[Louisa Sasko]

Hi Sue,

Ive looked at all 3 documents. Sorry my question isn’t probably precise.

I need to find out if there are any guidelines on choosing plain hand soaps that are to be used in healthcare facilities in clinical environments such as on wards.

Or can any plain soap be used for hand hygiene in the clinical environment?

Lou

Regards
Louisa
CNC Infection Control
Ryde Hospital Sydney
Ph 985 87664
M 0434323266
Pager 54581

>>> 27/11/2012 3:08 pm >>>
Hi Louisa,
You will find information about hand hygiene products on the HHA website,
and in the Australian Guidelines for the Prevention and Control of
Infections in Health Care (NHMRC 2010), You will also find additional
information in the NSW Health Hand Hygiene Policy 2010 (PD 2010_058).

Regards,
Sue

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

Louisa Sasko
Sent by: ACIPC Infexion Connexion
27/11/2012 02:54 PM
Please respond to
ACIPC Infexion Connexion

To
AICALIST@AICALIST.ORG.AU
cc

Subject
hand soaps for healthcare areas [SECNo Protective Marking]

Hi all,

I am currently desperate for some information regarding hand soaps being
used in the clinical setting. Are there any guidelines that stipulate what
soaps are allowed to be used by Healthcare Workers for instance it must be
a hospital grade soap or TGA registered/approved soap for clinical use.

Thanks in advance

Regards
Louisa
CNC Infection Control
Ryde Hospital Sydney
Ph 985 87664
M 0434323266
Pager 54581

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[Louisa Sasko]

Hi all,

I am currently desperate for some information regarding hand soaps being used in the clinical setting. Are there any guidelines that stipulate what soaps are allowed to be used by Healthcare Workers for instance it must be a hospital grade soap or TGA registered/approved soap for clinical use.

Thanks in advance

Regards
Louisa
CNC Infection Control
Ryde Hospital Sydney
Ph 985 87664
M 0434323266
Pager 54581

Views expressed in this message are those of the individual sender, and are not necessarily the views of the Local Health District or associated entities.

Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.

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[Louisa Sasko]

Hi all,

This is all I can find from the NSW Food Authority, ‘Guidelines for
food service to vulnerable persons’ Page 9:

2.38) Where equipment and utensils are cleaned and sanitised in a
dishwasher, the
following should be done to ensure the dishwasher is working
correctly:
(a) The dishwasher should be regularly maintained and serviced
according to
manufacturers instructions
(b) A detergent and/or sanitiser appropriate for the equipment should
be used in
the dishwasher
(c) The dishwasher should be operated using the hottest water rinse
cycle
available (economy cycle should not be used as this is not designed to
provide a high enough temperature for the time needed to sanitise)

(d) A visual check should be done of equipment and utensils when
removed from the dishwasher to ensure they are clean
(e) The dishwasher should be cleaned so that there is no accumulation
of food residues

Any thoughts to add to this?

Lou

Regards
Louisa
CNC Infection Control
Ryde Hospital Sydney
Ph 985 87664
M 0434323266
Pager 54581

>>> Louisa Sasko 26/10/2012 8:54 am
>>>
Hi Joe,

It is so that they can use plates and cutlery and then wash them in the
dishwasher to be used by other patients in the facility.

I have expressed my concerns about this process in that it changes all
the patients into household contacts but am lacking any real support to
the recommendations I am providing.

Thanks Michael, my thoughts were the same

Lou

Regards
Louisa
CNC Infection Control
Ryde Hospital Sydney
Ph 985 87664
M 0434323266
Pager 54581

>>> Joe-Anne Bendall
25/10/2012 4:16 pm >>>
Hi Louise
What is the purpose of the dishwasher? Is it part of the rehabilitation
program for patients?

Thanks

Joe

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

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

—–Original Message—–
Behalf Of Louisa Sasko

Hi all,

Currently we are involved in the development and building of a new
rehab facility.

The issue surrounding placing domestic dishwashers in the patients
dining room/pantry area has arisen. I have expressed concerns around
this.

I was wondering if anyone had any experience, info, supporting
documentation that they could share with me.

Many thanks in advance

Louisa

Regards
Louisa

CNC Infection Control
Ryde Hospital Sydney
Ph 985 87664
M 0434323266
Pager 54581

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[Louisa Sasko]

Hi Joe,

It is so that they can use plates and cutlery and then wash them in the dishwasher to be used by other patients in the facility.

I have expressed my concerns about this process in that it changes all the patients into household contacts but am lacking any real support to the recommendations I am providing.

Thanks Michael, my thoughts were the same

Lou

Regards
Louisa
CNC Infection Control
Ryde Hospital Sydney
Ph 985 87664
M 0434323266
Pager 54581

>>> Joe-Anne Bendall 25/10/2012 4:16 pm >>>
Hi Louise
What is the purpose of the dishwasher? Is it part of the rehabilitation program for patients?

Thanks

Joe

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

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

—–Original Message—–

Hi all,

Currently we are involved in the development and building of a new rehab facility.

The issue surrounding placing domestic dishwashers in the patients dining room/pantry area has arisen. I have expressed concerns around this.

I was wondering if anyone had any experience, info, supporting documentation that they could share with me.

Many thanks in advance

Louisa

Regards
Louisa

CNC Infection Control
Ryde Hospital Sydney
Ph 985 87664
M 0434323266
Pager 54581

Views expressed in this message are those of the individual sender, and are not necessarily the views of the Local Health District or associated entities.

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[Louisa Sasko]

Hi all,

Currently we are involved in the development and building of a new rehab facility.

The issue surrounding placing domestic dishwashers in the patients dining room/pantry area has arisen. I have expressed concerns around this.

I was wondering if anyone had any experience, info, supporting documentation that they could share with me.

Many thanks in advance

Louisa

Regards
Louisa
CNC Infection Control
Ryde Hospital Sydney
Ph 985 87664
M 0434323266
Pager 54581

Views expressed in this message are those of the individual sender, and are not necessarily the views of the Local Health District or associated entities.

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[Louisa Sasko]

Hi Tim,

In reply to your message, Ive already posted a message through the AICA list.

All environmental surfaces that come into direct contact or indirect contact with the patient should be cleaned in between each patient. So with non-MRO patients this should be a neutral detergent and with MRO’s an appropriate disinfectant.

Yes you should clean appropriately in between each patient with the same MRO strain and the reason for this is the patient will have other flora that is unknown to the HCW. They could have other MRO’s. So the environment/equipment must be cleaned with the appropriate solution.

Regards
Louisa
>>> Tim Spencer 23/08/2012 8:49 am >>>
Hi Michael,
I find this interesting also.
I use a procedureal area for CVAD insertion, seeing up to 5-8 patients a day.
Quite often, these have an MRO (incl VRE) and I often see these patients towards the end of the day after the ‘non-infectious’ patients.
50% of my patients are immuno-compromised and so I triage my requests lists based around immune and infection status.
Between non-infectious patietns, we don’t get regular decontamination done, however do so after each MRO patient.
What I’d like to know is it necessary to decontaminate betwween patietns who have the same strain of MRO?
My procedureal bay is a large isolation room in our ICU that is NOT used for anythign except my procedures.
I get our after hours cleaner to do the room at the end of the day also.
Interested in hearing peoples thoughts on this also.
Regards,
Tim..
Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant | Central Venous Access & Parenteral Nutrition Service
Conjoint Lecturer, University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital, Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel 02 8738 3603 | Fax 02 8738 3551 | Mob 0409 463 428 | Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au

—–Original Message—–

Hi all

Just trying to see what the current thoughts are in regard to management of patients with multi resistant organisms in procedural areas. Do most facilities still have ‘special cleaning’ after procedures on patients colonised or infected with MRSA, ESBL and MRGN’s? I would assume that most facilities would still have special cleaning following procedures on patients colonised or infected with VRE.

In my opinion, provided we have a good process for cleaning the immediate environment between cases, ‘special cleaning’ for MRSA / ESBL / MRGN is not necessary, and these organisms should be easily removed with normal cleaning techniques. The opportunities for widespread environmental colonisation from patients in procedural areas where patient movement is severely controlled is reasonably low, unlike in ward accommodation situations. VRE as an environmentally hardy organism requires a different approach, however. Does anyone else use this approach?

Also, should all MRO patients always be placed last on a list?

Any expert opinions out there?

Thanks
Michael

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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[Louisa Sasko]

Hi Michael,

In my facility and some of those Ive previously worked in staff in procedural areas are instructed to do a ‘spot clean’ with the appropriate disinfectant post MRO patient. A terminal clean is only required if there is widespread contamination of the environment. The rationale is that the patient isn’t in the procedural area for very long and cleaning the surfaces with the appropriate solution is sufficient to break the chain of infection

However placing patients last on the list is something that causes much angst as far as Im concerned. I do not encourage this as patient’s are being discriminated against according to MRO status. Also there should be no need to place the patient last on the list as the work area should be cleaned in between each patient and the only difference with a MRO patient is the choice of cleaning product. Also there is risk to the patient placing them last on the list in that when procedural lists are running sometimes they are late and often patients get cancelled. Its been my previous experience that a MRSA patient was to go for a amputation of a MRSA infected foot and was placed last on the list in surgery and got cancelled 3 times. He developed a MRSA bacteremia and subsequently died. So I feel very strongly against placing patients last on the list as it has the potential to impact on patient outcomes, when there should be no difference in care of the patient in terms of cleaning the environment ie choose a disinfectant and ‘spot clean’.

Hope this helps

Louisa

Regards
Louisa
CNC Infection Control
Ph 985 87664
M 0434323266
Pager 54581

>>> Michael Wishart 23/08/2012 8:32 am >>>
Hi all

Just trying to see what the current thoughts are in regard to management of patients with multi resistant organisms in procedural areas. Do most facilities still have ‘special cleaning’ after procedures on patients colonised or infected with MRSA, ESBL and MRGN’s? I would assume that most facilities would still have special cleaning following procedures on patients colonised or infected with VRE.

In my opinion, provided we have a good process for cleaning the immediate environment between cases, ‘special cleaning’ for MRSA / ESBL / MRGN is not necessary, and these organisms should be easily removed with normal cleaning techniques. The opportunities for widespread environmental colonisation from patients in procedural areas where patient movement is severely controlled is reasonably low, unlike in ward accommodation situations. VRE as an environmentally hardy organism requires a different approach, however. Does anyone else use this approach?

Also, should all MRO patients always be placed last on a list?

Any expert opinions out there?

Thanks
Michael

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
Please consider the environment before printing this email

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[Louisa Sasko]

Hi Fiona,

The NSW Infection Control Policy states that everything that comes into contact with a patient must be cleaned in between each patient. Having this as a principle it would sound like the device described would be inappropriate for the clinical setting because how could you properly decontaminate the IV line that is reusable in between each patient not to mention the end of the line that attaches to the patient side. This area would not be able to be cleaned properly due to grooves and the fact that contamination of sterile contrast would be a risk.

I don’t like the sound of the system, but not having seen it I can’t make a recommendation.

Regards
Louisa
CNC Infection Control
Ph 985 87664
M 0434323266
Pager 54581

>>> Fiona de Sousa 12/07/2012 8:56 am >>>
Thanks Kathy,

How do you ensure that the line connector does not become contaminated
with the multiple access that is required for the reusable part of the
system?

Kind regards,

Fiona De Sousa

Infection Prevention & Control Coordinator

Sydney Adventist Hospital

Fiona.Desousa@sah.org.au

185 Fox Valley Road, Wahroonga, NSW, 2076

________________________________

Behalf Of Katherine Taylor

Hi Fiona,

We have looked a a number of automated contrast delivery systems, and
had the same concern about multi-patient consumables. The Acist system
was one we evaluated recently, this system has a one way/anti-reflux
valve in the single patient consumable tubing, which was not the case
when we evaluated a similar pump about two years ago. With the addition
of the one way valve and information that similar pumps are in use in
other Brisbane hospitals without any increase in infection, our
infection control team agreed to trial.

The major reason for changing to the automated system was a number of
nursing staff injuries due to RSI from repeated injection of contrast by
hand. The other benefit is that the patient receives less contrast
using the automated system, which benefits the patient and also has a
cost benefit to the organisation. Hope this information is useful to
you.

Regards

Kathy

Kathy Taylor CICP

Infection Control Manager

The Wesley Hospital

PO Box 499,

Toowong, Qld 4066

07 3232 7558

katherine.taylor@uchealth.com.au

________________________________

Behalf Of Fiona de Sousa

Hi All,

I have been asked to evaluate a new system for injecting CT contrast to
determine its suitability for our facility. The transflux system allows
for multi use of syringes, common reusable tubing (both changed daily)
and a connector tubing that is changed for every patient. It has TGA
approval. It has been used for a number of years in Europe.

I am concerned about the potential for line contamination from blood as
well as the sterility of the connector ends. I would like to hear from
anyone who has previously evaluated this system or has used it.

Kind Regards,

Fiona De Sousa

Infection Prevention & Control Coordinator

Sydney Adventist Hospital

Fiona.Desousa@sah.org.au

185 Fox Valley Road, Wahroonga, NSW, 2076

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