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Hi Marija
I certainly agree. Similar to sterile stock we purchase (we don’t audit them on AS 4187 compliance, we get documentation they meet requirement), we should have copies of the external laundry provider’s certifications as part of the contract.
There is one external infection control audit group I know of that does request these audits are down by the facility, though. And, I will admit, it gives the ICP an opportunity to visit the laundry annually, which I have found to be useful in order to understand the laundry process and meet the key stakeholders.
Maybe rather than a formal audit, ICP’s could request to visit the external laundry for a tour?
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Hi All,
I agree and yes it should be built into the contract ( and something I check when the contracts are due for renewal) for the linen services provided for the organisation and something that can be requested by your Hotel Services Manager.
This is not for us to audit (we have enough as it is to do), but for the service to provide their evidence if required and for us to ensure that linen managed on site is managed within the guidelines/standards.My thoughts.
Kind Regards
Marija Juraja |Nurse Unit Manager -CALHN Infection Prevention & Control Unit|
Division of Acute Medicine (RN, GCNS Inf Ctrl, CICP-E)
t: +61 8 7074 2810 (RAH) 8222 7588 (TQEH)| M: 0466 379 821|e:marija.juraja@sa.gov.au |
Adjunct Clinical Lecturer | University of South Australia | Division of Health Sciences
[Conumers]Dear all,
I have heard some hospitals teams are being asked during accreditation about their linen service compliance with Australian and NZ Linen standard 4146:2000.
While this would be appropriate for internal laundry services I would be interested to know of any regulatory requirement for annual/other auditing requirements by hospital staff (infection control/hospital service) when the provider is a 3rd party provider (external)?
Surely compliance with relevant standards/regulations is included contracts with 3rd party providers and hence such providers themselves could be compelled can provide evidence if requested?
It does not seem like a good use of busy infection control/other hospitals personnel resources to be conducting audits (annual or otherwise) on 3rd party providers whom they have no direct jurisdiction over?
Regards
Glenys
Glenys Harrington
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
E: infexion@ozemail.com.au
[Description: ICC Diagram ICCversion]Hi All,
We are currently looking at alternative tools for auditing 3rd party laundry premises. Does anyone have a tool they would be willing to share?
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_controlIPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’
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Hi Tracie
It’s a debateable question. But if you include cost of time spent by staff drawing up saline, and the cost of extra needles. labels, etc, then it gets quite close. The main reason we have persisted with them is the reduction of risk of contamination of flushes, as a strategy to reduce risk of line associated infections. Certainly not mainly as a cost savings exercise. If we can prevent one significant line associated bacteraemia per year, it would be a cost effective strategy, in my view.
The company we purchase the prefilled saline syringes from did provide us with a cost analysis showing a small cost savings, but the items and costs included can be debated.
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Hi Michael,
what about cost of the prefilled syringes. Are they cost effective.
thanks
Tracie Oates
ICP
Heathcote Health
39 Hospital st
Heathcote, Victoria,
03 5431 0900________________________________
Hi Jenny
We use pre-filled saline syringes for all of our IV saline flushes now, including when inserting and changing central lines and CVADs. We have a non-sterile outer pack and a sterile outer pack syringe, depending how the procedure is performed, to allow use on a sterile field.
We have had no real issues with staff use and acceptance of these, and it certainly reduces risks of contamination in my view.
Cheers
Michael
Michael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]
Good morning,
I did not receive any correspondence about this inquiry-however did email from my personal email not my work one.We are looking at the improvements in aseptic technique compliance and improved outcomes for patients if we can use the pre-filled saline syringes for flushing our Central venous access devices.
We would like to know if any other Hospital group currently uses these and for which particular procedures they have been approved for. Also if the use of these have been restricted across any other procedures.Kind regards
Jenny
Jennifer Breen
Clinical Nurse Consultant- Infection PreventionPeter MacCallum Cancer Centre
305 Grattan Street
Melbourne VIC 3000
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Hi Jenny
We use pre-filled saline syringes for all of our IV saline flushes now, including when inserting and changing central lines and CVADs. We have a non-sterile outer pack and a sterile outer pack syringe, depending how the procedure is performed, to allow use on a sterile field.
We have had no real issues with staff use and acceptance of these, and it certainly reduces risks of contamination in my view.
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Good morning,
I did not receive any correspondence about this inquiry-however did email from my personal email not my work one.We are looking at the improvements in aseptic technique compliance and improved outcomes for patients if we can use the pre-filled saline syringes for flushing our Central venous access devices.
We would like to know if any other Hospital group currently uses these and for which particular procedures they have been approved for. Also if the use of these have been restricted across any other procedures.Kind regards
Jenny
Jennifer Breen
Clinical Nurse Consultant- Infection PreventionPeter MacCallum Cancer Centre
305 Grattan Street
Melbourne VIC 3000
______________________________________________________________________
This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return https://clicktime.symantec.com/3CXuZZuxx1neePFrJQoBBwk7Vc?uemail%2C%20delete%20the%20Email%2C%20and%20do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
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Hi Tina
Our approach is similar to that described by Joanna Harris. I did a presentation to some per-operative nurses here about this. The key was investigating current practices between patients and plugging the holes (ie who cleans what make sure everyone knows their role).
I think you need to work out what will work in your setting, though. I do not believe a one-size-fits-all approach will work.
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W http://www.hsnph.org.au[cid:image001.jpg@01D46C86.4CDB6090]
From: ACIPC Infexion Connexion On Behalf Of The Harrises
Sent: Thursday, 13 December 2018 4:31 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: Reviewing management of MRO’s in perioperative unit.Hello Tina, and welcome.
The important thing is to thoroughly look at the risks associated with MROs in theatre balanced with the risks associated with managing patients known to be colonised. Also recognise that you do not probably know the MRO colonisation status in real time for every single patient.
Here in the Illawarra Shoalhaven in NSW we have adopted a much more horizontal approach to our infection prevention and control policies. Essentially this can be described as doing the right thing for everyone. By doing this we make things simpler for staff, prevent discriminatory practices for those patients with a history of MRO colonisation, and avoid problems such as the ones you have described with wasted theatre time and equipment issues.
I would be very happy to discuss off line, and share policies etc. if you are interested.JoannaHarris
Nurse Manager, Infection Management and Control Service,
Illawarra Shoalhaven LHD, NSW.
Joanna.Harris@health.nsw.gov.auSent from my iPhone
On 7 Dec 2018, at 15:09, Tina Muller <Tina.Muller@HEALTH.QLD.GOV.AU> wrote:
Afternoon,Im a new member, and very excited to be able to network with such a diverse body of knowledge.
Question?
We are currently reviewing our management of MROs within the perioperative Unit.
Specifically focusing on decanting theatres prior to admitting the patient into theatre.
This includes the anaesthetic drugs trolley which is kept close at hand outside the door.
Yes, we allocate an outside runner.There are two components that we are keen to focus on.
1. Decanting the Theatre we are discussing the Non-Contact vs Contact Zone
2. Recovering of patient in the theatre ( VRE / ESBL/CRE ) vs PACU (MRSA)These are the core issue that cause grief among the staff.
Ana Folk- not ready access to emergent equipment if required.
Loss of theatre time in recovering patient in Theatre.As you are aware, this implicates theatre staff and activity time.
This is addressed with allocating the MRO patients to the end of the elective lists
If we have a spare theatre – we will take the MRO patients there, so there is minimal lost time in their home theatre( while someone else cleans up or recovers the patient)
No so easy to negotiate if this is an emerg patient.Earlier this year, I emailed across QHealth via SWAPNET, and thank-you to all who responded.
This has given us much to consider, drawing us to the Contact vs Non-Contact area within the actual theatre.[cid:image001.jpg@01D48E36.7789BA40]
Before I totally re-write our Policy reflecting the changes, I would like the opinion of the ACIPC Network.
I thank-you for your time and consideration in this matter.Regards,
TinaTina Muller
Clinical Nurse Consultant / Perioperative & CSD.
Mackay Hospital and Health Service
P: 07 4885 5387
E:tina.muller@health.qld.gov.au[Email Signature]
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This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by returhttps://clicktime.symantec.com/a/1/wU_6MlKtcY6VTa4EumrzadlTUl231Tg3gqNlBy_BSY4=?d=ARPWbsrFNs07YUZFt0kEfjrINUVz0mizz50xpJLfUp5EzjxpJ220kbHSec6vZsDAf99liWNSKleXZof6pFafd-V9j6WvT11kFGr9pPFN_4v_4a6EQG89ycsV65XSRtr07qInvHxHE22HPc6FzWFjQ79FncKKOgqiJuK9_g9_-IUYXFZBRpt6RxLg8e-k3Tss04MbG0CZFGb9HfnttJsVjCtH91dIdKHRLhhhcGi-xbFMJqdiGEV8PErzm_Ec2gZS0vKfFFyoE3Kc7HMXq0cr0xCRPJy24cWQjhjSkoxYRm-eFHgjwCxSCSd13ZdCK43D6GPPBSdID7aRlzSTwLq5MdQCAMFfXfRjc2IkMTBKm1tUVBv5gsyDUhoOouFpOs5CrZRCa_jdzE8CLLhth182Wfv_0A2zrxsCQw%3D%3D&u=n%20email%2C%20delete%20the%20Email%2C%20anddo not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
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Hi again Emma
Not much more helpful, but apparently the Consensus Proceedings have been updated this year (thanks to Dr Tammy Wijesuriya for letting me know)
Question 7: Does the type of surgical drape (disposable vs. nondisposable) used affect the risk of subsequent SSIs/PJIs in patients undergoing orthopedic surgery? Recommendation: Unknown. The data from nonorthopedic procedures suggest that disposable drapes resist bacterial passage and reduce the risks of subsequent SSIs. Impermeable barriers should be used regardless of whether disposable or nondisposable drapes are used. Level of Evidence: Limited Delegate Vote: Agree: 90%, Disagree: 3%, Abstain: 7% (Super Majority, Strong Consensus) Rationale: Surgical drapes act as a barrier to prevent the contamination of the surgical field during a procedure. They are used to isolate the prepared surgical field from the nonsterile, nonsurgical area. Reusable drapes are made of a woven material and are laundered and sterilized between procedures. In contrast, disposable drapes are usually made of nonwoven material and are disposed of after each operation. Various physical properties of drapes and surgical conditions can affect the bacterial permeability of drapes. For example, it is known that there is increased bacterial passage when drapes are made wet by normal saline or blood [73,74]. Disposable drapes have been shown to decrease rates of bacterial passage, even when made wet by normal saline; however, this decreased bacterial transmission does not clearly indicate decreased risks of SSIs/PJIs [75,76]. We performed a systematic review using PUBMED, Medline, Web of Science, Embase, Google Scholar, and the Cochrane Library of studies in English. We included journal articles, communications, and conference proceedings. Unfortunately, there is a paucity of studies relating specifically to orthopedic surgery on this topic. Randomized controlled trials in cardiac surgery and general surgery demonstrated no statistically significant differences in infection rates between the 2 types of drapes [77,78]. However, a different prospective randomized study of 102 reconstructive breast surgeries demonstrated a statistically significant lower rate of infection 30 days after surgery in the disposable drape cohort (0 vs. 12%) [79]. The current literature on this topic is inconclusive, and there are no studies involving orthopedic or spine surgery patients; future research efforts should be focused on this topic.
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W http://www.hsnph.org.au[cid:image001.jpg@01D46C86.4CDB6090]
Hi Emma
A large Consensus forum by Orthopods in 2013 did not find type of drape an issue:
Question 29: What type of draping should be used (reusable or disposable)?
Delegate Vote: Agree: 90%, Disagree: 6%, Abstain: 4% (Strong Consensus)
Two RCTs were conducted comparing reusable and disposable drapes and gowns in coronary artery bypass graft and elective abdominal surgery, with SSI as their main outcome. None of these studies found differences between the two types of gowns and drapes.155, 156
The whole document can be found here: https://www.efort.org/wp-content/uploads/2013/10/philadelphia_consensus.pdf
Not sure it will be easy to convince them…
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W http://www.hsnph.org.au[cid:image001.jpg@01D46C86.4CDB6090]
Dear Brains Trust,
In line with AS4187 we are trying to get linen out of our lives in Theatres!! I’m nearly there except for Orthopaedics…It seems to be in joint theatres where they still like to use linen as a base cover to ensure asepsis before they place on the impervious disposable drapes.
My two questions are;1. Has anyone found a disposable drape that potentially handles like linen?? – we have trialled various brands but the Orthopods have not found one they like – you may need to privately email me with this info re company names ect
2. Does anyone have any recent literature I can give to our Linen loving Surgeons re why not to use it for surgical procedures? !! I realise it’s seen as a foreign body – lint ect but need some firm evidence to assist with our hopeful conversion!
So appreciated & lovely to see you all at the Conference!!
Emma Trippe
Infection Control Consultant
[cid:image001.png@01D4889F.C7DDDA90]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.auHospitality | Healing | Stewardship | Respect
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Hi Emma
A large Consensus forum by Orthopods in 2013 did not find type of drape an issue:
Question 29: What type of draping should be used (reusable or disposable)?
Delegate Vote: Agree: 90%, Disagree: 6%, Abstain: 4% (Strong Consensus)
Two RCTs were conducted comparing reusable and disposable drapes and gowns in coronary artery bypass graft and elective abdominal surgery, with SSI as their main outcome. None of these studies found differences between the two types of gowns and drapes.155, 156
The whole document can be found here: https://www.efort.org/wp-content/uploads/2013/10/philadelphia_consensus.pdf
Not sure it will be easy to convince them…
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W http://www.hsnph.org.au[cid:image001.jpg@01D46C86.4CDB6090]
Dear Brains Trust,
In line with AS4187 we are trying to get linen out of our lives in Theatres!! I’m nearly there except for Orthopaedics…It seems to be in joint theatres where they still like to use linen as a base cover to ensure asepsis before they place on the impervious disposable drapes.
My two questions are;1. Has anyone found a disposable drape that potentially handles like linen?? – we have trialled various brands but the Orthopods have not found one they like – you may need to privately email me with this info re company names ect
2. Does anyone have any recent literature I can give to our Linen loving Surgeons re why not to use it for surgical procedures? !! I realise it’s seen as a foreign body – lint ect but need some firm evidence to assist with our hopeful conversion!
So appreciated & lovely to see you all at the Conference!!
Emma Trippe
Infection Control Consultant
[cid:image001.png@01D4889F.C7DDDA90]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.auHospitality | Healing | Stewardship | Respect
Continuing the Mission of the Sisters of the Little Company of MaryThis email is confidential and may be subject to copyright and legal professional privilege. If this email is not intended for you please do not use the information in any way, but delete and notify us immediately. For full copy of our Privacy Policy please visit
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Hi Jenny
Queensland Health have a module on endoscope reprocessing: http://www.chrispqld.com/endoscopy/default.htm
The Victorian Dept of Health have a freely available endoscope reprocessing competency tool. https://www2.health.vic.gov.au/about/publications/policiesandguidelines/Endoscopic-Reprocessing-Competency-Tool
My recommendation would be that any staff reprocessing endoscopes should fully compete an endoscope reprocessing module, and also annually complete a competency.
Cheers
MichaelMichael Wishart, CICP-E
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0] [cid:image002.png@01D47697.F1F93F50]
P Please consider the environment before printing this emailTo all,
I would appreciate a copy of a competency for cleaning and processing flexible endoscopes.
Is there a link?
Thanks for your helpJenny Bourne
Education & Environment Coordinator
169 Seventeen Mile Rocks Road Oxley QLD 4075
Phone 0449 199 223
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Hi Sharon
I think she means contact screening. This is what the Commonwealth document says:
4.9. Screening Close contacts or roommates of the colonised or infected patient who were in the same bay/room for longer than 24 hours with an affected patient in the 28 days prior to first identification should be screened for C. auris colonisation. Newly identified colonised patients should be isolated and managed as in 4.4 Managing transmission above. The aim is to prevent the spread of C. auris to those most at risk of becoming infected. If contacts have already been discharged then the facility should provide consumer information to the patient and, where able, contact the patient$B!G(Bs general practitioner. All healthcare facilities should have a system for identifying patients at re-admission or outpatient attendance who have previously isolated the organism or who are identified as a contact but have not been cleared of colonisation. Similarly, patients who have been inpatients of a hospital in another country which has reported multiple cases and/or transmission should be identified at presentation and screened. Screening samples should be collected on three consecutive days. Screening should be undertaken promptly. Screening performed whilst the patient is on antifungal medication or had been treated within the preceding 7 days or who had been exposed to topical antiseptic washes in the preceding 48 hours must be repeated when such factors no longer apply before a negative result can be considered valid. Screening should consist of taking swabs from both axilla and both sides of the groin which can be pooled and processed as the one sample by the laboratory. If screening a patient who is known to be previously colonised or infected with C. auris, it is recommended that the original site of colonisation as well as axilla/groins are sampled. The laboratory must be informed that C. auris is under investigation.
From https://www.health.qld.gov.au/__data/assets/pdf_file/0028/722827/Candida-auris-guideline.pdf
Cheers
MichaelMichael Wishart, CICP-E
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0] [cid:image002.png@01D475D7.7EDD5580]
P Please consider the environment before printing this emailJust wondering what cohort of people would you screen?
I have had a look on CDC and there seems to be only advice for those who have tested positive and their contacts.
Cheers,
Sharon Deen
Infection Control Nurse[http://www.ramsayhealth.com/~/media/Images/email/email-RHC-logo.jpg]
Peel Health Campus
Infection Control
Phone:08 9531 8570
Fax:
08 9531 8409
Email:
DeenSharon@ramsayhealth.com.au
Web:
Address:
110 Lakes Road, Mandurah WA 6210
[http://www.ramsayhealth.com/~/media/Images/email/email-social-media2.jpg]
Dear All, just updating our MRO policy with reference to C.auris – which sites are we meant to screen ? I$B!G(Bve read a lot of literature but there is nothing specifically outling the testing sites.
I$B!G(Bm thinking;
Groin/ perineum &
Additional specimens should be obtained as follows: (if relevant)
$B!|(B Urine – voided or catheter urine
$B!|(B Skin lesions and wound swabs
$B!|(B Swabs of sites of catheters or other skin penetrating devicesAprreciate your advice
Emma Trippe
Infection Control Consultant
[cid:image001.png@01D475D3.A2307160]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.auHospitality | Healing | Stewardship | Respect
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Hi Jayne
Can I ask for what reason you would want to ‘rest’ an OT after an MRO or ‘dirty’ case? Once appropriate cleaning has occurred, you can safely use the OT for another case after surfaces are dry.
The only times we would delay the start of the next case after cleaning is either in the case of a known or suspected airborne pathogen like measles, or to allow latex particles to settle prior to a latex allergic case.
I am not sure what you are trying to achieve with a ‘rest’ for environmental contamination that has been appropriately cleaned. Maybe I am missing something, though?
Cheers
MichaelMichael Wishart, CICP-E
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0] [cid:image002.png@01D475BD.F9AE85A0]
P Please consider the environment before printing this emailDear Brains Trust,
I am sure I have asked this question before?? Regarding resting theatre following a dirty/MRO case.
We are currently debating this issue again, does anyone rest the theatre after the clean has taken place and for how long? Where possible the cases are last on the list, but we appreciate that not all MRO cases/dirty cases can go last on the list.
Advise on this matter would be greatly received.
Many thanks in advance
Jayne O’Connor RN ,BSc.,Inf.Cont
IPC Co-Ordinator
Sydney Adventist Hospital | 185 Fox Valley Road, Wahroonga, NSW 2076p: +61 2 9487 9732 | f: +61 2 9473 8052 | m: +61 0406 752685 | e: jayne.oconnor@sah.org.au
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Oh, and we didn’t ‘install’ them. Only portable fans are allowed. Try and regulate use to clinically appropriate only, not just run them all the time.
Cheers
MichaelMichael Wishart, CICP-E
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0] [cid:image002.png@01D46AB9.EE8AE100]
P Please consider the environment before printing this emailHi Jane
We changed our policy a couple of years ago to state that only bladeless fans could be used in clinical areas. We had so many problems with dust on blades, so we got rid of the blades!
Staff report the bladeless fans are just as good for cooling patients, and even ICU are happy with them. More expensive to purchase initially, but better than no fans at all, so the clinicians say.
I’m not going to get into the argument about dispersal of bugs via fan air currents in multi-bedded rooms and ICU…. sometimes I think you just need to put the individual patient first for a change. They may be fighting words, I know, but sometimes some air cooling is really what a patient needs in the short term.
My opinion, anyway.
Cheers
MichaelMichael Wishart, CICP-E
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0] [cid:image002.png@01D46AB9.AEC754E0]
P Please consider the environment before printing this emailDear Brains Trust,
Fans!!!!!, could I please ask what the general consensus is on the use of Fans in clinical environment, in particularly in the ICU setting.
We didn’t install them in our new build for all the IPC reasons of spreading bugs, dust collectors etc. however I have been asked today if we could install them because the benefits to the patient is ‘huge’?! My immediate response is NO but would like to know what others are doing.
Many thanks
Jayne O’Connor RN ,BSc.,Inf.Cont
IPC Co-Ordinator
Sydney Adventist Hospital | 185 Fox Valley Road, Wahroonga, NSW 2076p: +61 2 9487 9732 | f: +61 2 9473 8052 | m: +61 0406 752685 | e: jayne.oconnor@sah.org.au
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Hi Jane
We changed our policy a couple of years ago to state that only bladeless fans could be used in clinical areas. We had so many problems with dust on blades, so we got rid of the blades!
Staff report the bladeless fans are just as good for cooling patients, and even ICU are happy with them. More expensive to purchase initially, but better than no fans at all, so the clinicians say.
I’m not going to get into the argument about dispersal of bugs via fan air currents in multi-bedded rooms and ICU…. sometimes I think you just need to put the individual patient first for a change. They may be fighting words, I know, but sometimes some air cooling is really what a patient needs in the short term.
My opinion, anyway.
Cheers
MichaelMichael Wishart, CICP-E
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
[cid:image001.png@01D01926.61F1C2B0] [cid:image002.png@01D46AB9.AEC754E0]
P Please consider the environment before printing this emailDear Brains Trust,
Fans!!!!!, could I please ask what the general consensus is on the use of Fans in clinical environment, in particularly in the ICU setting.
We didn’t install them in our new build for all the IPC reasons of spreading bugs, dust collectors etc. however I have been asked today if we could install them because the benefits to the patient is ‘huge’?! My immediate response is NO but would like to know what others are doing.
Many thanks
Jayne O’Connor RN ,BSc.,Inf.Cont
IPC Co-Ordinator
Sydney Adventist Hospital | 185 Fox Valley Road, Wahroonga, NSW 2076p: +61 2 9487 9732 | f: +61 2 9473 8052 | m: +61 0406 752685 | e: jayne.oconnor@sah.org.au
http://www.sah.org.au[SAH_EntitySignature2017][cid:image002.png@01D46ABE.6E92C530]
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is prohibited. If you have received this message in error please notify the sender immediately, then destroy the original message.
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Hi Cath
We use a PICC insertion kit in ICU, Emerg and Radiology. All other lines (PIVC, CVC, Hickman, etc) dont come in a specific insertion pack.
It is good for standardisation, as we can, for example, ensure our recommended skin prep, dressing and stabilisation devices are standardised for all PICC insertions.
As far as reduction of PICC CLABSII are concerned, we have a low rate anyway, and most CLABSI are in longer indwelling devices vs soon after insertion, so its debatable how much impact insertion technique has on these infections. We have been using these kits for about 5 years, with no real change in overall PICC CLABSI rate.
Cheers
MichaelMichael Wishart, CICP-E
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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P Please consider the environment before printing this emailFrom: ACIPC Infexion Connexion On Behalf Of Cathryn Murphy
Sent: Tuesday, 23 October 2018 8:53 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: VAD Insertion KitsDear All
I am investigating use of pre-packaged kits for vascular access device insertion. Do any of your organisations use them. Or perhaps only some wards/units use them.
If so other than standardisation what otther benefits have you seen? ?any change of CLABSI or CRBSI?
What are the essential items that such a kit should include?
Also, if your organisation doesn’t use them, what are some of the reasons (other than cost and/or individual user preference?
I would be very grateful for any responses either here or by direct email.
A few years ago a paper from Melb included insertion kits as part of a bundle. They reported reductions in VAD-related infections.
I also think that WA has widespread kit use.
Many thanks
Cath
Cathryn Murphy RN Bach. Photog. MPH. PhD. CIC
Chief Executive Officer
Infection Control Plus Pty Ltd
http://www.infectioncontrolplus.com.au
Ph:+61 428 154 154______________________________________________________________________
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Thanks Terry
I think the issue here is rooms used for multiple purposes. For example, we do bronchoscopies here in a procedure room that is also used for ERCP’s. So, the question then becomes: should we consider a dual mode air handling unit (switchable for both positive and negative pressure – which is not really recommended these days), or should we choose one or the other and potentially limit use of the procedure room?
In my view, it’s about balancing risks. If you are doing diagnostic bronchoscopies on patients that might have TB, how likely is this to actually be TB? Is it more likely to be atypical mycobacterial disease?
What we try and do here, is avoid doing bronchoscopies on KNOWN TB patients in our unit. Because we do not have negative pressure rooms. And the majority of our ?TB patients tend not to be confirmed as TB. On the odd occasion they do, our processes for these patients normally would have minimised transmission risks to others (eg all staff wear N95 masks, patient recovered in procedure room not general recovery bay). Our biggest issue normally is if they are an outpatient, how long did they share a waiting room with other patients?
Yes, the guidelines are clear for procedure rooms used for patients likely to have or known to have pulmonary TB, but it gets greyer after that, in my view. Knowing the demographic profile of your patients is very important in this discussion, I believe.
Cheers
MichaelMichael Wishart, CICP-E
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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P Please consider the environment before printing this emailHi Vicki,
The AusHFG are easy and free to access.
This link will take you to the room data sheet for an endoscopy procedure room and you will see it clearly states negative pressure required for broncoscopy.
https://aushfg-prod-com-au.s3.amazonaws.com/download/RDS_ENPR_1.pdf
Kind Regards
Terry McAuley
Director
MSc Medical Device DecontaminationPO BOX 2249, Greenvale VIC Australia 3059
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Hi All,
We are currently in the process of a new build & I have been notified that there is no inclusion of negative pressure air conditioning within the new Endoscopy unit.I have been informed that Australian Health Facility Guidelines do not require negative pressure within endoscopy units, despite bronchoscopies revealing TB in some cases
Is there any Endoscopy Units that have negative pressure incorporate in either their stand-alone units or those that are attached ( via corridors ) to their theatres
Many thanks
Vicki Denyer
Vicki Denyer
Clinical Nurse Consultant | Infection Prevention and Control
Infection Control Unit Lismore Base Hospital
‘ 02 6620 2385 Fax: 02 66 202287
* vicki.denyer@health.nsw.gov.auInfection Prevention & Control is Everyone’s Business
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Hi Mary
I wasnt sure how much historical wives tale was in this recommendation not to use CHG and PI together, so did a quick lit search. Most interesting article is a systematic review of cationic agents (CHG) and anionic agents (?PI not quite clear to me), and the possible issue of degradation of antiseptic actions.
http://jsurgdermatol.com/index.php/JSD/article/view/21
Conclusion was: Although limited evidence linking CHG incompatibility and anionic agents exists, clinicians should carefully consider the nature of topical agents used if CHG is concurrently applied. Increased awareness of CHG incompatibility may result in better antibacterial activity thus ensuring optimal patient management.
Interesting question!
Cheers
MichaelMichael Wishart, CICP-E
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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P Please consider the environment before printing this emailFrom: ACIPC Infexion Connexion On Behalf Of Mary Willimann (Subiaco)
Sent: Thursday, 27 September 2018 11:51 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: Surgical site skin preparationDear Marg
Thanks so much for your help.
I have checked the guidelines and although there is a lot of discussion around which one to use (either CHG or PVP-I, with or without alcohol), I cant see much in regard to using both CHG and PVP-I together.
The ACORN standards state: The same antimicrobial agent shall be used for all phases of the patients skin preparation, to ensure full residual benefit and consistent action, but I have been unable to locate any reasons/evidence to support this further.
Again many thanks for any advice.
Regards
MaryMary Willimann CICP-E| Manager Infection Control
St John of God Subiaco Hospital
T: (08) 9382 6871 | M: 0439993772 | F: (08) 9382 6785 | E: Mary.Willimann@sjog.org.au
12 Salvado Road Subiaco WA 6008 | PO Box 14, Subiaco WA 6904
http://www.sjog.org.au/subiaco | Twitter | LinkedIn | Facebook[cid:image002.png@01D45647.91219170]
We acknowledge the Traditional Owners of Country throughout Australia and recognise their continuing connection to land, waters and community.
We pay our respect to them and their cultures and to Elders past and present.From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Marg Jennings
Sent: Thursday, 27 September 2018 6:39 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Surgical site skin preparationDear Mary check the national guide first. From first principles look at the pH on each and they ought be the same to avoid neutralization. what you get from chlorhex is quick and sustained activity against a narrower range of bacteria ( and some viruses) while with iodine you get a broader range of activity but it’s slower to act. That may be why the surgeons are asking for it but do refer to the national guidelines. The question to be asked is ” what is the aim of skin disinfection at the surgical site” ie what microorganisms are you requiring to disinfect”. This is important because not all anatomical sites have the same flora.
Margaret Jennings
0404088754
Marjen education services
Microbiologist and infection control educator/ consultant to office based practiceSent from my HTC on the Telstra Mobile network
—– Reply message —–
From: “Mary Willimann (Subiaco)” <Mary.Willimann@SJOG.ORG.AU>
To: <ACIPCLIST@ACIPC.ORG.AU>
Subject: [ACIPC_Infexion_Connexion] Surgical site skin preparation
Date: Wed, Sep 26, 2018 6:19 PMDear Brains Trust
I have recently been asked by some of our surgeons if it is acceptable to use both alcohol based CHG and povidone-iodine solutions for surgical site skin prep; i.e. use alcoholic povidone-iodine first, allow to dry and then repeat with 2% CHG in 70% alcohol. I have always been of the understanding that this should not occur due the antiseptic effects of CHG and PVP-I being neutralised by each other, but cant seem to find enough evidence to support this. Would anyone be able to assist?
Many thanks
Mary
Mary Willimann CICP-E| Manager Infection Control
St John of God Subiaco Hospital
T: (08) 9382 6871 | M: 0439993772 | F: (08) 9382 6785 | E: Mary.Willimann@sjog.org.au
12 Salvado Road Subiaco WA 6008 | PO Box 14, Subiaco WA 6904
http://www.sjog.org.au/subiaco | Twitter<http://twitter.com/sjog_healthcare> | LinkedIn<http://www.linkedin.com/company/st-john-of-god-health-care> | Facebook<http://facebook.com/StJohnOfGodSubiacoHospital>
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Hi Fiona
* Do you screen or not screen?
* Yes, we screen as per the Queensland Health guidelines (link as posted by Meredith
* If you screen, what patient population is screened?
* ICU – weekly, all cardiothoracic patients pre-op, direct transfers from other hospitals, those with an overnight hospital stay in the past six weeks, or with a past history of VRE.
* If you have stopped screening – Why?
* Not applicable
* If you have stopped screening what is the impact on VRE infection rates?
* Not applicable
* How are VRE positive patients managed?
* As per QHealth, with single room and contact precautions in wards. We also have specific precautions in procedural areas simply because we do not yet routinely clean with disinfectants.
Hope this helps, but I doubt it! 🙂Cheers
MichaelPS Apologies for any confusion to date over my multiple email addresses… have changed to this one now for ACIPC membership and this list.
Michael Wishart, CICP-E
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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P Please consider the environment before printing this emailDear Brains Trust,
Our facility recently underwent accreditation and there was surprise expressed at our ongoing screening of patients for VRE, with verbal reports that a number of hospitals no longer routinely screen for VRE.
I would like to know what people are doing in their facilities
* Do you screen or not screen?
* If you screen, what patient population is screened?
* If you have stopped screening – Why?
* If you have stopped screening what is the impact on VRE infection rates?
* How are VRE positive patients managed?Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control________________________________
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MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return email, delete the Email, and do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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