[Joeanne Bendall]

Hi Sonny
We use the manufactures guidelines such as these:

http://www.swissmedic.ch/recalllists_dl/00776/Vk_20080819_03-e1.pdf

Thanks

Joe

Joe-anne Bendall
Infection Prevention and Control CNC
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
Sydney 2000

Phone: 93827199
Mobile: 0418984255
Fax: 93827510
Page: 21552

joeanne.bendall@sesiahs.health.nsw.gov.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Sony SO
Sent: Wednesday, 25 July 2012 11:13 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Cleaning of Tonometers

Hi Joe,

Thank for your sharing.

I would like to have additional information for the fluroceine leak testing.

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
Please consider the environment before printing this e-mail

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Joeanne Bendall
Sent: Wednesday, July 25, 2012 7:04 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Cleaning of Tonometers

Hi Heidi

We do the following, based on the manufacturers instructions:

1. Single use for any suspected or known eye infection

2. Tonometers is rinsed and cleaned with 70% Isopropyl Alcohol wipe/swab between patients (for the am or pm clinic session)

3. At the end of each session, the Tonometers are cleaned (neutral detergent), rinsed and soaked for 10mins in Milton solution

4. The tonometers are rinsed under running water and dried with a lint free cloth

5. Each month, 8-10 tenometers are chosen at random for fluroceine leak testing and a visual inspection with a slit lamp this is part of the quality program

Thanks

Joe

Joe-anne Bendall
Infection Prevention and Control CNC
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
Sydney 2000

Phone: 93827199
Mobile: 0418984255
Fax: 93827510
Page: 21552

joeanne.bendall@sesiahs.health.nsw.gov.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Paul Simpson
Sent: Tuesday, 24 July 2012 3:42 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Cleaning of Tonometers

Hi Heidi,

The issue of how to appropriately clean Tonometer prisms has been a long running one at the Eye & Ear, which I have recently inherited.

The current procedure here is to clean the Tonometer prism with a 70% Isopropyl Alcohol wipe/swab between patients. If a patient has a suspected infectious eye then the Tonometer is rinsed under running water for 30-60 seconds, then soaked in a disinfectant solution, we currently use 3% Hydrogen Peroxide solution, for 10mins (alternatively a 500 ppm Sodium Hypochlorite solution could be used). Finally, the tonometer is rinsed under running water again for 60 seconds & dried with a one-way clean & soft tissue. This complies with the tonometer manufactures guidelines. I am guessing there is a very small risk of transmitting Hep B from the eye but you may want to apply this higher level of disinfection for this patient.

Having said all this I believe our current process needs reviewed with the use of disposable Tonometer prisms given full consideration. However, there has been a long running cost versus benefit debate here in the light of little or no evidence of infections being transmitted by tonometers. Please feel free to contact me directly if you need any further information.

Regards,

Paul Simpson, RN, MSc
Infection Control Consultant

[cid:image001.png@01CD69AD.642EF4B0]

32 Gisborne Street, East Melbourne, 3002, VIC
Tel: +613 9929 8523 | Pager: 366 | Fax: +613 9663 7203
[cid:image002.png@01CD69AD.642EF4B0]

—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of SUBSCRIBE AICALIST Heidi Gettons
Sent: Tuesday, 24 July 2012 2:28 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Cleaning of Tonometers

I have been approached by an opthalmologist for advice on how to clean a tonometer (an instrument used to measure intraocular pressure) following use on a patient who is positive for Hepatitis B. I am unsure on how they clean it at the moment. Any information would be greatly appreciated.

Thanks

Heidi

Heidi Gettons

Infection Control Coordinator

The Bays Hospital

Mornington VIC

Ph: 59765249

hgettons@hotmail.com

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[Joeanne Bendall]

Hi Heidi

We do the following, based on the manufacturers instructions:

1. Single use for any suspected or known eye infection

2. Tonometers is rinsed and cleaned with 70% Isopropyl Alcohol wipe/swab between patients (for the am or pm clinic session)

3. At the end of each session, the Tonometers are cleaned (neutral detergent), rinsed and soaked for 10mins in Milton solution

4. The tonometers are rinsed under running water and dried with a lint free cloth

5. Each month, 8-10 tenometers are chosen at random for fluroceine leak testing and a visual inspection with a slit lamp this is part of the quality program

Thanks

Joe

Joe-anne Bendall
Infection Prevention and Control CNC
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
Sydney 2000

Phone: 93827199
Mobile: 0418984255
Fax: 93827510
Page: 21552

joeanne.bendall@sesiahs.health.nsw.gov.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Paul Simpson
Sent: Tuesday, 24 July 2012 3:42 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Cleaning of Tonometers

Hi Heidi,

The issue of how to appropriately clean Tonometer prisms has been a long running one at the Eye & Ear, which I have recently inherited.

The current procedure here is to clean the Tonometer prism with a 70% Isopropyl Alcohol wipe/swab between patients. If a patient has a suspected infectious eye then the Tonometer is rinsed under running water for 30-60 seconds, then soaked in a disinfectant solution, we currently use 3% Hydrogen Peroxide solution, for 10mins (alternatively a 500 ppm Sodium Hypochlorite solution could be used). Finally, the tonometer is rinsed under running water again for 60 seconds & dried with a one-way clean & soft tissue. This complies with the tonometer manufactures guidelines. I am guessing there is a very small risk of transmitting Hep B from the eye but you may want to apply this higher level of disinfection for this patient.

Having said all this I believe our current process needs reviewed with the use of disposable Tonometer prisms given full consideration. However, there has been a long running cost versus benefit debate here in the light of little or no evidence of infections being transmitted by tonometers. Please feel free to contact me directly if you need any further information.

Regards,

Paul Simpson, RN, MSc
Infection Control Consultant

[cid:image001.png@01CD69AD.642EF4B0]

32 Gisborne Street, East Melbourne, 3002, VIC
Tel: +613 9929 8523 | Pager: 366 | Fax: +613 9663 7203
[cid:image002.png@01CD69AD.642EF4B0]

—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of SUBSCRIBE AICALIST Heidi Gettons
Sent: Tuesday, 24 July 2012 2:28 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Cleaning of Tonometers

I have been approached by an opthalmologist for advice on how to clean a tonometer (an instrument used to measure intraocular pressure) following use on a patient who is positive for Hepatitis B. I am unsure on how they clean it at the moment. Any information would be greatly appreciated.

Thanks

Heidi

Heidi Gettons

Infection Control Coordinator

The Bays Hospital

Mornington VIC

Ph: 59765249

hgettons@hotmail.com

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The Royal Victorian Eye and Ear Hospital however does not warrant the message is free of viruses.

It is recommended as a prudent business practice the recipient perform a virus scan of any message received.
______________________________________________________________________
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[Joeanne Bendall]

Hi Rebecca
We do not use alginate bags in the public system within NSW

Thanks

Joe

Joe-anne Bendall
Infection Prevention and Control CNC
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
Sydney 2000

Phone: 93827199
Mobile: 0418984255
Fax: 93827510
Page: 21552

joeanne.bendall@sesiahs.health.nsw.gov.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Ruth Ryburn
Sent: Friday, 20 July 2012 5:43 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Management of MROs in the Operating Suite

Hi Rebecca,

Thank you for the excerpt from your MRSA/VRE policy which was interesting.

I did note that you specify using alginate bags for contaminated linen but I was under the impression these were no longer in vogue. Can anyone confirm or otherwise please?

Many thanks,

Ruth Ryburn
Infection Control Coordinator
[cid:image002.jpg@01CD663A.84CFA730]
58 Quirk St
Dee Why, NSW 2099
T: +612 8978 5276
F: +612 9971 7299
M: 0414 801 660
The content of this e-mail is the view of the sender or stated author and does not necessarily reflect the view of Delmar Private Hospital. The content, including attachments, is a confidential communication between of Delmar Private Hospital and the intended recipient. If you are not the intended recipient, any use, interference with, disclosure or copying of this e-mail, including attachments is unauthorised and expressly prohibited. If you have received this e-mail in error please contact the sender immediately and delete the e-mail and any attachments from your system.
P Please consider the environment before printing this email

________________________________
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Rebecca O’Donnell
Sent: Tuesday, 17 July 2012 12:32 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Management of MROs in the Operating Suite

Hi Sue,

Here is an excerpt from our MRSA / VRE policy. Hope it helps?

Management of MRSA Positive Patients in the Operating Suite

Ensure the Infection Control Coordinator is notified

Ensure MRSA positive patients be admitted directly to the ward, and then transferred to directly theatre. This will avoid unnecessary travel throughout day surgery unit and other areas of theatre department

For ease of management and cleaning purposes, patients who are known to be colonised or infected with MRSA must be placed last on the theatre list

Ensure patients with MRSA be recovered in the operating room where possible then transferred directly back to the ward

If this is not possible, then the patient will be cared for by designated nurse in recovery area

The operating room and/or recovery area must be thoroughly cleaned with hospital approved cleaning solution for MRSA (see General Cleaning Procedure). This includes the anaesthetic machine, trolley. All horizontal surfaces must be cleaned and walls should be spot cleaned

Ensure non disposable equipment is wiped down with hospital approved cleaning solution for MRSA (see General Cleaning Procedure) before being returned to general use

Ensure all linen is discarded in alginate bags then placed in white linen bags

Ensure all clinical waste e.g. dressings, sputum, blood soaked items be discarded in yellow clinical waste bags/bins

Kind regards,

Rebecca ODonnell | Infection Control Co-ordinator

St Vincent’s Hospital Toowoomba | 22-36 Scott Street TOOWOOMBA 4350

T 07 4690 4042 | F 07 46904400

E rebecca.odonnell@stvincents.org.au | W http://www.stvincents.org.au

Please consider the environment before printing this email.

This e-mail and any attachments to it (the “Communication”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. The Communication may contain copyright material of St Vincent’s Health & Aged Care (“SVHAC”), or any of its related entities or of third parties. If you are not the intended recipient of the Communication, please notify the sender immediately by return e-mail, delete the Communication, and do not read, copy, print, retransmit, store or act in reliance on the Communication. Any views expressed in the Communication are those of the individual sender only, unless expressly stated to be those of SVHAC. SVHAC does not guarantee the integrity of the Communication, or that it is free from errors, viruses or interference.

—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Sue Flockhart
Sent: Monday, 16 July 2012 5:41 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Management of MROs in the Operating Suite

Hi All,

We are loking at standardising our approach to the management of patients with known MROs in our operating suite. I am interested to know what other facilites are doing and would you share guidelines/policies etc.

kind Regards

Sue Flockhart

Manager, Infection Prevention & Control Unit Staff Immunisation Clinic Ballarat Health Services Victoria

0437856349

sueflock@bhs.org.au

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[Joeanne Bendall]

Hi

Is anyone doing the National Hand Hygiene 5 Moments audit in an operating theatre? If you are, I would be interested in finding out about your education program, process of auditing, barriers, engagement with medical staff and the improvements you have made.

Our operating theatre is very keen to be involved in participating in the audit

Thanks

Joe

Joe-anne Bendall
Infection Prevention and Control CNC
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
Sydney 2000

joeanne.bendall@sesiahs.health.nsw.gov.au

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Illawarra Shoalhaven Local Health District, South East Sydney Local Health District and Sydney Children’s Hospital Network (Randwick Campus) Confidentiality Notice

This email, and the files transmitted with it, are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient, you are not permitted to distribute or use this email or any of its attachments in any way. We also request that you advise the sender of the incorrect addressing.

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[Joeanne Bendall]

Hi Michelle
We have a number of patients with fungal infections of the eye.

Some links that would help with education includes photos

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC88956/

http://eyemicrobiology.upmc.com/PhotoGallery.htm

Thanks

Joe

Joe-anne Bendall
Infection Prevention and Control CNC
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
Sydney 2000

Phone: 93827199
Fax: 93827510
Page: 21552

joeanne.bendall@sesiahs.health.nsw.gov.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michelle Cook
Sent: Wednesday, 13 June 2012 10:46 AM
To: AICALIST@AICALIST.ORG.AU
Subject: fungal infection

Hi
I am looking for general information on fungal infections focus on the elderly -that can be used for in-service education
Any suggestions greatly appreciated

Michelle Cook
Infection Control/Staff Health
Garrawarra Centre
Ph 02 8545 4602
Email: michelleann.cook@sesiahs.health.nsw.gov.au
please consider the environment before printing this e-mail

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[Joeanne Bendall]

John
How about POP ANTT (principles of practice aseptic non-touch technique)

Thanks

Joe

Joe-anne Bendall
Infection Prevention and Control CNC
Sydney Hospital and Sydney Eye Hospital
Macquarie St
Sydney

Phone: 93827199
Page: 21552

joeanne.bendall@sesiahs.health.nsw.gov.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of John Ferguson
Sent: Monday, 4 June 2012 11:46 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 nontouch 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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[Joeanne Bendall]

Hi Jan
For mass flu vaccination clinics for staff we do not wear gloves. We perform hand hygiene between with alcohol hand gel between each vaccination

Thanks

Joe

Joe-anne Bendall
Infection Prevention and Control CNC
Sydney Hospital and Sydney Eye Hospital
Macquarie St
Sydney

Phone: 93827199
Page: 21552

joeanne.bendall@sesiahs.health.nsw.gov.au

—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Wendy Naisoro
Sent: Tuesday, 29 May 2012 3:43 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Gloves use during Immunisation clinics

Hi Jan,

I run Staff Health and Wellbeing and do the immunisations here:

1. As an immunisation provider I do not wear gloves to give the vaccinations.
2. N/A – but if I was wearing gloves to do this then I would be changing them between each staff member (client)
3. Hand Hygiene between each staff member (client) is a must, I use alcohol hand gel unless my hands are visibly dirty.

I hope that this helps

Many thanks
Mrs Wendy Naisoro
Sydney Adventist Hospital
Staff Health and Wellbeing Advisor

029487 9236

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[Joeanne Bendall]

That’s correct Jayne
NSW Ministry of Health sent out a Safety Alert in September 2010 in response to this incident

http://www.health.nsw.gov.au/quality/sabs/index.asp

Thanks

Joe

Joe-anne Bendall
Infection Prevention and Control CNC
Sydney Hospital and Sydney Eye Hospital
Macquarie St
Sydney

joeanne.bendall@sesiahs.health.nsw.gov.au

Hi Jayne,

Recently there was a case when a woman was injected with clear chlorhexidine by error – she was having an epidural inserted .

Because of this; it is preferred that prep for lines be dyed. This also has the advantage of being able to see what parts of the skin have been prepped.

The ICU I used to work in used “lollipops”; so there could be no error.

Regards

Prue Wright

Infection Control Co-ordinator
Hurstville Private

Hi Jayne,
Currently, the CDC Guidelines, along with NICE (UK), SHEA (USA), INS (USA) and AVA (USA), ESPEN (Europe) and IVNNZ (New Zealand) all recommend 2% CHG with 70% IPA.
It’s is pretty much the worldwide standard for skin antisepsis prior to inserion of a IV device (peripheral or central), as well as hub/cap/valve decontamination on any IV device.

Never heard of it being injected into the patient! I would be interested to see your ID physicians supportive evidence to show any accidental injection of CHG & IPA into the patient and any detriments it may have.

The evidence speaks correctly. I would base your policy from “evidence-based research and practices’, not speculation from various individuals.

There is plenty of supportive literature.
Regards,
Tim..

Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant | Central Venous Access & Parenteral Nutrition Service
Conjoint Lecturer, University of NSW
Dept of Critical Care, Level 2, Clinical Building, Liverpool Hospital, Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel 02 8738 3603 | Fax 02 8738 3551 | Mob 0409 463 428 | Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au
[cid:815383006@24052012-2F04][cid:815383006@24052012-2F0B]
________________________________
Dear All,

We are currently revising our CVC policy and just wondering what everyone used for cleaning the ports? All evidence points to 2% Chlorhexidine in 70% alcohol, but we have had conflicting advice from our ID physicians due to safety issues of injecting chlorhexidine into lines?

Look forward to responses.

Kind Regards

Jayne

Jayne O’Connor RN, BSc.in Infection Control
Clinical Nurse Consultant- Infection Prevention & Control
Sydney Adventist Hospital,
185 Fox Valley Rd,.
Wahroonga,
NSW 2076.

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[Joeanne Bendall]

Hi Richard

We have Clinical Support Officers who perform monthly audits in clinical areas for the last 3 years (developed by my predecessor). We have fed the results back to staff with the hand hygiene audits results and this has made some changes. The difficult change has been with staff continuing to wear wrist watches. The Executive, for recognition of Nurses on International Nurses Day, presented Nurses with a fobwatch (hospital name on it). This has proved very successful with making a significant change and boosted moral at the same time.

I am happy to supply you with details of the company as we received an excellent deal!

Thanks

Joe

Joe-anne Bendall
Infection Prevention and Control CNC
Sydney Hospital and Sydney Eye Hospital
Macquarie St
Sydney

joeanne.bendall@sesiahs.health.nsw.gov.au

Hi Richard,
We developed a handover check list to be ticked off each handover session. Top of the list is bare below elbow, staff do a quick ‘netball check’ of everyone, fingers and arms, then tick the box and move onto handover discussion. Very successful, now 100% compliance in the first two dialysis clinics trialled at.

Sincerely
Carolyn

Carolyn Chenoweth
National Quality Coordinator
Fresenius Medical Care – NephroCare

Nephrocare Payneham Dialysis Centre
2 Portrush Road
PAYNEHAM SA 5070
phone (08) 81654313
mobile 0407 810 800
email: carolyn.chenoweth@fmc-asia.com

Sent by: ACIPC Infexion Connexion
________________________________

Dear All,
We’re about to embark on a campaign designed to improve compliance with our dress code and hand hygiene procedures, namely, in relation to nail polish, artificial nails and jewellery.

o Keeping fingernails clean and short, (e.g. the length of the finger pad)
o Artificial fingernails of any sort and nail polish must not be worn by staff who are involved in direct patient care;
o Keeping hand and wrist free from jewellery except for one plain ring. Bracelets, wrist watches and rings with stones or ridges must not be worn when providing clinical care.

We are very interested to hear from any one who has achieved improved compliance in campaigns such as bare below the elbows?

Regards

Richard Bartolo
Manager Infection Prevention

Western Health
Gordon Street, Footscray VIC 3011
Tel. 03 8345 6113
Pager. 03 8345 6666 No. 506
Mob. 0438 560 441
Email. richard.bartolo@wh.org.au
Web. http://www.westernhealth.org.au

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