[John Ferguson]

Dear Glenys and co

Of course the NHSN definition is the best we have at the present time and is the de facto standard. Unfortunately NHSN are not keen to change it despite its obvious deficiencies.
For instance:
-The inclusion of a surgeon determined category is a problem.
-The inclusion of a requirement for culture positivity when a wound is opened is a problem – by that time most patients are on antibiotics.
-The lack of inclusion of criteria to gauge ‘purulence’ is a deficiency.
-The requirement to determine what level the purulent drainage is coming from is problematic.
-The lack of inclusion of a criterion under deep category that includes ‘organisms isolated from an aseptically-obtained culture of fluid or tissue ‘ is an omission.
-The inclusion of that same statement under superficial is an error (that they admitted to me some time back)
-The lack of clear microbiological criteria about what constitutes positive micro is a problem

With regard to Sternal wound infections, even the VICNISS validation study found that differentiation of superficial versus deep/organ space under the NHSN definition is problematic. In that review of 169 Victorian operations[1], 7 of 16 events coded as superficial sternal site infections were actually deep or organ space infections upon independent review.
And so many ‘apples’ turned out to be ‘oranges’ even in a State where there had been an extensive network of well trained ICPs doing infection surveillance of cardiac surgical procedures for many years.

In fact, in quite a proportion of cardiac cases, there is no subskin (fat) closure possible due to the thin tissue anterior to the sternum.

And so my case is that a majority of what are called ‘superficial sternal infections’ are in fact deeper. The more secure approach is to rely on an infection rate that encompasses infections diagnosed in all layers and not place undue emphasis on deep/organ space infection rates for this operative site.

There are a similar range of issues to do with staging of prosthetic joint infection which I won’t go in to

John

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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

[cid:image001.jpg@01CEBAA0.67D0E480]

Hi Irene,

How complex an individual finds the NHSN definitions depends on; a) how often they are using them, b) how well they have been trained (including competency assessment) in the standardised application of the definitions and c) quality checks that need to be in place before reporting an infection.

The aim of surveillance for surveillance purposes (i.e. not clinical management) is to standardise the application of the surveillance methods and definitions so we are comparing apples with apples either over time internally or externally
(understanding the limitations of inter-hospital comparisons and benchmarking).

In NHSN surveillance specific sites are assigned to organ space to further identify the location of the infection. This may not be of particular relevance to micro, ID, IC however, it will be of interest to surgeons/surgical registrars who for the purpose of internal audits/death audits, registries etc may classify infections to an anatomical location in addition to other criteria.

Given the extensive use of the NHSN definitions worldwide we should leave any modifications/changes to CDC (who have the funds) and where we have concerns focus on training or retraining those collecting the surveillance data in the standardised application of the surveillance methods and definitions.

This approach has worked well for infection control teams/infectious diseases staff who I have trained in NHSN surveillance methods/application of the definitions and was in a setting where the surveillance data was utilised for research studies.

No surveillance method definitions will identify 100% of infections – the definitions will miss some infections and on occasions will over call some infections. As long as we are all doing the same thing (strict application of each definition) this should not be an issue in terms of why we are collecting the data timely feedback to relevant clinical and executive management staff and measuring and monitoring the impact of evidence based interventions that are implemented to improve patients outcomes.

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

Hi Glenys,

Personally I believe the NHSN definitions are overly complex. I can understand the reason for distinguishing superficial infections from deep/organ space, but really what is the purpose of distinguishing deep from organ space? The likely causes/sources of infection and hence preventive measures would be similar.

Regards,
Irene

Irene Wilkinson
Manager, Infection Control Service
SA Health
Irene.wilkinson@health.sa.gov.au

Hi John,

While there is no muscle there is fascia and if involved you would proceed with using the deep definition to see if you meet the other criteria. From your description it seems in your cases you would meet b plus 1 signs of infection confirming it was a deep infection.

The definition seems fairly straight forward to me and I have found it very easy to use over the years. It is a definition for surveillance purposes not clinical management.

By definition an organ space infection does not include the wound, hence infection deep to the deep fascia a deep (or organ space infection) is not the correct application of the organ space definition.

Vac dressings can be used on lots of wounds including superficial sternal wounds (see below). The foam is cut and contoured to fit the size of the tissue defect, and covered with an adhesive drape and connected through the evacuation tube to the vacuum pump. There is no exposure of the wound bed/surface using these devices.

From memory there is usually an percutaneous suture in closure of a sternal wound.
Bapat V et al. Experience with Vacuum-assisted closure of sternal wound infections following cardiac surgery and evaluation of chronic complications associated with its use. J Card Surg. 2008 May-Jun;23(3):227-33Department of Cardiothoracic Surgery, St Thomas’ Hospital, London, UK. vnbapat@yahoo.com
Dezfuli B et al, Treatment of Sternal Wound Infection With Vacuum-assisted Closure. Wounds. 2013;25(2)

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

Thanks Glenys

However, there is no muscle overlaying the sternum and the deep fascia is just above the periosteum of the sternum.
For the most part there is just skin and subcut tissue in front of the sternum. These tissues overlying the sternum are very thin in most people.
And so it is nonsensical to distinguish superficial from deep based on this definition in my view

I don’t think that most surgeons put a closure layer beneath the skin once the sternum is wired- it is impossible. Effectively, then, opening or dehiscence of the incision will expose the fascia. Similarly, I cannot see that application of a vac can be done to a ‘superficial’ wound as the fascia will be exposed in these sort of wounds.
I could cope if the definition specified in this case that infection deep to the deep fascia a deep (or organ space infection); however that is not what it says.

We are long overdue for a better NHSN SSI definition., esp for sternal wounds

John

[cid:image002.jpg@01CEB910.B1B99D30]

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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

[cid:image003.jpg@01CEB90F.65088BF0]

Hi John,

Whether or not these wounds are superficial or deep depends on the first part of the definition as to what tissue is involved. This question has to be answered before progressing to the rest of the definition.

Superficial – Infection occurs within 30 days after any NHSN operative procedure and involves only skin and subcutaneous tissue of the incision

Deep – Infection occurs within 30 or 90 days after the NHSN operative procedure and involves deep soft tissues of the incision (e.g., fascial and muscle layers)

If only skin and subcutaneous tissue are involved it meets the superficial definition as from your description c below is met and, Im assuming that the patient had at least 1 of the sign or symptom below.

patient has at least 1 of the following:

a. purulent drainage from the superficial incision

b. organsims isolated from an aseptically-obtained culture of fluid or tissue from the superficial incision

c. superficial incision that is deliberately opened by a surgeon and is culture-positive or not cultured

and

patient has at least one of the following signs or symptoms of infection: pain or tenderness; localized swelling; redness; or heat. A culture negative finding does not meet this criterion

d. diagnosis of superficial incisional SSI by the surgeon or attending physician

If deep soft tissues (e.g., fascial and muscle layers) are involved it will meet the deep definition as from your description b below has been met and Im assuming that the patient has at least 1 of the sign or symptom below.

patient has at least one of the following:

a. purulent drainage from the deep incision

b. a deep incision that spontaneously dehisces or is deliberately opened by a surgeon and is culture- positive or not cultured

and

patient has at least one of the following signs or symptoms: fever (>38C); localized pain or tenderness. A culture-negative finding does not meet this criterion.

c. an abscess or other evidence of infection involving the deep incision is found on direct examination, during invasive procedure, or by histopathologic examination or imaging test.

d. diagnosis of a deep incisional SSI by a surgeon or attending physician.

Hence in the first instance you need to know what level the surgeon has opened these wounds too as VACs can be used on superficial or deep would infections.

Just on organ space infections these wounds as described would not be considered an organ space infection as such infections exclude the skin incision, fascia, or muscle layers, that is opened or manipulated during the operative procedure (i.e. the incisional wound is not involved at all). In this surgical setting an organ space infection would be something like osteomyelitis of the sternum without surgical incision/wound involvement.

I use a definition checklist (i.e. it either meets or does not meet the criteria) when training staff in the interpretation of the definitions for surveillance purposes.

Can send a copy if you like.

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

Dear All

Would appreciate advice on interpretation of the definition (below)

In two sternotomy cases, there has been prolonged ooze post op (several days) and the surgeon concerned has opened the wound on the ward and then instituted vac dressings
The cases required prolonged nursing management but did not come to formal debridement or removal of sternal wires etc. CT scans did not show retrosternal collections (ie not organ space infection)

In my view, this constitutes a ‘deep’ wound infection. What would others say?
Our other surgeons would have usually taken such cases to theatre and performed open debridement

in one case the culture grew Serratia
in the other, culture was no growth; in that case, the determination rests then on whether we had ‘purulent drainage’ observed from the ‘deep incision’
it does beg the question as to how one gauges from what level the drainage is coming fron and also whether one should use an objective measure for what is purulent etc!
criterion b under superficial is also problematic – how does one ever get ‘aseptically-obtained’ samples from a superficial incision? wound swabs presumably not ok but I would guess are used

Would be very interested to know of how people teach surveillance staff to apply the NHSN definition, esp for sternotomies , where essentially the superficial wound is extremely close to the deep sternal structure , and also for prosthetic joints where similar problems of distinguishing the depth of infection arise

thanks
John

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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
[cid:image001.jpg@01CEB86A.85790C70]

[cid:image002.png@01CEB86A.85790C70][cid:image003.png@01CEB86A.85790C70]
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________________________________
[1] Infect Control Hosp Epidemiol. 2007 Jul;28(7):812-7. Epub 2007 May 17. Validation of coronary artery bypass graft surgical site infection surveillance data from a statewide surveillance system in Australia. Friedman ND, Russo PL, Bull AL, Richards MJ, Kelly H.

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[John Ferguson]

Thanks Glenys

However, there is no muscle overlaying the sternum and the deep fascia is just above the periosteum of the sternum.
For the most part there is just skin and subcut tissue in front of the sternum. These tissues overlying the sternum are very thin in most people.
And so it is nonsensical to distinguish superficial from deep based on this definition in my view

I don’t think that most surgeons put a closure layer beneath the skin once the sternum is wired- it is impossible. Effectively, then, opening or dehiscence of the incision will expose the fascia. Similarly, I cannot see that application of a vac can be done to a ‘superficial’ wound as the fascia will be exposed in these sort of wounds.
I could cope if the definition specified in this case that infection deep to the deep fascia a deep (or organ space infection); however that is not what it says.

We are long overdue for a better NHSN SSI definition., esp for sternal wounds

John

[cid:image002.jpg@01CEB910.B1B99D30]

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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

[cid:image003.jpg@01CEB90F.65088BF0]

Hi John,

Whether or not these wounds are superficial or deep depends on the first part of the definition as to what tissue is involved. This question has to be answered before progressing to the rest of the definition.

Superficial – Infection occurs within 30 days after any NHSN operative procedure and involves only skin and subcutaneous tissue of the incision

Deep – Infection occurs within 30 or 90 days after the NHSN operative procedure and involves deep soft tissues of the incision (e.g., fascial and muscle layers)

If only skin and subcutaneous tissue are involved it meets the superficial definition as from your description c below is met and, Im assuming that the patient had at least 1 of the sign or symptom below.

patient has at least 1 of the following:

a. purulent drainage from the superficial incision

b. organsims isolated from an aseptically-obtained culture of fluid or tissue from the superficial incision

c. superficial incision that is deliberately opened by a surgeon and is culture-positive or not cultured

and

patient has at least one of the following signs or symptoms of infection: pain or tenderness; localized swelling; redness; or heat. A culture negative finding does not meet this criterion

d. diagnosis of superficial incisional SSI by the surgeon or attending physician

If deep soft tissues (e.g., fascial and muscle layers) are involved it will meet the deep definition as from your description b below has been met and Im assuming that the patient has at least 1 of the sign or symptom below.

patient has at least one of the following:

a. purulent drainage from the deep incision

b. a deep incision that spontaneously dehisces or is deliberately opened by a surgeon and is culture- positive or not cultured

and

patient has at least one of the following signs or symptoms: fever (>38C); localized pain or tenderness. A culture-negative finding does not meet this criterion.

c. an abscess or other evidence of infection involving the deep incision is found on direct examination, during invasive procedure, or by histopathologic examination or imaging test.

d. diagnosis of a deep incisional SSI by a surgeon or attending physician.

Hence in the first instance you need to know what level the surgeon has opened these wounds too as VACs can be used on superficial or deep would infections.

Just on organ space infections these wounds as described would not be considered an organ space infection as such infections exclude the skin incision, fascia, or muscle layers, that is opened or manipulated during the operative procedure (i.e. the incisional wound is not involved at all). In this surgical setting an organ space infection would be something like osteomyelitis of the sternum without surgical incision/wound involvement.

I use a definition checklist (i.e. it either meets or does not meet the criteria) when training staff in the interpretation of the definitions for surveillance purposes.

Can send a copy if you like.

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

Dear All

Would appreciate advice on interpretation of the definition (below)

In two sternotomy cases, there has been prolonged ooze post op (several days) and the surgeon concerned has opened the wound on the ward and then instituted vac dressings
The cases required prolonged nursing management but did not come to formal debridement or removal of sternal wires etc. CT scans did not show retrosternal collections (ie not organ space infection)

In my view, this constitutes a ‘deep’ wound infection. What would others say?
Our other surgeons would have usually taken such cases to theatre and performed open debridement

in one case the culture grew Serratia
in the other, culture was no growth; in that case, the determination rests then on whether we had ‘purulent drainage’ observed from the ‘deep incision’
it does beg the question as to how one gauges from what level the drainage is coming fron and also whether one should use an objective measure for what is purulent etc!
criterion b under superficial is also problematic – how does one ever get ‘aseptically-obtained’ samples from a superficial incision? wound swabs presumably not ok but I would guess are used

Would be very interested to know of how people teach surveillance staff to apply the NHSN definition, esp for sternotomies , where essentially the superficial wound is extremely close to the deep sternal structure , and also for prosthetic joints where similar problems of distinguishing the depth of infection arise

thanks
John

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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
[cid:image001.jpg@01CEB86A.85790C70]

[cid:image002.png@01CEB86A.85790C70][cid:image003.png@01CEB86A.85790C70]
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[John Ferguson]

Thanks Glenys
Agree reversible rooms not a good idea
The single design with dual function is the go

Hi John,

See link to the Victorian DOH “Guidelines for the classification and design of isolation rooms in health care facilities”

http://www.health.vic.gov.au/infectionprevention/publications/design_isolation_rooms.htm

Full PDF at the bottom of the page

As Kevin mentioned in his response dual purpose room are not recommended – see 2.4 Class A-Alternating pressure (negative/positive pressure) on page 7

“Rooms with reversible airflow mechanisms enabling the room to be either negative or positive pressure are not recommended.(7) Problems with such rooms include the difficulty of configuring appropriate airflow for two fundamentally different purposes (see section 5.4), the risk of operator error, complex engineering and fail safe mechanisms”

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

Dear Brainstrust

Some time ago, I came across a novel configuration of a single room that provides for both protective (positive pressure barrier) and isolation (negative pressure) requirements. Extensive testing was described at the Hospital Infection Society Conference, Amsterdam 2006. It was specified under Building Note 4 by HEFMA but the link no longer works and I’ve been unsuccessful with chasing down the design. Concept involves an isolation room with a positive pressure anteroom and exhaust from the ensuite room which is entered from the main room. The design is relatively fail-safe and does not need to be manually configured.

I wondered whether anyone has come across this? Has anyone built functioning dual purpose isolation/barrier rooms? We are building a new paed ICU and we need both types of room !

thanks

John

http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
Infectious Diseases Physician, Division of Medicine, John Hunter Hospital
Clinical Microbiologist, Hunter Area Pathology, Pathology North
Conjoint Associate Professor, University of Newcastle, Adjunct Professor, University of New England
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
[cid:image001.jpg@01CE9DA5.63986720]

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[John Ferguson]

Dear Rebecca,
http://hicsigwiki.asid.net.au/index.php?titleOperating_theatre_commissioning_-_Microbiological
quite aside from the validity of air sampling, this webpage describes are clear protocol to follow for sampling

It certainly overdue that agreed national approach for this issue and stopped unnecessary time wasting!

Regards,

John

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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

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Dear All

Can anyone advise of your current practices for the requirement to perform microbiological air sampling following construction of or major refurbishment of operating rooms. The WA policy is based on the 2002 Hoffman paper and I am not aware of any more recent extensive publications on this subject.
A commentary in JHI in 2005 questioned the value of microbiological sampling (Jowitt / Morris), and the Aust HFG recommend it is performed on commissioning but give no acceptable cfu counts. The 2005 Loddon/Mallee text, give various counts for fungi and bacteria and HB 260 does not mention nor do the Australian Infection Control Guidelines.

If anyone can shed some light on the way forward in 2013 it would be appreciated.

Kind Regards

Rebecca

Rebecca McCann Program Manager
Healthcare Associated Infection Unit (HAIU)
Communicable Disease Control Directorate Department of Health
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[John Ferguson]

Dear all,
thanks everybody for your replies very useful!

I was particularly after the design that does not require switching of ventilation

Thanks to Marija, I’ve located the design which is described in the UK document, The link has been updated on the built environment web page. The design is called a positive pressure ventilated lobby room. Would be very interested to hear from anyone with experience of this design. Donna, is this the design you have ? Rosie, your design is different – is it specified/validated anywhere?

http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

kind regards,
John
Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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

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Dear John,

We’ve got 2 dual-purpose isolation rooms currently in service that were probably based on older guidelines (before my time here).

These rooms have the ability to switch from positive to negative pressure by the flick of a key-switch (the ante-room is always positive pressured with the exhaust located in the ensuite).

Current guidelines do not support these designs owing to the huge risk they pose if activated incorrectly by staff e.g. sputum positive TB cases having positive pressure instead of negative pressure by inattentive staff, etc.

It would be preferable, from a risk perspective, that your Type 5 negative pressured rooms remain as dedicated negative pressured ones… these settings are thus pre-configured and your Engineering departments then conduct regular servicing and monitors the air pressure exchanges.

We are currently undergoing a major hospital redevelopment and have factored in dedicated Type 5 negative pressured rooms in our planning for various wards.

Airflow for these rooms come via positive pressure from the anteroom and from the doorway leading to the ward corridor (if the door is temporarily opened)… the air then flows to the negative pressured exhausts in the ensuite and the main room.

The air is exhausted out of the building immediately and does not get re-circulated (some older designs filter the exhausted air from these rooms or not at all, and re-circulate it… this is not ideal).

I’m very keen to have a look at the functional design of this novel concept isolation room should you manage to find the link, John.

Kind regards,
Gerald

Gerald Chan
Coordinator Infection Control

St John of God Murdoch Hospital
100 Murdoch Drive
MURDOCH. WA 6150

P: 9366 1552
M: 0405 495 906 (7804)
F: 9311 4604

E: Gerald.Chan@sjog.org.au
W: http://www.sjog.org.au/murdoch

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[cid:ABYGQXSVVMZY.IMAGE_92.png] twitter.com/sjgh_murdoch
>>> John Ferguson <John.Ferguson@HNEHEALTH.NSW.GOV.AU> 20/08/2013 1:26 PM >>>

Dear Brainstrust

Some time ago, I came across a novel configuration of a single room that provides for both protective (positive pressure barrier) and isolation (negative pressure) requirements. Extensive testing was described at the Hospital Infection Society Conference, Amsterdam 2006. It was specified under Building Note 4 by HEFMA but the link no longer works and I’ve been unsuccessful with chasing down the design. Concept involves an isolation room with a positive pressure anteroom and exhaust from the ensuite room which is entered from the main room. The design is relatively fail-safe and does not need to be manually configured.

I wondered whether anyone has come across this? Has anyone built functioning dual purpose isolation/barrier rooms? We are building a new paed ICU and we need both types of room !

thanks

John

http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
Infectious Diseases Physician, Division of Medicine, John Hunter Hospital
Clinical Microbiologist, Hunter Area Pathology, Pathology North
Conjoint Associate Professor, University of Newcastle, Adjunct Professor, University of New England
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
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[John Ferguson]

http://www.asid.net.au/gramnegative has all the presentations from the recent MRGN Superbug meeting

http://hicsigwiki.asid.net.au/index.php?titleInfection_control_related_blogs_and_forums
has a listing of interesting infection control and other blogs/forums
please let me know of any other!

regards
JOhn

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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

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Hi Brenda

Kindly refer to link:
http://www.cec.health.nsw.gov.au/resources/environmental-cleaning-sop/environmental-cleaning
Here are some insights:

Cleaning daily residues checks at random paying attention to hard to clean and cannulised instruments (logged/recorded)

Inspection dirty items, items for repair/sharpening, electrosurgical testing, missing items/parts of an item, functionality compromises all documented

Assembly missing parts of an item, random processed sterile item check, end user non-conforming incident reports

Among others give me a ring on or email me if you need to explore further.
I would assume the link would suffice to get you through.
Happy to help.
Cheers
Roel

Roel Castillo
Project Officer SSD
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*hWK4nY*

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

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[John Ferguson]

Dear Ruth and Co

I came across these tools yesterday below from Scotland- Peter Davey was in Sydney this week
They audit every ward every week across all hospitals- just 5 patients per ward per week
Theyve had a massive impact reducing their targeted 4 Cs (cephs, cipro, clinda, coamoxyclav (augmentin) across hospital and community settings
And this has lead to significant reductions in C diff mrsa and MRGN
A great example of change implementation

Perhaps we are way too conservative with our national antibiotic guidelines and we should revisit reliance on Bactrim, doxcycline, amoxil and gentamicin etc in the way of the Scots
For an example guideline see- http://www.nhsgrampian.org/nhsgrampian/GJF_general_new.jsp?pContentID=5784&p_applic=CCC&pElementID=1225&pMenuID=464&p_service=Content.show&amp;

I have copies of Peter Daveys talks; but much is evident on the web

A useful discussion group / blog run by ISC is here – http://inventory.infectionnet.org/forums#/discussion/5/restricted-antimicrobials

Regards
John

[Cindy, can you please cross-post to the SHPA List thanks

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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
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From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Craig Boutlis
Sent: Monday, 25 February 2013 10:50 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Tools to Assess Complance with Antimicrobial Stewardship

Hi Ruth,

There is a fellow named Rod James who is part of the Guidance MS team in Melbourne who has been involved with point prevalence survey audits (including measures of compliance with guidelines and appropriateness) in public hospitals. They are also part of a research team that is looking at the challenges/opportunities in implementing stewardship programs in private hospitals. They have a presence on the web in terms of contact emails etc.

Craig Boutlis

Competing interests: We have been involved in the audits and use the Guidance MS software but I am not promoting it in any way here.

Craig Boutlis

Department Head, Infectious Diseases | IMACS
LMB 8808, SCMC, NSW, 2521
Tel. 02 4222 5898 | craig.boutlis@sesiahs.health.nsw.gov.au

[http://www.health.nsw.gov.au/images/communications/e-signatures/images/NSW-Health-Illawarra-Shoalhaven-LHD.jpg]

________________________________
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Dalrymple, Ruth
Sent: Friday, 22 February 2013 12:08 PM
To: AICALIST@AICALIST.ORG.AU
Subject: [ACIPC_Infexion_Connexion] Tools to Assess Complance with Antimicrobial Stewardship
Dear All,
I was wondering if anyone would have a good Audit Tool to access the compliance of Doctors with the Antimicrobial Stewardship Policy of the hospital which complies with Standard 3 of the National Standards?
Regards

Ruth Dalrymple
Quality Risk/Infection Control Co-Ordinator
Hurstville Private Hospital
37 Gloucester Road, Hurstville NSW 2220, Australia
T 9579 7773 F 9586 2311
E Ruth.Dalrymple@healthecare.com.au W
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[John Ferguson]

Hi Deb

Most of us I think adapt the NHSN approach – ie,
a) ‘significant’ bacteraemia – as per CLABSI
b) no other apparent primary site of infection or disseminated (I guess this will be debated – endocarditis or disciitis would constitute secondary sites; skin or soft tissue or pneumonia would be primary sites)
c) presence of cannula within 48 hrs of the event or evidence of local site infection where a cannula was placed previously

regards
John

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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

[cid:image001.jpg@01CDFEFD.7ED71BE0]

Hello everyone

Are there any Infection Prevention teams out there working with a
local or adapted definition for surveillance of Peripheral IV cannula associated BSI?

If so I would be delighted to hear from you.

Many thanks
Kind regards

Deb Rhodes
Infection Prevention Project Nurse
Infection Prevention & Healthcare Epidemiology Unit
m 0429418495
p 4066
t 03 90763139 e D.Rhodes@alfred.org.au

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

[cid:955253402@29012013-20E1]

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[John Ferguson]

THe original AICA-NAB definitions have not been updated- they were available previously on the old aica site.

THey did serve as the basis of the national SAB definitions – there are only v cosmetic changes in fact

ACHS I think has recently completed a review of their inf control indicators; perhaps someone can give us an update as to the outcome

regards
John

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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

[cid:image001.jpg@01CDDDEE.C1D418B0]

Hi Ruth,
Have a look at the VICNISS website, I believe SAB data is collected nationally therefore national definitions.
Cheers,

Tracy

Tracy Sloane
Senior Infection Control Consultant
Dandenong Hospital, Southern Health
T (03) 95548173 F (03) 95541905
E tracy.sloane@southernhealth.org.au

Hi there,
Please can someone tell me if there are any Australian national infection prevention and control surveillance definitions for healthcare associated blood stream infections? I am aware of the ACSQHC CLABSI and SAB surveillance guides but I was wondering if there are any national ones for all HABSI used in Australia. The only ones I can find are the AICA ones from a number of years ago.

I am interested in this because in our New Zealand facility we previously used these AICA definitions in the past and need to update now.

Cheers

Ruth

[cid:image001.png@01CDDD0F.72BD02D0]

Ruth Barratt RN, BSc, MAdvPrac (Hons)
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[John Ferguson]

We are just thinking about the ISOPRO system which is in current use for env audits on tablets by NSW HealthShare , the group resp for env management / cleaning. It appears to fit the bill

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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

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Good Morning

Does anyone know of a good electronic auditing system that can be used on an Ipad or similar electronic device? We are looking for a system where data can be entered onto the electronic device and saved to a computer which will also collate the data.

Thank you

Bronwyn Wellington I Quality and Infection Control Coordinator

Quality and Infection Control I Glengarry Private Hospital
53 Arnisdale Road
Duncraig WA 6023

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[John Ferguson]

Alternative for sharing tools etc is the HICSIG wiki
Just send them to Michelle Taylor (hicsig1@gmail.com)
we can get them up v quickly. Current resource page is here-
http://hicsigwiki.asid.net.au/index.php?title=Peripheral_intravenous_cannulae

[It has been recently discussed with ACIPC about the possibility of this wiki becoming a comanaged resource for IPC and AMS

regards
john

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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

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From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
Sent: Thursday, 15 November 2012 12:27 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Observational Audit Tools for IV Cannulation

Hi all

Steve Burke, the Operations Manager for ACIPC, has said he is happy to host files on the ACIPC website if there are no copyright or intellectual property issues.

Until a better process has been developed, I would suggest that anyone that has files to share should contact Steve directly (opsmanager@acipc.org.au), and then once uploaded to the ACIPC website, can post information to the list regarding where members can access them.

ACIPC may also be able to provide the broader ACIPC membership with information on what files and tools are available via their regular e-Bulletins.

Would suggest Rachel still contact ACIPC Board formally to ensure a correct process is established for sharing such tools, but in the interim this may be one option.

Cheers
Michael Wishart
ACIPC Infexion Connexion Administrator

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3326 3523
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Thomson, Rachel EA (DHHS)
Sent: Thursday, 15 November 2012 9:58 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Observational Audit Tools for IV Cannulation

Thanks Michael (and Matt),

I will happily approach ACIPC and bring this idea forward!

Cheers
Rachel

Rachel Thomson

Nurse Unit Manager
Infection Prevention & Control Unit
Royal Hobart Hospital
Ph: 03 62227882/8658
E: rachel.thomson@dhhs.tas.gov.au

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From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
Sent: Thursday, 15 November 2012 10:42 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Observational Audit Tools for IV Cannulation

Hi Rachel

I really think sharing such tools is a great idea!

Unfortunately Infexion Connexion does not support attachments, so unless any files are hosted elsewhere, we cannot share them through this list.

Maybe ACIPC could be approached to develop a portal that resources could be uploaded to, and then links could be posted on the list?

Cheers
Michael Wishart
ACPCI Infexion Connexion Administrator

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Thomson, Rachel EA (DHHS)
Sent: Thursday, 15 November 2012 8:31 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Observational Audit Tools for IV Cannulation

Hi Rhea and others,

So here is a thingit seems to me that quite a number of people may have a genuine interest in looking at your tool as discussed in a number of forums including the recent IC day in Melbourne. I wonder if you would be willing to post the tool through the Infexion Connexion list? Maybe others might like to do a similar thing so that people can build on their resources, share etc. Just a thought!!

Cheers for now
Rachel

Rachel Thomson

Nurse Unit Manager
Infection Prevention & Control Unit
Royal Hobart Hospital
Ph: 03 62227882/8658
E: rachel.thomson@dhhs.tas.gov.au

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From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Helen Scott
Sent: Thursday, 15 November 2012 8:34 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Observational Audit Tools for IV Cannulation

Hi, Can I also please have a look,
Thanks,

Helen Scott
Infection Control Co-ordinator |
Nurse Educator |
Nepean Private Hospital
Kingswood, NSW.
Tel 02 4725 8758 | helen.scott@healthscope.com.au

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>>> On 14/11/2012 at 5:08 pm, in message <0C876A281769DB4A91C9CFC6E68C65E80B704FCCA2@EMSCM006.sagemsmrd01.sa.gov.au>, “Moore, Genevieve (Health)” <Genevieve.Moore@HEALTH.SA.GOV.AU> wrote:
Hi Rhea
Can you please share these audit tools with me also as I have looking for an audit tool for IV for a while
Thanks
Genevieve

Genevieve Moore

Diabetes Educator

Clinical Placement Coordinator

Infection Control Link Nurse

Southern Flinders Health – Crystal Brook Campus
Country Health SA Local Health Network
Edmund Terrace
Crystal Brook SA 5523

Tel: (08) 8636 1164

Fax: (08) 8636 2077
Email: Genevieve.moore@health.sa.gov.au

This email may contain confidential information, which also may be legally privileged. Only the intended recipient(s) may access, use, distribute or copy this email. If this email is received in error, please inform the sender by return email and delete the original. If there are doubts about the validity of this message, please contact the sender by telephone. It is the recipients responsibility to check the email and any attached files for viruses.

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From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of MARTIN, Rhea
Sent: Wednesday, 14 November 2012 16:19
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Observational Audit Tools for IV Cannulation

Hi Craig,
Would be happy to share audit tool with you. We use two, one audits insertion (use this in ED where there is plenty of action) and the other is a ward based audit tool which looks at management of IVs on the ward
Rhea

Rhea Martin
Manager Infection Control Team
Austin Health
Studley Rd., Heidelberg
Victoria, Australia 3084
Phone 9496 5801
Page 2556
Mobile 0407 806 299

From: Craig Boutlis [mailto:Craig.Boutlis@SESIAHS.HEALTH.NSW.GOV.AU]
Sent: Wednesday, 14 November 2012 16:37
To: MARTIN, Rhea
Subject: FW: Observational Audit Tools for IV Cannulation

Hi Rhea,

I’m pretty sure that you would be on this email list but I thought I should forward this to you just in case. Would you be happy to share the audit tool that you presented at the recent Melbourne Infection Control education day? If so, would you mind cc’ing me in too?

The NSW policy is out for review at the moment and I’m going to make sure that I contribute that we should be moving to credentialling statewide along the lines of your program (thanks for making me aware of it).

Craig

________________________________
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Joe-Anne Bendall
Sent: Wednesday, 14 November 2012 4:12 PM
To: AICALIST@AICALIST.ORG.AU
Subject: [ACIPC_Infexion_Connexion] Observational Audit Tools for IV Cannulation
Hi everyone

I have a very keen medical officer who wants to be a champion for improving IV cannula insertion. Does anyone have an observational audit tool they would like to share?

I have an observational audit tool for aseptic technique wound dressing I would be willing to swap for IV cannula insertion!

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

Joe-Anne.Bendall@sesiahs.health.nsw.gov.au

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[John Ferguson]

Hi Carolyn
We have a 1 week divided course for Link nurses- Sandy Berenger can give you an overview of the course content. We are discussing a shorter version of the course

Our current service agreement specifies three focus areas for link nurses
– Hand hygiene
– IV devices
– Environmental hygiene

Our core role statement is like this in the service agreement that management sign up to

Kind regards
John

F. Infection Prevention and Control Liaison Nurse: Core Role Statement

1. Hand Hygiene
Infection Prevention and Control Liaison (ICL) staff member should be a HHA credentialed hand hygiene compliance auditor.
Responsible for attending the 5 Moments of Hand Hygiene compliance audit in accordance with the Hand Hygiene Australia program, three times per calendar year. In most circumstances, the ICL person would audit a single clinical area within your facility (which may not be their own area- cross auditing is encouraged).
In the event of audit compliance less than 70%, then additional activities and audits may be required in line with a locally driven quality improvement process.

Critical issues to reinforce with staff throughout the year:
Encourage use of hand moisturiser regularly by staff
Alerts NUM or equivalent about staff with complex rings, artificial nails etc
Staff with dermatitis; facilitate referral to Staff Health person if required (liaise with the NUM)
Ensure with the Manager constant availability/supply of alcohol hand rub with clearance of nozzles as necessary etc

2. Intravenous Device management
Ensuring relevant policies, fact sheets, display posters and procedures relating to IV devices are readily available to all staff involved in their management;
Together with the NUM, actively remind staff to assess, report and document the condition of all IV devices in accord with policy
Conduct monthly audit of IV device compliance

Critical issues for focus:
Ambulance and/or cubital fossa cannulae must replace these ASAP or remove when patients condition is stable
Use of single patient use adhesive tape rolls
Use of single patient use tourniquets
Use of correct antiseptic for skin disinfection prior to insertion

3. Environmental management
To enable cleaning to be performed to adequate standard, all clinical areas must reduce clutter on an ongoing basis.
The IP&C liaison staff member should work with the manager and staff of the ward / department / facility to establish a routine for cleaning and designating labelled sites for storing forms, medical devices and equipment, allowing more effective environmental cleaning to be carried out.
House rules (see draft example below) should be developed and discussed amongst staff and then implemented by the NUM/Manager. These rules should additionally specify whose responsibility it is for daily cleanup and cleaning of shared clinical areas. The NUM should engage with CMOs and resident medical staff (if present) and ask them to share the responsibility for maintaining of a safe environment.

Critical issues for focus
Remove ad hoc unlaminated notices stuck to walls and desks etc
Regular cleaning/disinfection of keyboards, computer mice and boxes and leads
State of bedside charts – should not be cracked, peeling or stuck down with adhesive tape. Should be disinfected after patient discharge. Should remain at the bedside or outside the room and not in common clinical areas
Monitoring of IV trolleys – no reused adhesive surgical tapes, proper management of tourniquets. Availability of large alcohol wipes on trolley for routine disinfection. Availability of correct antiseptic for skin insertion site disinfection
Patient monitoring equipment (BP/PS02) trolleys; Availability of large alcohol wipes on trolley for routine disinfection.
Monitor intact surfaces of mattresses / bedside chairs / pillows etc.

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
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

[cid:image001.jpg@01CDBCD3.379D00D0]

HI All,
I am developing an Infection Prevention & Control portfolio which a link nurse in each of our dialysis clinics will manage.
I have a few questions
1. What training do your link nurses have to manage IPC portfolios?
2. What tasks are included in the portfolio?
3. How much time are they given to manage the portfolios?
4. What short infection control courses are available for the private sector in each of the States and Territories?

With best regards
Carolyn Chenoweth
National Quality Coordinator
NephroCare

Fresenius Medical Care Australia Pty Ltd.
Payneham Dialysis Clinic, 2 Portrush Road,
PAYNEHAM
SA 5070 Adelaide
Australia
T: +61 8 8165 4313
F: +61 8 8336 4833
M: +61 0 407 810 800
http://www.fmc-ag.com

THE RENAL COMPANY – A Lifelong Commitment

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[John Ferguson]

Dear Glenys

You may wish to d/w Dr Jane Carthey who spoke to this in passing at her recent ACIPC presentation. She is current Chair of the Australian Healthcare Design Council.

There are current mandatory requirements for healthcare facility design that preclude the use of linen / refuse shuts per se owing to fire/OHS considerations. Question would be whether these would be considered in that light.

Kind regards
John

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health

[cid:image001.jpg@01CDB1C0.D577FC60]

Dear All,

Many of you will know that I’m interested in hospital design, construction and renovation.

Recently I have been reading about a vacuum system of sealed pipes powered by efficient fans to pull material from multiple points throughout a hospital to a single collection point.

These systems replace most of the manual handling of waste and linen.

I’m interested to know if these systems are in use or being considered for use your healthcare facility?

Does anyone have one of these systems or a similar system in their healthcare facility?

Would anyone be willing to share their thoughts/experiences in relation to these system with me?

Many thanks in anticipation.

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

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[John Ferguson]

Dear All

Just to keep the ball rolling
Would people again please share any further resources/ approaches to 3.10?
Would all those attending the conference please bring along examples of your work?
Some desks can perhaps be provided for you to demonstrate these

thanks
John

Dr John Ferguson
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

[cid:image001.jpg@01CD9CAB.C6F15DA0]

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 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 technique
3.10.2 Compliance with aseptic technique is regularly audited
3.10.3 Action is taken to increase compliance with the aseptic 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 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 technique: 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

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[John Ferguson]

I’m told that the relevant proportion of Australian baby boomers who are positive for hep C is 1 in 50.

John

Dr John Ferguson
Infectious Diseases & Microbiology
John Hunter Hospital, Newcastle, 2300
+61 428 885573

—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
Sent: Friday, 17 August 2012 8:01 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Updated: CDC Expanded Hepatitis C Testing Recommendations

I thought this may be of interest to list subscribers.

The CDC in the US is now recommending that US citizens born between 1945 and 1965 are tested for Hepatitis C, as below.

The full recommendations can be accessed here: http://www.cdc.gov/mmwr/PDF/rr/rr6104.pdf

CDC now recommends that all U.S. baby boomers get a one-time test for the hepatitis C virus. Data show that 1 in 30 baby boomers has been infected with hepatitis C and this population is five times more likely than other adult Americans to be infected with the virus. In addition, more than 15,000 Americans, most of them baby boomers, die of hepatitis C-related illness each year.CDC has put together a digital press kit full of helpful resources for your readers, viewers, and listeners. This kit includes key messages, charts, related links, and quotes from CDC hepatitis C experts. (http://www.cdc.gov/media/releases/2012/dpk0830-hepC.html ).

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3326 3523
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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