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Michael Wishart

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  • Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Helen

    We have this statement in our IV infusion care policy:

    Intermittent disconnection of administration sets used for continuous infusions, is not recommended due to the increased risk of infection through manipulation of the hub and occlusion due to reflux of blood into the cannula tip when the line is disconnected; Intermittent administration sets should be discarded after each use if disconnected

    This is based on the QLD iCARE guidelines (https://www.health.qld.gov.au/__data/assets/pdf_file/0025/444490/icare-pivc-guideline.pdf ).

    Hope this helps.

    Cheers
    Michael

    Michael Wishart, CICP-E
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
    P Please consider the environment before printing this email

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Helen Scott
    Sent: Wednesday, 21 February 2018 11:31 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: [ACIPC_Infexion_Connexion] Discouraging disconnection of IV fluids for showering patients ad going to X-ray etc.

    Hi all,

    Does anyone have any evidence or best practice guidelines for the above please?
    Where I am currently working, this happens all the time, both with PIVCs and CVADs (rather worrisome).
    Sometimes these giving sets are hanging around, disconnected for several hours. And theres the risk of them being forgotten.
    But the biggest problem is the staff capping the end and thinking this is ok. Im not seeing good hand hygiene for a start but surely theres a risk of contamination once the giving set is disconnected from the the cannula? And does anyone have anything around how long IV fluids can sit in the giving set for once disconnected?
    I have found a guideline from 2009 from the Royal Hospital for Women, but its not quite specific enough.

    Thanks in advance,
    Helen Scott, ICP.
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    in reply to: immunisation electronic record #74315
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Moderator note:

    Can I please remind subscribers to send specific information about specific commercial products directly to the email of the person requesting this information, rather than to the list? (ie do not use ‘reply’ or ‘reply all’ which includes the list email address). ACIPC policy is to not post information about commercial products where possible (eg it is not essential to the nature of the question). ACIPC values the relationship it has with commercial partners.

    If list subscribers want a more detailed list of products which have been sent to the person requesting information, they should request this directly via the email of the person originally posting the question, not through the list.

    Thanks you all for your understanding and support for ACIPC Infexion Connexion.

    Cheers
    Michael Wishart
    ACIPC Infexion Connexion Administrator

    Michael Wishart, CICP-E
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
    P Please consider the environment before printing this email

    Hi all
    Just wondering if anybody is able to advise me on an IT system for recording employees immunisation status and ongoing immunisations whilst they are employed by our facility.
    Ideally it would then be able to provide a printout which could be given to the employee when leaving.
    Our immunisation nurse has been unable to find a system .

    Cheers
    Heather

    Heather Gill (cert Inf Control, MACN)
    Infection Prevention and Control Practitioner.
    Theatre Nurse Unit Manager
    CastertonMemorial Hospital
    63-69 Russell St
    Casterton 3311
    Victoria
    Ph. 03 55542555
    heather.gill@cmh.org.au
    [cid:image001.png@01D2E055.60270E60]

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    in reply to: Re: Environmental Cleaning #74309
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    [Posting on behalf on Marija – Moderator]

    Can you attach this and send it out as an adjunct to my previous ACIPC post as the embedded picture didn’t work.

    Kind Regards

    Marija Juraja |Nurse Unit Manager -CALHN Infection Prevention & Control Unit|
    Division of Acute Medicine (RN, GCNS Inf Ctrl, CICP-E)
    The Royal Adelaide Hospital| Central Adelaide Local Health Network
    8E Rm256 Port Road, ADELAIDE 5000
    The Queen Elizabeth Hospital | Central Adelaide Local Health Network
    Level 8 Tower Building | 28 Woodville Road, WOODVILLE SOUTH 5011
    t: +61 8 7074 2810 (RAH) 8222 7588 (TQEH)| f: +61 8 7074 6228 (RAH) +61 8 8222 6461 (TQEH) | m: 0466 379 821|DX: 465432 (TQEH) |e:marija.juraja@sa.gov.au |web: IPCU Intranet Site and Resources
    Adjunct Clinical Lecturer | University of South Australia | Division of Health Sciences

    Michael Wishart, CICP-E
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
    P Please consider the environment before printing this email

    Hi Janine,

    The Centers for Disease Control. Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, MMWR Recommendations and Reports. 2005; 54 (17):1-141 has a good table.
    It depends on the air exchanges as to when its free of 99.9% of contaminants.
    With 12 to 15 air exchanges we say 30 minutes before its safe for staff to enter and clean without wearing a mask.

    [cid:image001.gif@01D3A1C1.C6529FA0]

    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
    [cid:image002.jpg@01D3A1C1.C6529FA0]

    Hi,

    Just a Friday afternoon question:

    Can anyone provide me with evidence in regards to how long we should leave a room prior to cleaning an airborne precaution room

    o In our local procedure we have 2 hours

    However, I thought that had been decreased to 30minutes

    o I’m aware of the airchanges etc in our negative pressure rooms but this query has come from our Emergency Department.
    Any help greatly appreciated

    Regards

    Janine Egart
    Clinical Nurse Consultant – DDHHS
    Clinical Governance Unit
    p: 07 46166206 | m: 0400704118 (SD: 1947)
    a: Pechy Street, Toowoomba, Qld 4350
    e: Janine.egart@health.qld.gov.au | w: Darling Downs Hospital and Health Service

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    in reply to: TOE probe storage cupboard #74218
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Linda

    The storage requirements for TOE probe and other non-lumened probes for invasive procedures is still a bit unclear at this stage. As Terry mentioned, they are not a lumened device, so do not have the same requirements as lumened devices for storage.

    The rationale for HEPA air filtration of lumens of lumened devices is to prolong storage and remove the need for reprocessing again before use.

    How long non-lumened devices can be stored for before they need reprocessing before use of a patient is really dependent on the storage method, not the air flow (unlike lumened scopes and probes). If they are stored back in their cases, it is good practice to reprocess them again before use. If they are stored dry in a closed hanging cabinet, there is no need for reprocessing after ‘prolonged’ storage (eg 7 days or more). This is not well documented yet in either CSSD guidelines or ultrasound guidelines (like ASUM guidelines). We use a reference in a UK document from 2011 to support our assertion that TOE probes do not need reprocessing if stored in a closed cabinet.

    Hope this helps.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
    P Please consider the environment before printing this email

    Hi

    Just seeking clarification as to whether the storage cupboard for a processed TOE probe requires HEPA filtration.

    Regarding storage, the current ACIPC / ASUM guidelines (2017) state :

    “after cleaning, all transducers must be stored in an appropriate environment to protect from environmental contamination (AS/NZS4187:2014, Table 5.1). It is recommended that a specific cabinet is used, but if this is not available the minimum standard recommended is a clean disposable cover applied to the transducer to mitigate risks from environmental contaminants”

    So I gather as HEPA filtration is not mentioned, that it is not a requirement. Is my understanding correct?

    Kind Regards

    Linda McCaskill
    Infection Control Manager
    Ashford Hospital
    55 Anzac Highway, Ashford, SA 5035
    t: 8375 5209 (external) or ext 4209 (internal) e: linda.mccaskill@acha.org.au
    Please note I work Monday – Thursday

    [clean-hands-day-WHO]

    .

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    in reply to: Re: infection control courses in Australia #74188
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Glenys

    There is a list of approved courses on the ACIPC Credentialling page (approved for ACIPC credentialling applications). Not sure how exhaustive this list is for courses available currently.

    https://www.acipc.org.au/credentialling/

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
    P Please consider the environment before printing this email

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of sonja wegert
    Sent: Tuesday, 5 December 2017 8:51 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: infection control courses in Australia

    Hi Glenys,

    I know Adelaide University is doing Grad Cert in IC and JCU is doing IC courses as Ive spoken to the tutor during the ACIPC conference.
    To my knowledge the Flinders Medical Centre and the Alfred running annual courses over a couple of days, I believe.

    Regards
    Sonja

    Sonja Wegert | Infection Control Practitioner (ICP)
    Infection Prevention and Control Unit | Central Australia Health Service
    Northern Territory Government
    Alice Springs Hospital, Gap Rd, Alice Springs
    GPO Box 2234, Suburb, NT Postcode
    p … 08 89517977
    e … sonja.wegert@nt.gov.au http://www.nt.gov.au/health

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Peta-Anne Zimmerman
    Sent: Tuesday, 5 December 2017 8:14 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: infection control courses in Australia

    Hi Glenys
    I don’t have a complete list but there is the Graduate Certificate and the Master of Infection Prevention and Control at Griffith University.

    Kind regards
    Peta-Anne

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    On 4 December 2017 at 16:53, Glenys Harrington <infexion@ozemail.com.au> wrote:
    Hi All,

    Im often asked for details of infection control course (i.e. certificate, graduate diploma, masters) in Australia.

    Does anyone have a list?

    If not Im happy to compile a list and share on infexion-connexion if colleagues can send me through the details or links.

    Many thanks in anticipation.

    Glenys

    Glenys Harrington
    Infection Control Consultancy (ICC)
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    Melbourne
    Australia, 3004
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    in reply to: Re: Toilet lids #74178
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Our hospital architect raised an interesting point. We had disabledaccess toilets installed in our new day oncology unit. With these toilets, they had to have a certain backrest fitted. We found that toilet lids wouldnt stay up on these toilets because of the back rest, but the oncology staff were adamant that the toilets in the unit had to have lids. So, even though the toilets are now non-compliant for disabled access, the back rest was removed as it was considered the risk of plume contain chemotherapeutic agents was greater than the risk of not having a back rest.

    Just another piece in this puzzle to ponder.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Juraja, Marija (Health)
    Sent: Monday, 4 December 2017 3:22 PM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: Toilet lids

    Hi Leah,

    We have toilet lids in both our newly built hospital and our sister hospital TQEH on all toilets, including bariatric.
    The rationale we used for retaining them was exactly that with regard to plume and risk of transmission.
    The commode/shower chair we use allows for the chair to sit over the toilet without causing any issues to the lid.
    Its being selective and trying out the chair and pan base to make sure they fit so that you can still use the lid once the chair is pulled away.
    Several articles below that highlight the potential for cross contamination from the plume when flushing.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4692156/
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4666014/
    https://www.ncbi.nlm.nih.gov/pubmed/23040490
    https://www.ncbi.nlm.nih.gov/pubmed/22137761

    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
    [cid:image002.jpg@01D36D17.DBECC900]

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terri Cripps (SCHN)
    Sent: Monday, 4 December 2017 12:12 PM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: [ACIPC_Infexion_Connexion] Toilet lids

    I think that the lack of toilet lids is due to them being attributed to increased falls in the toilet when the patient is opening and closing the lids. The act of opening and closing the lids cause the patient to become unsteady and lead to falls. So to reduce the falls risk, the lids have been removed.

    It also is easier to get commodes over the toilet if there is no lid.

    I agree with you all about the plume when flushing be of concern but it seems that falls outweigh infection prevention and control issues.

    Interesting point of discussion.
    Thanks,
    Terri Cripps | Clinical Nurse Consultant – Infection Prevention and Control | SCHN Medical Diagnostics and HIV/Immunology
    t: (02) 9382 1876 | f: (02) 9382 2084 | e: TERRI.Cripps@health.nsw.gov.au | w: http://www.schn.health.nsw.gov.au
    p: 47140
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    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Kelly Barton
    Sent: Monday, 4 December 2017 11:49 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: Toilet lids

    I think the lack of toilet lids is very widespread. After advising staff to put the lid down to flush during an outbreak I was advised there were no lids. I have been taking note when I am in other facilities in the last few years and have found that most places I have seen do not have them. Considering what we now know about plume and MROs becoming more difficult to treat I am surprised this has not come up more often. Current design of over toilet chairs and equipment would make it difficult for lids to close for flushing.

    I have seen toilet systems overseas where there is a vacuum system of evacuating contents with minimal water used. I would assumes that there would be less plume generated with these, but have not seen any research/study on them.

    Keen to hear of other approaches also.

    Kelly

    Kelly Barton
    Infection Prevention & Control Officer
    Monday- Friday
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    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Van Someren, Leah M (THS)
    Sent: Monday, 4 December 2017 10:02 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Toilet lids

    Hi everyone,

    We are currently building a 10 storey hospital here in Hobart. The redevelopment team have recommended against installing lids on the toilets.

    The Infection Prevention and Control team have recommended that all toilets have lids. We have based this decision on the evidence of toilet plume and the potentially increased risk of transmitting pathogenic organisms through environmental contamination.

    We are interested in the approach taken in other hospitals.

    If you are working in a newly developed hospital that has recommended toilets lids on all toilets we would particularly like to hear from you including what influenced your decision making.

    Furthermore, we have heard that there are a number of new hospitals built or being built around Australia where toilet lids are either not installed, or installed only in specific locations. If you are working in a facility that did not recommend installing toilet lids in all locations, can you please share your rationale for this?

    Thank you in advance.

    Leah

    Leah Van Someren
    Clinical Nurse Consultant
    Infection Prevention and Control Service

    THS- Southern Region
    PH: 61662704
    Mobile: 0417 986 084
    Email: leah.vansomeren@ths.tas.gov.au
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    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Thanks Glenys, very useful.

    According to one of our perfusionists, Minncare has been available in Australia as a ‘cleaner’ (not TGA registered) for dialysis machines and HCUs for years now. It seems LivaNova is now getting TGA approval for its use as a disinfectant in their machines, so it has been withdrawn from the market until approval is obtained.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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    Dear All,

    Find below a link to the TGA update on Infections associated with heater-cooler devices

    https://www.tga.gov.au/alert/infections-associated-heater-cooler-devices

    In summary:

    A total of six Australians have been confirmed with Mycobacterium chimaera infections following heart surgery involving heater-cooler devices

    The confirmed cases of infection are associated with contaminated Stckert Heater-Cooler 3T heater-cooler units that were manufactured before September 2014

    Testing of Stckert 3T Heater-Cooler System (3T) devices by hospitals in Australia has identified that 25% of these devices have tested positive for the Mycobacterium chimaera organism or other organisms. All devices that tested positive were manufactured prior to September 2014

    The TGA previously published advice regarding the potential for water within heater-cooler units to become contaminated with bacteria, most commonly non-tuberculous mycobacterium (NTM). There is evidence to suggest that patients are infected when bacteria in the device’s water tank becomes airborne

    The latest recall for production correction by LivaNova, published on the TGA Recall actions web site on 27 October 2017, is to install a modification that reduces the risk of potential patient infection by preventing dispersion of contaminated aerosols in the operating room:

    o This correction will be implemented by onsite modification of units currently in use

    o The servicing will be undertaken in the field by LivaNova service personnel or a local agent

    Although the potential for infection is less likely when the 3T device’s water system is maintained according to the current Instructions for Use (IFU), the disinfectant required to undertake the maintenance is not currently included in the appropriate category of the Austrlian Register of therapeutic Goods (ARTG)

    Therefore, the TGA has suspended the supply of new 3T devices until the disinfectant can be suitably accessed to ensure adequate maintenance

    o The suspension of the 3T’s device’s ARTG entry does not preclude LivaNova from undertaking the modifications to existing 3T devices

    o The 1T devices will be replaced with 3T devices as the 1T devices are unable to be modified to prevent aerosol dispersion

    I contacted Livanova PTY LTD who advised that the disinfectant going through the assessment process for registration with the TGA is a product called Minncare Cold Sterilant (22% Hydrogen peroxide w/w, Peracetic acid 4.5%). I have attached the safety data sheet.

    The registration assessment process may take some months.

    If you need more information you can contact Livanova PTY LTD and ask for the Service Department
    https://www.whitepages.com.au/livanova-australia-pty-limited-11933816/toowong-qld-11933814B

    regards

    Glenys

    Glenys Harrington
    Infection Control Consultancy (ICC)
    P.O. Box 6385
    Melbourne
    Australia, 3004
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    in reply to: UV Disinfection & TGA Requirements #74143
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Cath

    You have to ask the question “is this a therapeutic good?” to decide if it needs to be listed on the ARTG by TGA. For disinfectants, it’s about claims made about the disinfectant.

    See the TGA website here: https://www.tga.gov.au/regulation-disinfectants-and-sterilants

    In my opinion this is a bit of a minefield in which the actual disinfectant sponsors and manufacturers get confused in, so that makes it hard for health professionals to determine what is necessary.

    Any disinfectant with claims should be TGA approved for any application, but there are some exclusions at the bottom of the page (refer to the actual regulation for completeness).

    Hope this helps in some way. If in doubt, best advice is to contact the TGA.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
    P Please consider the environment before printing this email
    [https://www.safetyandquality.gov.au/wp-content/uploads/2017/11/AAW-2017-Signature-block.jpg]

    Dear ACIPC Members

    I am seeking information and responses to a series of questions regarding UV disinfection. I am not sure what the TGA’s regulatory requirements are and would be grateful for any advice.

    Advance thanks.

    When does a device require TGA approval?

    What are the TGA requirement for UV disinfection?

    Can a disinfection device be used outside of healthcare facilities without TGA approval?

    Cath

    Cathryn Murphy RN B. Photog MPH PhD CIC
    Chief Executive Officer & Creative Director
    Infection Control Plus Pty Ltd
    QLD, Australia

    E: Cath@infectioncontrolplus.com.au
    M: +61 428 154154
    W:http://www.infectioncontrolplus.com.au

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    in reply to: sterile processing near misses #74119
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Jayne

    I asked this question of David McNamara, our CSSD guru….

    As per our updated policy – refers to ASNZS4187.2104 Section 2.5.2 Nonconformance (one word in standards – I used to have as non-conformance) – I have attached the latest Policy version (attached) awaiting to be presented to the policy Committee.

    ‘Nonconforming reusable medical device(s) shall include those items that do not meet acceptance criteria after completion of cleaning, disinfection and sterilization processes. Documentation is to be maintained of the investigation performed for a nonconforming RMD’. (Standards direct quote).

    It is now a necessity to keep and report Nonconformance records – generally speaking to a central committee as we do here to the ICSM – we just have been doing it longer and more specific than most. The Standards have been out now for 2 years and all HSO with CSDs should be reporting this information e.g. the reporting line however is prone to local HSO interpretation and even within the SVHA it is hard to get any benchmarking e.g. SVHM Public – the OT NUM demands that THE CSD NUM only reports to her and has not passed on anything to the IFC.

    However there is also a report for Recall of items from failed sterilizer cycles and proof that items have been recovered & not used & has subsequent investigations as per HSO process. HSNPH has never had a sterilizer fail where any items have been distributed. I treat this as a separate issue as does not fall under the umbrella of Nonconformance but ‘Recall’.

    Benchmarks for Nonconformance is a variable thing dependant on how you keep your records and what you report! About 8 years ago there was a speaker at the National SRACA conference who gave a ‘benchmark’ of 2% for net CSD error/ fault rate. Note I use this on the CSD report. If you want further information you can refer to the attached policy. Just as a note – electronic tracking system never had Nonconformance as part of thire records till I had put into the Meditrax system > 20 years ago – all electronic tracking systems now have it available. Fact – I have been speaking on this subject at State and National conferences for >15years.

    Regards
    David L McNamara
    CSSD Manager
    Holy Spirit Northside Private Hospital
    p 07 3326 3904 | f 07 3326 3907
    a 627 Rode Road, Chermside Q 4032
    e david.mcnamara@svha.org.au
    wwww.holyspiritnorthside.org.au

    If you want a copy of our non-conformance policy I could email it to you separately.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A627 Rode Road, Chermside QLD 4032
    P(07) 3326 3068| F(07) 3607 2226| Emichael.wishart@svha.org.au| W http://www.hsnph.org.au

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    —–Original Message—–
    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Jayne OConnor
    Sent: Tuesday, 31 October 2017 12:39 PM
    To: AICALIST@AICALIST.ORG.AU
    Subject: sterile processing near misses

    Dear All,

    Does anyone know of or have an acceptable range/bench mark for sterile processing failure/near misses(realising zero may not be achievable all the time).
    It is something that crops up now and again at our IPC committee meetings? Would be grateful for some guidance.

    Many thanks in advance

    Jayne O’Connor RN,BSc.Inf.Cont.
    IPC Co-Ordinator
    Sydney Adventist Hospital
    185 Fox Valley Rd.,
    Wahroonga 2076

    Tel DD: (02) 9487 9732
    Mobile: 0406752685

    Email: jayne.oconnor@sah.org.au
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    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    I need to clarify a point in my previous email.

    As far as I am aware, there is not a written requirement from NSW Health for annual competency education on high level disinfection wipe systems. (I would be happy to be proven wrong, but I do not have any such documentation available to me.)

    However, Queensland Health does definitely have this requirement (see ‘Reprocessing audit tool’ on this page: https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/reprocessing/intracavity-ultrasound-transducers)

    As a general rule, competencies that seek to validate a process should be undertaken regularly (eg annually), so you can demonstrate that the process is indeed being followed. This is most important when there are no physical parameters documented (like temperatures or chemical concentrations) to show proof of process.

    I hope this clarifies the previous comment I made.

    Thanks
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
    P Please consider the environment before printing this email

    Hi Pam

    Some points for you to ponder, from myself and my CSSD Manager

    * The TGA licensing (ARTG entry) will outline the basis for the use of the product. Deviation from the licensed use is deemed non-0compliance.

    * The Information For Use (IFU) for any product is to be the basis for use.

    * Note where a product requires specific timings for contact and specific sequence of a cleaning / disinfection / neutralisation process for the product to be effective than this process needs to be followed, and documented.

    * Non completion of the supplier recommended process will mean noncompliance with the approved use of the product, and the product will not have achieved the High Level Disinfection required. The operator then must accept they are using a contaminated reusable medical device (RMD)!

    * NSW Health requires where these types of product are used, a formal education and annual competency on using these wipes for all staff who are involved in areas such as ENT clinics where this product is known to be used.

    * If you do not have a documented training process and competency then I believe the organisation must accept they are potentially supplying contaminated RMD (ie no evidence the manufacturer’s process has been followed), and wear any subsequent legal action for cross contamination. Be warned!

    * Be aware that there are specific transmittable viruses that are not inactivated by these wipes if not used correctly.

    Good luck! We have been lucky (!) enough here to steer clear of use of this type of product thus far.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
    P Please consider the environment before printing this email

    Good afternoon everyone,

    We use a 3 wipe high level disinfection process for non-channelled ENT scopes.

    We were wondering if the new 4187 standard will not permit wipe systems to be used for high level disinfection for reusable medical devices.

    Does anyone have any advice?

    Thanks so much in advance.

    Cheers from Pam (sweating +++ in Darwin!!)

    Pamela Boon | Clinical Nurse Manager
    Infection Prevention & Management Unit
    Royal Darwin Hospital |Top End Health and Hospital Services

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    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Glenys

    I don’t have access to the full discussion, but it is summarized here in this Safety Notice:

    http://www.health.nsw.gov.au/sabs/Documents/2014-sn-001.PDF

    There was a discussion about this with more detail some time ago on Infexion Connexion.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
    P Please consider the environment before printing this email

    Interesting summary Michael.

    Do you have a link to the NSW Health requirement that you refer to below?

    Regards

    Glenys

    Glenys Harrington
    Infection Control Consultancy (ICC)
    P.O. Box 6385
    Melbourne
    Australia, 3004
    M: +61 404816434
    E: infexion@ozemail.com.au

    Hi Pam

    Some points for you to ponder, from myself and my CSSD Manager

    * The TGA licensing (ARTG entry) will outline the basis for the use of the product. Deviation from the licensed use is deemed non-0compliance.

    * The Information For Use (IFU) for any product is to be the basis for use.

    * Note where a product requires specific timings for contact and specific sequence of a cleaning / disinfection / neutralisation process for the product to be effective than this process needs to be followed, and documented.

    * Non completion of the supplier recommended process will mean noncompliance with the approved use of the product, and the product will not have achieved the High Level Disinfection required. The operator then must accept they are using a contaminated reusable medical device (RMD)!

    * NSW Health requires where these types of product are used, a formal education and annual competency on using these wipes for all staff who are involved in areas such as ENT clinics where this product is known to be used.

    * If you do not have a documented training process and competency then I believe the organisation must accept they are potentially supplying contaminated RMD (ie no evidence the manufacturer’s process has been followed), and wear any subsequent legal action for cross contamination. Be warned!

    * Be aware that there are specific transmittable viruses that are not inactivated by these wipes if not used correctly.

    Good luck! We have been lucky (!) enough here to steer clear of use of this type of product thus far.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
    P Please consider the environment before printing this email

    Good afternoon everyone,

    We use a 3 wipe high level disinfection process for non-channelled ENT scopes.

    We were wondering if the new 4187 standard will not permit wipe systems to be used for high level disinfection for reusable medical devices.

    Does anyone have any advice?

    Thanks so much in advance.

    Cheers from Pam (sweating +++ in Darwin!!)

    Pamela Boon | Clinical Nurse Manager
    Infection Prevention & Management Unit
    Royal Darwin Hospital |Top End Health and Hospital Services

    ______________________________________________________________________
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    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Pam

    Some points for you to ponder, from myself and my CSSD Manager

    * The TGA licensing (ARTG entry) will outline the basis for the use of the product. Deviation from the licensed use is deemed non-0compliance.

    * The Information For Use (IFU) for any product is to be the basis for use.

    * Note where a product requires specific timings for contact and specific sequence of a cleaning / disinfection / neutralisation process for the product to be effective than this process needs to be followed, and documented.

    * Non completion of the supplier recommended process will mean noncompliance with the approved use of the product, and the product will not have achieved the High Level Disinfection required. The operator then must accept they are using a contaminated reusable medical device (RMD)!

    * NSW Health requires where these types of product are used, a formal education and annual competency on using these wipes for all staff who are involved in areas such as ENT clinics where this product is known to be used.

    * If you do not have a documented training process and competency then I believe the organisation must accept they are potentially supplying contaminated RMD (ie no evidence the manufacturer’s process has been followed), and wear any subsequent legal action for cross contamination. Be warned!

    * Be aware that there are specific transmittable viruses that are not inactivated by these wipes if not used correctly.

    Good luck! We have been lucky (!) enough here to steer clear of use of this type of product thus far.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
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    Good afternoon everyone,

    We use a 3 wipe high level disinfection process for non-channelled ENT scopes.

    We were wondering if the new 4187 standard will not permit wipe systems to be used for high level disinfection for reusable medical devices.

    Does anyone have any advice?

    Thanks so much in advance.

    Cheers from Pam (sweating +++ in Darwin!!)

    Pamela Boon | Clinical Nurse Manager
    Infection Prevention & Management Unit
    Royal Darwin Hospital |Top End Health and Hospital Services

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    in reply to: Tips for Podiatry Patients – infection control #74087
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Joe

    I had a quick look at the video and their other documents, and they reference the right things (NHMRC guidelines and AS/NZS 4815), and nothing seems inappropriate or glaringly omitted on a quick scan. My only criticism would be that they do not list in their policy any specific infection control requirements for podiatrists, merely refer to the NHMRC guidelines. The audit tool they do have does seem to cover the important issues, though.

    But there is no reference to any infection control professionals being consulted on these infection control documents from the Podiatry Board that I can see, so maybe there is an opportunity for ACIPC to offer ‘endorsement’ of these guidelines?

    Would be useful to suggest this to the Board through the national office manager I would think.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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    Good morning

    Has anyone had a chance to view the video from the Podiatry Board of Australia. It was produced with APHRA.
    I don’t think there was any IP&C consultation?

    http://www.podiatryboard.gov.au/News/2017-10-20-media-release-tips.aspx

    Thanks
    Joe

    Joe-Anne Bendall

    HAI Program Manager | Governance and Assurance
    Level 17, 2-24 Rawson Place, Haymarket, NSW 2000
    Tel (02) 9269 5614 | Fax (02) 9269 5599 | Joe-Anne.Bendall@health.nsw.gov.au
    http://www.cec.health.nsw.gov.au/patient-safety-programs/assurance-governance/healthcare-associated-infections

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    in reply to: Re: Nasal Decolonisation #74073
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Matthias

    In regard to an attempt to minimise self-inoculation with Staph aureus in the peri and early post-operative phase, would not 10 hours be a reasonable target?

    I dont disagree with your terminology assessment, but, terminology aside, if we are attempting to prevent early-onset SSI with Staph aureus, would not this claim be reasonable in that context?

    One of the posters cited on that website also suggested that peri-operative staff use of this product (voluntary, of course!) also could result in lower incidence of Staph aureus SSI. If there any biological plausibility in that concept?

    Just wondering if this product does have a use, albeit not as a decoloniser.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
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    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Matthias Maiwald (SingHealth – PATH)
    Sent: Monday, 23 October 2017 3:11 PM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: Nasal Decolonisation

    Hi Cath, hi Michael,

    Thank you so much!

    It was in fact exactly the Steed et al. 2014 paper and also the Infection Control Today White Paper that I had seen earlier (a while ago see my comment) and that I found unconvincing.

    Similarly, what is written on the Nozin webpage is unconvincing.

    Most of us, when we talk about, or read about decolonisation, we understand or imply that the effect is sustained for some time, e.g. weeks or months, or ideally permanently in the absence of external re-exposure. If I am not wrong, I think the historical origins of the modern S. aureus or MRSA decolonisation lie in the 1960s and 1970s in efforts to (a) reduce S. aureus infections affecting neonates in nurseries, and (b) to end the cycle of endogenous reinfection that is driving furunculosis.

    The Steed paper is astonishing in its claims. It tests a reduction of S. aureus nasal bacterial counts up to 10 hours after application, but not any follow-up beyond these 10 hours. That is not what most of us in the profession would understand as decolonisation.

    Neither the ICT White Paper nor the Website nor the Steed article seems to provide any data that go beyond these 10 hours, and yet, claims are made (e.g. page 5, White Paper) of sustained decolonization. The website describes it as long lasting and unlike the fleeting effect of hand sanitizers. Again, there is nothing to support this claim.

    Combined with the problems of applying alcohol to mucous membranes (see my earlier e-mail), I would say that biological plausibility of how this agent is supposed to provide sustained decolonisation in the sense of what we usually understand as decolonisation is not established.

    Best regards, Matthias.


    Matthias Maiwald, MD, FRCPA
    Senior Consultant in Microbiology
    Adj. Assoc. Prof., Natl. Univ. Singapore
    Department of Pathology and Laboratory Medicine
    KK Women’s and Children’s Hospital
    100 Bukit Timah Road
    Singapore 229899
    Tel. +65 6394 8725 (Office)
    Tel. +65 6394 1389 (Laboratory)
    Fax +65 6394 1387

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
    Sent: Monday, 23 October, 2017 12:24 PM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: Nasal Decolonisation

    Hi Cath

    This product is not available in Australia, either. I would be surprised if there are any centres in Australia using formulations of ethanol or povidone iodine for nasal decolonisation currently, but would love to hear from anyone that can source appropriate nasal decolonisation products of this type in Australia.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
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    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Cathryn Murphy
    Sent: Monday, 23 October 2017 1:59 PM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: Nasal Decolonisation

    Hi Matthias

    I was loathe to use trade names on this site. However, I will to respond. There is a growing body of US evidence around a product called Nozin. More details are at nozinpro.com

    When I was at APIC in June 2017 there was a lot of interest in the product in healthcare and other settings.

    Thanks for your view on the existing literature Matthias, I always enjoy your responses.

    Yours sincerely

    Cath

    Cathryn Murphy RN B. Photog MPH PhD CIC
    Chief Executive Officer & Creative Director
    Infection Control Plus Pty Ltd
    QLD, Australia

    E: Cath@infectioncontrolplus.com.au
    M: +61 428 154154
    W:http://www.infectioncontrolplus.com.au

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Matthias Maiwald (SingHealth – PATH)
    Sent: Monday, 23 October 2017 12:50
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: Nasal Decolonisation

    Hi Cath, hi Michael,

    I am curious about the remark below concerning ethanol for nasal decolonisation. The last time I looked (which is a while ago), the results achieved were not convincing.

    From a physiological and/or conceptual point of view, while alcohol is a fantastic antiseptic/disinfectant for superficial skin, it is usually deemed unsuitable for mucous membranes (which the inside of the nose consists of), due to its more aggressive nature than aqueous antiseptics.

    Best regards, Matthias.


    Matthias Maiwald, MD, FRCPA
    Senior Consultant in Microbiology
    Adj. Assoc. Prof., Natl. Univ. Singapore
    Department of Pathology and Laboratory Medicine
    KK Women’s and Children’s Hospital
    100 Bukit Timah Road
    Singapore 229899
    Tel. +65 6394 8725 (Office)
    Tel. +65 6394 1389 (Laboratory)
    Fax +65 6394 1387

    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
    Sent: Monday, 23 October, 2017 5:57 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Re: Nasal Decolonisation

    Hi Cath

    Just a comment: the povidone iodine nasal cream commonly used pre-op in the US is not yet available in Australia, as far as I am aware. I wish it was, as getting traditional pre-admission nasal decolonisation (5 days of mupuricin or the like) done in a private hospital is not easy!

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
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    From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Cathryn Murphy
    Sent: Monday, 23 October 2017 7:26 AM
    To: AICALIST@AICALIST.ORG.AU
    Subject: Nasal Decolonisation

    Dear All

    I am interested in learning more about the adoption and use of nasal decolonisation in Australia and New Zealand. In the US this appears to be being used sometimes in place of Contact Precautions. There is a download from IC Today to that effect plus some recent papers. Happy to share if anyone wants it, please email me. So would any of you be able to comment on these questions and if and how you use nasal decolonisation in your organisations please. Thanks in advance.

    a) other than ethanol and povidone iodine (e.g.: 3M and others) what else is used for nasal decolonisation right before surgery?
    b) which are the most commonly used products?
    c) what are the surgery profiles where these are used? (e.g.: ortho, open heart, hernia repair etc)
    d) what is the adoption rate for using something like this? Is it universal or a % of surgeons opt to do it?

    Yours sincerely

    Cath

    Cathryn Murphy RN B. Photog MPH PhD CIC
    Chief Executive Officer & Creative Director
    Infection Control Plus Pty Ltd
    QLD, Australia

    E: Cath@infectioncontrolplus.com.au
    M: +61 428 154154
    W:http://www.infectioncontrolplus.com.au

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    in reply to: Fans in ICU #74071
    Michael Wishart
    Participant

    Author:
    Michael Wishart

    Position:

    Organisation:

    State:
    NSW

    Hi Kay

    We had this debate in ICU, but mainly focussing on the dust on the blades of the fans. Nobody seemed to want to clean them… so we opted for non-bladed fans. They still move air (and thus if there is concern about airflow disruption, this will still pertain), but are much easier to keep clean, and no blades to have to wipe.

    Cheers
    Michael

    Michael Wishart
    Infection Control Coordinator

    A 627 Rode Road, Chermside QLD 4032
    P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
    [cid:image001.png@01D01926.61F1C2B0]
    P Please consider the environment before printing this email

    Greetings!

    I am seeking information on the use of oscillating, portable fans for patient cooling in ICU settings. Our units are very enthusiastic to purchase said items, however we are not keen due to the risk of turbulent airflow, aerosolization of pathogens etc. The ICU teams are requesting documentation/studies/evidence to support our stance – a brief look has failed to find anything but we are wondering, before I dig deeper, if anyone had had to respond to this issue and was able to share this information.

    Katherine McKay
    Clinical Nurse Consultant
    Hand Hygiene Portfolio
    Infection Prevention and Control Services
    Box Hill Hospital
    Eastern Health

    P: (03) 9895 3480
    E: katherine.mckay@easternhealth.org.au

    http://www.easternhealth.org.au
    [emailsignature]

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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.

    Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

    Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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