[Joe-Anne Bendall]

Hi Maureen
Most of the hospitals I have worked at over the last 5 years have all decommissioned their flash sterilisers. All for the reasons you have stated.

Joe Bendall
CNC Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital

Hi All

What are your opinions on Flash autoclaves? When I worked in Theatre in London in the 70s it was considered unacceptable to use flash autoclaves as there are significant risks associated with this practice. We made sure we had enough instruments for our booked lists and emergency surgery plus single wrapped extra instruments to replace dropped instruments.

The HICPAC definition is Flash sterilization is a modification of conventional steam sterilization (either gravity, prevacuum, or steam-flush pressure-pulse) in which the flashed item is placed in an open tray or is placed in a specially designed, covered, rigid container to allow for rapid penetration of steam.

I am surprised that any OR in Australia would consider using “flash ” sterilizers rather than purchasing sufficient instruments to meet the needs of the facility. What is your opinion?

Maureen Cremin
Regional Infection Control Coordinator
WACHS Great Southern
Phone 08 9892 2211

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[Joe-Anne Bendall]

Hi Cath
It has been almost a year since we completed our accreditation using the new standards. I think the big changes from previous accreditations: (I have been through hospital accreditations since 1978…….)

1. The need for a comprehensive gap analysis against the new standards and subsequent Action Plan

2. The number of audits required – but then you need to be creative and do what suits your hospital and not follow all the suggestions in the Commissions booklets. Making sure you spend more time on the recommendations and outcomes rather than more auditing

What I have changed

3. I had good templates for all my reports and project plans, but now they all have the Standard 3 Number at the top and I save all documents with the Standard Number and date eg 3.17.1 TSSU – desktop scenario – testing of the recall procedure 22 March 2013.doc. I can then search for evidence using the number when I put my evidence file together next time.

4. Developing an infection control committee standing agenda item template under the Standard 3 Headings. All reports are now tabled against each subject. This will also make it easier for accreditation into the future

I think some of the challenges are to keep the program fresh, innovative while engaging with all clinicians. Also, do not speak about ‘accreditation’ but talk about patient safety.

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| 7 Fax 93827510 |
Mobile 0418984255 | * Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

Hi Cath
We are a small stand alone private facilty (47 acute beds) and have just gone through the accreditation process (all 10 Standards and just having changed over to ISO – great fun!!)
and I agree with Micheal – I have found the AMS component very hard to demonstrate. While the guide for smaller facilities was very helpful I felt there was no where to go when there was non compliance with the antibiotic guidelines (just have to continue to report it at the relevant commitees).
Having said that the one area we did not get compliance in was 3.19!
regards
Jenny

Jenny McCarthy
OR Manager/Infection Prevention and Control Coordinator
Maryvale Private Hospital

________________________________
Hi Cath

We were accredited via the new Standards by ACHS late last year, and I think the process of having to demonstrate minimum requirements is good. Most of Standard 3 involves things we have been doing for a while (or should have been doing) in infection control, and most of meeting Standard 3 is just closing the loop with documentation and evaluation of what we do. So mostly good – to have all facilities measured against these Standards can only lead to improved patient outcomes, in my opinion.

My biggest gripe is AMS – AMS is an important infection prevention issue, don’t get me wrong, but ICP’s don’t prescribe antibiotics. In a facility with a standalone ICP (ie not part of a team with ID Physicians and clinical microbiologists) getting medical staff (who, in the private sector, are not even part of the workforce, really) to prescribe according to guidelines is a target way out of reach. Sure, we can audit and put up posters and stuff, but the responsibility for this part of Standard 3 should NOT be upon the facility, in my view, but put back on the medical staff, at least in the private sector. That’s my main gripe within Standard 3.

Just some thoughts.

Cheers
Michael

Michael Wishart
Infection Control Coordinator
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
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[cid:image001.png@01CF136C.06F021B0]

Greetings all

One year since their implementation I am wondering how most IPs are coping with the Commission’s national safety and quality standards and in particular Standard 3. As some of you may know I was personally involved in some of their development through membership on two of the Commission’s committees. Yesterday I enquired of the Commission about any publically available information on how the Standards implementation is progressing but they are unable to report anything. To my knowledge there are no papers in peer-reviewed journals either. The Commission’s timeframe for review as stated on their website is 2015.

I am especially keen to hear in IP-speak 1) the challenges, rewards and obstacles that IPs may have faced as a result of Standard 3. 2)How “usual” ways of work may have changed and 3) any assistance that would make the task of implementing them easier.

In their Annual Report and at ACIPC 2012 Conference in Sydney the Commission referred to HH compliance, C Diff rates and SAB rates as the markers they will use to assess Stdnard 3’s impact. I’m more interested in the impact on programs or the IP role. Please feel free to share your experiences good, bad or indifferent through discussion here or email me personally.

And many thanks for those of you who discussed publically or as a sidebar, the issue of single-use pt care equipment – your insights were very illuminating.

Thanks and warm 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
http://www.infectioncontrolplus.com.au
[cid:image001.jpg@01CF1369.6866B8D0][cid:image002.jpg@01CF1369.6866B8D0][cid:image003.jpg@01CF1369.6866B8D0]

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[Joe-Anne Bendall]

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
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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

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[Joe-Anne Bendall]

Hi
I started auditing the operating theatre suite (OR, anaesthetics, RR) this year. Last year, I did some practice audits to determine how I was going to audit in the operating room. I found the auditing of anaesthetics a challenge and it took a while to have some different rules eg after giving IV anaesthetic drugs and then intubating they cannot perform HH as it is a patient safety risk

The staff have welcomed the auditing process and we have identified some gaps eg certain groups and the location of alcohol hand gels

In November, the OR used their data to run a month long hand hygiene awareness campaign.

Thanks

Joe

Joe-anne Bendall
HAI Project Officer
Clinical Governance Unit
(Tuesday and Wednesday only)

Phone: 93827621
Mobile: 0434323222
Joe-anne.Bendall@sesiahs.health.nsw.gov.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of SDH Manager
Sent: Wednesday, 11 December 2013 11:33 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Hand Hygiene auditing in the operating room

HI Maree

We are only a very small day hospital and I have always audited in the operating theatre (our theatre staff & anaesthetists), as well as our PACU. HHA are aware of this and have never said anything to me, so I will continue to do it.

Personally, I think theatre should be audited. We have Alcoholic rubs placed in theatre for staff to use. The circulating nurse is touching the patient and then touching other items in the theatre, as well the anaesthetist and anaesthetic nurse are also touching the patient and putting in IVs and doing other invasive procedures, so why shouldnt they be audited? We are also planning on doing surgical scrub audits and hand hygiene observational audits on our surgeons, they are statistically the worst offenders!

Regards

Tina Owens, RN
Clinical Manager
Southport Day Hospital
Tel: (07) 5555 7800 / Fax: (07) 55557801
Mb: 0419 026 091
Email: manager@southportdayhospital.com.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Maree Sommerville
Sent: Wednesday, 11 December 2013 7:40 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Hand Hygiene auditing in the operating room

Dear all,
I am interested to know if anyone does HH auditing in the operating room.
It is my intention to do some ad hoc audits in the New Year.

I have already done a preliminary assessment and the biggest challenge is defining the areas (patient care zone or health care zone).
The HH audit tool currently in use easily suits a ward but will it suit this type of critical care area.

Has anyone audited this area?
If so, how did you define the zones for each group (anaesthetic team / surgical team / theatre tech)?
If any of you have audited this area, did you adapt the current HHA tool or did you use another?

Look forward to your responses.
Maree

Maree Sommerville
Infection Control Coordinator
Mercy Hospital for Women

163 Studley Road
Heidelberg 3084
Phone: 8458 4759
Mob: 0408 789 798
Fax: 8458 4751

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[Joe-Anne Bendall]

Hi Vicky
Check NSW Policy on off-label for medications http://www0.health.nsw.gov.au/policies/pd/2008/pdf/PD2008_037.pdf

This may be helpful – it tells the drug committees how to assess any off-label use of medications before it can be used

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| 7 Fax 93827510 |
Mobile 0418984255 | * Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

Many thanks for this information Fiona,

Whilst I can understand why potentially there may be steps to utilization antibiotics topically ( under strict supervision) it’s the issue that here they are using IV gentamycin – impregnated onto another dressing bed to apply. In accordance with the antibiotic guidelines this is not the designated application
Currently I believe TGA has not approved a topical gentamycin application & in accordance with antibiotic stewardship I thought I had some strong support to stop this practise. However seem to be fighting a losing battle. . I also tried with inappropriate use of medication as well as the doctors prescribe this on medication charts ( wrong route/wrong dose etc…)

Thanks again with supplying this information …

Vicki Denyer

Clinical Nurse Consultant | Infection Prevention & Control Unit
Lismore Base Hospital
Tel 02 6620 2385 | vicki.denyer@ncahs.health.nsw.gov.au

[cid:image001.png@01CEE460.61A6AE70]

Hi Vicki,
I posed this question to our Wound care consultant and this is the response I received

Topical antibiotics have traditionally been frowned upon in the care of chronic wounds.
However, recent developments in what is now known as biofilm wound bed preparation is recommending that antibiotics are part of the following steps :
* Wound debridement at every dressing change [low frequency ultrasound is becoming more common]
* Wound bed antisepsis [Prontosan or iodine preparations are common]
* Topical antibiotics [dependent on pathology]
* Appropriate dressing and bandaging
* Systemic antibiotics if required
Consistent and persistent wound assessment is vital, as the topical & systemic antibiotics need to be stopped once the desired clinical effect is obtained.
Hope this is useful info.

Kind Regards,

Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
Fiona.Desousa@sah.org.au
185 Fox Valley Road, Wahroonga, NSW, 2076

Hi All,

I would appreciate any additional advice on the following issue:

Rural hospital with medical staff prescribing IV gentamycin as a topical application onto dressings for ulcers.

Vicki Denyer

Clinical Nurse Consultant | Infection Prevention & Control Unit
Lismore Base Hospital
Tel 02 6620 2385 | vicki.denyer@ncahs.health.nsw.gov.au

[cid:image001.png@01CECF22.8F98DA40]

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[Joe-Anne Bendall]

Hi
We treat them as general waste. Our education includes:

1. Does it pass the ‘ouch test’

2. If the spike is covered in the IV bag, empty the IV bag and place into general waste – do not cut it off

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| 7 Fax 93827510 |
Mobile 0418984255 | * Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

Hi Michael,
I agree. In some jurisdictions/institutions, sharps definition (along with “..could penetrate human skin”)… includes “… or puncture waste bags”. i.e. IV spikes and other sharp-edged items that might puncture/rupture a yellow bag with resultant potential for blood/OPIM leakage onto handlers.
T.

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
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Hi Verily

The problem with this question is it is local legislation and local waste management regulation specific. It will depend upon what your state legislation requires, and also what your local waste management regulations (eg local council area or landfill site) requires.

In principle, the ‘spigot end’ of an IV giving set is not a sharp designed to penetrate skin, or to be used for that purpose, and thus may not meet the definition for sharp in some jurisdictions. But your local legislation and regulations may have specific guidance for this, so that should be your first line of enquiry.

Most regulations allow facilities to develop their own polices with in the guidance of the regulations. Thus, if you want to consider all IV administration sets as clinical waste, it can be a facility decision. You could not decide to allow used clinical sharps to be placed in general waste, though, if this would be a breach of the regulations.

Hope these thoughts help.

Cheers
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
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[cid:image001.jpg@01CEE44A.88CD6CC0]

Dear All

I wonder if anyone out there can assist with a good response to feedback to staff regarding this question I am so often asked. I have tried with reason to advise however I would appreciate any further input from out there to address this issue:

The question:

‘During one of the COPS meetings a question was raised around how to appropriately dispose of peritoneal dialysis fluid and whether the spigot of an IV line is classified as a sharp. Some wards believe that if they separate a used IV bag from the line, they must cut the spigot end off and put this in the sharps bin and dispose of the rest of the line in the clinical waste bin. I was hoping to get some clarification on these issues so I can feed it back to the COPS group.’

Thanks for your assistance.

Regards

Verily Thomas
Clinical Nurse Consultant | Infection Prevention and Control
SWSLHD-Bankstown/Lidcombe Hospital
Eldridge Road, Bansktown.NSW 2200
Tel 02 97228000 pager 28230
Tel 02 9722 8633 | Fax 02 9722 7822 | verily.thomas@sswahs.nsw.gov.au
http://www.health.nsw.gov.au

[cid:image001.jpg@01CEE214.AD0A9BE0]
LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVES

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[Joe-Anne Bendall]

Hi
We isolate for all ESBL’s with Contact Precautions

Thanks

Joe-Anne Bendall

Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
SYDNEY NSW 2000
|| 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 Rita Roy
Sent: Monday, 9 September 2013 10:26 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: ESBL’s – which ones?

Here at Hornsby, we isolate and manage with Contact precautions 1 all Klebsiella pneumoniae and Enterobacter cloacae ESBLs. I know that some hospitals all isolate for E coli ESBLs as well.

Rita Roy

Clinical Nurse Consultant | Infection Control Hornsby Kuringai Health Services Tel 02 9477 9232 | Fax 02 9477 9013 | Mob 0422 930 370 | Rita.Roy@health.nsw.gov.au http://www.health.nsw.gov.au

________________________________________
From: ACIPC Infexion Connexion [AICALIST@AICALIST.ORG.AU] on behalf of Michael Wishart [michael.wishart@INTERNODE.ON.NET]
Sent: Monday, 9 September 2013 10:04 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: ESBL’s – which ones?

Hi all

Just thought I’d bump this question again, as I didn’t get any responses. Surely someone has an opinion on which gram-negatives need to be managed as MROs?

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
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[Joe-Anne Bendall]

Hi John
NSW Ministry of Health have Core Competencies that also has some components that can be used for the basic processes that underpin sterilization and disinfection
http://www0.health.nsw.gov.au/pubs/2003/pdf/steril_dis_core.pdf

I know that the Sterilizing Working Party have these on their agenda for review – I think they are waiting for the updated AS4187 to begin. Maybe in their review, that they acknowledge the online training program for endopscopes?

Thanks

Joe-Anne Bendall

Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
SYDNEY NSW 2000
|* ph +61 2 9382 7199 |page 22070 via switch 9382 7111| 7 Fax 93827510 |
Mobile 0418984255 | * Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

Hi everyone,

My response is to the second part of John’s question.

We should be encouraging all CSSD staff to undertake at minimum, the Certificate III in Sterilising Services.

This is the National Health Training Package for this category of personnel and is a competency based program.

This program has been conducted by various Registered Training Organisations throughout Australia from approximately 2001 and prior to this there were for many years state / territory based qualifications for CSSD technicians.

Regards
Terry McAuley
Sterilisation & Infection Prevention and Control Consultant
STEAM Consulting
E: terry@steamconsulting.com.au
W: http://www.steamconsulting.com.au
A: PO BOX 779
Endeavour Hills
VIC Australia 3802

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Dear All

Would anyone be able to share what they do please?
Am sure all of us are in this situation!

Additionally, as we have to credential all of our staff who work in CSSDs etc, what are people using for that?

I am aware that the UK has an excellent online program of instruction for such staff .

Thanks
John

Dr John Ferguson
Infectious Diseases & Microbiology
+61 428 885573

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[Joe-Anne Bendall]

Hi
Before our accreditation in April, we underwent an AS4187 audit by independent auditors. We had evidence of our audit results, actions against recommendations and all our quality auditing requirements. We had developed a number of quality activities for the sterilizing unit

They were very happy with our compliance and noted it as an excellent unit during the accreditation summation.

I would be very happy to discuss this if you wanted to give me a call

Thanks

Joe-Anne Bendall

Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
SYDNEY NSW 2000
| ph +61 2 9382 7199 |page 22070 via switch 9382 7111| 7 Fax 93827510 |
Mobile 0418984255 | Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of SDH Manager
Sent: Monday, 19 August 2013 10:32 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: AS/NZS 4187 Section 7 re monitoring of sterilizers and associated equipment

Hi Brenda,

We didnt seem to have any issues with accreditation concerning our processes, we simply have medtrax record books to keep track of our sterilisation processes. We also do internal audits.

However, if you need any audit tools, you can go to the QLD Health site. I note they actually havent got any up for Standard 3 yet, but should very soon, so just keep an eye on this site, if you havent already discovered it.

http://www.health.qld.gov.au/psq/safetyand quality/nsqhss-audit-tools.asp

Regards

Tina Owens, RN
Clinical Manager
Southport Day Hospital
Tel: (07) 5555 7800 / Fax: (07) 55557801
Mb: 0419 026 091
Email: manager@southportdayhospital.com.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Brenda Anderson
Sent: Thursday, 15 August 2013 12:38 PM
To: AICALIST@AICALIST.ORG.AU
Subject: AS/NZS 4187 Section 7 re monitoring of sterilizers and associated equipment

I am interested to know how people interpret the statement in AS/NZS 4187:2003 Section 7.1

All stages of the sterilization process shall be developed and documented to ensure that the items can be sterilized.
The process shall be reliably reproduced and routinely monitored to the desired probability of a non sterile item.

Routinely monitored (is where I want input) I realize each step will be written up in a policy/procedure manual- but how is the procedure monitored to know the policy is being followed.

All stages are then listed:
(a) cleaning – how is manual cleaning monitored??
(b) Inspection how is the inspection process monitored??
(c) Assembly How is the assembly process monitored??
Etc.. goes to (k) validation of the process
I realize that the sterilizers and washer/ disinfectors have monitoring mechanisms in place (i.e bowie dick, soil tests etc and these are monitoring the performance of the machines) I am interested in the process indicators for the manual components of the process?

This is a theme of accreditation standard 3.3.16.1 quality control systems to monitor each stage of handling or items requiring reprocessing.

I would appreciate any comments or even better audit tools

Regards
Brenda Anderson

Mrs. Brenda Anderson
Regional Infection Control Consultant
Hume Region Infection Control Resource and Consulting Service
Northeast Health Wangaratta

Northeast Health Wangaratta
Green St, Wangaratta, VIC 3677

Brenda.Anderson@hume.org.au
http://www.nhw.hume.org.au

Tel: 03 5722 5486
Mob: 0429 412 780

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[Joe-Anne Bendall]

Hi Helen
We audited the form for the CVL insertion – analysed the aseptic technique bundle. This audit was able to be used for aseptic technique and insertion of invasive devices

Thanks

Joe-Anne Bendall

Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
SYDNEY NSW 2000
|* ph +61 2 9382 7199 |page 22070 via switch 9382 7111| 7 Fax 93827510 |
Mobile 0418984255 | * Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

Hi,

Does anyone have an audit tool for Invasive Devices to meet standard 3.8.1?

I have audit tools for PIVCs, wounds, venepuncture and urinary catheters.
I don’t have an audit tool I can use specifically for CVADs, UWSDs, wound drains and epidurals.

Thanks,
Helen.

Helen Scott
Infection Control Co-ordinator |
Staff Educator |
Nepean Private Hospital
Kingswood, NSW.
Tel 02 4725 8758 | helen.scott@healthscope.com.au
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[Joe-Anne Bendall]

Hi
They are at the final drafting stage – it required a few tweaks and is then being sent for sign off – that was 2 weeks

Thanks

Joe-Anne Bendall

Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
SYDNEY NSW 2000
|* ph +61 2 9382 7199 |page 22070 via switch 9382 7111| 7 Fax 93827510 |
Mobile 0418984255 | * Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

Hello Joe-Anne

I have heard rumours of that safety alert for nearly 18 months now, and had come to the conclusion that it is not coming. Do you have any idea when it may be released?

Thanks
Diane

Diane Hobday
Accreditation Manager – DIAS

National Association of Testing Authorities, Australia
Level 1, 675 Victoria Street
Abbotsford VIC 3067

http://www.nata.com.au

Hi Vicki
NSW Ministry of Health are currently reviewing the compliance of the product with AS4187 and will be issuing a Safety Alert for NSW healthcare facilities. I would hold off any purchases until the Safety Alert is released

Thanks

Joe-Anne Bendall

Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
SYDNEY NSW 2000
|* ph +61 2 9382 7199 |page 22070 via switch 9382 7111| 7 Fax 93827510 |
Mobile 0418984255 | * Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

I was just inquiring as to whether there are any hospitals currently using the Tristel wipes system within their facility & whether they would be willing to contact me to discuss this product/process please

Vicki Denyer

Clinical Nurse Consultant | Infection Prevention & Control Unit
Lismore Base Hospital
Tel 02 6620 2385 | vicki.denyer@ncahs.health.nsw.gov.au

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[Joe-Anne Bendall]

Hi Vicki
NSW Ministry of Health are currently reviewing the compliance of the product with AS4187 and will be issuing a Safety Alert for NSW healthcare facilities. I would hold off any purchases until the Safety Alert is released

Thanks

Joe-Anne Bendall

Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
SYDNEY NSW 2000
|* ph +61 2 9382 7199 |page 22070 via switch 9382 7111| 7 Fax 93827510 |
Mobile 0418984255 | * Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

I was just inquiring as to whether there are any hospitals currently using the Tristel wipes system within their facility & whether they would be willing to contact me to discuss this product/process please

Vicki Denyer

Clinical Nurse Consultant | Infection Prevention & Control Unit
Lismore Base Hospital
Tel 02 6620 2385 | vicki.denyer@ncahs.health.nsw.gov.au

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[Joe-Anne Bendall]

Hi Jenny
We have a number of standing orders for cataract surgery. One of our Registrars is currently developing an app for ophthalmic drugs
Our accreditation was last month and we did not receive any recommendations for Standard 3 – we met all the core and developmental actions

I am happy to put you in touch with our chief pharmacist

Thanks

Joe-Anne Bendall

Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital|* ph +61 2 9382 7199 |page 22070 via switch 9382 7111| 7 Fax 93827510 |
Mobile 0418984255 | * Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

Hi Everyone,
I am working on the completion of standard 3 at the moment and would like some advise on Antibiotic Stewardship for Ophthalmic Day Surgical Facilities. We are a stand alone facility and predominantly perform Cataract surgery. Antibiotic prophylaxis for Ophthalmic surgery includes intra-cameral cephazolin for intraocular ophthalmic surgery and for lids chloramphenicol ointment.

I would like to know how other facilities have dealt with antibiotic stewardship and how pre and post operative antibiotics been included as well. If you have ideas or advice to share I would appreciate hearing them.
Kind regards
Jenny Cartwright
Infection Control Nurse
Eye Surgery Foundation
44 Ord Street West Perth WA 6005
PH 0430054722
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[Joe-Anne Bendall]

Just to add fuel to the conversation, NSW Ministry of Health are introducing scrubs to all clinical staff as the new uniform in 2013…………..

Thanks

Joe-Anne Bendall

Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital|* ph +61 2 9382 7199 |page 22070 via switch 9382 7111| 7 Fax 93827510 |
Mobile 0418984255 | * Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

Dear all,
An additional quote for the discussion – “there is nothing common about common sense” Sue Greig

This is interesting discussion and I agree with several of the comments made including Matthias that highlights the absence of evidence is no excuse for bad practice.

Having looked at this issue now for several years in a variety of settings – the evidence is scarce if you are looking for rationale on the exact question of where and when to wear operating theatre scrubs. Sometimes it is good to think outside the box and never forget a common sense approach.

Some of the variables I have had to contend ( that may provide food for thought for others) with include:

* Where governance sits on this issue – do they support and actively participate in enforcing policy and procedures that the organisation endorses? even in the absence of strong evidence
* Why is the organisation using scrubs at all – they are expensive and not part of the PPE required as part of infection prevention or workplace health and safety however, they are historically seen as part of the required attire to enter the restricted environment of operating theatres. This environment is special and this is in part created by environmental controls, identified risks for workforce and patients, the need for asepsis, public perceptions and habits.
* Who owns the scrubs – do they belong to the organisation or to the staff and what are the requirements for wearing them in the organisation, outside the organisation, to and from work? Consider co-located organisations
* How laundering is managed – by the organisation or by the staff – How important is it that this is known and if it is seen as important how is this controlled and monitored?
* Where are clean scrubs stored in the organisation – often in theatre change rooms they are located adjacent to toilets on open racks or shelving, even with frequent use they still can be exposed to contamination from air and hands.
* What are the limitations or boundaries applied to wearing scrubs outside the theatre/procedural setting – this varies from organisation to organisation depending on scope of services provided and layout of the buildings and placement of the services in the buildings. Is it OK to go from rooms (or theatres in another organisation) via the carpark and then straight in to the operating theatre? if the answer is no – what are you going to do about it
* Are scrubs just a uniform? Who wears the uniform? – surgeon, theatre nurses, anaesthetists, orderlies, and what additional apparel do they wear to protect the patient in the special environment? Often an anaesthetist will wear nothing additional even for procedures that require aseptic technique.

And so on……

Good luck,

Regards,
Sue

Sue Greig
Senior Project Officer
Australian Commission on Safety and Quality in Health Care
GPO Box 5480 Sydney NSW 2001 | Level 7, 1 Oxford Street, Darlinghurst NSW 2010
( direct (02) 9126 3565 | ( switchboard (02) 9126 3600 | 6 (02) 9126 3613 |
Email sue.greig@safetyandquality.gov.au | http://www.safetyandquality.gov.au

Cath Murphy
Sent by: ACIPC Infexion Connexion

04/03/2013 05:16 PM
Please respond to
ACIPC Infexion Connexion

To

AICALIST@AICALIST.ORG.AU

cc

Subject

We recently posted on our Facebook Page https://www.facebook.com/infectioncontrolplus a recently taken image from a large public hospital in Australia depicting this exact scenario. The comments raised by respondents make curious reading and they come from practitioners from multiple disciplines across the globe and at various stages of chronologic and professional maturity. They make for interesting viewing. I have been dismayed my entire life to know this is a worldwide malpractice. Perhaps yet another sign of the decay of the well needed sense of asepsis?

Cheers
Cath

Cathryn Murphy PhD
Executive Director
Infection Control Plus Pty Ltd
http://www.infectioncontrolplus.com.au

Dear Colleagues,

To use a famous quote:

“Absence of evidence is not evidence of absence”.

http://en.wikipedia.org/wiki/Argument_from_ignorance

and another one: “Those who cannot remember the past are condemned to repeat it” (George Santayana).

What I am trying to say is that the question of whether or not to wear theatre clothing, and in which circumstances, is — in my opinion — more complex than to say “there is no evidence for it” or vice versa, “there is evidence for doing it in a particular way”.

Some of it boils down to what we want to accept as evidence — is it only evidence from randomized clinical trials with surgical infection rates as the outcome (for which there are none in theatre clothing — so we would not find any evidence), or is it evidence from microbiology, historical/anecdotal sources, combined with “what makes sense”? If we were to accept only high-quality evidence from RCTs, we would have no basis for many everyday clinical decisions that otherwise make perfect sense (think of the famous parachute article in the 2003 Christmas edition of BMJ). In the absence of good-quality evidence from clinical trials, some answers may come from other sources and include scientific reasoning, common sense and sociological issues (e.g. institutional identity and public perception, as pointed out by Paul Smollen).

It is for some of these reasons that some of the analyses in the HIS document (Woodhead et al. 2002) — while it is overall a reasonable document and a laudable approach to query the issues — lack a little depth to fully address these issues (they also point out social and/or theatre discipline issues).

Things started in the 19th century, around Lister’s time. Senior surgeons often took pride in how dirty, blood- and pus-splattered their gowns were, because this was viewed as a status symbol. (Not sure, is wearing scrubs in cafeterias also a kind of status symbol?). In the late 19th and early 20th century, the principle of aseptic surgery was introduced (including scrubs, gowns, sterile field, etc.) and then refined during the first half of the 20th century. Note that by about the 1970s, the infection rates for clean surgery (classified as clean) were already quite similar to what they are today. Advancements came mostly from the other categories (clean-contaminated and higher).

The microbiological rationale for wearing dedicated operating theatre clothing, i.e. scrubs, comes from the fact that when freshly-laundered clothing is put on, this clothing acquires the wearer’s (and to a lesser extent the environment’s) microorganisms, and this bacterial burden increases over the time of wearing. This is thought to be in principle very similar for street clothing and scrubs, and what happens is that over time, the microorganisms on the clothing reach a saturated state and then the wearer disperses these microorganisms into the environment around her/him, although this also depends on how tightly woven the garments are (scrubs are more tightly woven, so lesser shedding). This is called the “cloud phenomenon”, and someone who has published on this in recent times is Robert (“Bob”) Sherertz from the USA. The acquisition and dispersal of microorganisms includes pathogens like Staph. aureus (also MRSA) in those who are colonised. That means, what the wearing of fresh scrub suits effectively does is to set the “clock” of microorganism acquisition and dispersal back to zero each time a new suit is put on. The consequence is that if there is an institutional scrub-wearing policy, then the institution has some control over this microorganism acquisition and dispersal, whereas if people can wear street clothes or re-use old scrubs, then there is no institutional control over this biological process. (People may come in with several-days-old street clothing or just put the scrubs in the locker for re-use if the process is not controlled). Much of this research dates back to about the 1950s and 1960s, before the advent of evidence-based medicine, and therefore information in the very recent literature is scarce. (I need to credit my colleague Andreas Widmer from Switzerland for bringing my attention to this microbiological rationale — a quote from Andreas is “what’s the point of having clean HEPA-filtered OT air when the clothing makes the bacteria airborne?”).

A publication by Bob Sherertz is here:

Bischoff WE, Tucker BK, Wallis ML, Reboussin BA, Pfaller MA, Hayden FG, Sherertz RJ. Preventing the airborne spread of Staphylococcus aureus by persons with the common cold: effect of surgical scrubs, gowns, and masks. Infect Control Hosp Epidemiol. 2007 Oct;28(10):1148-54.
http://www.ncbi.nlm.nih.gov/pubmed/17828691

While the above provides a clear rationale (I can’t call it evidence) for wearing dedicated scrubs in OT and for having an institutional OT attire policy, the rationale for changing when leaving OT and for putting on fresh scrubs when reentering, or alternatively for putting on cover gowns, is less clear. The microbial contamination between scrubs dedicated to the OT and scrubs worn outside the OT is generally not very different from each other. However, one study from the 1980s found that the microbial burden on scrubs was less when covergowns were worn outside the OT or when fresh scrubs were put on while reentering, while there was more contamination when no covergowns were worn, or when scrubs were just put in lockers and worn again after a lunch break:

Copp G, Mailhot CB, Zalar M, Slezak L, Copp AJ. Covergowns and the control of operating room contamination. Nurs Res. 1986 Sep-Oct;35(5):263-8.
http://www.ncbi.nlm.nih.gov/pubmed/3529043

Also to consider is the image of professionality and the professional image of healthcare staff on patients and the general public (see Paul Smollen’s comment).

Another issue to consider is the inadvertent contamination of scrubs with blood and body fluids (staff may have individually different perception as to when they regard scrubs as contaminated) and any potential infection risk to food/drink consumption areas, although I am not aware of any good literature on this.

Another interesting article is here:

Wright SN, Gerry JS, Busowski MT, Klochko AY, McNulty SG, Brown SA, Sieger BE, Ken Michaels P, Wallace MR. Gordonia bronchialis sternal wound infection in 3 patients following open heart surgery: intraoperative transmission from a healthcare worker. Infect Control Hosp Epidemiol. 2012 Dec;33(12):1238-41.
http://www.ncbi.nlm.nih.gov/pubmed/23143362

This is a recent case cluster of G. bronchialis sternal wound infections after cardiac surgery in the USA that was traced to contaminated scrub suits by a nurse anaesthetist. This was traced back (most likely) to home laundering of the scrub suits (a practice that is apparently still done at some institutions in the USA) with a badly-maintained, contaminated washing machine. That means, contaminated scrub suits definitely have the potential to cause surgical site infections.

Again, I am not claiming to have conclusive evidence here, but the above may be some food for thought.

Best regards, Matthias.

—
Matthias Maiwald, MD, FRCPA
Consultant in Microbiology
Adj. Assoc. Prof., Natl. Univ. Singapore
Department of Pathology and Laboratory Medicine
KK Women’s and Children’s Hospital
100 Bukit Timah Road
Singapore 229899
Tel. +65 6394 8725 (Office)
Tel. +65 6394 1389 (Laboratory)
Fax +65 6394 1387

An “oldie but a goodie” is the Hospital Infectioin Society working party report on “behaviours and rituals in the operating theatre” this was published in the journal of hospital infection quite a number of years ago now.
http://www.his.org.uk/_db/_documents/Rituals-02.pdf The working party reviewed all of the available evidence at the time and made recommendations based on the level of evidence available. Theatre attire, scrubs, overgowns & overshoes are addressed in this document.

Overgowns are not necessary outside the operating theatre. Scrubs must be changed as soon as there is any blood/body fluid contamination regardless of whether staff are remaining in the OT suite or leaving to go to the cafe.

I recommend a quick literature search of Pubmed for the latest literature/evidence on this subject.

Fiona Randall
CNC Infection Prevention & Control
Wesley Mission Brisbane.

On Fri, Mar 1, 2013 at 2:40 PM, Paul Smollen <Paul.Smollen@cec.health.nsw.gov.au> wrote:
Toni,

I do enjoy this chestnut. While it is a public perception, facilities and us at the Ministry receive multiple complaints from visitors about this issues. One of the complaints we get is that the public see them in the gowns in the cafe and are worried they are going off to operate on their family member. This alone could convince your OT staff against the practice.

The problems lies with no valid evidence. This comment may open a can of worms….. but I find this should be a two way street and if OT staff want to walk around a hospital and outside and do all normal activities in their scrubs, then they should allow people to walk into an OT in street clothes. I really see no difference. While we are concerned with levels of evidence about scrubs outside an OT what level of evidence is there about wearing scrubs inside an OT? The scrubs are usually kept on open shelves in open change rooms with toilets and showers nearby.

I do know of facilities that have a lunch ordering system with their cafe and the food is delivered there. This may be an option you could explore.

Good luck with it all.

Paul Smollen
Project Manager, Healthcare Associated Infections (HAI)
Clinical Excellence Commission | Level 14/227 Elizabeth Street, Sydney NSW 2000
T: (02) 9269 5586 |F: (02) 9269 5599 | E: Paul.Smollen@cec.health.nsw.gov.au
http://www.cec.health.nsw.gov.au

Dear All,
The issue of where you can and cannot wear operating theatre attire (blues) has arisen at our facilities – again.
I would be interested to know if your facilities/organisations allow theatre staff to eat and drink in the on-site cafeteria if they have clean blues that are covered.
Food is not supplied to the OT; staff are permitted to collect food from the on-site cafeteria if in clean blues that are covered; there is a tea room but it is said that it can be over crowded at peak times.
The public perseption (and complaints received) says that they should not be allowed to eat and drink there.
What valid evidence is there and what do others do or say to back up that they should not eat and drink in on-site cafeterias (if at all).
Look forward t your comments.
Regards, Toni.

Toni Schouten CICP
Clinica Quality Manager
Sydney Local Health District
toni.schouten@sswahs.nsw.gov.au

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[Joe-Anne Bendall]

Hi. Thanks for your comments. It has been an interesting time for us, as each of the incidents were different the only common factor has been fatigue.

Thanks

Joe

Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital| ph +61 2 9382 7199 |page 22070 via switch 9382 7111| 7 Fax 93827510 |
Mobile 0418984255 | Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of SAWMH.ICC
Sent: Thursday, 24 January 2013 7:27 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Occupational Exposures

Hi Marilyn and Joe,

A few year ago this was also the case here. We have now a policy in place, stating that in case a patient are not able to dial-up their own insulin pen, or are unable to remove the needle or administer the insulin for themselves, an insulin vial is ordered from the pharmacy and nurses use disposable syringes to administer it safely. The only time we see incidents now is when nurses don’t follow the policy.

Regards

Marlize Senekal
Infection Prevention and Control Coordinator
St. Andrew’s War Memorial Hospital
457 Wickham Terrace, Spring Hill
Brisbane
Ph. 07-3834 4444
Ext. 4328, Pg. 0328

________________________________
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Marilyn Harris
Sent: Wednesday, 23 January 2013 17:38
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Occupational Exposures
Hi Joe,

I was laughing as I read your opening line Just curious to find out ….

Im sure theres a few of us who have noticed abnormal events.

This one had a common contributing factor.
A couple of years ago I noticed an abnormal increase in NSI and discovered that some nurses were using their fingers to remove the needle from the insulin pen for patients.
The Product Information describes how to safely remove the needle when a patient is not able to do so however I discovered that the nurses had not read it.
So, I made a one-page poster with photographs, summarising that procedure and referring the nurses to the full Product Information.
The poster is displayed in the Medication Rooms, and I tell the story and show it at Orientation.
Those types of NSI now rarely occur.

There was also one week, in April a few years ago, when the OH&S Coordinator had daily reports of staff injuries and I received daily reports of occupational exposures. Really made us wonder what was going on. There were no common factors for facility or procedure or anything. Just a statistical blip?

Regards,
Marilyn

Marilyn Harris

CNC Infection Prevention | Population Health | Justice Health & Forensic Mental Health Network
Level One Dawn de Loas. Locked Bag 130 Silverwater Mail Centre, NSW 1811
Tel 02 9289 5482 | Pager 02 9937 2506 | Mob 0417 472 612 | Fax 02 9289 5486
marilyn.harris@justicehealth.nsw.gov.au
Our Values: Care, Clear Communication, Honesty, Professionalism, Respect

[cid:image002.jpg@01CDF996.A9A64830]

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Joe-Anne Bendall
Sent: Wednesday, 23 January 2013 7:31 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Occupational Exposures

Good morning everyone
Just curious to find out if any other healthcare facilities have ever experienced an abnormal increase in occupational exposures at any time? What were the common contributing factors and were they linked?

Also, for healthcare facilities that are performing surgery with microscopes or loupes have you had occupational exposures when staff move sharps outside their field of vision? If you have, what strategies did you put in place to reduce the risk?

Thanks

Joe

Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital| ph +61 2 9382 7199 |page 22070 via switch 9382 7111| 7 Fax 93827510 |
Mobile 0418984255 | Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

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