[McEwan, Melissa MS]

UNCLASSIFIED

Sounds like there needs to be a policy on this, I have looked but can’t
find a policy in regard to inhalers. There are disposable inhalers and
the hard plastic inhalers as far as I can see state single patient use.
There is no barrier to protect an inhaler to stop cross transmission.
Best practice would have to be single patient use for all inhalers and
spacers, there is too much risk involved otherwise.
Melissa McEwan
Nurse Coordinator KAPC
Contractor to Defence
Wagga Wagga
02 69338413
melissa.mcewan@defence.gov.au

________________________________

Behalf Of Che Jarvis

Hi Meryl,

I agree with Michael, & Julie on the potential risk for transmission of
droplet based organisms.

Our HCF only utilises inhalers as single patient use, & even our spacers
are for single patient use & are purchased by the patient’s/parents.

Regards,
Che Jarvis
Acting CNC Infection Control| Nepean Hospital
Level 2, South Block
Tel 02 4734 2228 | Fax | Mob | che.jarvis@health.nsw.gov.au
http://www.health.nsw.gov.au

________________________________

Julie Hunt [Julie.Hunt1@HEALTH.NSW.GOV.AU]

Hi Meryl,

I agree with Michael regarding potential risks of droplet contamination
of respiratory viruses within the inhaler if used between patients.

In our HCF the inhalers we use are labelled as single patient use so
they are only approved for more than one episode of use on one patient
only. We do not reuse these items for different patients. They are
cleaned with a neutral detergent when required although we do ask that
staff check the manufacturer’s instructions as some are not designed to
be cleaned or dismantled & have a life expectancy similar to a puffer.

Regards

Julie Hunt

Clinical Nurse Consultant

Infection Prevention & Control

Royal North Shore Hospital

Reserve Rd St Leonards 2065

Tel 02 99264339 or 99264490

Behalf Of Meryl Jones

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

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[McEwan, Melissa MS]

UNCLASSIFIED

Is the nurse who is immunising a nurse immuniser who is accredited and
immunising under an immunisation schedule?
There are many vaccines administered off a MO order by a RN, in which
case they would not be able to administer adrenaline unless there is an
internal policy to enable them to do so or if they are First Line
Emergency Care accredited.
Different situations, different locations, different policies apply
Shame as nurses we are not a National body practicing under the same
rules every where
Melissa McEwan
Nurse Coordinator KAPC
Contractor to Defence
Wagga Wagga
02 69338413
melissa.mcewan@defence.gov.au

________________________________

Behalf Of Maree Sommerville
vaccination

Dear all,

I am really enjoying these responses. Thank you.

All of our nurse immunisers are aware of the process and are accredited
nurse immunisers.

The question has come from the chair of the resuscitation committee.

I will discuss this at a meeting I have scheduled next week.

Maree Sommerville

Infection Control Coordinator

Mercy Hospital for Women

(03) 8458 4759

Behalf Of Makejev, Delma
vaccination

For the Nurse Immunisers in NSW

Kind regards

Delma

Delma Makejev
Clinical Nurse Specialist | Staff Clinic,
Infection Control Unit Lismore Base Hospital
‘ 02 6620 2516 |* Delma.Makejev@ncahs.health.nsw.gov.au

Staff Clinic held on Monday, Tuesday afternoons and Thursday, Friday
mornings. Please phone 6620 2516 to book appointment.

http://www.health.nsw.gov.au/images/communications/e-signatures/images/N
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Behalf Of Michael Wishart
anaphylaxis following ‘flu vaccination

Hmmm.. no attachment – trying again. It is available via the link, if
this doesn’t work…

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@01D01926.61F1C2B0
P Please consider the environment before printing this email

Behalf Of Michael Wishart
vaccination

[Posted on behalf of Sue Atkins – Moderator]

Maree,
I would not wait.
The attached secretary approval document covers the administration of
adrenaline by the nurse immuniser in Victoria, and who can and can not
administer.

This is the link
to the other relevant documents relevant to Victoria

Cheers
Sue

Sue Atkins
Regional Infection Control Consultant | CICP | Service & Workforce
Development | Grampians Region
Department of Health & Human Services
35 Armstrong Street South, Ballarat, Victoria, 3350
p. 03 5333 6023 | f. 03 5333 6093 | m. 0438 227 989
e. sue.e.atkins@dhhs.vic.gov.au
| http://www.grhc.org.au

Maree Sommerville <MSommerville@MERCY.COM.AU
>

AICALIST@AICALIST.ORG.AU

01/05/2015 11:50 AM

Administering adrenaline for anaphylaxis following ‘flu vaccination

Sent by:

ACIPC Infexion Connexion <AICALIST@AICALIST.ORG.AU
>

________________________________

Dear all.
This is a question relevant to nurse immunisers
We are now in the middle of our employee ‘flu vaccination campaign and
the question has arisen about administering adrenaline.
If an employee has a reaction following administration of the vaccine
and the health service has a 24 hour anaesthetic service and a code
blue team, should the nurse immuniser wait to administer adrenaline
until the team arrives?
Thanks in anticipation
Maree

Maree Sommerville
Infection Control Coordinator
Mercy Hospital for Women

163 Studley Road
Heidelberg 3084

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[McEwan, Melissa MS]

UNCLASSIFIED

There are sharps’ engineered insulin pens available in Australia,
whether they are available in different health services is another story
Melissa McEwan RN, BN, Grad Cert Infect Control
Quality Manager
Contractor to Defence
Wagga Wagga
02 69338338
Private mobile 0428 753783
melissa.mcewan@defence.gov.au

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________________________________

Behalf Of Lincoln Fowler

I wouldn’t recommend using the insulin pens unless the self-sheathing
needles were provided for staff. I have used some of these products when
working in Europe but haven’t seen them in Australia.

Lincoln Fowler

Infection Prevention Consultant

Bairnsdale Regional Health Service

http://www.brhs.com.au

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Behalf Of Margaret Evans

Hi All

Our physician wants pharmacy to dispense a prefilled insulin pen to the
patient and nursing staff use this to administer the required dose. This
pen would then be used by both the nursing staff & patient throughout
the patients admission.

I am wondering about the safety of using insulin pens as we have had a
number of needlestick injuries from them in the past. If you do use then
do you have procedures in place to prevent NSI that you would be happy
to share

Thanks for your thoughts

Kind regards

Margie

Margaret Evans IP&C CNC

Royal Hospital for Women

Locked Mail Bag 2000

Randwick 2031

Phone 02 93826339

Senior Clinical lectures,

Sydney university

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[McEwan, Melissa MS]

UNCLASSIFIED

The only time I have seen potassium permanganate (aka condy’s crystals)
used is for a foot condition called pitted keratolysis, which is a skin
infection often on the feet.
It has been used within the Defence environment, a few granules into a
dish of water as a foot wash. A wound dressing may raise concerns of
absorption systemically. The only info I have is the Safety Data Sheet,
available on chemalert
Melissa McEwan RN, BN, Grad Cert Infect Control
Quality Manager
Contractor to Defence
Wagga Wagga
02 69338338
Private mobile 0428 753783
melissa.mcewan@defence.gov.au

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________________________________

Behalf Of Denyer, Vicki

My recall of this product was as a debriding solution but if too much
applied could do more damage than assistance to the wound bed- again
this was way back when I was a “real” nurse working on the wards.

Vicki Denyer

Clinical Nurse Consultant | Infection Prevention & Control Unit
Lismore Base Hospital
Tel 02 6620 2385 | vicki.denyer@ncahs.health.nsw.gov.au

Behalf Of Montague, Cathi (Health)

Gosh, that takes me back to the 80’s!! Also known as Condys Crystals, a
fabulous purple color if I recall.

I remember wringing out some dressings in this in the acute care setting
as a nursing student, but can’t for the life of me remember what!

Good luck with the research.

Best Regards,
Cathi

Cathi Montague RN, MClinNsg, FCENA

Nurse Management Facilitator – Clinical Care Systems Co-ordination

‘High quality, compassionate health care’

SA Prison Health Service

Central Adelaide Local Health Network

SA Health

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Behalf Of Bronwyn Pyke

Very good for severe tinea of feet. Podiatrists use it. Not aware of
other uses.

Bronwyn Pyke

Infection Control Coordinator

Alexandra District Hospital

PO Box 21

Alexandra, 3714

p: 0357720905

f: 0357720920

Behalf Of Lawson, Christine

Hi,

One of our physicians is prescribing potassium permanganate as a wound
dressing – the staff are keen for a safe guideline to continue using.
Is anyone still using and could they offer any assistance?

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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[McEwan, Melissa MS]

UNCLASSIFIED

Hi Tim
Do you think it would be possible to get a recording of this
presentation for us country folk?
Melissa McEwan RN, BN, Grad Cert Infect Control
Regional Quality Manager
Contractor to Defence
Wagga Wagga
02 69338338
Private mobile 0428 753783
melissa.mcewan@defence.gov.au

________________________________

Behalf Of Tim Spencer
still available

There are currently places still available for the Dr Marcia Ryder
lecture being held in Sydney.

Please see attached invitation for details and contact information to
secure your place.

This is a not to be missed opportunity with one of the world’s leading
experts on biofilm and CRBSI.

Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant, Central Venous Access & Parenteral Nutrition
Service

Conjoint Lecturer, South West Sydney Clinical School | Faculty of
Medicine | University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital,
Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel (+61) 2 8738 3603 | Fax (+61) 2 8738 3551 | Mob +61 (0)409 463 428 |
Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au
200 yeas logo white.jpg

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

[mailto:austvasociety@gmail.com]

————————————————————————
————————————————————————
——————————————–

Please find attached the invitation to the NSW Maria Ryder Educational
Dinner for the 17th October at the Pullman Hotel at Sydney Olympic Park.

Dr Ryder will be speaking on her research on needle free connectors,
infection control and vascular access.

Please contact Lorraine Bobosevic, DDS Account Manager South NSW/ACT
Hospira

0417 944 430

for details in regards to booking your place.

————————————————————————
————————————————————————
———————————————

Tim Spencer

—
PRESIDENT

——————————————-

Australian Vascular Access Society

_____________________________________________________________________
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[McEwan, Melissa MS]

UNCLASSIFIED

Hi Beth
I am not an expert in this area but I know that the staff use distilled
water in the Lisa sterilisers that are used in dental .
The steam quality specifications – isn’t this your Bowie Dick and Helix
test.
The water reservoir in the Lisa is cleaned following the manufacturer
instructions ( I believe this is an alcohol solution)
If you need any further help with this, I can put you in touch with the
dental manager
Regards

Melissa McEwan RN, BN, Grad Cert Infect Control
Quality Manager
Contractor to Defence
Wagga Wagga
02 69338338
Private mobile 0428 753783
melissa.mcewan@defence.gov.au

and is subject to the jurisdiction of section 70 of the Crimes Act 1914.
If you have received this email in error, you are requested to contact
the sender and delete the email.

________________________________

Behalf Of Beth Bint

Hi All

Hoping someone can offer some advice.

We have not be able to find definitive specifications for water and
steam quality required for benchtop sterilisers (Dental Autoclaves).

We have two questions:

1. Some manufacturers suggest the use of distilled or de-ionised
water. If a water distiller is used how is the water quality controlled
when refilling the reservoir?

2. What are the steam quality specifications for benchtop
sterilisers, and where is the reference for these?

Thank you for any assistance you can provide.

Beth

Beth Bint

Clinical Nurse Consultant | Infection Management and Control Service
Level 1 Lawson House, Wollongong Hospital 2500, NSW
Tel. 02 4222 5869 | Fax. 02 4222 5367 |
beth.bint@sesiahs.health.nsw.gov.au

http://www.health.nsw.gov.au/images/communications/e-signatures/images/N
SW-Health-Illawarra-Shoalhaven-LHD.jpg

————————————————————————
———————

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[McEwan, Melissa MS]

UNCLASSIFIED

Just wondering what is INS?
Melissa McEwan RN, BN, Grad Cert Infect Control
Quality Manager
Kapooka Health Centre
Contractor to Defence
02 69338338
Private mobile 0428 753783
melissa.mcewan@defence.gov.au

and is subject to the jurisdiction of section 70 of the Crimes Act 1914.
If you have received this email in error, you are requested to contact
the sender and delete the email.

________________________________

Behalf Of Tim Spencer

INS 2012 Guidelines recommend;

Practice Criteria

III. Primary Intermittent Infusions

A. Primary intermittent administration sets should be changed every 24
hours. When an intermittent infusion is repeatedly disconnected and
reconnected for the infusion, there is increased risk of contamination
at the catheter hub, needleless connector, and the male luer end of the
administration set, potentially increasing risk for catheter-related
bloodstream infection. There is an absence of studies addressing
administration set changes for intermittent infusions. In a
meta-analysis of 12 randomized, controlled trials that supported
increasing the time interval for administration set changes to 96 hours,
at least 2 of the studies excluded administration sets used for heparin
locked catheters and in sets disconnected for more than 4 hours. In
several others, exclusions were not stated.1,5 (V)

B. A new, sterile, compatible covering device should be aseptically
attached to the end of the administration set after each intermittent
use. The practice of attaching the exposed end of the administration set
to a port on the same set (“looping”) should be avoided.1,5 (V)

REFERENCES

1. Hadaway L. Infusion therapy equipment. In: Alexander M, Corrigan A,
Gorski L, Hankins J, Perucca R, eds. Infusion Nursing: An Evidence-Based
Approach. 3rd ed. St Louis, MO: Saunders/Elsevier; 2010:391-436.

2. Gillies D, O’Riordan L, Wallen M, Morrison A, Rankin K, Nagy S.
Optimal timing for intravenous administration set replacement. Cochrane
Database Syst Rev. 2005;(4):CD003588.

3. Rickard CM, Lipman J, Courtney M, et al. Routine changing of
intravenous administration sets does not reduce colonization or
infection in central venous catheters. Infect Control Hosp Epidemiol.
2004;25;650-655.

4. Raad I, Hanna HA, Awas A, et al. Optimal changing of intravenous
administration sets: is it safe to prolong use beyond 72 hours? Infect
Control Hosp Epidemiol. 2001;22(3):136-139.

5. Institute for Safe Medication Practices. Failure to cap IV tubing and
disconnect IV ports place patients at risk for infections. Medication
Safety Alert! Published July 26, 2007. Accessed June 17, 2010.

Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant, Central Venous Access & Parenteral Nutrition
Service

Conjoint Lecturer, South West Sydney Clinical School | Faculty of
Medicine | University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital,
Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel (+61) 2 8738 3603 | Fax (+61) 2 8738 3551 | Mob +61 (0)409 463 428 |
Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au

Behalf Of Maree Sommerville

Dear all,

I would be interested in knowing how other organisations manage the
issue surrounding the frequency of replacement for IV administration
sets when they are used intermittently. The 2011 CDC ‘Guidelines for
Prevention of Intravascular Catheter Infections’ mark this as an
unresolved issue.

My experience has been that many organisations discard after 24 hours
(ritual or evidence based??).

Our packaging is marked with symbol meaning DO NOT REUSE indicating it
is intended to be used on an individual patient during a single
procedure and then discarded.

I would be interested in your views.

Thanks

Maree Sommerville
Infection Control Coordinator
Mercy Hospital for Women
163 Studley Road
Heidelberg, Victoria, 3084

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[McEwan, Melissa MS]

UNCLASSIFIED

There is a small section in the Australian Guidelines on ice machines
http://www.nhmrc.gov.au/book/australian-guidelines-prevention-and-contro
l-infection-healthcare-2010/c6-2-4-reducing-water-bo
Melissa McEwan RN, BN, Grad Cert Infect Control
Quality Manager
Kapooka Health Centre
Contractor to Defence
02 69338338
melissa.mcewan@defence.gov.au

and is subject to the jurisdiction of section 70 of the Crimes Act 1914.
If you have received this email in error, you are requested to contact
the sender and delete the email.

________________________________

Behalf Of Tara Stanway
machines

Morning Sony
The Cape York Hospital and Health Service are also preparing for
accreditation, and you have just reminded me about our ice machine. This
is something that had not crossed my mind in regard to infection
control.
Thanks
Tara
Tara Stanway
A/ CN Infection Prevention and Control
Cape York Hospital and Health Service
tara_stanway@health.qld.gov.au

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