[Michael Wishart]

Can list subscribers please respond to Wendy directly with their replies rather than to the list? Her email address is: wendy.naisoro@SAH.ORG.AU

Wendy will then later post a summary of responses to the list.

Thanks
Michael Wishart
ACIPC Infexion Connexion Administrator

—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Wendy Naisoro
Sent: Monday, 4 March 2013 12:35 PM
To: AICALIST@AICALIST.ORG.AU
Subject: National Standards 3.6 – Immunisations

Dear Colleagues,

I am interested in finding out how each of your facilities are attending to 3.6 of the National Standards Developing, implementing and monitoring a risk- based workforce immunisation program in accordance with the current NHMRC Australian Immunisation Guidelines.

In particular I am looking at:
1.Who is paying for the recommended vaccinations? Eg. Organisation or staff member.
2.If the organisation is paying for the vaccinations, which vaccinations are they paying for?
3.If you are sending the staff to the GP how do you get the information back to be able to place on staff health file?
4.Do you have a database or system in place to be able to record the vaccinations and / or refusal of vaccinations?
5.What resources do you have available to you? Eg. Clinical staff to vaccinate, clerical staff, funding for vaccinations and / or serology
6.How many beds do you have?
7.How many staff do you have, including both clinical and non clinical(not FTEs but head of staff)?
8.And how many Staff Health or Occupational Health personnel do you have at your organisation both clinical and clerical?

Just trying to get a guide on where everyone is at due to this being in the National Guidelines and a mandatory requirement.

Kind regards

Mrs Wendy Naisoro
Staff Health and Wellbeing Advisor
Sydney Adventist Hospital
185 Fox Valley Road
Wahroonga NSW 2076

Office: 02) 9487 9236

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[Michael Wishart]

Hi Christine

We treat all MRSA’s the same, regardless of antibiogram / labels. If it is Staph aureus that is resistant to di(flu)cloxacillin, it’s deemed an MRSA and managed exactly the same way here. We do report them to our Committee as multi or non-multi, as there are definitely different patterns of infectivity and different treatment options, but we consider all of them transmissible within the healthcare environment and thus managed accordingly.

Cheers
Michael

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside,Qld4032
t: (07) 3326 3068 | f: (07) 3607 2226
e:Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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—–Original Message—–

Hi,
Can you help me – are you nursing these patients with contact precautions.

Christine Lawson | RN

Quality and Risk Manager | Infection Control Coordinator | Education Coordinator | 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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[Michael Wishart]

Hi Toni

We allow anyone in the facility who wear scrubs to wear them in the public cafe, and any other place within the hospital buildings. If they go outside, they have to change, though. There is no evidence to suggest that they are a risk to anyone unless their scrubs are stained with blood or body fluid – then they have to change before leaving the OR. We do have a tea room with food supplied in OR, but the caf has better coffee and so many staff will go there, and often still in scrubs. Cath lab, CSD, ICU and Endo staff also often wear scrubs, and again are not restricted from moving around inside the hospital. We have done away with ‘cover gowns’, and are now looking at removing overshoes in OR (yes, we still use them, some changes come slowly…). There is no evidence to suggest that clothing worn by staff has any impact on SSI, so the public perception is not founded on risk. Having said that, in my view your issue is not really an infection control issue, but a public relations issue. Good luck handing it over, though!

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

Dear All,
The issue of where you can and cannot wear operating theatre attire (blues) has arisen at our facilities – again.
I would be interested to know if your facilities/organisations allow theatre staff to eat and drink in the on-site cafeteria if they have clean blues that are covered.
Food is not supplied to the OT; staff are permitted to collect food from the on-site cafeteria if in clean blues that are covered; there is a tea room but it is said that it can be over crowded at peak times.
The public perseption (and complaints received) says that they should not be allowed to eat and drink there.
What valid evidence is there and what do others do or say to back up that they should not eat and drink in on-site cafeterias (if at all).
Look forward t your comments.
Regards, Toni.

Toni Schouten CICP
Clinica Quality Manager
Sydney Local Health District
toni.schouten@sswahs.nsw.gov.au

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[Michael Wishart]

Hi Glenys

We actually do not manage our clearance regimes very well at all. We do alert all positives in our electronic patient master index, and do place a sticker in their casenotes, and use this to try and track them each admission and try and acheive clearance over time, but it is all manually done. We do not generally follow them up through their GP, but I know some hospitals that do, and they organise clearance swabs this way.

In reality, very few of our VRE identified patients are cleared, but the protocol is there to be followed if we can follow it.

We based this on some recommendations that came out of CHRISP: http://www.health.qld.gov.au/qhpolicy/docs/ptl/qh-ptl-321-1-2.pdf

Cheers
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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________________________________

Hi Michael,

Im interested to know how you manage the clearance regime to get the weekly rectal swabs over a three week period for all your VRE positive patients over time.

Do you have a computer tracking and readmission and flagging system or is this tracking done manually?

What if the VRE patient goes home before the 3 weeks is up? Im guessing that with the exception of your dialysis patients the average length of stay of most inpatients is probably only 4-5 days so do you follow up pts after discharge to complete the clearance regime?

Would be interested to hear from other infection control teams with similar clearance regimes and those who also have a large accumulated numbers of VRE positive patients as to how tracking and readmission flagging/identification occurs.

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 Barbara

In my lovely hospital here we have 80+% single rooms (including 2 in our 15 bed ICU), so isolation of inpatients with VRE is not a problem, and we isolate all patients with a history of VRE. We do have a clearance regime that involves 3 negative rectal swabs (plus any other infected / colonised sites) at least 3 months after last positive, on no antibiotic therapy for at least 2 weeks, and the clearance swabs must be at least a week apart.

Having said all that, in hospitals with limited single rooms I have seen all sorts of algorithms for isolation of VRE. Some of the thoughts in these include risk of transmission (high risk patients: those with diarrhoea or symptomatic infection; high risk areas like dialysis / transplant / oncology / ICU) and time since last positive.

There was actually a discussion a while ago (?Ozbug, ?HICSIG) about the whole value of VRE precaution, since the actual morbidity with VRE infection is low (even though colonisation rates may be increasing), so there are varied opinions on this.

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

Hello,
My managers have asked me to review our current practices of isolating VRE positive patients. This is mainly due to the limited number of single rooms within our facility. I am interested to know how you manage patients who have a positive VRE screen, whether you isolate or not, what risk assessments you undertake to determine as to whether to isolate or not and whether you have introduced a yoghurt regime for these patients and how you then manage these patients.

Thanking you in advance,
Barbara

Barbara May
CNC Infection Control
Hastings Macleay Clinical Network
Ph. 0255242061
Mo. 0402890677

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[Michael Wishart]

Hi Gemma

Interesting question. We would not routinely change a needleless access device connected to a cannula / lumen every 24 hours, but we would change any needless access device that was considered part of a ‘line’ every 24 hours (or on completion of TPN) for any ‘lines’ used to administer TPN (or any blood products). Had never really thought about the needleless access devices used to connect the line to the cannula / lumen, as had always considered those as part of the cannula / catheter, not part of the ‘line’ or ‘giving set’.

Food for thought, though. Is the risk of biofilm in the needleless access device after infusion of lipids, etc higher than the risk of breaking the ‘closed’ system to replace the valve?

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,

With regard to administration of parenteral nutrition via a central line, I’m wondering how frequently people recommend that the needleless access device is changed (if one is used at all in this case).

Thanks,

Gemma

Gemma Klintworth
CLABSI Project Coordinator
Infection Prevention and Healthcare Epidemiology

t 03 90762250 e G.Klintworth@alfred.org.au

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia

[cid:364084200@28022013-0175]

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[Michael Wishart]

Hi Barbara

In my lovely hospital here we have 80+% single rooms (including 2 in our 15 bed ICU), so isolation of inpatients with VRE is not a problem, and we isolate all patients with a history of VRE. We do have a ‘clearance’ regime that involves 3 negative rectal swabs (plus any other infected / colonised sites) at least 3 months after last positive, on no antibiotic therapy for at least 2 weeks, and the clearance swabs must be at least a week apart.

Having said all that, in hospitals with limited single rooms I have seen all sorts of algorithms for isolation of VRE. Some of the thoughts in these include risk of transmission (high risk patients: those with diarrhoea or symptomatic infection; high risk areas like dialysis / transplant / oncology / ICU) and time since last positive.

There was actually a discussion a while ago (?Ozbug, ?HICSIG) about the whole value of VRE precaution, since the actual morbidity with VRE infection is low (even though colonisation rates may be increasing), so there are varied opinions on this.

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

Hello,
My managers have asked me to review our current practices of isolating VRE positive patients. This is mainly due to the limited number of single rooms within our facility. I am interested to know how you manage patients who have a positive VRE screen, whether you isolate or not, what risk assessments you undertake to determine as to whether to isolate or not and whether you have introduced a yoghurt regime for these patients and how you then manage these patients.

Thanking you in advance,
Barbara

Barbara May
CNC Infection Control
Hastings Macleay Clinical Network
Ph. 0255242061
Mo. 0402890677

This message is intended for the addressee(s) named and may contain confidential information. If you are not the intended recipient, please delete the message and any attachments and notify the sender. Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.
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[Michael Wishart]

Hi Jennifer

More as a householder with experience living in possum infested houses than in hospital facilities, I would say residual smell is most likely a deceased possum which remains in al cavity (wall/roof/floor, take your pick). We actually had an issue here at HSN during a building expansion program where a possum found its way into a ceiling cavity (small crawl space) and ended up dying in there. The flies came first (humidity breeds them quickly), then the smell, which grew as time progressed, then abated, but the flies persisted. Took lots of unpleasant crawling to find the offender, actually. Would suggest a pest control expert with experience in possum infestations to do a full check. Other than that, lots of ozone generating machine for a long time….

Good luck.

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

Im wondering if anyone has experience with clean up after possum infiltration?
One of our smaller clinics had the pesky critters come visiting and they managed to make a rather gruesome mess while awaiting their eviction. Clean up has occurred but there still is a malingering smell… particularly with warmer weather…. Any suggestions?

Jennifer Benjamin
Infection Control Consulant
Melbourne Pathology
M: 0402000590
Quality is in our DNA
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[Michael Wishart]

Hi Sandra

Like has already been suggested, it is mostly about where the techs need to go, and what they will be near. If your CSD is within the OT suite, and beyond the ‘line’, they should change (or at least wear a cover gown and head covering). If they have to walk past working operating rooms, they should change. If the need to walk past or enter an working packing area, they need to change (or at least wear a head covering to stop hair falling onto trays, etc). If they are working in close proximity to cooling sterile stock, or an open sterile stock area, they should change.

We may not require them to change to work on the sterilisers in CSD here as there is a separate entrance to that area, and the whole department is below theatre, not even on the same level. But if the needed to enter the packing area to work on the clean side of the washers, dryers, then we would get them to change.

I don’t think there is a ‘one-size-fits-all’ answer.

Cheers
Michael

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside,Qld4032
t: (07) 3326 3068 | f: (07) 3607 2226
e:Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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—–Original Message—–

What to wear when entering the SSD Department, is being hotly debated in our area.

The question is – Do maintenance staff have to put on theatre scrubs when entering the SSD dept to perform routine work on the sterilisers?

I would like to know what other facilities do.

Thanks
Sandra

Sandra Wharton
Infection Prevention and Control CNC Western NSW LHD | Nursing and Midwifery Building 3, Bloomfield Campus, Forest Road, ORANGE NSW 2800 Tel 02 6369 3840 | Fax 02 6360 2087 | Mob 0407 558 377 | sandra.wharton@gwahs.health.nsw.gov.au
http://www.wnswlhd.nsw.gov.au ( http://www.wnswlhd.nsw.gov.au/ )

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[Michael Wishart]

Hi Kathy

I believe the difference here is symptoms. It is difficult to quantify the risk of transmission in these instances, but if symptoms are present then the risk transmission has occurred is markedly increased. Tihs group of patients has not yet been diagnosed with CJD, but are a possibility because of their possible risk of previous exposure, hence high risk.

No symptoms leaves them in a low risk.

That is how I have always understood this, anyway.

Cheers
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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________________________________________

[Posted on behalf of Kathy Wilson – Moderator]

Hi,
Just need some clarification on the classification of high risk and low
risk patients, Appendix 1 (high risk)under accidentally transmitted
risk factors include treatment with human cadaver pituitary growth
hormone, gonadotrophin or human dura mater graft and exposure to
surgical instruments that have come into contact with higher infectivity
tissues previously used in a case of definite or probable human prion
disease. And in Appendix 2 (low risk) Recipients of cadaver-derived
human pituitary hormones before 1986 Dura mater grafts before 1990 and
individuals involved in a lock back from exposure to surgical
instruments that have been used on high or medium infective tissue from
patients later to be found to have contracted CJD.
What determines if these patients are high risk or low risk?

Kathy Wilson
Castle Hill Day Surgery
72-74 Cecil Ave Castle Hill
NSW 2154
Phone 02 88500500
Fax 02 88503011

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[Michael Wishart]

Hi Joanna

1. We process our oesophageal dilators through our Soluscope 3 machines using glutaraldehyde, only in our Endoscopy Department.

2. We use a terminal rinse in the Soluscope 3 which includes an alcohol rinse through the lumens.

3. They are stored flat in their cases, and processed immediately before use. Emergency use is extremely rare here, but it would be almost impossible to process them immediately before emergency use.

4. Sterrad does provide sterilisation, but would possibly be unsuitable for these items due to composition and lumen length/diameter. We would need to get Sterrad and dilator manufacturer agreement they could be appropriately processed in Sterrad.

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
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From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Joanna Harris
Sent: Friday, 22 February 2013 10:27 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Reprocessing of Savary Gilliard dilators

We are currently reviewing our reprocessing of Savary-Gilliard oesophageal dilators.

Please could you tell me;

1. What process / machine / disinfectant agent are you currently using for reprocessing these items?

2. If a Steris machine is being used, do you use alcohol to flush the lumen prior to storage?

3. How do you store the items, and for how long after processing and before their re-use?

4. Do you consider the Sterrad system (using hydrogen peroxide) to be a gas steriliser?

Thanks

Joanna Harris

Manager, | Infection Management and Control Service (IMACS)
Level 1 Lawson House, Wollongong Hospital, Wollongong 2500, NSW
Tel 02 4222 5898 | Fax 02 4222 5367 | joanna.harris@sesiahs.health.nsw.gov.au
http://www.islhd.health.nsw.gov.au

[http://www.health.nsw.gov.au/images/communications/e-signatures/images/NSW-Health-Master.jpg]

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[Michael Wishart]

Hi Ruth

That is a good question, with a difficult answer! In Australia, high filtration masks are considered P2 masks, which is similar to the N95 standard in the US, (not the same though). In the US, they also sell “laser plume” masks”, which are not considered N95 masks, but are designed to protect from “laser plume”.

My opinion is that if you have very good local exhaust extraction for surgical cutting that may create aerosols (“surgical smoke”), then the type of masks is not as important. Many theatres even in Australia use “laser plume masks” for surgical cutting specifically with lasers, but not with all Electrocautery.

There is no real simple answer as to which is the “best” mask for this purpose, as the risks are still not fully identified. Ask the mask manufacturers what their recommendations are for their masks, and what evidence they have to support this.

Hopefully others on the list may have more advice on this.

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
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Dear Michael,
I guess that raises another question. What is the best surgical mask in Australia to use in OT that would be appropriately called a High filtration surgical masks?

Ruth Dalrymple
Quality Risk/Infection Control Co-Ordinator
Hurstville Private Hospital
37 Gloucester Road, Hurstville NSW 2220, Australia
T 9579 7773 F 9586 2311
E Ruth.Dalrymple@healthecare.com.au W

Hi Ruth

I think this is referring to ‘laser plume’ as a mechanism for transmission of papillomavirus. Electrocautery is also a risk, but less well identified.

The main risk minimisation for these types of procedures is to use well-fitting masks, and use a local exhaust suction system to minimise aerosol dispersal. I am sure there are many guidelines to this effect available. Obviously using different treatments for these warts where this is an option should also be considered.

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
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Dear All,
I was wondering if anyone could tell me any extra precautions necessary, when operating on a patient with vaginal and anal warts. There was apparently a claim that when the warts are diathermied off, it would cause the virus to become airborne? I was asked to check up on it. Is there any truth in this statement?
Regards

Ruth Dalrymple
Quality Risk/Infection Control Co-Ordinator
Hurstville Private Hospital
37 Gloucester Road, Hurstville NSW 2220, Australia
T 9579 7773 F 9586 2311
E Ruth.Dalrymple@healthecare.com.au W
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[Michael Wishart]

Hi Ruth

I think this is referring to ‘laser plume’ as a mechanism for transmission of papillomavirus. Electrocautery is also a risk, but less well identified.

The main risk minimisation for these types of procedures is to use well-fitting masks, and use a local exhaust suction system to minimise aerosol dispersal. I am sure there are many guidelines to this effect available. Obviously using different treatments for these warts where this is an option should also be considered.

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

Dear All,
I was wondering if anyone could tell me any extra precautions necessary, when operating on a patient with vaginal and anal warts. There was apparently a claim that when the warts are diathermied off, it would cause the virus to become airborne? I was asked to check up on it. Is there any truth in this statement?
Regards

Ruth Dalrymple
Quality Risk/Infection Control Co-Ordinator
Hurstville Private Hospital
37 Gloucester Road, Hurstville NSW 2220, Australia
T 9579 7773 F 9586 2311
E Ruth.Dalrymple@healthecare.com.au W
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[Michael Wishart]

Hi Sony

My understanding is that in Australia, most new hospital buildings, and indeed those being refurbished, have removed linen and waste chutes due to fire regulations prohibiting them. So I would not think there are many hospitals with these kinds of chutes left in this country.

Cheers
Michael Wishart

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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________________________________

Dear All,

We are preparing our hospital renovation project, hence we would like to know whether you would use linen chute &/or waste chute.

Your sharing would be a tremendous help.

Regards,

Sony SO
Nursing Officer, Infection Control Team
Kwong Wah Hospital
HONG KONG SAR, CHINA
Tel:+ 852 3517-2409 Fax: +852 2332-3348 email:sony@ha.org.hk
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[Michael Wishart]

[Apologies all, I omitted some important information from ACIPC about this review – moderator]

Review of the Biohazard Waste Industry’s Industry Code of Practice for the Management of Clinical and Related Wastes (6th Edition)

The College is seeking comments from the membership by COB on 15 February 2013 in order to submit a co-ordinated response from ACIPC.
Comments can be sent back to admin@acipc.org.au.

17th December 2012

Dear submitter,

As a previous reviewer of the 6th Edition of the Biohazard Waste Industry Code of Practice (or interested party), we invite you to provide comments on the technical content and general arrangement of the document for the 7th Edition.

A summary of amendments proposed by BWI members has been provided as a marked-up copy of the 6th Edition of the Code for your reference as you make your submission. Please click here http://www.wmaa.com.au/hidden/DBW/dbw_markedupCodeofPractice_Dec12.pdf to download the marked-up copy of the 6th Edition.

*Comments may be submitted via e-mail to **bwi@wmaa.asn.au* by Close of Business AEDT Friday 22nd February 2013.*

When submitting your comments please download http://www.wmaa.com.au/hidden/DBW/dbw_CodeofPractice_CommentsForm.doc and use the template provided, which is prepared in MS-Word format and it is made up of two sections. Please do not modify the format of the table i.e. columns width, merging of cells etc as this will cause difficulty during compilation of comments.

*Section 1 – Submitter’s details*
When completing this section, please fill in your name and contact details.

*Section 2 – Comments*
When completing this section the following columns should be used as indicated:

* *Page Number*
Indicate the page of the 5th Edition to which your comment refers using only ref. numbers – do not type the word /Page/. If your
comment refers to the whole document, please leave column blank.
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[Michael Wishart]

Hi Joe

Have seen many and varied increases in exposures over the years, some related to devices (such as introduction of pen needles), some to changes in practice (increase in IM medication use due to drug changes). Also have seen increases due to better reporting (mainly in theatre areas with surgeons and anaesthetists).

Have worked in many facilities that use microscopes / loupes/ magnifying headsets and even robots, and not seen an increase in needlesticks or a cluster of needlesticks relating to use of these. Handling of any sharps during procedures is always an issue, and strategies surrounding this include good communication within the operating team (discussing sharps handling before the procedure is useful), use of safety devices where available, and use of transfer trays and safe zones. I would suggest that handling sharps where vision is limited comes mainly under the communication one, and partly also safe zones. A bit like not putting any part of your body over the zone in which hand suturing is occurring, to allow the operator to pull upwards safely with their stitch as needed. It is about raising awareness of staff involved in the procedure as to where the sharps may be, and what needs to happen to maintain safety.

Good luck with this.

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

Good morning everyone
Just curious to find out if any other healthcare facilities have ever experienced an abnormal increase in occupational exposures at any time? What were the common contributing factors and were they linked?

Also, for healthcare facilities that are performing surgery with microscopes or loupes – have you had occupational exposures when staff move sharps outside their field of vision? If you have, what strategies did you put in place to reduce the risk?

Thanks

Joe

Joe-anne Bendall | Clinical Nurse Consultant Infection Prevention and Control
Sydney Hospital and Sydney Eye Hospital|* ph +61 2 9382 7199 |page 22070 via switch 9382 7111| 7 Fax 93827510 |
Mobile 0418984255 | * Joe-anne.Bendall@SESIAHS.HEALTH.NSW.GOV.AU

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