[Willimann, Mary]

Hi Rachel and Glenys

Thanks very much for your input and advice – you have made some very useful points so very much appreciated. I guess it’s to try and always use a risk management approach and lots of common sense!

Many thanks
Mary

Mary Willimann CICP | Infection Prevention and Control Coordinator
Child and Adolescent Health Service, Roberts Road Subiaco WA 6008
T: (08) 9340 8281 | 0466 350 206
E: mary.willimann@health.wa.gov.au
Delivering a Healthy WA

Agreed!

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi Rachel,

The shared and close placement of these children is increasing the risk not only to the carer and visitors but to other child/children who are sharing the room .

The real fix is that you need more segregation (distancing) and more single rooms.

To bring this to the attention of hospital executive staff I would write an incident report each time this co-sharing is required detailing the associated potential risks.

Probably not a risk an organisation should be taking outside of a respiratory outbreak setting when there are large numbers of presentations

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

Hi Glenys,

In many circumstances the answer is yes for children and infants, I certainly don’t disagree with you. However, in our experience, rather than having a child in a room at home, which may even be a separate room, we place child and parent/care giver in very close proximity. Invariably, we seat the parent/caregiver next to the bed. In shared rooms, this is even more problematic, and the parent/ caregiver is obliged to sit very close. Our focus has been to include our parents/caregivers in our consideration for the use of PPE rather than assume that they have been exposed and then ensure that this is the case.

We certainly do focus on respiratory and hand hygiene; it is simply that we include our parents/care givers in the considerations we make, and framework we have developed here at the RHH over time.

Cheers
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi Rachel,

Wouldn’t the primary care giver have already been exposed?

Probably more important to focus on good respiratory hygiene and hand hygiene.

Also less work load for nurses in terms of training primary care givers and visitors in PPE when it may not be needed.

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

Hi Mary,

I have been particularly busy, so I haven’t noticed if you have had many replies to you question. I personally find this a tricky area, but thought I would share our organisation’s approach.

We have extended the ‘privilege’ of PPE to all visitors, including parents visiting ill children. That is, we make provision for all to people entering the care zone to wear PPE. We ask our nursing staff to educate parents/carers in the role/purpose and use of PPE. We do not mandate wearing of PPE for principle care-givers for pathogens such as MRSA, VRE etc. but encourage these individuals to consider protecting their own health with use of masks and appropriate HH when the child has an acute respiratory illness, such as Influenza. For pathogens/ clinical syndromes such as;
Adenovirus (respiratory syndrome only)
Bronchiolitis
Croup
Human metapneumovirus
RSV
Rhinovirus

We make provision that only during direct contact with the child that staff need to wear PPE (mask, gown, gloves). We have adopted the principle that where the primary care giver could be at risk from infection with the pathogen that protection should be afforded to these parents/carers. We also recognise that parents/carers rooming in cannot spend all day in PPE, nor can they sleep in such equipment.

In short, we do not have a perfect solution, but very much have adopted an approach that parents/carers have a right to be protected, need to be educated in the use of PPE if they are going to use it.

Hope this helps?

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi Everyone

I am hoping that you might be able to assist with possible guidelines/policies relating to the implementation of transmission based precautions in paediatric patients. Having recently moved to a paediatric environment I am curious to see if transmission based precautions should be applied differently/modified as children possibly have unique needs when it comes to infection prevention. For example, should droplet and contact precautions be applied to children with respiratory viruses due to the fact that children tend to put everything in their mouths and are not as good as adults with respiratory etiquette?

I understand that standard precautions must always be applied and that a risk management approach still needs to occur but would be very grateful for any advice and/or direction!

Many thanks
Mary

Mary Willimann CICP | Infection Prevention and Control Coordinator
Child and Adolescent Health Service, Roberts Road Subiaco WA 6008
T: (08) 9340 7822 | 0466 350 206
E: mary.willimann@health.wa.gov.au
Delivering a Healthy WA

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