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Marija Juraja

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  • in reply to: Re: Aged Standards for withdrawal #72223
    Marija Juraja
    Participant

    Author:
    Marija Juraja

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    Thanks Terry.

    I was aware only a day or two regarding these standards. The Policy Committee are going to collective provide a response from the college. If any member would like to contribute to this response please email them directly to the college secretary.

    Kind Regards

    Marija Juraja
    Immediate Past President
    Chair Policy Committee
    ________________________________________

    Hi Terry,

    I agree it is a shame that the technical committee members weren’t originally contacted to ascertain whether there should be a project proposal developed and submitted to update and / or reconfirm these standards before seeking public consultation regarding their withdrawal. I agree with you regarding the challenge to raise funds for Standards review via stakeholders. I believe many important healthcare related standards will not be reviewed because of the funding models now in place.

    There were other Standards on the complete list specific to sterilising equipment – some of whom CommitteeHE-023 [of which I am a member] are responsible for due to an amalgamation of Committee ME03 with HE-023 back in 2009ish or earlier. Further, several of the listed standards for sterilising equipment had agreed to be withdrawn way back in 2010 and other reconfirmed for retention [despite their age]. I have sent an email to the HE-023 Project Manger asking her to take note of that and correct the situation as soon as possible.

    However, should the infection prevention and control community wish to retain those standards listed below – I suggest that ACIPC or individuals submit their comment according to the process outlined when you click on the link in the original email.

    Kind Regards

    Terry McAuley
    Sterilisation & Infection Prevention and Control Consultant
    STEAM Consulting Pty Ltd [as of April 1st 2015]
    ACN 604 439 698
    E: terry@steamconsulting.com.au
    W: http://www.steamconsulting.com.au
    A: PO BOX 779
    Endeavour Hills
    VIC Australia 3802
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    Thank you very much Terry Mc.
    It surprises and saddens me that this important notice was not distributed by Standards Australia to all former members on these committees (I represented ASM).
    With Standards Australia now requiring stakeholder funding to review standards, it is highly unlikely they will get much participation. Therefore these standards, as old as they are, should remain on file they are cited in just about every state Guideline.
    Unless Standards Australia can review them without asking stakeholders for funding.

    Kind regards, Terry

    Terry Grimmond FASM, BAgrSc, GrDpAdEd
    Consultant Microbiologist
    Grimmond and Associates
    Ph (NZ): +64 7 855 3212
    Mob (NZ): +64 274 365 140
    E: terry@terrygrimmond.com
    [cid:image002.png@01D0ACDD.AB187100]: @terrygrimmond
    W: http://terrygrimmond.com
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    Hi Everyone,

    You may have received an email from Standards Australia to notify consumers / Stakeholders regarding the proposed withdrawal of several aged standards – but just in case you haven’t I thought I would snip out those most relevant to the infection prevention and control community – however there were many others on the list. A full list can be accessed here http://www.standards.org.au/StandardsDevelopment/Developing_Standards/Pages/Withdrawing-Standards.aspx

    Notice of Intention to Withdraw Aged Standards – Health and Community Services

    17-June-2015

    [cid:image001.png@01D0ACDD.CDCF9E30]

    As part of our ongoing commitment to maintaining a contemporary and relevant catalogue of Australian Standards, Standards Australia has identified the following Aged Standards (over 10 years old) which fall under the responsibility of an inactive Technical Committee and are therefore proposed for withdrawal. Notification of the intention to withdraw these Standards will be publicised on the Standards Australia website for a 9 week commenting period (see below dates). If no objections are received during the commenting period Standards Australia will seek approval from the Production Management Group (PMG) to withdraw the Standards.

    Standard Number

    Title

    Publication Year

    Product Type

    Scope of Standard

    Committee ID

    Committee Title

    AS 4031-1992

    Non-reusable containers for the collection of sharp medical items used in health care areas

    1992

    AS

    This Standard sets out requirements for non-reusable containers intended for the safe collection and transport of used sharp objects, which may be infectious, in health care areas, and are disposed of with their contents.

    HE-009

    Hypodermic Equipment – General Medical

    AS 4031-1992 AMDT 1

    Non-reusable containers for the collection of sharp medical items used in health care areas

    1996

    ASAM

    Not applicable.

    HE-009

    Hypodermic Equipment – General Medical

    AS 4939-2001

    Non-reusable personal use containers for the collection and disposal of hypodermic needles and syringes

    2001

    AS

    This Standard sets out requirements for non-reusable personal use containers intended for the safe collection and disposal of hypodermic needles and syringes. The containers are disposed of with their contents.

    HE-011

    Safe Disposal of Sharps and Clinical Wastes

    AS NZS 3816-1998

    Management of clinical and related wastes

    1998

    JS

    This Standard sets out requirements for the identification, segregation, handling, storage, transport, treatment and ultimate safe disposal of clinical and related wastes
    which may be hazardous, in an environmentally responsible manner in order to reduce the impact to human health and safety. Such wastes include, but are not restricted to, wastes arising from medical, nursing, dental, veterinary, laboratories, pharmaceutical, podiatry, tattooing, body piercing, brothels, emergency services, blood banks, mortuary practices and other similar practices, and wastes generated in health care facilities or other facilities during the investigation or treatment of patients or in research projects.

    HE-011

    Safe Disposal of Sharps and Clinical Wastes

    AS NZS 3825-1998

    Procedures and devices for the removal and disposal of scalpel blades from scalpel handles

    1998

    JS

    This Standard sets out performance characteristics of devices used in, and procedures for, the removal and disposal of scalpel blades and similar instruments, e.g. stitch cutters, from scalpel handles.

    HE-011

    Safe Disposal of Sharps and Clinical Wastes

    AS NZS 4478-1997

    Guide to the reprocessing of reusable containers for the collection of sharp items used in human and animal clinical/medical applications

    1997

    JS

    This Standard gives guidelines for the emptying, cleaning and disinfection of reusable containers utilized in the collection of sharp items used in human and animal clinical/medical applications.

    HE-009

    Hypodermic Equipment – General Medical

    HB 202-2000

    A management system for clinical and related wastes – Guide to application of AS/NZS 3816-1998- Management of clinical and related wastes

    2000

    HB

    This Clause is applicable to all health care and related facilities. The Standard can also apply to, or be used in, situations not mentioned in the Standard.

    HE-011

    Safe Disposal of Sharps and Clinical Wastes

    HB 260-2003

    Hospital acquired infections – Engineering down the risk

    2003

    HB

    This Handbook provides guidelines for persons, including engineers, architects, building contractors, project managers and health care workers, involved in the building design phase of new buildings for hospitals or of buildings undergoing refurbishment or renovations in hospitals, to minimize the risk of acquiring infections in hospitals. Facilities for acute medical, surgical, paediatric and obstetric patients are covered in this handbook, but not psychiatric and long-term aged facilities, nor rehabilitation day care facilities.

    H-000

    Health Standards Sector Board

    Thought you should know.

    Regards

    Terry McAuley
    Sterilisation & Infection Prevention and Control Consultant
    STEAM Consulting Pty Ltd [as of April 1st 2015]
    ACN 604 439 698
    E: terry@steamconsulting.com.au
    W: http://www.steamconsulting.com.au
    A: PO BOX 779
    Endeavour Hills
    VIC Australia 3802

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    Marija Juraja
    Participant

    Author:
    Marija Juraja

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    Hi Meryl,

    When I worked at the WCH we use to wash and disinfect the inhaler between patients i.e. warm soapy water and dried followed by alcohol wipe.
    The internal medication was taken out, wiped with a disposable alcohol wipe and then replaced into a clean inhaler.
    I checked recently with colleagues still working there since this was close to 10 years ago that I left, but it is still the practice.
    We also use to educate the parents to bring in their child’s inhalers so that we could utilise their own medication if possible.

    Kind Regards

    Marija Juraja |Clinical Service Coordinator (RN, GCNS Inf Ctrl, CICP)
    Infection Prevention & Control Unit| Division of Acute Medicine
    t: +61 8 8222 7588| p: 47757|
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    HI Meryl,
    I would also be interested to hear of any updates on this topic, as we regularly use an inhaler with cardboard spacer for our recruits having spirometry .
    There may be some months between use of the inhaler , but each person gets a new spacer.

    Regards
    Helen
    Helen Truscott RN, RM, MPH
    Team Leader-Health and Medical
    Health & Safety Branch

    [cid:image001.gif@01D08E37.66A306D0]

    E Helen.Truscott@fire.nsw.gov.au | T 02 9265 2976| F 02 9265 2986 | M 0417 677 802
    http://www.fire.nsw.gov.au
    Level 8, 227 Elizabeth Street, Sydney, NSW 2000

    [cid:image002.jpg@01D08E37.66A306D0]

    Hi Meryl

    My concern would not be so much who has handled the inhaler (as these can be wiped over easily), but what are the risks of contamination within the inhaler by children coughing or blowing into them (despite the use of spacers, this could still be a real risk). Spreading RSV or influenza virus, as just two examples, is a real risk in my view from this possibility. Because children are the ones having these inhalers used on them, the risk of this may actually be higher than for adults (less likely to correctly follow instructions).

    Just my thoughts. Not sure there are any definitive guidelines around this.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 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
    [cid:image001.gif@01D08E36.61ACD800]
    P Please consider the environment before printing this email

    Good morning everyone,

    I have been approached our ED to find out the risks of cross-infection through use of an inhaler with a spacer. To put this into context, the use of spacers is restricted to individual patients, but the inhalers are currently used for multiple patients. My concerns are as follows:

    * Children in ED are usually undifferentiated as and such we do not know what infection they have or what kind of additional transmission-based precautions might be required.

    * The valve in the spacer is a valve not a filter thus there is the possibility of contamination of the inhaler through the valve of the spacer.

    * The inhaler sits at the patient’s bedside before moving to the medication room and then on to another patient’s room, being handled by children, parents and nursing staff along the way.
    Thus far I have not been able to find any literature on this but was wondering if anyone could inform me what their local practice is and the rationale behind it.

    Many thanks in advance,

    Meryl

    Meryl Jones
    Clinical Nurse
    Infection Management and Prevention Service

    Children’s Health Queensland Hospital and Health Service
    Level 12
    Lady Cilento Children’s Hospital, South Brisbane QLD 4101

    T: 07 3068 4145.
    E: meryl.jones@health.qld.gov.au
    W: http://www.childrens.health.qld.gov.au

    [cid:image001.png@01D08E34.09FD4060][cid:image002.png@01D08E34.09FD4060][cid:image003.png@01D08E34.09FD4060][cid:image004.png@01D08E34.09FD4060]
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    in reply to: Interesting nursing home study on MRSA #72052
    Marija Juraja
    Participant

    Author:
    Marija Juraja

    Position:

    Organisation:

    State:

    Dear colleagues,

    Heartily agree with your views.
    It’s a discussion we have been having for a significant time within our own unit, especially with the alarming numbers of other MROs coming in such as ESBLs and AMPC etc. Its endemic in the community and over concern is CRE and do we really want that endemic!
    I agree it is their home but wouldn’t most people be keeping their home clean and tidy, washing their hands and using products that remove bio-burden. I know cost seems to be the biggest push in these facilities as well as the over usage of antibiotics for asymptomatic UTIs.
    I agree everyday practice of standard precautions improves the care and has potential to reduce poor outcomes.
    AMS in RACF is another issue that is another beast that needs to be addressed and I think things have already started in that arena through NAPS.

    Again just my personal views.

    Kind Regards

    Marija Juraja |Clinical Service Coordinator (RN, GCNS Inf Ctrl, CICP)
    Infection Prevention & Control Unit| Division of Acute Medicine
    t: +61 8 8222 7588| p: 47757|

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    [cid:image001.jpg@01D07375.43CA1770]

    Dear colleagues,
    I find this whole debate on decolonisation strategies interesting. I agree with Michael that the literature seems to support a role for decolonisation of carriers prior to high risk procedures, but is not necessarily effective as a strategy for overall decrease of carriage rate. I did note that the intervention group showed a slightly greater decrease in carriage rate compared to the control group, although this was not statistically significant.

    The interesting thing I thought about this study is that in both groups of nursing homes the colonisation rate decreased significantly, which I would suggest was due to better reinforcement of standard precautions. The overall adherence to standard precautions in nursing homes is generally rather poor. The usual excuse I have heard: “this is the resident’s home, and we don’t want to alarm them by wearing PPE, etc.” doesn’t wash with me. I believe residents would be relieved to know that the standard of infection control in their home was of the highest order. I think it is a matter of proper risk communication.

    My thought for the day!
    Irene

    Irene Wilkinson
    Manager, Infection Control Service
    Communicable Disease Control Branch
    SA Department of Health
    PO Box 6 Rundle Mall, Adelaide SA 5000

    http://www.sahealth.sa.gov.au/infectionprevention
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    Hi Verily

    Yes, it is vexing that the majority of infection risk is within acute care. My understanding of previous studies seems to indicate that decolonisation as a strategy is useful to minimise short term risk (ie decolonisation prior to a major procedure), but is not as useful as a long term carrier-eradication strategy. This study would support that idea.

    This may suggest that acute care facilities need to continue look at checking carrier status and then providing appropriate decolonisation/antibiotic prophylaxis regimes prior to high risk procedures, rather than depend upon residential care decolonisation strategies.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 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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    It is interesting indeed that even though this being said the majority of patients presenting to acute care facilities and now an even greater burden on healthcare than healthcare associated staphylococcus aureus (MRSA & MSSA) blood stream infections seem to come from the community with a significant number of these coming from long term care residential facilities.

    Makes me wonder whether these infections are being costed to, LTCRF or to acute care facilities, just saying.Isnt this the whole idea of decolonisation to9 prevent simple colonisations turning into life threatening and debilitating infections?

    Kind Regards

    Verily Thomas
    Clinical Nurse Consultant | Infection Prevention and Control
    SWSLHD-Bankstown/Lidcombe Hospital
    Eldridge Road, Bansktown.NSW 2200
    Tel 02 97228000 pager 28230
    Tel 02 9722 8633 | Fax 02 9722 7822 | verily.thomas@sswahs.nsw.gov.au
    http://www.health.nsw.gov.au

    [cid:image001.jpg@01D0736C.5A999060]
    LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
    HAND HYGIENE SAVES LIVES

    This recently published study on nursing home MRSA in Switzerland demonstrated a screening and decolonisation programme had no effect on MRSA carriage rates.

    http://journals.cambridge.org/action/displayAbstract?fromPageonline&aid9611081&fulltextTypeRA&fileIdS0899823X14000749

    Great to see such a negative study published from the non-acute sector.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 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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    Marija Juraja
    Participant

    Author:
    Marija Juraja

    Position:

    Organisation:

    State:

    Wow love the discussion this opened up and that it went global!
    Agreed there are many considerations especially when looking at data, data collection and even the auditing process.

    Kind Regards

    Marija Juraja |Clinical Service Coordinator (RN, GCNS Inf Ctrl, CICP)
    Infection Prevention & Control Unit| Division of Acute Medicine
    t: +61 8 8222 7588| p: 47757|

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    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Brett Mitchell
    Sent: Wednesday, 25 March 2015 11:02 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: [ACIPC_Infexion_Connexion] Fwd: Denominator Doesn’t Matter: Standardizing Healthcare-Associated Infection Rates by Bed Days or Device Days.

    Agree. Metrics are very important, especially in the case of UTIs/CAUTIs if catheter utilisation is the denominator. An intervention may be aimed at reducing catheter usage but you may see an increase in infection rate if this was to occur – with all things being equal.

    Thanks
    Brett

    Associate Professor Brett Mitchell
    Associate Professor of Nursing, RN, BN, PhD, M.Adv.Prac, CICP, MRCNA
    Faculty of Nursing and Health and Director Lifestyle Research Centre, Cooranbong

    Avondale College Ltd trading as Avondale College of Higher Education
    ACN: 108 186 401 | ABN: 53 108 186 401 | CRICOS: 02731D | TEQSA: PRV12015
    http://www.avondale.edu.au | http://www.designedforlife.me
    185 Fox Valley Road, Wahroonga NSW 2076 Australia
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    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Kevin Kavanagh
    Sent: Wednesday, 25 March 2015 11:07 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: [ACIPC_Infexion_Connexion] Fwd: Denominator Doesn’t Matter: Standardizing Healthcare-Associated Infection Rates by Bed Days or Device Days.

    I believe the key here is that device utilization did not change over time. However, if for example urinary catheter utilization would have dropped, then there would be less infections and the two metrics would have had different results.
    Kevin

    Kevin Kavanagh, MD, MS
    Health Watch USA
    Lexington Kentucky, USA
    606-874-3642

    ———- Forwarded message ———-
    From: Juraja, Marija (Health) <Marija.Juraja@health.sa.gov.au>
    Date: Tue, Mar 24, 2015 at 7:39 PM
    Subject: Denominator Doesn’t Matter: Standardizing Healthcare-Associated Infection Rates by Bed Days or Device Days.
    To: AICALIST@aicalist.org.au
    Interesting paper where the findings show that device days and bed days are equally effective for comparing HCAI rates between hospitals with device utilisation i.e. CLABSI.
    http://www.ncbi.nlm.nih.gov/pubmed/25782986

    Kind Regards

    Marija Juraja |Clinical Service Coordinator (RN, GCNS Inf Ctrl, CICP)
    Infection Prevention & Control Unit| Division of Acute Medicine
    The Queen Elizabeth Hospital | Central Adelaide Local Health Network
    Level 8 Tower Building | 28 Woodville Road, WOODVILLE SOUTH 5011
    t: +61 8 8222 7588| p: 47757| f: +61 8 8222 6461 | DX: 465432 |e:marija.juraja@health.sa.gov.au

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    in reply to: Hand Hygiene meal try sachets #71939
    Marija Juraja
    Participant

    Author:
    Marija Juraja

    Position:

    Organisation:

    State:

    In 2009 we introduced disposable patient wipes in packet of 25 to every patient at their bedside to promote hand hygiene compliance especially when they are bed bound.
    They are a very cost effective product less than $1.00 per packet and covers all opportunities for washing hands.
    Our annual surveys also show compliance and patient satisfaction has improved.
    Anything that helps to promote infection prevention awareness and the importance of personal hygiene is the best marketing and protection we can provide to our consumers.

    Kind Regards

    Marija Juraja |Clinical Service Coordinator (RN, GCNS Inf Ctrl, CICP)
    Infection Prevention & Control Unit| Division of Acute Medicine
    t: +61 8 8222 7588| p: 47757|

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    [cid:image003.jpg@01D0619C.B58AF680]

    Hi Phillipa,
    We have discussed this at Bendigo Health and it was not deemed possible logistically or financially. As an alternative, I have just completed a trial in our Orthopaedic ward, whereby all patients were given a 60 ml bottle of alcohol based hand rub for the duration of their stay. Patients were surveyed and it was very well received.
    Cheers,
    Amanda Ayres.
    Amanda Ayres | Infection Control Consultant |Hand Hygiene Program Coordinator| Infection Prevention & Control
    Bendigo Health
    PO Box 126 Bendigo Victoria 3552
    p. 03 5454 8423 | f. 03 54548419| m. 0498745454
    e.aayres@bendigohealth.org.au
    [cid:image001.png@01D06196.7186E940]

    Does anybody supply individual hand wipe sachets on meal trays?
    If so, how have they been received and have you had positive patient feedback?

    Kind regards
    Phillipa

    Phillipa Parsons
    Infection Prevention and Control Clinical Coordinator
    Cabrini
    183 Wattletree Rd
    Malvern Vic 3144
    03 9508 1577
    0400 369 741

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    in reply to: Resource #71801
    Marija Juraja
    Participant

    Author:
    Marija Juraja

    Position:

    Organisation:

    State:

    Thanks Cath.

    Great time to remind everyone about what resources are available for consumers to engage them on their journey in healthcare and preventing infections.
    ACIPC Member Services Committee also developed these excellent resource for consumers that can be found on the link below.
    Each page has a printable FAQ.
    Encourage everyone to share it and spread the knowledge.

    http://interactivejam.com.au/ACIPC-Consumer-minisite-v2/

    Sorry to hear Terry about your close friend and hope the outcome in the end is good.

    Kind Regards

    Marija Juraja
    RN, Grad Cert IC, CICP
    Immediate Past President, ACIPC
    Chair Policy Committee, ACIPC
    Chair 2015 ACIPC Conference Committee
    [cid:image001.png@01D0355F.BCFB3790]
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    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry Grimmond
    Sent: Wednesday, 21 January 2015 8:51 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: [ACIPC_Infexion_Connexion] Resource

    Thanks Cath very pertinent a close friend had hip replacement in Dec and after 3rd redo from infection, is on Vancomycin, has diarrhea, and is not faring well.

    Regards, Terry

    Terry Grimmond FASM, BAgrSc, GrDpAdEd
    Consultant Microbiologist
    Grimmond and Associates
    Ph (NZ): +64 7 855 3212
    Mob (NZ): +64 274 365 140
    E: terry@terrygrimmond.com
    [cid:image001.png@01D0356B.F4D3D300]: @terrygrimmond
    W: http://terrygrimmond.com
    [cid:image002.gif@01D0356B.F4D3D300]
    “This email (including any attachments) is intended only for the use of the individual or entity named above and may contain information that is confidential and privileged. If you are not the intended recipient, you are reminded that any dissemination, distribution or copying of this email or attachments is prohibited. If you have received this email in error, please notify me immediately by return email or telephone and destroy the original message. Thank you.”

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Cath Murphy
    Sent: Wednesday, January 21, 2015 11:03 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Resource

    Great post from CDC that members may find useful in education of families and patients.

    Patients can get infections while receiving medical treatment in a healthcare facility. Learn six ways to be a safe patient and how protect yourself from infections at the hospital. http://1.usa.gov/1xRnyEy

    Regards
    Cath

    Dr Cathryn Murphy RN MPH PhD CIC
    Executive Director
    Infection Control Plus Pty Ltd
    Ph: +61 428 154 154
    http://www.infectioncontrolplus.com.au

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    in reply to: Ultrasound probe cleaning #71751
    Marija Juraja
    Participant

    Author:
    Marija Juraja

    Position:

    Organisation:

    State:

    Good morning,

    Last year the ACIPC Policy Committee provided a response to ASA (Australian Sonographers Association) Guidelines on the Hygienic use and storage of ultrasound gel which also included care of the solid (non-lumen)probes. There is also a policy also on disinfection of ultrasound transducers. There are also specific instrument disposable detergent wipes that have TGA approval for cleaning solid (non-lumen)probes between use that still meets the pre-clean prior to disinfection.

    Hopefully this may answer your questions regarding Australian Guidelines.

    Here is the link to the document:

    http://www.a-s-a.com.au/fileRepository/files/Website/Public%20site/Quality%20Practice/ASA%20Guidelines/ASA_Guideline_Gel_Useage.pdf

    http://www.asum.com.au/newsite/files/documents/policies/PS/B2_policy.pdf

    Kind Regards
    Marija Juraja
    RN, Grad Cert IC, CICP
    Immediate Past President, ACIPC
    Mob: 0410 567 385
    [cid:image002.jpg@01D01A98.418A7AD0]

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Tim Spencer
    Sent: Thursday, 18 December 2014 6:03 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: [ACIPC_Infexion_Connexion] Ultrasound probe cleaning

    Hi James,
    Current literature I could find

    American Institute of Ultrasound in Medicine
    Guidelines for Cleaning and Preparing External- and Internal-Use Ultrasound Probes Between Patients
    Approved 4/2/2014
    http://www.aium.org/officialstatements/57

    Society of Radiographers, UK
    https://www.sor.org/system/files/article/201410/ultrasound_probe_cleaning_decontamination_disinfection_and_sterilisation.pdf
    Friday, October 17, 2014, Issue 12

    CDC Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 (old reference but they havent updated the guidelines as far as I can see)
    http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf

    This seems to all thats currently new.
    Hope this provides some help with your search.
    Regards,
    Tim..

    Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert, VA-BC.
    Independent Vascular Access Consultant
    President, Australian Vascular Access Society
    Conjoint Lecturer, South West Sydney Clinical School | Faculty of Medicine | University of NSW
    Director-at-Large, Vascular Access Certification Corporation (VACC)
    M: +1 (623) 326 8889 (USA)
    M: +61 (0)409 463 428 (AU)
    E: tim.spencer68@icloud.com

    Be a yardstick of quality. Some people aren’t used to an environment where excellence is expected. Steve Jobs

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of James Rippey
    Sent: Tuesday, December 16, 2014 7:52 PM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Ultrasound probe cleaning

    Dear Team,

    I am a member of the Standards of Practice Committee for the Australasian Society for Ultrasound in Medicine.

    There remains a great deal of heterogeneity in recommendations regarding cleaning of ultrasound transducers, and conflicting recommendations by various bodies. We also receive pressure from vendors to support their products, usually backed by a host of complicated and difficult to interpret evidence.

    I wondered whether you had specific up to date evidence based references you would recommend us reviewing regarding:

    1. Regular cleaning of ultrasound transducers used on closed skin.

    2. Cleaning of transducers used for intracavity scanning.

    For those of you wishing to read further:

    Currently most ultrasound users are aware they should perform:

    1. Regular cleaning of ultrasound transducers used on closed skin.

    * Clean as you would your hands – wash with warm mild detergent and running water between each patient.
    * Some would use Chlorhexidine wash or alcohol impregnated wipes – although these are not recommended by manufacturers as they may damage the face of the transducer.
    * Where there is contact with body fluids clean as per intracavity transducer.
    2. Cleaning of intracavity transducers – high level disinfection

    * Wash removing all visible gel / residue – running water, mild detergent, wipe dry.
    * Use one of the approved agents according to manufacturer guidelines
    * Including hydrogen peroxide, glutaraldehyde, ortho-phthalaldehyde (OPA)
    * Opinion on chlorine dioxide delivered via the wipe system, and paracetic acid seems divided.
    * The concern regarding the wipes is based on inter user variability.
    * There has been some literature describing paracetic acid damage to endoscopes.
    Your advice is again much appreciated.
    Just want to ensure we remain up to date.

    Sincerely
    James Rippey


    Associate Professor James Rippey

    Emergency Physician
    University of Western Australia
    Sir Charles Gairdner Hospital
    King Edward Memorial Hospital for Women
    Emergency Medicine Lead for the Kimberley

    Mobile 0400990186

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    in reply to: Re: Have you heard about this? #71722
    Marija Juraja
    Participant

    Author:
    Marija Juraja

    Position:

    Organisation:

    State:

    Dear all,

    The college will be providing a response on behalf of the ACIPC membership and we also encourage individual ICPs to respond.
    Could you please send your responses to myself by Monday the 26th of January to allow me time to collate and send a final written response from the college.
    Email: marija.juraja@health.sa.gov.au
    Contact no: 08 8222 7588

    Kind Regards
    Marija Juraja
    RN, Grad Cert IC, CICP
    Immediate Past President, ACIPC
    Mob: 0410 567 385
    [cid:image002.jpg@01D01480.2630B4C0]

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
    Sent: Wednesday, 10 December 2014 1:22 PM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: [ACIPC_Infexion_Connexion] Have you heard about this?

    To answer your question about who has been involved in the drafting of this standard, I think the list of bodies mentioned in the draft standard makes this clear:

    The following interests are represented on the committee responsible for this draft
    Australian Standard:
    Australian Chamber of Commerce and Industry
    Australian Medical Association
    Australian Nursing and Midwifery Federation
    Consumers Federation
    Department of Defence
    Hand Hygiene Australia
    Human Factors and Ergonomics Society of Australia
    Medical Technology Association of Australia
    Queensland Emergency Medicine Research Foundation
    Royal Australasian College of Physicians
    Safety Institute of Australia
    Together Queensland
    University of New South Wales

    Not an ICP in sight in that lot that I can see.

    I would encourage all ICPs to review and provide feedback through the process outlined.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 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
    [cid:image001.png@01D01478.1F7A1570]
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    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry Grimmond
    Sent: Wednesday, 10 December 2014 12:25 PM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: Have you heard about this?

    Hi Terry,
    I am gobsmacked that such an important Standard could have gone unnoticed. I had no idea. Hopefully they had a good representation of Infection Preventionists as stakeholders!!

    Regards, Terry
    Terry Grimmond FASM, BAgrSc, GrDpAdEd
    Consultant Microbiologist
    Grimmond and Associates
    Ph (NZ): +64 7 855 3212
    Mob (NZ): +64 274 365 140
    E: terry@terrygrimmond.com
    [cid:image001.png@01D0148D.6A5D5470]: @terrygrimmond
    W: http://terrygrimmond.com
    [cid:image002.gif@01D0148D.6A5D5470]
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    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry McAuley
    Sent: Wednesday, December 10, 2014 2:32 PM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Have you heard about this?
    Importance: High

    Hi everyone,

    Just came across this snippet in a Standards Australia e-newsletter – see attached. This is the first I have heard about it – so I am hoping that practitioners out there have been involved in some way.

    Regards
    Terry McAuley
    Sterilisation & Infection Prevention and Control Consultant
    STEAM Consulting
    Mob: +61 (0)438 109 692
    E: terry@steamconsulting.com.au
    W: http://www.steamconsulting.com.au
    A: PO BOX 779
    Endeavour Hills
    VIC Australia 3802

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    in reply to: Hand hygiene seminar in Melbourne #71704
    Marija Juraja
    Participant

    Author:
    Marija Juraja

    Position:

    Organisation:

    State:

    Hi Linda,
    I have several posters that you can use (all around the 5 moments) and there is also this website that you can go to for patient information.
    http://www.jointcommission.org/Speak_Up__Five_Things_You_Can_Do_To_Prevent_Infection/
    http://interactivejam.com.au/ACIPC-Consumer-minisite-v2/

    Kind Regards

    Marija Juraja |Clinical Service Coordinator (CICP) -Infection Prevention & Control Unit|
    Division of Acute Medicine
    t: +61 8 8222 7588| p: 47757|

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    [cid:image001.jpg@01D0146E.D24FAF20]

    Hi

    Does anyone have a poster that they would share with me that is for the patient to remind healthcare workers to practise hand hygiene?

    Regards

    Linda

    Linda McCaskill
    ACHA Infection Control Manager
    Ashford Hospital
    ph (08) 8375 5209 or ext 4209
    (Mon-Thurs)

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    Marija Juraja
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    Hi Beth,

    As far as I am aware any new commissioning of areas such DSS or Operating Theatres, the recommendation from ACORN Standards and AHFG is air-sampling be undertaken on commissioning or when reconstruction work has been undertaken within these areas.

    Australasian Health Facility Guidelines states page 653….
    900.11.00
    + Conduct air sampling and particle counts and implement a program of regular air sampling in high-risk areas, allowing time for culturing and results and repeat cleaning and testing prior to occupation.

    The air count is done to ensure that the area has been cleaned appropriately, including air filters.

    Kind Regards

    Marija Juraja |Clinical Service Coordinator (CICP) -Infection Prevention & Control Unit|
    Division of Acute Medicine
    t: +61 8 8222 7588| p:47757|

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    —–Original Message—–

    Good Evening

    I am someone within the AICALIST brains trust can provide some advice regarding the necessity for microbial sampling of newly constructed SSD. I have not been able to find any reference to this being recommended prior to opening.

    Does anyone know of any guidelines that apply to NSW?

    Or, national or international references that may indicate that this would be recommended from a best practice point of view.

    I would be grateful for any advice within the next few days, if possible.

    Thank you
    Beth

    Beth Bint

    Infection Prevention and Control Clinical Nurse Consultant | Infection Management and Control Service Level 1 Lawson House Wollongong Hospital Tel 02 4222 5898 |beth.bint@SESIAHS.HEALTH.NSW.GOV.AU
    http://www.health.nsw.gov.au
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    Marija Juraja
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    Marija Juraja

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    Hi Rita,

    No it’s not a silly question to ask.

    Rehabilitation centres are a step down from the acute setting, and there are two in our local health network. They still have patients that require wound dressings, access of PICC lines for medications/antibiotics and they still have their MROs. Our policies for these sites are different in regards to MRO management as it is based on a risk assessment that includes clinical demographics and patient compliance) as well as location within the unit. Aseptic Technique is still the same regardless.

    If you would like a procedure I am more than happy to share, just email me directly.

    Kind Regards

    Marija Juraja |Clinical Service Coordinator (CICP) -Infection Prevention & Control Unit|
    Division of Acute Medicine
    t: +61 8 8222 7588| p: 47757|

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    [cid:image001.jpg@01CFC1CA.3BADBC70]

    Dear colleagues,
    This may seem like question from a complete novice. However I am bravely asking it. Do hospitals which are purely for rehabilitation have different infection control policy and procedures from acute hospitals? I know that there will be some differences, but what about managing of patients with MROs, aseptic technique, and other infection control related matters? Is there anybody willing to share policies/procedures for rehabilitation facilities ? Any advice is welcome.
    Many thanks in anticipation,
    Rita

    Rita Roy

    Clinical Nurse Consultant | Infection Control
    Hornsby Ku ring gai Health Service, Palmerston Road, Hornsby NSW 2077
    Tel (02) 9477 9232 | Fax (02) 9477 9013 | Mob 0422 930 370 | Rita.Roy@health.nsw.gov.au
    http://www.health.nsw.gov.au

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    in reply to: Update on draft AS4187 #71272
    Marija Juraja
    Participant

    Author:
    Marija Juraja

    Position:

    Organisation:

    State:

    Hi Cath,

    The college has had significant input through representation on the 4187 Standard, as well as providing two submissions to the draft documents in the past 12 months.
    The last response being only 6 weeks ago.
    Most recommendations that the college submitted have been included but the final outcome from this last round won’t be known for at least another few weeks.
    I can’t give you any other information regarding when the final document will be launched, apart from this being hopefully the last round of consultation.

    Kind Regards
    Marija Juraja
    RN, Grad Cert IC, CICP
    Immediate Past President, ACIPC
    [cid:image001.jpg@01CFAFCA.1430F0C0]

    Could someone please give me a brief overview of where Standards Australia are up to with the review of AS 4187? I have accessed materials available to members on the College website but am keen to know how close we may be to a final version and if it is publically available information, how much of the College’s recommendations were considered in the final version?

    Hope someone can help as preparing for implementation is critically important.

    Regards
    Cath

    Dr Cathryn Murphy RN MPH PhD CIC
    Executive Director
    Infection Control Plus Pty Ltd

    Adjunct Professor
    Griffith University, School of Nursing and Midwifery
    http://www.infectioncontrolplus.com.au
    [cid:image001.jpg@01CFAFCA.0C7F2EF0][cid:image002.jpg@01CFAFCA.0C7F2EF0][cid:image003.jpg@01CFAFCA.0C7F2EF0]

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    Marija Juraja
    Participant

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    Marija Juraja

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    Hi Michael,

    I have these guidelines from the UK with the literature evidence on page 23 which may help re the infusion sets.

    Kind Regards

    Marija Juraja |Clinical Service Coordinator (CICP) – Infection Prevention & Control Unit|
    t: +61 8 8222 7588| p:47757| f: +61 8 8222 6461 | DX: 465432 |e:marija.juraja@health.sa.gov.au

    Care Excellence Collaboration Integrity
    GERMS CAN KILL…

    Hi all

    We are reviewing our central line policies and have two different standards for administration set (line) changes: one for oncology haematology, and one for every else, including ICU. Haem/onc routinely change administration sets for all central devices (CVC’s and PICC’s) every three days (dressings and needleless access devices changed every 7 days), whilst everyone else routinely changes everything (administration sets, needleless access devices, dressings) every 7 days.

    Is anyone aware of any specific data supporting more frequent line changes for haem/onc patients? Is it standard practice in other places to change all administration sets for central devices every 7 days?

    Thanks for any discussion (and specifically supporting evidence) on this.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator
    Holy Spirit Northside Private Hospital
    627 Rode Road, Chermside, Qld 4032
    t: (07) 3326 3068 | f: (07) 3607 2226
    e: Michael.Wishart@hsn.org.au
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    in reply to: Re: re swabbing pre injection #70563
    Marija Juraja
    Participant

    Author:
    Marija Juraja

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    Hi Christine,

    I have an article from Ireland that I am happy to send you.

    Kind Regards

    Marija Juraja |Clinical Service Coordinator (CICP) – Infection Prevention & Control Unit|
    t: +61 8 8222 7588| p:47757| f: +61 8 8222 6461 | DX: 465432 |e:marija.juraja@health.sa.gov.au

    Care Excellence Collaboration Integrity
    GERMS CAN KILL…

    Thanks guys – I do have this information for immunisations – I was thinking more of in hospital – S/C or IMI narcotics or clexane/heparin.

    Christine Lawson | RN

    Quality and Risk Manager | Caboolture Private Hospital
    Caboolture Private Hospital
    McKean Street, CABOOLTURE QLD 4510
    t: 07 5495 9418
    e: LawsonC@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

    [cid:image001.jpg@01CEC9BA.83C85F50]

    Hi Christine

    The Australian Immunisation Handbook states:

    2.2.4 Preparation for vaccine administration
    Skin cleaning
    Provided the skin is visibly clean, there is no need to wipe it with an antiseptic (e.g. alcohol wipe).3,8 If the immunisation service provider decides to clean the skin, or if the skin is visibly not clean, alcohol and other disinfecting agents must be allowed to dry before vaccine injection (to prevent inactivation of live vaccines and to reduce the likelihood of irritation at the injection site).9
    http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/handbook10-2-2

    Cheers
    Michael

    Michael Wishart
    CNC Infection Control
    Holy Spirit Northside Private Hospital
    627 Rode Road, Chermside, Qld 4032
    t: (07) 3326 3068 | f: (07) 3607 2226
    e: Michael.Wishart@hsn.org.au
    w:www.holyspiritnorthside.org.au
    Please consider the environment before printing this email

    Hi all,

    Wondering if anyone can guide me to reference/ evidence base re swabbing skin before s/c or imi injection is or is not recommended.

    Christine Lawson | RN

    Quality and Risk Manager | Caboolture Private Hospital
    Caboolture Private Hospital
    McKean Street, CABOOLTURE QLD 4510
    t: 07 5495 9418
    e: LawsonC@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

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    Marija Juraja
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    Marija Juraja

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    Hi John,

    Yes the world of SSIs are changing.

    As the surgeon opened the wound and instituted a vac dressing ( a newer, slower and less invasive procedure than surgical debridement including a cleaner closure and surgical wound edge), I would classify go with a deep wound infection.

    When we undertake SSI review on a daily basis: we look at several criteria including what other clinical symptoms did the they have including antibiotic treatment before the wound cultures were taken, have they used the correct technique in getting the specimen. Did the anti-thrombolytic agents contribute to the ooze?

    John we have mainly implants i.e. joint replacements and we would use the criteria above to determine if they have a SSI. Many times there are no swabs or tissue samples or they are discarded and not sent, but the clinical picture, the invasive procedure and the treatment by the surgeon are all indicators of an SSI.

    My thoughts.

    Kind Regards

    Marija Juraja |Clinical Service Coordinator (CICP) – Infection Prevention & Control Unit|
    t: +61 8 8222 7588| p:47757| f: +61 8 8222 6461 | DX: 465432 |e:marija.juraja@health.sa.gov.au

    Care Excellence Collaboration Integrity
    GERMS CAN KILL…

    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
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