[Louise Davis]

Dear Sony,
There is a 3rd edition available of Infection Control in Endoscopy
(ICE) which is produced by GESA & GENCA but unfortunately it isn’t yet
available electronically.
I have been in touch with GENCA and pointed out to them that the 2nd
edition is still available on the GESA website and this will be
rectified shortly.

No editions of ICE have ever recommended any form of disinfection per
se but give instructions for both manual and machine disinfection. The
latest version addresses the emergence on the market of machines that
have been approved for both cleaning and disinfection processes.

Although the 3rd edition is not currently available electronically the
text on the Endoscope Reprocessing website (available at
http://www.health.qld.gov.au/EndoscopeReprocessing/) has been updated
to reflect the changes made in the latest edition of Infection Control
in Endoscopy. An audit tool is available on this site also which was
developed to allow staff to identify whether their practice is in
compliance with the guidelines.

There are World Gastroenterology Organisation guidelines on endoscope
reprocessing which take a tiered approach to the requirements, based on
the economic level of the country. So there are baseline-all-must-do
steps then additional ones for the more developed sites and then the
ultimate for the 1st world countries.

kind regards
Louise

C. Louise Davis
CHRISP (Centre for Healthcare Related Infection Surveillance and
Prevention)
Queensland Health
louise_davis@health.qld.gov.au | Web: http://www.health.qld.gov.au/chrisp

>>> Sony SO 21/06/2011 1:00 am >>>

Dear All,

My hospital is preparing for the hospital Accreditation in accordance
with Australian Council on Healthcare Standards ( http://www.achs.org.au
) (ACHS)s audit criteria.

We are not familiar with theAustralians infection control practices,
and we would like to have your comment for whether manual disinfection
process for used endoscopes is allowed in Australian.

We have reviewed The Gastroenterological Society of Australia.
Infection Control in Endoscopy (
http://www.gesa.org.au/pdf/booklets/I_Control_2nd_Edition.pdf )
Second Edition 2003. Reprinted 2006
http://www.gesa.org.au/pdf/booklets/I_Control_2nd_Edition.pdf, and
manual disinfection is recommended. Refer to page 31 fro details.

Regards,

Sony SO
Nursing Officer, Infection Control Team
KwongWah Hospital
HONG KONG SAR, CHINA
Tel:+852 3517-2409 Fax: +852 2332-3348 email:sony@ha.org.hk
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[Louise Davis]

Hello,
Just to clarify a couple of things:
The content of the website is based on the GENCA guidelines ‘Infection Control in Endoscopy’ available on the GENCA website http://www.genca.org/member-services/policies-and-guidelines.html
GENCA maintain the currency of the information on the site and Queensland Health host and update the site as required.
You are probably all aware that ‘Infection Control in Endoscopy’ is currently being updated with the new version due to be published soon.
Following publication the website content will be reviewed by GENCA & updated to ensure it remains in keeping with their guidelines.
kind regards
Louise Davis

C. Louise Davis
Principal Project Officer
CHRISP (Centre for Healthcare Related Infection Surveillance and Prevention)
Communicable Diseases Branch | Health Protection | Division of the Chief Health Officer | Queensland Health
Level 3, 15 Butterfield Street, Herston QLD 4006 | PO Box 2368 Fortitude Valley BC 4006

>>> “Wishart, Michael” 12/08/2010 10:16 am >>>
Hi all

This is the response I received from the GENCA President concerning questions about endoscopy reprocessing accreditation.
Apologies for the delayed posting of this!

Cheers
Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

Ramsay Health Care is an environmentally responsible corporation, please consider the environment before printing this email.
________________________________________

Hi Michael,
The website was an initiative of Qld Health and GENCA in around 2002. The names of the people involved in its development are on the About Us section of the webpage. It is an interactive site and there is no charge to complete the online component, which is what we request that staff who reprocess scopes complete. At the end of the package there is a questionnaire that is completed. A printout stating the number of correct answers is then available. We have requested that Qld Health add a date validation on this, which can then be used to show when the online component was completed. Staff can then apply through GENCA to be assessed by a GENCA assessor, at no cost to members, but a fee is charged to non members. This is a recommendation but not a requirement.
It will not be a requirement of membership as not all our members reprocess scopes.
We envisage that each hospital will require that their staff keeps a record of the completed questionnaire to validate their completion of the package.
I hope that answers your questions, please ring me if you would like further clarification.
regards
Beth

>>> “Wishart, Michael” 3/08/2010 10:47 am >>>
Hi Beth

See Cath Murphy’s questions about validation of the GENCA course and the
QH online education. Can either of you comment on how these have been
validated?

Thanks
Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate St, Greenslopes QLD 4120
t: 07 3394 7919 | pager 047 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

Ramsay Health Care is an environmentally responsible corporation, please
consider the environment before printing this email.

—–Original Message—–
Behalf Of Cath Murphy
reprocessing of flexible scopes

This is an interesting development. I am assuming it could mirror AICA’s
possible intentions to make recommendations regarding its AICA.

Is anyone able to advise if there is a fee associated with completing
the training and how GENCA has validated the learning package content?
Was there a large scale comprehensive practice analysis of GENCA’s
members work performed or was the package merely the work of GENCA or
QLD Health experts?

I’m also curious as to how GENCA intends to enforce the Position and if
a member is unable to commit to undertaking the training would GENCA
deny that person membership (which would seem crazy from a strategic and
financial point of view).

The whole issue of certification/ credentialing and on-going education
is an interesting one and in the US has lead to substantial review and
consideration of the most appropriate model that brings positive
improvements for patients.

There are also substantial administrative burdens associated with
promoting such a position.

None of these issues are new to AICA and it is very interesting to see
how continuing competence is measured and moulded in Australia and
beyond and in different specialities.

Thanks for sharing this with AICA members.

Regards

Cath

Cath Murphy RN PhD
Clinical Nurse Consultant
Infection Control
Robina Hospital

—–Original Message—–
Behalf Of Claire Boardman
reprocessing of flexible scopes

No doubt some of you may already have seen this but just in case please
find information relating to the GENCA Position statement.

The Gastroenterological Nurses College of Australia have published a
Position Statement for Education Requirements for Personnel Reprocessing
Flexible Endoscopic Equipment.

The Statement is available at the following link:
http://www.genca.org/images/stories/PDFs/publications/positionstatements
/position_statement_education_requirements.pdf

Claire Boardman
AICA President

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This communication should not be copied or disseminated
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[Louise Davis]

Hello,

Thanks for passing this information on.
Does anyone else think that this is too broad a collection of findings
of which any are to be considered pointers of severe disease?
The statement implies that any combination of the findings listed
should lead one to consider severe disease in the presence of
C.difficile infection?
I suspect that this will wave too broad a brush and needs to be refined
to specific combinations of these findings.
kind regards

Louise Davis
Microbiologist
Queensland

>>> “Wishart, Michael” 20/05/2010 5:18
pm >>>
[Posted on behalf of Claire Boardman, AICA President – Moderator]

Dear PHSC Member,

I am writing to you to inform you that at today’s meeting of the
Commission’s HAI Advisory Committee it was reported by one of the
members that a hospital case of highly virulent (NAP1/027) strain of
Clostridium difficile infection had been detected with probable
transmission to other patients within that facility. You may be aware of
this through your usual infectious diseases channels.
The emergence of C. difficile (NAP1/027) in North America and Europe
has been associated with increased frequency, severity and relapse of C.
difficile infection as well as a significant increase in mortality and
morbidity.
As you will recall in December 2008 Australian Health Ministers
endorsed a recommendation that all hospitals monitor and report through
their relevant jurisdiction into a national data collection C. difficile
infections.
The reasons for inclusion for monitoring were that C. difficile
infection:
*is a common HAI infection that causes significant patient morbidity
and mortality for already infected patients in hospitals and long term
care facilities.
*there has been an inconsistent approach to its prevention,
identification and management in Australia
*local capacity to detect and respond to virulent strain emergence is
limited because of the absence of co-ordinated surveillance
*the early detection of highly virulent strains of C. difficile
infection in Australia, will enable early interventions to prevent major
harm to Australian patients.
As a consequence of the Health Ministers endorsement, the Commission
developed a recommended surveillance approach within a data dictionary
for HAI Infection that was circulated to Heads of Jurisdictional
Departments of Health (and copied to Inter-jurisdictional Committee
Members) by the Commission in December 2009 (see web link below).
Effective antimicrobial stewardship, Standard Precautions including
hand washing, environmental cleaning and disinfection and additional
contact isolation precautions are the key prevention and control
measures for C. difficile infection.
Advice from the Commission’s HAI Advisory Committee is that specimens
and/or C. difficile isolates from patients displaying criteria of severe
disease (below) should be referred to a specialised reference laboratory
for identification and typing as soon as practicable.
If you were not aware of this case, you may care to consider the
implications for your own C. difficile infection surveillance.
The Commission has advised the Commonwealth Chief Medical Officer of
this situation.
Yours sincerely

Professor Chris Baggoley
Chief Executive
20 May 2010

Severe C. difficile Infection
Severe disease should be considered in the following setting, if
combinations of these findings are present in the presence of C
difficile infection.
*age >60 years,
*temperature >38.3C,
*serum albumin 15,000 cells/microL
*deteriorating renal function
*elevated serum lactate
*endoscopic evidence of pseudomembranous colitis or treatment in the
intensive care unit
*subtotal colectomy performed.
*toxic megacolon diagnosed

http://www.safetyandquality.gov.au/internet/safety/publishing.nsf/Content/8ACDDE1B8F648482CA2573AF007BC2D4/$File/DDC-Guidelines-HAI.pdf

The putative international standard of practice is now the Clinical
Practice Guidelines for Clostridium difficile Infection in Adults: 2010
Update by the Society for Healthcare Epidemiology of America (SHEA) and
the Infectious Diseases Society of America (IDSA). This is available via
http://www.journals.uchicago.edu/doi/full/10.1086/651706 .

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information that is confidential and subject to privilege. If you
are not the intended recipient, and have received the e-mail
in error, you are notified that any use, dissemination,
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and any attached files is strictly prohibited. If you have
received this e-mail message in error please immediately
advise the sender by return e-mail, or telephone 1800 243 903.
You must destroy the original transmission and its contents.
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the individual sender, except where the sender specifically
states them to be the views of Ramsay Health Care.
This communication should not be copied or disseminated
without permission.
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Messages posted to this list are solely the opinion of the authors, and
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Any unauthorised use, alteration, disclosure, distribution or review of this email is strictly prohibited. The information contained in this email, including any attachment sent with it, may be subject to a statutory duty of confidentiality if it relates to health service matters.
If you are not the intended recipient(s), or if you have received this email in error, you are asked to immediately notify the sender by telephone collect on Australia +61 1800 198 175 or by return email. You should also delete this email, and any copies, from your computer system network and destroy any hard copies produced.
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