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Thank you Cath,
I am currently reviewing the evidence related to our acceptance of small rural hospitals carrying out both surgical procedures and endoscopy in the same theatre.
This doesn’t fit the basic clean/dirty concept and has always concerned me, even if the risk assessment is lower for low risk/less invasive surgical procedures the level of environmental contamination during endoscopes to me is quite significant although carried out on separate days.
If anyone has further literature related to this I would appreciate it and is along similar lines to Terrys initial question.Kind regards,
Mary-Rose Godsell | RGON, MAdvPrac(Hons) | SW Nurse Consultant |
Infection Prevention & Control – Nursing
WACHS South West
The Tower, 61 Victoria Street, Bunbury WA
T: (08) 9781 2314 | M: 0439 961 015
E: Mary-Rose.Godsell@health.wa.gov.au
http://www.health.wa.gov.auFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Cathryn Murphy
Sent: Friday, 6 October 2017 6:47 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Mixing of endoscopy and ophthalmology procedures in a HEPA filtered Operating RoomHi Terry and All
A little relatedI have been working on a project in relation to ultra-clean OR particularly in relation to implants and as an adjunct to all the other standard approaches asepsis, surgical skill, environmental cleaning and surgical hand asepsis.
This is an incredibly interesting paper from AJIC that infers our current approaches can be improved. It is particularly encouraging to see Australia mentioned. The paper is worth a read in my opinion anyway.
Yours sincerely
Cath
Cathryn Murphy RN B. Photog MPH PhD CIC
Chief Executive Officer & Creative Director
Infection Control Plus Pty Ltd
QLD, AustraliaE: Cath@infectioncontrolplus.com.au
M: +61 428 154154
W:http://www.infectioncontrolplus.com.auFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry McAuley
Sent: Friday, 6 October 2017 08:33
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Mixing of endoscopy and ophthalmology procedures in a HEPA filtered Operating RoomThanks Michael,
I’ve suggested a waiting period between cases based on the time taken to achieve a full air exchange in the OR and of course cleaning thoroughly between cases (as they should already be).
Kind Regards
Terry McAuley
Director
STEAM Consulting Pty Ltd
M: 0438109692Sent from my Samsung Mobile on the Telstra Mobile Network
——– Original message ——–
From: Michael Wishart <Michael.Wishart@SVHA.ORG.AU>
Date: 6/10/17 7:46 am (GMT+10:00)
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Mixing of endoscopy and ophthalmology procedures in a HEPA filtered Operating RoomHi Terry
We had this question many years ago at St Elsewheres when we opened a new imaging procedure room that was used for vascular grafts. Because the imaging was so good, a gastroenterologist wanted to do so specific colonoscopy procedures requiring imaging in it. The vascular surgeons kicked up a big stink, but the ID/micro people supported it with the appropriate cleaning between cases and use of the procedure room (it was HEPA filtered) for both types of cases.
Similar concept. Not sure if there would be a need to be a waiting period to ensure appropriate air changes before ophthalmic procedures that followed endoscopies (eg possible aerosolized viruses?).
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
[cid:image001.png@01D01926.61F1C2B0]
P Please consider the environment before printing this emailFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry McAuley
Sent: Thursday, 5 October 2017 5:54 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Mixing of endoscopy and ophthalmology procedures in a HEPA filtered Operating Room
Importance: HighHi Everyone,
I have been asked if there is any evidence available that would indicate that you should not perform ophthalmic procedures in a correctly ventilated Operating Room after the OR has been used for endoscopy procedures.
I havent been able to locate anything suggesting that this is an issue however before making a recommendation I thought I would ask the Brain Bank if they have ever researched this question and if so have they found an answer?
Kind Regards
Terry McAuley
Sterilisation & Infection Prevention and Control Consultant
STEAM Consulting Pty Ltd ACN 604 439 698
Mob: +61 (0)438 109 692
E: terry@steamconsulting.com.au
W: http://www.steamconsulting.com.au
A: PO BOX 779
Endeavour Hills
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Dear Jo,
Disposable or material curtains can be changed 6 monthly or more frequently if visibly soiled with blood or body fluids or for patients under transmission-based precautions.
Either disposable or material curtains in healthcare can be used however it’s the process of how they managed which is important and the monitoring of the quality cycle.
Kind regardsKind regards,
Mary-Rose Godsell | Nurse Consultant | Infection Prevention & Control | Nursing
Department of Health
The Tower, 61 Victoria Street, Bunbury WA
T: (08) 9781 2314 | M: 0439 961 015
E: Mary-Rose.Godsell@health.wa.gov.au
http://www.health.wa.gov.auMonday Tuesday + Thursday Friday (work days)
Preventing urinary catheter infections
What are the indications for urinary catheter insertion?
Aseptic technique during insertion is carried out
Check daily if the catheter can be removed
Delivering a Healthy WAHi All
Two questions for those of you who have moved across to disposable privacy curtains.
1. How often do you routinely change the curtains?
2. Apart issues such as damage, visible staining etc do you change these curtains more frequently ( e.g. c diff patients, CPE, Norovirus outbreak….)
Oops – another question – would you recommend them? If not why not.
Thanks folks
jo
Joanne Cocks | Infection Control Coordinator
St Vincent’s Melbourne | PO Box 2900 | 41 Victoria Parade, Fitzroy VIC 3065
t: +61 3 9231 4069 | f: +61 3 9231 4068 http://www.svha.org.au[Description: Description: email signature_envision]
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Hi Terri,
The literature ive read says that diarrhoea can also be aerosoled.
Cleaning being a key preventative measure, Ive had similar reduction of
cases once initated
regards
Mary-Rose
Kind regards
Mary-Rose Godsell
RGON, AFAAQHC, GDipHSM, CICP, MAdvPrac(Hons) Infection Prevention &
Control
South West Infection Control Nurse Consultant
Southern Country Health Service – South West‘Hand hygiene reduces the
spread of infection’ph:08) 9781 2314
mobile 04 3996 1015
e-mail: Mary-Rose.Godsell@health.wa.gov.auThe contents of this email, including any attachments sent with it, are
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Behalf Of Jane Tomlinson
HI Terri
What a great discussion, here at RCH Brisbane we use P2 masks until
vomiting has ceased, then we swap to contact precautions – we also see
significant long standing norovirus colonisation in our oncology
patients.
My rationale is that the vomiting is likely aerosol and that I should
provide the best protection to my HCW.
We find outbreaks are usually from environmental persistence of a
child’s vomit, and usually once we do a disinfectant clean – and find
this usually stops any new cases in outbreak (of course we also close
area to admission and have all exposed pts ‘at risk’ under contact
precautions).
cheers
JaneWe Passed Accreditation – met with merit for standard 3 Infection
Prevention – many thanks for your assistance and great work
Jane Tomlinson RN
Clinical Nurse Consultant
Infection Management and Prevention Service
Royal Children’s Hospital
Children’s Health Queensland
T: 07 3636 7856 | M: 0408 236 266
| F: 3636 5505
E: jane_tomlinson@health.qld.gov.au
Ground Floor, South TowerHerston Rd, HERSTON QLD 4029
http://www.health.qld.gov.au/childrenshealth
>>> TERRI CRIPPS 25/10/13 15:52
>>>Hi everyone,
Always on a Friday afternoon!
We have had a great debate here about what sort of precautions Norovirus
requires and what sort of isolation room they need to be nursed in.The NSW Ministry of Health Infection Control policy PD2007_036 states:
“Contact and Airborne precautions.
P2 mask when there is potential for aerosol dissemination e.g. patient
vomiting or toileting (diarrhoea), disposing of faeces.Airborne negative pressure room if available and P2 mask
Contact gown/apron, gloves
Ensure consistent environmental cleaning and disinfection.”
I have always advised the staff that contact and DROPLET precautions are
required if the patient is vomiting or has profuse/explosive diarrhoea.
I have also advised that a surgical mask is sufficient (if worn
correctly). Our little ones don’t vomit and expel faeces as far as
adults do too.We do not have the luxury of having a negative pressure room for them to
be nursed in either as we do not have that many.I think CDC simply suggests single rooms and contact precautions.
Just thought I would ask the other experts out there what they think
about this topic?Also if I advise staff to follow the contact and droplet precautions and
surgical mask route, am I going against policy?Any help on this matter would be appreciated. Happy to admit I am wrong!
Terri Cripps | Clinical Nurse Consultant Infection Control | Sydney
Children’s Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 |8 :
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Dear Barbara,
We are increasing our chlorine cleaning (one step) to be more generalise
e.g for all gastroenteritis cases, however not using it routinely as
there are OSH concerns for staff carrying out the cleaning.
We are looking at using a product that is in tablet form, which reduces
the risk during dilution process
Kind regards
Mary-Rose Godsell
RGON, AFAAQHC, GDipHSM, CICP, MAdvPrac(Hons) Infection Prevention &
Control
South West Infection Control Nurse Consultant
Southern Country Health Service – South West‘Hand hygiene reduces the
spread of infection’ph:08) 9781 2314
mobile 04 3996 1015
e-mail: Mary-Rose.Godsell@health.wa.gov.auThe contents of this email, including any attachments sent with it, are
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Behalf Of Barbara Elliott
Does anyone have any tips/ideas on how best to implement chlorine based
cleaning products for one step cleaning? With the increase in C diff and
MRO’s being identified we are keen to introduce chlorine based cleaning
for routine cleaning.
We have had a trial here at our hospital with a product widely used in
other hospital settings but have come against some resistance (excuse
the pun!) from a number of cleaning staff who complain about the smell
despite being given safety instructions for use and they have enlisted
the OS&E department to fight the implementation of this.
Any thoughts/ suggestions gratefully received.
Thank you
BarbaraBarbara Elliott I Coordinator Infection Prevention & Control I St John
of God Subiaco HospitalLevel 3, 12 Salvado Road SUBIACO WA 6008
P: 08 9382 6871 F: 08 9382 6785 M: 0413706384 E:
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Dear Ruth,
In the South West WA we launder curtains for these patients.
Recent webnair – William Rutala discusses using hydrogen peroxide to
disinfect curtains or laundering. No discussion on steam cleaning of
curtainsKind regards
Mary-Rose Godsell
RGON, AFAAQHC, GDipHSM, CICP, MAdvPrac(Hons) Infection Prevention &
Control
South West Infection Control Nurse Consultant
Southern Country Health Service – South West‘Hand hygiene reduces the
spread of infection’ph:08) 9781 2314
mobile 04 3996 1015
e-mail: Mary-Rose.Godsell@health.wa.gov.auThe contents of this email, including any attachments sent with it, are
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Behalf Of Ruth Barratt
Do your facilities use steam cleaners to decontaminate curtains in situ
at the bed space after patient discharge or transfer from a bed that is
deemed infectious?One example would be when a patient has developed diarrhoea and vomiting
and is then moved to a side room. The bed space undergoes a disinfection
clean including the bed screens or privacy curtains. These are either
removed for laundering or in some cases they are steam cleaned in situ.
If the bed is in a multi room we are investigating if it is possible to
transfer the pathogens via the steam / spray through the curtain to
contaminate the adjacent bed area?Any thoughts on this would be appreciated.
Thanks
Ruth
cid:image001.png@01CD258C.3ACB65F0
Ruth Barratt RN, BSc, MAdvPrac (Hons)
Clinical NurseSpecialist Infection Prevention and Control
:: ruth.barratt@cdhb.health.nz
(: + 64 3 3640 083 or ext.80083
1098272744j4O36h: 0275 263175
Level 5, Riverside Building
Christchurch Hospital | Private Bag 4710, Christchurch
Clean Hands Save Lives!
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Dear Rosie,
Recent webnair – William Rutala recommends to change cleaning cloths
after each room clean, use at least 3 cloths per room ( typically 5-7
cloths). Do not replace cleaning cloth back into disinfectant solution
after using it to wipe the surface.
Change cotton mop ‘water’ containing disinfectant every 3 rooms and
after every isolation room clean.
Kind regards
Mary-Rose Godsell
RGON, AFAAQHC, GDipHSM, CICP, MAdvPrac(Hons) Infection Prevention &
Control
South West Infection Control Nurse Consultant
Southern Country Health Service – South West‘Hand hygiene reduces the
spread of infection’ph:08) 9781 2314
mobile 04 3996 1015
e-mail: Mary-Rose.Godsell@health.wa.gov.auThe contents of this email, including any attachments sent with it, are
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Behalf Of Lee, Rosie
Hello
I am interested in other ICP’s opinion on the frequency of change of
cleaning cloths used for daily cleaning of bed units. The recommended
cleaning practices in my hospital are to change each cloth (discard if
disposable or launder if reusable) after cleaning each bed space. The
method used here is to rinse the cloth depending on level of soil while
cleaning. The bucket of water is changed after each bed unit. My
rationaile is to reduce potential for cross contamination from one bed
space to the other.There were no issues with this until the introduction of this cleaning
device the staff refer to as a “dolly mop”. It is a mini version of a
floor mop. This has been introduced for OHS reasons – too much bending
stretching etc to reach difficult to access areas such as bed screen
rails under beds etc. These mops are expensive and I have identified
that these are not being managed with the same principles as cleaning
cloth. The staff are using these by rinsing them between each bed space.
I don’t believe this is acceptable and am wondering if others have had
this issue. The cleaning staff have placed barriers on laundry turn
around times etc. They want to dispose the mop after each bed space but
the costs are prohibitive.Just wondering if others use this mop in their hospitals and have
similar issues, have resolved this and happy to share.Regards
Rosie
Rosie Lee
RN. BSc. CICPCoordinator – Infection Prevention & Management
SMH Service – Royal Perth HospitalPh + 61 8 9224 2805 Fax + 61 8 9224 1989
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