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Michael Wishart

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  • in reply to: Re: expired isolation gowns #81504
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    I think we need to be careful when we make decisions about using stock that has passed a manufacturers expiry date. Products are often tested, eg in regard to deterioration in specific storage conditions, to see if the item will remain fit-for-purpose.

    If we decide to use items that have passed manufacturer recommendations, we need to have some assurance that the items still remain fit-for-purpose. Otherwise we could find ourselves facing questions about why we allowed something if any concerns are raised, which can result in problems for an organisation.

    Its not just about sterility concerns when thinking about expiry dates. Its very important that items remain fit-for-purpose, and continue to meet appropriate standards.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au
    [http://i2.cmail19.com/ei/t/C6/84D/FB1/102841/csfinal/StaticEmailFooter-SVPHN-Blank-650×150-V4-9900000000079e3c.png]

    St Vincents Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
    E michael.wishart@svha.org.au |
    W https://www.svphb.org.au
    [cid:image001.jpg@01D8EE90.492173A0]

    [cid:image002.png@01D8EE90.492173A0]

    From: ACIPC Infexion Connexion On Behalf Of Sarah Gaines Hill
    Sent: Wednesday, 2 November 2022 6:03 AM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: Re: [ACIPC_Infexion_Connexion] expired isolation gowns

    Hi Karen
    I had asked our LPHU the same question and was informed that providing they remain fit for purpose, we can use them.
    I found it highly unusual for them to have expiration dates as opposed to packaging dates.
    I am interested to see other IPC perspectives on this.

    Sarah

    [BlueCross]

    Sarah

    Gaines Hill

    Infection Prevention Manager

    P: +61 3 9828 1705

    |

    M: +61 429 480 183

    Wurundjeri Country

    Level 1, 117 Camberwell Road,

    Hawthorn East,

    VIC

    3123

    [BlueCross]

    From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Karen Kemp
    Sent: Monday, 31 October 2022 10:26 AM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: Re: [ACIPC_Infexion_Connexion] expired isolation gowns

    Good morning everyone
    A few months ago, there was a conversation on here regarding expiration dates for isolation gowns and whether they can be used. I cant remember the outcome of the conversation.

    We have a large supply from the Commonwealth stockpile that were very close to their expiration date at the time they were sent to us. Now there are some that are 4 months over the date.

    Can they still be safely used in a covid or any other outbreak?

    I appreciate any information that you can give me.

    Regards

    Karen Kemp OAM
    Infection Control and Staff Health CNC

    [cid:logo_a4fe3091-450f-4d0e-b594-635f37aad37c.jpg].

    .

    08 8080 1850
    KKemp@sccbh.com.au
    https://www.sccbh.com.au

    .

    .

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    in reply to: 3 lumen Picc line Blood culture #81468
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Aspasia

    Blood cultures drawn through central device lumens can be very informative in regard to potential sources of infection. If you have positive growth in lumen collected blood cultures, and negative peripheral blood cultures, this can help determine the need for treatment, including the need to remove or replace lines. Blood cultures from lumens that return positive growth more rapidly than peripheral collections can also help guide appropriate treatment and potentially indicate a source.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    St Vincents Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
    E michael.wishart@svha.org.au |
    W https://www.svphb.org.au

    —–Original Message—–
    From: ACIPC Infexion Connexion On Behalf Of Aspasia Kordanouli
    Sent: Tuesday, 25 October 2022 3:56 PM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: [ACIPC_Infexion_Connexion] 3 lumen Picc line Blood culture

    Hi all,
    Febrile neutropenia patient that has 3 lumen Picc- line insitu, what is the rationale of taking blood cultures of EACH lumen please?

    as per eviQ on management febrile neutropenia, 1 set blood cultures (aerobic and anaerobic bottles) from each lumen of central venous access device (CVAD) (if in situ)

    What about the blood loss?

    Aspasia Kordanouli
    Infection Control Nurse

    Calvary North Adelaide Hospital
    89 Strangways Terrace North Adelaide SA 5006

    E: Aspasia.Kordanouli@calvarycare.org.au
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    in reply to: Re: Lanyards #81440
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    I personally think we need to be clear about what the risks are, and why they should not be used.

    Many people say because they are contaminated with bacteria, they should be banned. But is there evidence of transmission from lanyards?

    We have seen studies show the pens we carry in our pockets are also contaminated with bacteria. Is there a huge cry to ban pens from an infection control perspective? Not that I have heard (although I do recall one company had a antibacterial pen for a while, but it never really took off)

    To me, its all about hand hygiene (surprise, surprise). Not about what is contaminated. We know there is bacteria in the environment, on our clothes, on things we carry. So perform hand hygiene before you touch that patient!

    I dont think lanyards are a good idea, but from a safety perspective, not an infection control one. So when people ask me if they should ban lanyards, I say there is no definitive evidence about an infection control risk, but you might want to think about safety concerns as suggested.

    My two cents worth.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    St Vincents Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
    E michael.wishart@svha.org.au |
    W https://www.svphb.org.au

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    From: ACIPC Infexion Connexion On Behalf Of Kareen Dunlop
    Sent: Thursday, 20 October 2022 9:56 AM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: Re: [ACIPC_Infexion_Connexion] Lanyards

    I would be concerned they could be used as a strangling agent too. As well as dangling onto clients in close work such as turning a patient.
    Kind regards
    Kareen Dunlop
    Consultant Nurse Educator
    Sent from my iPhone

    On 20 Oct 2022, at 12:05, Royston Barns <royston@freschegroup.com> wrote:

    Hi Jenny,

    This may be of interest.

    https://pubmed.ncbi.nlm.nih.gov/26300101/

    Kind Regards

    Royston Barns
    Research, Development and Innovations Manager
    [Logo Description automatically generated]
    Fresche Bioscience
    Unit 84, 1470 Ferntree Gully Road, Knoxfield, Victoria 3180 Australia
    T: +61 3 9763 4500 I +61 458 770 437
    E: royston@freschegroup.com
    W: freschegroup.com

    Creators of SIQURA and Gearlock.

    From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> on behalf of Jenny McCarthy <jenny@MARYVALEPH.COM.AU>
    Reply to: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU>
    Date: Thursday, 20 October 2022 at 8:34 am
    To: “ACIPCLIST@ACIPC.ORG.AU” <ACIPCLIST@ACIPC.ORG.AU>
    Subject: [ACIPC_Infexion_Connexion] Lanyards

    You don’t often get email from jenny@maryvaleph.com.au. Learn why this is important

    Good morning all
    Just after some advice on lanyards yes or no?
    We have not used them here in years, but our relatively new exec team want to reintroduce them.
    They have said they will be of a silicone material and can be wiped down regularly (not sure how that will go!!!)
    Does anyone have any recent articles/research regarding this that I could use?
    Thanks
    Jenny

    Jenny McCarthy
    Infection Prevention and Control Coordinator

    [cid:image001.png@01D8E45D.7546DF20]
    p | 5132 1200
    e | jenny@maryvaleph.com.au
    a | 286 Maryvale Road, Morwell, VIC 3840

    http://www.maryvaleph.com.au
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    in reply to: Documentation of PIVC #81430
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Yana

    A great example of a good PIVC documentation tool can be found on AVATAR’s website.

    I-DECIDED assessment and decision tool (avatargroup.org.au)

    We were part of the original trial of this tool (soon to be published study results), and while it is more paperwork for staff to complete, the results in improvement in outcomes for patients is well worth it.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    St Vincent’s Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
    E michael.wishart@svha.org.au |
    W https://www.svphb.org.au

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    [cid:image001.png@01D8E3C3.AC89F5C0]

    Good Morning All

    I am interested in examples of forms in use at other sites to document PIVC care. I am looking for ways to improve compliance with recording of daily device assessment and insertion and removal details. Currently this is recorded on the back of the observation chart however there are some barriers to compliance with this.

    Happy to be contacted directly.

    Cheers

    Kind regards

    Yana Albrey
    RN, BNurs, PGCert Clinical Nursing,
    PGCert Infection Prevention & Control
    CICP-A

    Clinical Nurse Manager
    Infection Prevention & Control
    Royal Darwin and Palmerston Hospitals| Top End Region

    Northern Territory Government
    Floor 1, Building 1, 105 Rocklands Drive, Tiwi
    GPO Box 41326, Casuarina, NT Postcode

    T. 08 892 28428
    Mob. 0459 899 037
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    in reply to: RACFs and PFRs and Fit-Testing #81348
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    {Posted on behalf of a member – Moderator]

    We managed to purchase our own fit testing machine and had 3 RNs trained to complete the fit testing for our organisation.

    Most of our staff have been fit tested.

    Ariella Gwitima
    Manager
    Embracia Reservoir
    Reservoir, Vic

    Hi Christine,

    Our facility has not conducted the credentialled Fit testing program, only in house.

    If your able to send me some information I will get my educator to either touch base with you or certainly call you

    Regards

    Sandy

    Sandy Miller
    Facility Manager | Registered Nurse
    smiller@standrew.com.au

    [cid:image001.jpg@01D8C908.FA446FA0]
    59 Bentinck Street
    BALLINA NSW 2478
    02 6620 5800
    0428 490 773

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    Good afternoon everyone,

    My organisation is organising a Fit-testing program for our residential facilities and I would be interested to know how many of you in Aged care have developed your own program or if you have outsourced this please?

    We also have Residential Homelessness shelters and Foster Care homes, so quite broad services to reach with such a program.

    Any advice or tips appreciated.

    Thanks in advance.

    Kind regards,

    Chris

    Christine Morrison
    Practice Facilitator – Infection Control
    Practice Facilitation Team
    [cid:image001.jpg@01D8C904.A5578C60]

    Level 3, Webber House,
    439 Ann St, Brisbane Q 4000
    PO Box 10556, Brisbane Adelaide St Q 4000

    M: 0499526913
    E: cmorrison2@anglicaresq.org.au
    E: pft@anglicaresq.org.au
    W: anglicaresq.org.au

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    in reply to: Consent for BBV Testing #81303
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Jenny

    We still have both on our surgical consent form currently, but we had previously received legal advice that suggested the consent for BBV testing was not valid unless it was appropriately explained (which we know it’s not as the surgeon will only focus on the procedural consent). So we do not utilise that consent in the case of a needlestick, which means we need to await the patient awakening post surgery and giving consent (or in the case of post op ventilated ICU patients, get the intensive care team to obtain or authorise consent).

    That’s within the private sector in Queensland.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    St Vincent’s Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
    E michael.wishart@svha.org.au |
    W https://www.svphb.org.au

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    [cid:image001.png@01D8C136.0D1A6CE0]

    Good Morning,
    We would be interested to know how many healthcare organisations have both consent for blood transfusion and consent for blood borne virus testing included in their consent for surgery documentation and any obstacles they faced when doing this.
    I understand this is more common practice in the private health sector but currently am more concerned about the public sector.
    Many thanks

    Jenny Breen

    Senior Infection Prevention Clinical Nurse Consultant

    Infection Prevention & Control Unit

    PO Box 52, Frankston Vic 3199

    T Direct 03 9784 8239 Fax 9784 2347 Switchboard 03 9784 7777

    E jbreen@phcn.vic.gov.au

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    in reply to: RAT testing #81283
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Lyn

    We stopped routine RAT testing on admission at both facilities some time ago, as there is no QLD Health mandate for this, and we had performed several thousand tests for one single unknown positive! We still ask pertinent pre-admission questions (are you unwell currently, are you a close contact, that sort of thing), but we only test (and from a clinical perspective a PCR or rapid PCR is preferred if we are looking to detect infection) on clinical need (eg patient turned up for routine elective admission and is clearly unwell).

    We still RAT test transfers out to other facilities, mainly to prevent delay in transfers rather than anything else.

    Hope this helps.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    St Vincent’s Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
    E michael.wishart@svha.org.au |
    W https://www.svphb.org.au

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    [cid:image001.png@01D8BC70.B1742E90]

    Afternoon,

    Just wanting to find out how the various private and public sectors are managing RAT testing patients if at all on admissions, we are trying to figure out whether or not to continue with this as it is resource draining and staff are needed elsewhere.

    Any information would be greatly appreciated.

    Thanks

    With kind regards

    Lynette Spence

    Lynette Spence

    Infection Control Coordinator

    St Andrew’s War Memorial Hospital

    t (07) 3834 4328 m 0427 141 223 f (07) 3834 4599

    e lynette.spence@uchealth.com.au

    457 Wickham Terrace, Spring Hill Q 4000
    standrewshospital.com.au

    [cid:0eeca506-6206-4a3f-bc4c-e5bdff1b6b64]

    [cid:ed06c8bc-6f18-4315-95cd-90d04d556ae8]

    UnitingCare respectfully acknowledge the Traditional Custodians of the lands on which we work and live. We acknowledge Elders both past and present, whose ongoing effort to protect and promote Aboriginal and Torres Strait Islander cultures will leave a lasting legacy for future leaders and reconciliation within Australia.
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    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Cathi

    Our main Infection Control Committee, which includes our VMOs (surgeons, intensivists microbiologists, ID physicians), meets every two months, and on the alternate month, we have a non-clinical meeting which looks at water results, cleaning, sterilisation and food services, which reports by exception to the main committee.

    We also have a sub committee for AMS. Fit testing is managed by workplace health and safety.

    The two monthly meeting schedule gives us enough time between meetings with not too great a burden on surveillance reports for a single meeting (one hour maximum).

    We also have the option of out-of-session email discussions, which we have used on occasion for urgent matters.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    St Vincents Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
    E michael.wishart@svha.org.au |
    W https://www.svphb.org.au

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    [cid:image001.png@01D8B3DE.B5391BC0]

    From: ACIPC Infexion Connexion On Behalf Of Montague, Cathryn (Health)
    Sent: Friday, 19 August 2022 12:39 PM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: [ACIPC_Infexion_Connexion] Infection Prevention and Control committee governance & meeting frequency

    OFFICIAL

    Hi all,

    How often does your IPC Committee meet? Is that frequency appropriate to meet governance needs?

    Do you have working groups or subcommittees? If so, for what?

    Any other IPC governance suggestions / initiatives that might be helpful?

    Always looking to improve!

    Thanks

    Kind regards,
    Cathi

    Cathi Montague
    Nurse Consultant Infection Prevention and Control (Tues-Thurs)
    Drug and Alcohol Services South Australia
    Email: Cathryn.Montague@sa,gov.au
    #GetFullyVaccinated #DontShareTheAir #HandHygiene #StayHomeIfSick #GetTested #BeKind
    [cid:image001.jpg@01D8B3C4.76924910]

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    in reply to: Mask extender use for P2s #81251
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Samantha

    I didnt think FDA approved ear loop N95 masks for use in clinical settings? Unless they have changed their policy. If you can email me the brand and model of the masks (off-list) Ican check this for you. Just because a mask says it complies with a certain standard does not necessarily make it suitable for use in all settings, either.

    Any addition you use to try and improve fit with N95 masks must be validated by appropriate fit testing to ensure a good seal. If you require mask extenders to improve the fit, then the masks are probably not a good fit to start with, and it is possible the mask extenders improve comfort but dont actually improve the seal.

    I would strongly encourage you to seek advice for fit testing your clinical workforce, rather than only relying upon fit checking. A single mask type and size will not necessarily fit all people, and so you will likely need a variety of mask sizes and types to be available.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    St Vincents Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
    E michael.wishart@svha.org.au |
    W https://www.svphb.org.au

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    [cid:image001.png@01D8B095.7B44ED00]

    From: ACIPC Infexion Connexion On Behalf Of Samantha Lavender
    Sent: Friday, 12 August 2022 7:12 AM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: [ACIPC_Infexion_Connexion] Mask extender use for P2s

    Hi all,

    My apologies if this question has already come up, I didn’t see it in the archives.

    I work for a service which includes aged care homes.
    They have received P2 masks (regular) that aren’t great achieving a good fit for most of the staff (the masks do meet standards. The masks are ear loops).
    The manufacturer advised, and supplied, plastic mask extenders. When used, these extenders do increase fit and seal on the face.

    Currently they service doesn’t fit test, but has a PPE and fit check program.
    May I ask the current advice on the use of mask extenders with P2s?

    Kind regards,
    Samantha Lavender

    Infection Prevention and Control Advisor
    Wesley Mission QLD

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    in reply to: Legionnaires Disease Diagnostics #81244
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Chris

    Not quite sure what you are asking, but we base detection of Legionella infection on culture of pathogenic Legionella from clinical specimens (eg sputum, bronchial washings, tissue).

    Probably the best resource for this is the CDNA National Guidelines on Legionellosis.

    https://www.health.gov.au/sites/default/files/documents/2020/02/legionellosis-cdna-national-guidelines-for-public-health-units.pdf

    If I am on the wrong track, could you please clarify your question?

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    St Vincent’s Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
    E michael.wishart@svha.org.au |
    W https://www.svphb.org.au

    —–Original Message—–

    Hi All,

    Was wondering if anyone had any information / processes / methods for diagnosing Legionnaires diseases in a hospital environment?

    Chris Pollard
    Sales Engineer – ANZ
    Kenelec Scientific Pty Ltd, 23 Redland Drive, Mitcham VIC 3132 d 0437 007 810 | m 0437 007 810 | e chris.pollard@kenelec.com.au Visit our website | View our Terms and Conditions

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    in reply to: PPE Tier 3 #81233
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    And here are the pictures.

    Cheers
    Michael Wishart
    ACIPCList Moderator

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    St Vincents Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
    E michael.wishart@svha.org.au |
    W https://www.svphb.org.au

    [http://i8.cmail19.com/ei/t/6C/F77/A00/141133/csfinal/StaticEmailFooter-SVPHN-Celebrating20Years-650×150-9900000000079e3c.png]

    [cid:image001.png@01D72F93.FCA8FC30]

    From: ACIPC Infexion Connexion On Behalf Of Sangeetha Selvarajah
    Sent: Tuesday, 26 July 2022 10:28 AM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: [ACIPC_Infexion_Connexion] PPE Tier 3

    Hi all

    I have a question. I am currently overlooking at a regional campus as a IPCC. Currently, the aged care is in lockdown due to Covid19 outbreak.

    I have a question about the PPE gowns that are used. The facility is supplied with surgical gowns as isolation gowns. My question is are the surgical gowns used as isolation gowns if there is no supply?

    I have attached the pictures for view.

    Regards
    Geetha

    IPC Team
    SEYMOUR HEALTH
    03 57936193
    sangeetha.selvarajah@seymourhealth.org.au

    Sangeetha Selvarajah

    Building a healthy Seymour”

    [cid:image4d4056.PNG@57054a41.4e80958e]

    IPC Team

    P: 03 5793 6193

    E: Sangeetha.Selvarajah@seymourhealth.org.au

    My working days are Tuesdays, Wednesdays and Thursdays.

    Our Values:
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    in reply to: PFR for source control #79508
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Ed

    Many, many years ago, I had it drummed into me by a wise (well, I thought he was wise at the time!) ID physician NOT to put PFR’s on patients with respiratory compromise because it was hard enough for them to breathe without adding a difficult-to-breathe-through layer. That always stuck with me, so I make sure the policies at facilities I work at don’t mandate patients donning PFRs.

    There is also no definitive evidence I have yet seen that would suggest a well fitted surgical mask is any less effective in potentially reducing transmission of respiratory pathogens than a PFR.

    So that relates to symptomatic patients, not well visitors, but since we don’t do any form of checking about respiratory compromise I’d be more comfortable in asking visitors as well as non-symptomatic patients to wear surgical masks rather than show them how to don a PFR and hope it didn’t cause an issue.

    Just my thoughts.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    St Vincent’s Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
    E michael.wishart@svha.org.au |
    W https://www.svphb.org.au

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    [cid:image001.png@01D72F93.FCA8FC30]

    Reposting this… Keen to hear if anyone has an opinion or experience of implementing PFR use for source control. I don’t think there’s a right answer.

    Thanks
    Ed

    ________________________________

    CAUTION External Communication: This email originated from outside of the organisation. Do not click links or open attachments unless you recognise the sender and know the content is safe.

    Hello IPC community,

    Are you recommending PFRs for source control in your facilities?

    We are considering use for

    1. COVID positive patients coming into outpatient areas for infusions/assessment
    2. All visitors to very high risk areas, eg bone marrow transplant unit, as we reduce stringency of RAT screening and have increasing levels of non-COVID respiratory illness in community

    The available literature seems to provide evidence of only marginal theoretical benefit which needs to be balanced against the cost and confusion of applying this targeted strategy.

    Summarised in this systematic review 2022 https://doi.org/10.1007/s00420-021-01775-y which in discussion says: “The results of the present review indicate that the use of a surgical mask by the source of the aerosol reaches a higher level of protection than the use of the N95 respirator by the receiver (Diaz and Smaldone 2010; Mansour and Smaldone 2013; Patel et al 2016). These data suggest that traditional surgical masks are useful in preventing the transmission of respiratory diseases when applied at the source of the infected aerosol, significantly reducing the exposure of pathogens, functioning as an inhalation barrier; however, in regard to respiratory protection equipment, there are still doubts about which is the best type to be used for this purpose (Patel et al. 2016 ). In an environment of 27 m3 occupied by five people, although the N95 respirator promotes greater filtration, surgical masks seemed to be more effective in reducing the release of bioaerosol, a difference mainly due to the adjustment and sealing of the mask to the face of the source (Xu et al. 2017).”

    This is primarily based on the Patel/Smaldone 2016 paper http://dx.doi.org/10.1080/15459624.2015.1043050 which reports findings from an in vitro model that perhaps underrepresents the efficiency and seal achieved in the majority of people with the current generation of soft shell PFRs.

    Keen to hear your approach/experience.

    Kind regards,
    Ed

    Dr Ed Raby
    Medical Director Infection Prevention and Control
    South Metropolitan Health Service, WA
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    in reply to: picture required #79477
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    This is the link to that toy ambulance: This item is unavailable | Etsy
    This item is unavailable | Etsy
    Find the perfect handmade gift, vintage & on-trend clothes, unique jewellery, and more lots more.
    http://www.etsy.com

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032

    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226

    E michael.wishart@svha.org.au|

    W https://www.svphn.org.au

    St Vincents Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
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    [cid:c472ce19-ce44-4803-bd7d-1cb6b4eeca6e]

    ________________________________

    [Petit Block Ambulance DIY or We Can Build It for You | Etsy]

    Anna Lillas
    Clinical Nurse Consultant Infection Prevention Unit

    [LOGO_PMAC_HORIZONTAL]
    Please note: Wednesday to Friday
    Phone +61 3 85562789
    Email anna.lillas@petermac.org

    ! EXTERNAL EMAIL: Think before you click. If suspicious send to CyberReport@petermac.org

    OFFICIAL

    Hello Brains trust

    Im looking for a picture for a presentation of a toy ambulance in sterile wrap.

    Can anyone help?

    Kind regards

    Lincoln Fowler

    Infection Prevention and Control Officer

    ACT Ambulance Service

    P. | M.0435 329 378 | E. Lincoln.Fowler@act.gov.au

    9 Amberley Avenue Fairbairn (Majura) ACT 2609| PO Box 158 Canberra City ACT 2601

    [Celebrating World Hand Hygiene Day, 2022 – Surewash]

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    in reply to: ESBL UTI in RAC #79468
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Vanessa

    The document cited below is based in Queensland, and local epidemiology needs to be considered. But the need for specific, targeted strategies for prevention of transmission of ESBLproducing organisms in residential care settings is not clear, and will also possibly depend upon the species of organism (eg in QLD, ESBL production in E.coli is not considered a trigger for transmission based precautions).

    There is conflicting evidence available on the merits of including ESBL-producing organisms
    in a targeted resistance mechanism-specific approach. It is recommended that acute and
    high-risk health services assess local epidemiology and perform an assessment of risk to
    determine the requirements of the local approach for ESBL-producers. An important factor
    to consider is that current laboratory procedures utilise the tests for ESBL-producers to
    detect carbapenem resistant organisms; this is an important step to determining if CPE are
    present.
    The assessment of risk should include the expertise of infection prevention and control
    practitioners, infectious diseases physicians and medical microbiologists. It is further
    recommended that infection prevention and control programs maintain awareness for
    increased numbers of infections with ESBL- producers in order to monitor for outbreaks. In
    the event of increased numbers, the local approach should be re-assessed.
    For other health services that are not usually considered high risk for MRO infection (e.g.
    residential aged care, outpatient settings, community-based settings), the decision to
    implement an organism- or resistance mechanism-specific program other than for CPE
    should be made per health service based on factors including local epidemiology, risk of
    transmission and risk of infection.
    Different combinations of strategies may be used for different health services, and the
    appropriate strategy may be a risk assessment approach that is applied to each individual
    client with an MRO colonisation or infection. For example, in residential aged care, use of
    isolation and contact precautions may not be required routinely for management of
    residents who are colonised with an MRO, but these measures may be put in place when a
    risk assessment indicates they are required. For example, a resident who currently has an
    infection with an MRO, or a resident colonised with an MRO who has trouble with hygiene
    behaviours.

    Management of multi-resistant organisms (health.qld.gov.au)

    My recommendation would be (based on the understanding that the patient did not have an indwelling urinary catheter, and resided in a single room with their own ensuite) that standard precautions would be sufficient in this setting. Some of your listed options, to me, are actually what should be part of standard precautions (eg good hand hygiene by all carers, gloves when handling contaminated items (eg used continence aids), apron when splashing is likely) and should be used for all client/resident contacts.

    Hope this helps you consider the most appreciate approach.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    St Vincents Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
    E michael.wishart@svha.org.au |
    W https://www.svphb.org.au

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    [cid:image001.png@01D72F93.FCA8FC30]

    From: ACIPC Infexion Connexion On Behalf Of Vanessa Davis
    Sent: Wednesday, 15 June 2022 3:58 PM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: [ACIPC_Infexion_Connexion] ESBL UTI in RAC

    Dear Clever People
    We have a resident who has been diagnosed with ESBL UTI. They have been commenced on ABx.

    What additional precautions should be implemented for this resident who lives in her own room with an ensuite.

    Based on what I have read, My guess is:
    1) Gloves when changing continence aids / toileting.
    2) ? plastic gown (? Long or ? Short sleeve)
    3) diligence with Hand hygiene (resident and staff)
    4) ? Additional cleaning of bathroom
    5) none of the above
    6) something else

    Many thanks for your guidance
    Vanessa Watkins

    RN, Quality Manager, IPC Lead
    Donwood Community Aged Care
    11 Diana Street, Croydon, Vic
    (03) 9845 8509
    vwatkins@donwood.com.au

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    in reply to: MSSA/SAB Bacteraemia question #79461
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Chris

    MSSA stands for Methicillin Sensitive Staphylococcus aureus, so it refers to a bacteria not a disease/infection. It is no considered multi-resistant therefore standard precautions only would apply.

    SAB stands for Staphylococcus aureus bacteraemia, which is an infection which can be caused by either MSSA or MRSA. If a SAB is caused by MSSA, standard precautions only applies. If a SAB is caused by MRSA, contact precautions may be required (some facilities for no use contact precautions for non-multiresistant MRSA (nmMRSA)).

    Hope this helps.

    Cheers
    Michael

    Michael Wishart | Infection Control Coordinator, CICP-E

    St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
    M +61 448 954 282 | T +61 7 3326 3068 | F +61 7 3607 2226
    E michael.wishart@svha.org.au |
    W https://www.svphn.org.au

    St Vincent’s Private Hospital Brisbane | 411 Main Street KANGAROO POINT QLD 4169
    M +61 448 954 282 | T +61 7 3240 1208 | F +61 7 3240 1166
    E michael.wishart@svha.org.au |
    W https://www.svphb.org.au

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    [cid:image001.png@01D72F93.FCA8FC30]

    Good morning brains trust.

    I have a few questions regarding MSSA Bacteraemia,
    Is MSSA and a SAB the same thing?
    Are there any Transmission based precautions required and if so for how long?

    Kind regards,

    Chris

    Christine Morrison
    Practice Facilitator – Infection Control
    Practice Facilitation Team
    [cid:image001.jpg@01D87CAB.71187630]

    Level 3, Webber House,
    439 Ann St, Brisbane Q 4000
    PO Box 10556, Brisbane Adelaide St Q 4000

    M: 0499526913
    E: cmorrison2@anglicaresq.org.au
    E: pft@anglicaresq.org.au
    W: anglicaresq.org.au

    [list-SM]
    [cid:image003.jpg@01D87CAB.71187630]

    I acknowledge and pay my respects to the traditional owners and custodians of the land in which I work, walk and live.

    ________________________________

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