07) 3607 2226 ****
>
> *e:** *Michael.Wishart@hsn.org.au****
>
> *w:*www.holyspiritnorthside.org.au****
>
> Please consider the environment before printing this email****
>
> ** **
>
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>
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[Jackie Miley]

Dear Kathy
I am aware that guidelines differ across the water (!) but herewith a link
to the UK guidelines.
Risk is generally assessed from a number of perspectives, eg what kind of
surgery is being proposed, what surgery has been undertaken previously,
etc etc.

http://www.dh.gov.uk/health/2012/11/acdp-guidance/

There may be some useful information/definitions here.

Kind regards

*Jackie *

*Jackie Miley* MSc, PG Cert Public Health, Cert Infection Control,
Dip Rn.

Senior Lecturer Infection Prevention and Control
Course Leader MSc Infection Prevention and Control
Course Leader Short Course Infection Prevention & Control

Oxford Brookes University
Faculty of Health and Life Sciences
Department of Biological and Medical Sciences
Jack Straw’s Lane
Marston
Oxford OX3 0FL

jmiley@brookes.ac.uk

On 25 February 2013 10:08, Michael Wishart wrote:

> [Posted on behalf of Kathy Wilson – Moderator]
>
> Hi,
> Just need some clarification on the classification of high risk and low
> risk patients, Appendix 1 (high risk)under accidentally transmitted risk
> factors include treatment with human cadaver pituitary growth hormone,
> gonadotrophin or human dura mater graft and exposure to surgical
> instruments that have come into contact with higher infectivity tissues
> previously used in a case of definite or probable human prion disease. And
> in Appendix 2 (low risk) Recipients of cadaver-derived human pituitary
> hormones before 1986 Dura mater grafts before 1990 and individuals
> involved in a lock back from exposure to surgical instruments that have
> been used on high or medium infective tissue from patients later to be
> found to have contracted CJD.
> What determines if these patients are high risk or low risk?
>
> Kathy Wilson
> Castle Hill Day Surgery
> 72-74 Cecil Ave Castle Hill
> NSW 2154
> Phone 02 88500500
> Fax 02 88503011
>
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[Jackie Miley]

Hi Sony
These are commonly used in the UK
I did a quick Google search and found some advertised there, or you could
contact your current supplier to discuss options for improvements.
Unfortunately they are necessary in today’s healthcare organisations.

*Jackie *

*Jackie Miley* MSc, PG Cert Public Health, Cert Infection Control,
Dip Rn.

Senior Lecturer Infection Prevention and Control
Course Leader MSc Infection Prevention and Control
Course Leader Short Course Infection Prevention & Control

Oxford Brookes University
Faculty of Health and Life Sciences
Department of Biological and Medical Sciences
Jack Straw’s Lane
Marston
Oxford OX3 0FL

jmiley@brookes.ac.uk

On 23 August 2012 14:07, Sony SO wrote:

> Dear All,****
>
> ** **
>
> In recent few weeks, we had two incidents related to patients accidental
> ingestion of alcohol hand rub (AHR). The ingested amount of AHR for these
> two cases in from a few nips to about 50 ml. Although these patients had
> no health harm caused, we would like to enhance our safety measures for
> using AHR.****
>
> ** **
>
> To minimize the above mentioned hazards, we would like to know whether you
> are using AHR dispenser rack with safety locker features.****
>
> ** **
>
> Regards,****
>
> ** **
>
> Sony SO****
>
> Nursing Officer, Infection Control Team****
>
> Kwong Wah Hospital****
>
> Hong Kong SAR, CHINA****
>
> http://www.ha.org.hk/kwh/default.htm****
>
> Tel:+ 852 3517-2409 Fax: +852 2332-3348 email:sony@ha.org.hk****
>
> Please consider the environment before printing this e-mail****
>
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[Jackie Miley]

HI Lincoln,
This has potential !
Well done

*Jackie *

*Jackie Miley* MSc, PG Cert Public Health, Cert Infection Control,
Dip Rn.

Senior Lecturer Infection Prevention and Control & Continuing Professional
Development
Course Leader MSc Infection Prevention and Control
Course Leader Short Course Infection Prevention & Control

Oxford Brookes University
Faculty of Health and Life Sciences
Jack Straw’s Lane
Marston
Oxford OX3 0FL

jmiley@brookes.ac.uk

On 6 June 2012 07:59, Fowler, Lincoln wrote:

> ** ** ** ** **
>
> Hi John****
>
> Assuming the acronym is to promote using the correct steps I would
> suggest: LOCATE****
>
> L: Location of procedure****
>
> O: Order of procedure****
>
> C: Cleaning and disinfection****
>
> A: Aseptic field established****
>
> T: Technique non-touch****
>
> (E: evaluate performace)****
>
> ** **
>
> The last is to encourage reflective practice.****
>
> Perhaps someone can dream up something better based on this.****
>
> Cheers****
>
> *****Lincoln****** Fowler* / Infection Control / CACH****
>
> *Department of Health*****
>
> Telephone: +61 8 9224 1407 / Fax: +61 8 9224 1612****
>
> ****Mobile****: 0467 771 233****
>
> E: Lincoln.Fowler@health.wa.gov.au****
>
> L3 **WASON****, ****151 Wellington St****, ****PERTH**** WA 6000********
>
> **www.health.wa.gov.au********
>
> **Delivering a *Healthy WA*****
> ****
>
> ** **
>
> ** **
> ——————————
>
> *From:* ACIPC Infexion Connexion [mailto:AICALIST@aicalist.org.au] *On
> Behalf Of *John Ferguson
> *Sent:* Monday, 4 June 2012 9:46 AM
> *To:* AICALIST@aicalist.org.au
> *Subject:* Aseptic non-touch technique
> *Importance:* High****
>
> ** **
>
> Dear Aicalist members,****
>
> ** **
>
> As you will know, the new ACSQHC Safety and Quality Standards include
> these (stretch) requirements:****
>
> 3.10 Developing and implementing protocols for aseptic non-touch technique
> ****
>
> 3.10.1 The clinical workforce is trained in aseptic non-touch technique***
> *
>
> 3.10.2 Compliance with aseptic non-touch technique is regularly audited***
> *
>
> 3.10.3 Action is taken to increase compliance with the aseptic non-touch
> technique protocols****
>
> It is quite a challenge to put in place a system that goes across all
> practitioners as I’m sure you know!****
>
> ** **
>
> The resources attached are available from ****UK**** (we have them on
> order). ****
>
> ** **
>
> The Commission would be interested to know about programs around the
> country that have developed ANTT policies and procedures.****
>
> Has anyone started regular auditing (other than say for CL insertion)? If
> so would you please share your audit tool(s)?****
>
> What examples of action taken to increase compliance do you have?****
>
> Have people had experience with the above ****UK**** resources?****
>
> ** **
>
> In Hunter New England, in addition to central line insertion, we’ve chosen
> to focus on IV insertion, wound dressing and IV medication preparation as
> our initial procedures to codify and audit. We already do skills lab
> training for IV inserters. ****
>
> ** **
>
> We’ve also been throwing around the following guiding principles list for
> ANTT – would welcome your comments! Could we perhaps come up with a natty
> acronym for these 5 ‘moments’ of ANTT?****
>
> ** **
>
> *Aseptic non-touch technique (ANTT) : core principles of practice*****
>
> 1. WHERE TO PERFORM- the physical environment for the procedure- where
> should it be performed; what are the situations where it should not be
> performed? ****
> 2. SEQUENCING – the most efficient and safest sequencing of procedure
> preparation and performance needs to be known by the operator and followed
> closely ****
> 3. DISINFECTION- Hands, procedure trolley and the patient procedure
> site; correct disinfectant, method of application and avoidance of
> recontamination ****
> 4. ESTABLISH AND PROTECT ‘ASEPTIC FIELDS’ – sterile drapes, plastic
> trays, sterile glove use, correct procedure sequencing and performance
> ****
> 5. NON-TOUCH PROCEDURE TECHNIQUE – specific to the procedure ****
>
> ** **
>
> Thanks!****
>
> ** **
>
> John****
>
> ** **
>
> *Dr John Ferguson*
> Chair, Healthcare Infection Advisory Committee, Australian Commission on
> Safety and Quality in Healthcare****
>
> Locked Bag 1, ****Newcastle**** Mail Centre, NSW 2310
> Tel * *61 2 4921 4444 | Fax * *61 2 4921 4440 | Mob +61 428 885 573 |
> john.ferguson@hnehealth.nsw.gov.au* *| http://www.hicsiganz.org****
>
> ** **
>
> ** **
>
> ** **
>
> *From:* Stephen Rowley ANTT [mailto:stephen.rowley@antt.org.uk]
> *Sent:* Monday, 4 June 2012 1:57 AM
> *To:* John Ferguson
> *Subject:* Re: Purchase of ANTT package
> *Importance:* High****
>
> ** **
>
> Dear John, ****
>
> ** **
>
> Thank you for your email and sorry for the slow response. We will post you
> the ANTT Guideline CD which includes ANTT Audit Tools and the ANTT Practice
> Framework to the address provided. ****
>
> ** **
>
> To implement ANTT effectively it is important to blend education with
> practical training. To support this, The Association for Safe Aseptic
> Practice (ASAP) provides ANTT Accredited training resources to help support
> training and implementation. The Implementation Pack includes all the
> resources required to implement ANTT across a large organisation. ****
>
> We charge a small amount for these resources to help support the ongoing
> development of ANTT resources. I have attached the Resource List along with
> a information sheet.****
>
> Please let me know if you have any further questions. ****
>
> Best regards****
>
> Pat****
>
> ** **
>
> Patricia Fernandes****
>
> Administrator and PA to:****
>
> Stephen Rowley****
>
> ** **
>
> *Clinical Director ANTT*****
>
> stephen.rowley@antt.org.uk****
>
> http://www.antt.org.uk****
>
> +44 (0)7739 000597****
>
> ** **
>
> ** **
>
> ** **
>
> ** **
>
> ** **
>
> ** **
>
> ** **
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[Jackie Miley]

Hi Beth
I concur with the statements made about through flow, but perhaps the
number of doors opening into the theatre should also be considered, eg many
new NHS facilities may have an outer door between the scrub room and a
corridor, but no door between the scrub room and the theatre – the
distances and ventilation are adequate to avoid splashing and aerosols.
Door openings, especially to facilitate the passage of scrub personnel
(wide open) may disturb large amounts of air, and interfere with whatever
laminar flow, other ventilation you plan to reduce air movements across
sterile fields.
Regards

*Jackie *

*Jackie Miley* MSc, PG Cert Public Health, Cert Infection Control,
Dip Rn.

Senior Lecturer Infection Prevention and Control & Continuing Professional
Development
Course Leader MSc Infection Prevention and Control
Course Leader Short Course Infection Prevention & Control

Oxford Brookes University
Faculty of Health and Life Sciences
Jack Straw’s Lane
Marston
Oxford OX3 0FL

jmiley@brookes.ac.uk

On 22 March 2012 19:57, Prue Wright wrote:

> Hi Beth,****
>
> ** **
>
> The problem I see is that the scrubbed personnel will have to walk past
> the patients bed through an area open to the general corridor; entering
> the OT through the same door as people going in and out. There is a
> potential for being collided with by porters and other staff entering or
> leaving the theatre.****
>
> ** **
>
> The enclosed scrub area is a good feature; but there is only one way in
> and out; another potential for contamination.****
>
> ** **
>
> It would be ideal to have a flow into the scrub area and then to the OT
> without backtracking or having to mix with general traffic.****
>
> ** **
>
> Regards****
>
> ** **
>
> Prue Wright****
>
> ** **
>
> Infection Control Co-ordinator****
>
> Hurstville Private****
>
> ** **
>
> Ph: (02) 9579 7777****
>
> Fax: (02) 9570 8359****
>
> Mob: 0409 311 057****
>
> ** **
>
> Email: InfectionControl@hurstvilleprivate.com.au****
>
> ** **
>
> ** **
>
> *From:* AICA Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] *On
> Behalf Of *Beth Bint
> *Sent:* Thursday, 22 March 2012 12:48 PM
> *To:* AICALIST@AICALIST.ORG.AU
> *Subject:* Design of theatre scrub bays****
>
> ** **
>
> Good Afternoon****
>
> ** **
>
> We are currently undertaking the design of a new theatre suite. During
> this process discuss has arisen regarding the need for dedicate doorways to
> exit the scrub bays into the operating theatre, compared single doorway for
> entering and leaving the scrub bay and then using a shared corridor
> entrance bay to enter the theatre. See table below for illustration of
> flow. Could you please advise if your theatres have this layout and if
> there have been any issues arise from this.****
>
> ** **
>
> We would also be interested in opinions regarding the potential hazards
> associated with this design.****
>
> ** **
>
> theatre****
>
> ** **
>
> ** **
>
> ****
>
> Opening doors****
>
> patient bed****
>
> ** **
>
> anaesthetic bay****
>
> ** **
>
> No door ****
>
> ** **
>
> Scrub sinks****
>
> ** **
>
> theatre corridor****
>
> ** **
>
> ** **
>
> Thank you for your assistance****
>
> Beth****
>
> ** **
>
> *Beth Bint*
>
> Clinical Nurse Consultant | *Infection Management and Control Service*
> Level 1 Lawson House, Wollongong Hospital 2500, NSW
> Tel. 02 4222 5898 | Fax. 02 4222 5367 |
> beth.bint@sesiahs.health.nsw.gov.au
>
>
> [image:
> http://www.health.nsw.gov.au/images/communications/e-signatures/images/NSW-Health-Illawarra-Shoalhaven-LHD.jpg%5D
> ****
>
> ** **
>
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[Jackie Miley]

Hi Fiona

I am Course Leader for MSc Infection Prevention and Control and a Short
Course in Infection Prevention and Control at Oxford Brookes University, and
just to let you know that we only teach ANTT , and indicate that it is
applicable to the insertion and ongoing care of invasive devices, and wound
care, whether in acute care, or in the community.
Some organisations here (in the UK) are implementing this initiative across
the board, with its audit tool, and signing off competence in all staff,
including medical staff, in relation to the insertion of peripheral venous
cannulae, IV medicines management, central line management, and insertion of
Urinary catheters.

Cheers

Jackie

Ms Jackie Miley

Course Leader MSc Infection Prevention and Control
Course Leader Short Course Infection Prevention & Control

Senior Lecturer Infection Prevention and Control & Continuing Professional
Development

Brookes University
School of Health and Social Care
Jack Straw’s Lane
Marston
Oxford OX3 0FL

01865 485251
jmiley@brookes.ac.uk

Dip RN, Cert Infection Control, PGCert Management, PGCert Public Health,
PGCert Higher Professional Education

On 27 June 2011 05:59, Wishart, Michael wrote:

> Hi Fiona
>
> I recall the work of Tal Ellis from the Uni of SA which proposed this
> concept for the management of long term, chronic wounds. My understanding
> was that is was not really suited to acute trauma or surgical wounds. I
> don’t have any sources to cite for this, sorry, just what I recall of
> previous discussions.
>
> I must admit I am surprised to hear universities teaching this concept for
> all wound care. Would be interested to hear if this is a widespread
> component of university training programs now.
>
> Cheers
> Michael
>
> Michael Wishart | GPH – Infection Control Coordinator
>
> GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
> Hospital
> Newdegate Street, Greenslopes QLD 4120
> t: 07 3394 7919 | f: 07 3394 7985
> e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au
>
>
> Ramsay Health Care is an environmentally responsible corporation, please
> consider the environment before printing this email.
> ________________________________________
> From: AICA Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf
> Of Fiona de Sousa
> Sent: Monday, 27 June 2011 1:24 PM
> To: AICALIST@AICALIST.ORG.AU
> Subject: [AICA_Infexion_Connexion] Wound Field Concept
>
> Hi All,
>
> I was recently introduced to the wound field concept by a new graduate
> nurse who had failed her aseptic non touch technique competency as she was
> using the wound field concept that she was taught at her university.
>
> Although I can find theoretical information on this concept I have not
> found any research to show that this is a clinically better practice than
> using an ANTT. It does not appear to be included in the latest Australian
> Infection Control Guidelines or the new national standards either.
>
> Does anyone have any references to support the wound field concept
> especially in relation to reduction in HAI rates?
> Does anyone use this concept in their facility?
>
> Kind Regards,
>
> Fiona De Sousa
> Infection Prevention & Control Coordinator
> Sydney Adventist Hospital
> Mobile: 0408 468 470
> Office: (02) 9487 9732
> Fax: (02) 9472 8053
> Fiona.Desousa@sah.org.au
> 185 Fox Valley Road, Wahroonga, NSW, 2076
>
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[Jackie Miley]

Hi Sony
Are you happy to do what your local technician recommends? Can you get an
opinion from the milk powder manufacturer?

I teach the Infection Prevention and Control module for Brookes University,
for AIE in Hong Kong.
I will be in HK in July teaching as I do each year.
My email address is jmiley@Brookes.ac.uk if you would like to get in touch

Kind regards
Jackie

Ms Jackie Miley

Course Leader MSc Infection Prevention and Control
Course Leader Short Course Infection Prevention & Control

Senior Lecturer Infection Prevention and Control & Continuing Professional
Development

Brookes University
School of Health and Social Care
Jack Straw’s Lane
Marston
Oxford OX3 0FL

01865 485251
jmiley@brookes.ac.uk

Dip RN, Cert Infection Control, PGCert Management, PGCert Public Health,
PGCert Higher Professional Education

On 17 June 2011 11:25, Sony SO wrote:

> **********
>
> Hi jacky,****
>
> ** **
>
> Local technician recommends us using 121OC for the cleaned bottles & pacifiers.
> After the bottles are filled with reconstituted milk, the sterilizers
> parameters are set to 105 OC for 18-20 mins., sterilize time maintain at
> 105 OC for 2 min.****
>
> ** **
>
> Sony SO****
>
> ** **
>
> ** **
> ——————————
>
> *From:* AICA Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] *On
> Behalf Of *Jackie Miley
> *Sent:* Friday, June 17, 2011 4:16 PM
>
> *To:* AICALIST@AICALIST.ORG.AU
> *Subject:* Re: sterilization parameters for powdered infant formula****
>
> ** **
>
> Hi Sony
> Have you approached the manufacturer of the product for advice?
> Jackie
>
> Ms Jackie Miley ****
>
> ** **
>
> Course Leader MSc Infection Prevention and Control****
>
> Course Leader Short Course Infection Prevention & Control****
>
>
> Senior Lecturer Infection Prevention and Control & Continuing Professional
> Development
>
> ****Brookes** ** University****
> ****School** of ** Health**** and Social Care
> Jack Straw’s Lane
> Marston
> ****Oxford**** OX3 0FL
>
> 01865 485251
> jmiley@brookes.ac.uk
>
> Dip RN, Cert Infection Control, PGCert Management, PGCert Public Health,
> PGCert Higher Professional Education****
>
>
>
> ****
>
> On 16 June 2011 18:22, Sony SO wrote:****
>
> Dear All,
>
> My hospital is mainly using the commercially sterile ready-to-feed liquid
> infant formula, however we still need to reconstitute powdered infant
> formula (PIF), and we use steam sterilizer to sterilize the PIF.
>
> We would like to know the recommended sterilization parameters such as
> temperature and the duration for this process.
>
> Regards,
>
> Sony SO
> Nursing Officer, Infection Control Team
> ****Kwong** ** Wah** **Hospital****
> HONG KONG ****SAR**, ** CHINA****
> Tel:+852 3517-2409 Fax: +852 2332-3348 email:sony@ha.org.hk
>
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[Jackie Miley]

Hi Sony
Have you approached the manufacturer of the product for advice?
Jackie

Ms Jackie Miley

Course Leader MSc Infection Prevention and Control
Course Leader Short Course Infection Prevention & Control

Senior Lecturer Infection Prevention and Control & Continuing Professional
Development

Brookes University
School of Health and Social Care
Jack Straw’s Lane
Marston
Oxford OX3 0FL

01865 485251
jmiley@brookes.ac.uk

Dip RN, Cert Infection Control, PGCert Management, PGCert Public Health,
PGCert Higher Professional Education

On 16 June 2011 18:22, Sony SO wrote:

> Dear All,
>
> My hospital is mainly using the commercially sterile ready-to-feed liquid
> infant formula, however we still need to reconstitute powdered infant
> formula (PIF), and we use steam sterilizer to sterilize the PIF.
>
> We would like to know the recommended sterilization parameters such as
> temperature and the duration for this process.
>
> Regards,
>
> Sony SO
> Nursing Officer, Infection Control Team
> Kwong Wah Hospital
> HONG KONG SAR, CHINA
> Tel:+852 3517-2409 Fax: +852 2332-3348 email:sony@ha.org.hk
>
> Messages posted to this list are solely the opinion of the authors, and do
> not represent the opinion of AICA.
>
> Archive of all messages are available at http://aicalist.org.au/archives –
> registration and login required.
>
> Replies to this message will be directed back to the list. To create a new
> message send an email to aicalist@aicalist.org.au
>
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> You can unsubscribe from this list be sending ‘signoff aicalist’ (without
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