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Hi Glenys
There is a question that impacts our understanding of this reported data: Is the measurement of hand hygiene compliance undertaken in the UK and Australia in the same structural environment?
The Cleanyourhands campaign with 5 moments auditing was introduced in the UK in 2006(?) but has not been maintained in recent years. As far as I know there is no centralised data reporting and no framework to ensure auditing compliance. (I’m happy to be informed on this!)
This means we can’t be sure the reported data would be measured to be the same here. It might be.
That also doesn’t mean we shouldn’t try to develop and use automated monitoring. After all, not every healthcare organisation has invested in decentralising hh audits.
CheersLincoln Fowler
Infection Prevention Nurse ConsultantBairnsdale Regional Health Service
http://www.brhs.com.auThink Green, read it from the screen.
Bairnsdale Regional Health Service acknowledges the Gunaikurnai people as the traditional owners of the land on which the health service is located.
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Dear All,
There was a debate in the UK parliament, Westminster Hall on 15/5/2018 in relation to hand hygiene compliance.
The parliament was told that actual hand hygiene compliance is only 18% – 44% in the UK and that direct observation is grossly overestimating HH compliance rates (Hawthorn effect).
The discussion has implications for direct observation of hand hygiene compliance programs in Australian healthcare settings.
It is time to review our direct observation HH compliance strategies and the significant infection control resources committed to such programs across Australia.
Regards
Glenys
Glenys Harrington
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
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Hi Phillipa
The use of overshoes would seem to be a cultural activity without a well thought out reason for being embraced.
The over shoe is subject to a lot of friction forces during use so it is hardly likely to be impervious for very long allowing whatever resides on the shoe of the wearer to escape to the floor. Once on the floor it probably will stay there as generally things that fall to the floor stay there unless deliberately lifted up. As I don’t see a mechanism for doing this I would resist the temptation to apply an overshoe. It does increase the chance of slipping for the wearer and that is the greater risk as far as I can ascertain.
If something is dirty it shouldn’t be allowed into the operating theatre without being cleaned first; shoes included.
An exception might be the trauma patient needing urgent surgery!
I hope this helps the discussion.
CheersLincoln Fowler
Infection Prevention Nurse ConsultantBairnsdale Regional Health Service
http://www.brhs.com.auThink Green, read it from the screen.
Bairnsdale Regional Health Service acknowledges the Gunaikurnai people as the traditional owners of the land on which the health service is located.
We recognise and respect their cultural heritage, beliefs and relationship with the lands. We pay our respects to elders both past and present and thank them for their contribution to the health service.This communication is intended only to be read or used by the addressee. Information contained in this communication may be confidential information. If you are not the intended recipient, any use, interference with, distribution, disclosure or copying of this material is unauthorised and prohibited. The confidentiality attached to this communication is not waived or lost by reason of the mistaken delivery to you. If you have received this communication in error, please destroy it and send a reply message to the author.
Dear All
I have been asked to advise on the issue of overshoes of who and when they should be worn in Perioperative settings.
We encourage all permanent staff to have their own theatre shoes and wear for convenience and safety. We ask that shoes should be cleaned regularly and if soiled or overshoes worn if spills occur.
We currently ask visitors, parents etc to wear overshoes into theatre. We also have identified overshoes can be a WHS (slip) issue as well with some shoes.
Just wondering if anyone could share how they manage the wearing of overshoes and who and when they should be worn. Is this the current recommended practise?
I believe that our practise is current with ACORN guidelines.
Happy to chat offline if anyone can add to the conversation.Kind regards
Phillipa Parsons
Infection Prevention and Control Clinical Coordinator, Cabrini Malvern
0400 369 741
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Thank you everyone for your consideration and responses.
I’ll ask another question: Do the standards/codes state, imply, require that a “Flusher Disinfector” must not be in a patient area such as a high dependency unit and should only be in a dirty utility room?
I’m mindful that aerosols could be a potential problem although the risks around using open disposal areas with splashing is probably much higher.
I’d be interested to know of anyone who has direct experience of this type of installation.
CheersLincoln Fowler
Infection Prevention Nurse ConsultantBairnsdale Regional Health Service
http://www.brhs.com.auThink Green, read it from the screen.
Bairnsdale Regional Health Service acknowledges the Gunaikurnai people as the traditional owners of the land on which the health service is located.
We recognise and respect their cultural heritage, beliefs and relationship with the lands. We pay our respects to elders both past and present and thank them for their contribution to the health service.This communication is intended only to be read or used by the addressee. Information contained in this communication may be confidential information. If you are not the intended recipient, any use, interference with, distribution, disclosure or copying of this material is unauthorised and prohibited. The confidentiality attached to this communication is not waived or lost by reason of the mistaken delivery to you. If you have received this communication in error, please destroy it and send a reply message to the author.
Hi Everyone
In developing an HDU the staff would like to have a pan sanitiser installed. Has anyone else had experience with this?
Are there any development guidelines that refer to the requirements around pan sanitisers?
Are they supposed to be located in a separate room, for example? Do they produce aerosols so require a separate room?
The AusHFG do not seem to provide that kind of detail so your assistance would be welcome.
CheersLincoln Fowler
Infection Prevention Nurse ConsultantBairnsdale Regional Health Service
http://www.brhs.com.auThink Green, read it from the screen.
Bairnsdale Regional Health Service acknowledges the Gunaikurnai people as the traditional owners of the land on which the health service is located.
We recognise and respect their cultural heritage, beliefs and relationship with the lands. We pay our respects to elders both past and present and thank them for their contribution to the health service.This communication is intended only to be read or used by the addressee. Information contained in this communication may be confidential information. If you are not the intended recipient, any use, interference with, distribution, disclosure or copying of this material is unauthorised and prohibited. The confidentiality attached to this communication is not waived or lost by reason of the mistaken delivery to you. If you have received this communication in error, please destroy it and send a reply message to the author.
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Hi John
The product you attached is marked single use so it must be changed after every patient.
It seems that the issue remains however does the filter actually protect the whole circuit from contamination by microbes and hence successive patients?
CheersLincoln Fowler
Infection Prevention Nurse ConsultantBairnsdale Regional Health Service
http://www.brhs.com.auThink Green, read it from the screen.
Bairnsdale Regional Health Service acknowledges the Gunaikurnai people as the traditional owners of the land on which the health service is located.
We recognise and respect their cultural heritage, beliefs and relationship with the lands. We pay our respects to elders both past and present and thank them for their contribution to the health service.This communication is intended only to be read or used by the addressee. Information contained in this communication may be confidential information. If you are not the intended recipient, any use, interference with, distribution, disclosure or copying of this material is unauthorised and prohibited. The confidentiality attached to this communication is not waived or lost by reason of the mistaken delivery to you. If you have received this communication in error, please destroy it and send a reply message to the author.
Hi All
Our theatres use the HMEF attached which is not changed between patients over the day – it protects the proximal anaesthetic circuit from contamination and transfers the humidity from the circuit to the distal (patient) tubes.
We are aware that not all theatres across NSW use the hydrophobic filters that provide the necessary barrier and are concerned that the cheaper more porous electrostatic filters are often in use (and reuse). The issue is unpacked well here – https://www.apsf.org/newsletters/html/2011/fall/06_dearsirs.htm . This posting gives background
http://www.derangedphysiology.com/main/core-topics-intensive-care/mechanical-ventilation-0/Chapter%201.3.2/heat-and-moisture-exchange-filter-hmeThere are no standards for ventilatory circuits specified in NSW Infection Control policy or by the ANZ College of Anaesthetists.
I would welcome your thoughts please . How can we get some proper national guidance out there?
Kind regards
JohnA/Prof John Ferguson MBBS DTM&H FRACP FRCPA
Director | Infection Prevention Service, HNELHD
John Hunter Hospital, Locked Bag 1, Newcastle Mail Centre, NSW 2310, Australia
T: 61 2 49214444 | F: 61 2 49214440 | M: +61(0)428 885573 (Speed Dial 67607) | Tw @mdjkfFollow http://www.aimed.net.au, the HNE Health/Pathology North site for practical discussions about antibiotic use.
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Hi Janine
At BRHS the ED is the primary review place for all occupation exposure incidents. The hospital executive believe that this must be, so as to provide the optimal care for staff as there is no Staff Health Department and no suitable specialists.
Senior medical staff must be involved in the process. There is a system for seeking an immunologist’s assistance by telephone when necessary.
Infection Prevention primarily provides follow-up as the service hours are a maximum of 32 hours/week only.
CheersLincoln Fowler
Infection Prevention Nurse ConsultantBairnsdale Regional Health Service
http://www.brhs.com.auThink Green, read it from the screen.
Bairnsdale Regional Health Service acknowledges the Gunaikurnai people as the traditional owners of the land on which the health service is located.
We recognise and respect their cultural heritage, beliefs and relationship with the lands. We pay our respects to elders both past and present and thank them for their contribution to the health service.This communication is intended only to be read or used by the addressee. Information contained in this communication may be confidential information. If you are not the intended recipient, any use, interference with, distribution, disclosure or copying of this material is unauthorised and prohibited. The confidentiality attached to this communication is not waived or lost by reason of the mistaken delivery to you. If you have received this communication in error, please destroy it and send a reply message to the author.
Hi All,
I am seeking information from our network about the management of staff occupational exposures afterhours, weekends, public holidays.
In our hospital, during business hours, staff present to staff clinic/infection control for management of their occupational exposure. Management includes blood test, counselling and follow-up.
After hours, staff present to the Emergency department for initial blood test and counselling. Infection control provides all follow-up from here on the next business day. During long periods of public holidays ie Easter, ED has followed up the initial blood test and provided PEP if appropriate.I would like to know what other hospitals arrangements are for management of occupational exposures as we are about to conduct a review of the role that ED plays in the management of occupational exposures, in particular how you manage after hours exposures when infection control is not physically on the premises. We do have an on call arrangement.
Thanks in advance.
Janine Carrucan
RN B AppSci MPHTM GradCertEd MAdvPrac (Infection Prevention & Control) CICP-E
Nursing Director , Infection Prevention & Control
The Townsville Hospital & Health Service
PO Box 670 Townsville Qld 4810
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Thank you Cath and M-L for your contributions.
I agree that there is enough evidence already present without having to spend more precious resources trying to provide proof positive.
I and many colleagues spend far too much time trying to convince HCWs of the value of vaccination as it is. Improved patient safety is apparently not enough of a reason…
RegardsLincoln Fowler
Infection Prevention Nurse ConsultantBairnsdale Regional Health Service
http://www.brhs.com.auThink Green, read it from the screen.
Bairnsdale Regional Health Service acknowledges the Gunaikurnai people as the traditional owners of the land on which the health service is located.
We recognise and respect their cultural heritage, beliefs and relationship with the lands. We pay our respects to elders both past and present and thank them for their contribution to the health service.This communication is intended only to be read or used by the addressee. Information contained in this communication may be confidential information. If you are not the intended recipient, any use, interference with, distribution, disclosure or copying of this material is unauthorised and prohibited. The confidentiality attached to this communication is not waived or lost by reason of the mistaken delivery to you. If you have received this communication in error, please destroy it and send a reply message to the author.
Agree completely with you ML.
Also often distressed by pushback from clinicians and even IPs who use the phrase “evidence-based” as a cop out for adopting measures that make biological or even plausible sense. It’s not like the global infection control community has endless time, money or intellectual capacity to create the evidence yet it’s an easy cop-out.
Look at other professions/ industries like law/ aviation/ mining/ food preparation where specific important matters are mandated not on evidence but on good common sense and reasonable consideration of potential for harm/ risk mitigation and/ or remediation. Yet in healthcare we so often flim-flam and procrastinate or put up an immediate brick wall to any hint of mandating and meanwhile poor practice, events which should be never and patient harm are tolerated.
Politics and finance are major drivers of infection prevention practice at every level but increasing I hope our profession can become more open to leading efforts to prevent infection rather than making excuses about why we should or shouldn’t support specific aspects.
Many may find this comment offensive or inflammatory and I am sorry of you interpret it as such – my intention is to provoke further thought and deeper consideration of how we can make sustainable improvements.
Respectfully
Cath
Cathryn Murphy MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
PO Box 3079
Burleigh Town 4220
OLD, AustraliaE: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W: infectioncontrolplus.com.auMichael
There are several evidential factors that should make HCWs accept annual vaccination:
1. flu can be transmitted at least 24 hours before symptoms,
2. flu can be present even when a case is asymptomatic
3. flu can be easily transmitted while symptomatic during just tidal breathing
4. Flu particles can travel 2.6 metres
There is evidence to back up all of these that makes mandatory vaccination every HCW’s patient safety duty.M-L
Professor Epidemiology Healthcare Associated Infection and Infectious Disease ControlSent from my iPhone
On 8 Feb 2017, at 9:19 pm, Michael Wishart <Michael.Wishart@SVHA.ORG.AU> wrote:
[Posted on behalf of Giulietta Pontivivo – Moderator]Hi Michael
The draft update of the MoH NSW Occupational Assessment, Screening and Vaccination Against Specific Infectious Diseases PD stipulates “HCW’s in Category A high risk groups will be mandated to be vaccinate before 31st may each year. If unvaccinated the HCW maybe deployed permanently to other low risk working environments”.
Personally I would have liked to see all HCW’s in category A be mandated to have a seasonal flu vaccine. Given that in NSW there were over 270 HC facilities that experienced influenza outbreaks last year with low rates of HCW influenza vaccination in such facilities then mandatory vaccination must be seen as a patient safety requirement.
Regards Giulietta
Giulietta Pontivivo CICP RN/RM/MPH| NM Infection Prevention Management and Staff Health Services- St Vincent’s Hospital (Unit Level 6, DeLacy Building), 390 Victoria Street Darlinghurst NSW 2010
Contact Details: t: 61 2 8382 3284 | f: 61 2 8382 3892 |M-0457 533 452 e: Giulietta.Pontivivo@svha.org.auThere has been an interesting discussion of the 2010 SHEA position paper on mandated influenza vaccination in the US on the Controversies in Hospital Infection Control blog (http://haicontroversies.blogspot.com.au/). The key blog posts are from Jan 29th, Feb 5th and Feb 6th.
For those who do not regularly follow this blog, it is an interesting debate. It is a discussion on evidence vs opinion for prescription of practice.
I agree with the original blog author: it is fine to state opinion and plausibility to recommend something, but if we want to mandate something, there needs to be clear evidence.
Would be interested to hear other ICP’s opinion on this topic.
Cheers
MichaelMichael Wishart
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
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Hi Erica
My approach is that when an issue is identified when I am auditing (more than once for same moment), 1 stop the audit, 2 approach the individual, apologise for interrupting their work and explain what I am auditing, 3 let the individual know what they have done correctly, 4 let them know exactly which moments I didn’t observe, 5 ask if there is a particular reason for the missed moment.
This usually helps get them along for the ride. I try to keep it non-confrontational and as objective as possible and out of hearing of other staff and patients. I generally report to the manager of the area afterwards to say I have spoken to this person about their HH performance.
Auditors would have to be confident in their ability to do this and so would require some training and support with scenarios I think. Things like this don’t always translate well from smaller facilities like mine…
I hope this is of some value.
CheersLincoln Fowler
Infection Prevention Nurse ConsultantBairnsdale Regional Health Service
http://www.brhs.com.auThink Green, read it from the screen.
Bairnsdale Regional Health Service acknowledges the Gunaikurnai people as the traditional owners of the land on which the health service is located.
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Good Afternoon All,
I am chasing some guidance/advice on how you best address noncompliance with the 5 moments for hand hygiene.
* How do you tack staff that are repeatedly non-compliant?
* What is your process for identifying repeat offenders?
* What is your process for addressing noncompliance? ie, training, management notification, executive escalation etc.
* What is your definition of non-compliance?
Thankyou in advance for your assistance.
Kind Regards
Erica Short | Infection Prevention and Management
Clinical Nurse, GradCert IPCSouth Metropolitan Health Service Fiona Stanley Hospital
Level Ground, Block, 11 Robin Warren Drive, MURDOCH WA 6150
Postal address: Locked Bag 100, PALMYRA DC WA 6961T: 6152 6635 | P: 28915
E: Erica.Short@health.wa.gov.auhttp://www.southmetropolitan.health.wa.gov.au
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Hi – Bairnsdale developed a building that houses both but in separate “wings”, with doors, consult rooms and waiting area in-between.
Let me know if you want more information.
CheersLincoln Fowler
Infection Prevention Nurse ConsultantBairnsdale Regional Health Service
http://www.brhs.com.auThink Green, read it from the screen.
Bairnsdale Regional Health Service acknowledges the Gunaikurnai people as the traditional owners of the land on which the health service is located.
We recognise and respect their cultural heritage, beliefs and relationship with the lands. We pay our respects to elders both past and present and thank them for their contribution to the health service.This communication is intended only to be read or used by the addressee. Information contained in this communication may be confidential information. If you are not the intended recipient, any use, interference with, distribution, disclosure or copying of this material is unauthorised and prohibited. The confidentiality attached to this communication is not waived or lost by reason of the mistaken delivery to you. If you have received this communication in error, please destroy it and send a reply message to the author.
Hi – I am about to have a meeting with our exec and architect to review redevelopment plans that show that haemodialysis and the day oncology unit will be amalgamated. I obviously have concerns about this situation. I would be very interested in hearing thoughts and advice from the group. Thanks Lesley Stewart
Lesley Stewart, Kaye Roberts & Carolyn Templeton
Infection Control & Wound Management
Western District Health Service
PO Box 283
Hamilton, Victoria 3300
Infection.wound@wdhs.net | http://www.wdhs.net[Description: Description: Description: Description: Description: text3126-7-9-4-1]
Excellence in Healthcare – Putting People FirstMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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Hi Michael
I have tried to improve vaccination rates and find that without mandating it the best that can be achieved is 80%. This seems remarkably similar to the results from this study!
I too think that requiring the use of a mask would be a good step. I guess you have to have an easy way to identify those who have been vaccinated though. In some places a sticker on the ID is used and although it isn’t terribly sophisticated probably helps amongst those who are keen to establish flu vaccination as a good practice.
ACIPC should probably have a position statement about HCW vaccination as it aligns well with our other practices.
CheersLincoln Fowler
Infection Prevention ConsultantBairnsdale Regional Health Service
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Bairnsdale Regional Health Service acknowledges the Gunaikurnai people as the traditional owners of the land on which the health service is located.
We recognise and respect their cultural heritage, beliefs and relationship with the lands. We pay our respects to elders both past and present and thank them for their contribution to the health service.This communication is intended only to be read or used by the addressee. Information contained in this communication may be confidential information. If you are not the intended recipient, any use, interference with, distribution, disclosure or copying of this material is unauthorised and prohibited. The confidentiality attached to this communication is not waived or lost by reason of the mistaken delivery to you. If you have received this communication in error, please destroy it and send a reply message to the author.
https://www.cdc.gov/mmwr/volumes/65/wr/mm6538a2.htm?s_cidmm6538a2_e#T1_down
I think we can definitely do better than we currently do in Australia. Maybe healthcare facilities need to use bigger sticks, like they do in the US? Should we have the mandatory influenza vaccination for healthcare workers discussion again? Sanctions (like mandatory masks for patient contact) for vaccine refusals?
Any comments?
Cheers
MichaelMichael Wishart
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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Hi Kelly
ACIPC has a position statement on this so check it out on the website and see if it helps.
CheersLincoln Fowler
Infection Prevention ConsultantBairnsdale Regional Health Service
http://www.brhs.com.auThink Green, read it from the screen.
Bairnsdale Regional Health Service acknowledges the Gunaikurnai people as the traditional owners of the land on which the health service is located.
We recognise and respect their cultural heritage, beliefs and relationship with the lands. We pay our respects to elders both past and present and thank them for their contribution to the health service.This communication is intended only to be read or used by the addressee. Information contained in this communication may be confidential information. If you are not the intended recipient, any use, interference with, distribution, disclosure or copying of this material is unauthorised and prohibited. The confidentiality attached to this communication is not waived or lost by reason of the mistaken delivery to you. If you have received this communication in error, please destroy it and send a reply message to the author.
Hello Brains trust,
Wondering if anyone has procedures re having pets in an acute area. We recently were palliating a patient who requesting to have their dog visit. I am interested to hear what other services have experienced and how they dealt with the request.
Cheers,Kelly
Kelly Barton
Infection Prevention & Control Officer
Monday- Friday.
Staff Immunisation Clinics:
1000-1400, 4th Monday of the Month -Mount Beauty
1000-1400, 4th Tuesday of the Month – Bright
1000-1400, 4th Wednesday of the Month – Myrtleford.
Please book an appointment with main reception at the hospital.[vaccination pear]
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Hi Sony
The laundry for our region doesn’t use starch and I can’t say I’ve seen it used in a very long time in any other region.
I hope this helps.Lincoln Fowler
Infection Prevention ConsultantBairnsdale Regional Health Service
Ph: (03) 5150 3432
Mobile: 0407 094 658
http://www.brhs.com.auBairnsdale Regional Health Service is located on the traditional land of the Gunaikurnai people.
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—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Sony SO
Sent: Wednesday, 22 July 2015 11:59 AM
To: AICALIST@AICALIST.ORG.AU
Subject: whether using laundry starch is a common practices in AUSDear All,
Meanwhile, we are conducting outbreak investigation regarding fungal-infected bed linenhttp://www.scmp.com/news/hong-kong/health-environment/article/1841412/third-fungal-infection-hong-kongs-queen-mary
We use laundry starch in the laundry process (faciliate ironing – crisp appearance), and we would like to know whether using laundry starch is a common practices in AUS.
Regards,
Sony SO
Nursing Officer, Infection Control Branch (Team 2) Centre for Health Protection office phone: +852 2125-2922; fax: +852 3523-0752 HA email sony@ha.org.hk; DH email no_icb4@dh.gov.hkMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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I wouldnt recommend using the insulin pens unless the self-sheathing needles were provided for staff. I have used some of these products when working in Europe but havent seen them in Australia.
Lincoln Fowler
Infection Prevention Consultant
Bairnsdale Regional Health Service
Ph: (03) 5150 3432
Mobile: 0407 094 658
Bairnsdale Regional Health Service is located on the traditional land of the Gunaikurnai people.
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From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Margaret Evans
Sent: Monday, 24 February 2014 7:25 AM
To: AICALIST@AICALIST.ORG.AU
Subject: safety of insulin pens for nursing staff use?Hi All
Our physician wants pharmacy to dispense a prefilled insulin pen to the patient and nursing staff use this to administer the required dose. This pen would then be used by both the nursing staff & patient throughout the patients admission.
I am wondering about the safety of using insulin pens as we have had a number of needlestick injuries from them in the past. If you do use then do you have procedures in place to prevent NSI that you would be happy to share
Thanks for your thoughts
Kind regards
Margie
Margaret Evans IP&C CNC
Royal Hospital for Women
Locked Mail Bag 2000
Randwick 2031
Phone 02 93826339
Senior Clinical lectures,
Sydney university
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