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Hi Margaret
I just had a quick look at a major supermarket website (nothing better to do, right? 🙂 ), and I get grapefruit, lavender, lemon and myrtle, and cherry blossom as ingredients of some of the hand sanitisers available. Some alcohol (listed a ‘denatured’), but no actual concentration. Claims that ‘99.9% of bacteria are removed’ by the hand sanitiser, which I could probably claim with just soap and water, actually.
Caveat emptor (buyer beware) is correct, indeed.
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]
Wed
Dear Michael,
I think you’ll find that the pump mechanism has been altered on the liquid dispensers of one common brand of ABHR and they now spray into the hand and don’t drip. I would question why any facility is still using the old pump type as it has been around for a year at least.Apart from the TGA issue, I am interested in what product is in a non alcohol handrub?
Regards,
Margaret Jennings
Marjen Education Serviceswebsite. http://www.marjenes.com.au
email. marjenes@optusnet.com.aumob. 0404 088 754
Hi Elena
Obviously carpeted floors are not the preferred floor coverings in acute care areas, but they are seen to be more attractive floor coverings for public and waiting areas.
But my understanding is that the requirement for not placing ABHR over carpet was because hand *rubs* are very liquid, and will drip when used onto the floor. I once worked in a hospital that had carpet in its ICU, and we trialled a hand *rub* and the drips stained the carpet very badly! So we switched to a hand *gel* product that did not drip, and the problem went away. You might also find some hand *foam* products are almost non-drip in use as well, so carpeted areas are not an issue.
I would encourage you to look at various alcohol based hand sanitiser products in different formulations, and test them in your carpeted areas to see if they do, indeed, create a stain issue or not. But I would also encourage you to also pursue use of a TGA approved product for use in healthcare, rather than an unregulated ‘supermarket’ product, for the reasons outlined by a previous poster.
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]
Hi Donna,
I am very interested in non – alcohol based hand rubs as we have a hand hygiene station within our foyer. The flooring is carpet and I am aware Hand hygiene Australia recommend ABHR dispensers should not be located over carpeted areas, unless the area is protected by active sprinklers. Sprinklers have not been installed.
We would like to encourage hand hygiene upon entering the building.
Any advice would be appreciated.Elena Donaghy
Manager of Clinical Education & Infection Control
e: Elena.Donaghy@shq.org.au | ph: 08 9227 6177 | f: 08 9227 6871
shq.org.auHi Donna,
Thank you for this. I am also interested to find a supplier of non-alcohol based hand rub, (brand names would be useful) to use within the correctional facility as alcohol based hand rubs are not permitted.Regards
Rebecca Curr | Clinical Nurse Specialist Immunisation
Public Health Unit | Central Australia Health ServiceNorthern Territory Government
Demountable Buiding, 6 Gap Rd, Alice Springs
GPO Box 721 Alice Springs, NT 0871.p … 08 8951 9505
f … 08 8951 7900
e … rebecca.curr@nt.gov.au
w… http://www.nt.gov.au/healthUse or transmittal of the information in this email other than for authorised NT Government business purposes may constitute misconduct under the NT Public Sector Code of Conduct and could potentially be an offence under the NT Criminal Code. If you are not the intended recipient, any use, disclosure or copying of this message or any attachments is unauthorised. If you have received this document in error, please advise the sender. No representation is given that attached files are free from viruses or other defects. Scanning for viruses is recommended.
Hi Everyone,
I have been asked by two different groups this week about non-alcohol based hand sanitisers. My initial thoughts were that, in accordance with all hand hygiene guidance for healthcare settings that I can find, alcohol-based hand rubs are the only acceptable products available. That non-alcohol based hand rubs haven’t undergone EN1500 testing and therefore shouldn’t be used.
I have subsequently been advised by one of the groups asking me about the product they current use (a non-alcohol based hand rub) that the product has achieved EN1500 certification. They will be providing me with this product information next week.
In the interim, I was interested to know if any other ICPs etc have either experience or knowledge of non-alcohol based hand rubs, their use (in a healthcare setting) and efficacy.
I realise we can’t use product names (I am happy for you to contact me directly (email below) if you wish to), but I am very interested to hear people’s thoughts/advice/experience on this topic. One of the groups was particularly keen to know about appropriateness in relation to coronavirus so your thoughts on that would also be appreciated.
Regards,
DonnaDonna Cameron
Infection Control Consultant
T +61 (0) 3 8344 3574 (Monday, Wednesday & Friday); +61 (0) 3 9096 5233 (Tuesday & Thursday)
donna.cameron@unimelb.edu.au
Microbiological Diagnostic Unit Public Health Laboratory
The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au
[cid:image001.gif@01D589CC.0CFE8C40][cid:image002.gif@01D589CC.0CFE8C40]
[cid:image003.gif@01D589CC.0CFE8C40]MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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This message (including any attachments) may be confidential and is intended solely for the use of the individual to whom it is addressed. If you are not the intended recipient, any use, disclosure or copying of this document is strictly prohibited. If you have received this document in error, please notify the sender by return e-mail and delete this message from your system. Before opening or using this e-mail and attachments, please scan them for viruses and defects. The Family Planning Association of Western Australia (Inc.) does not accept any liability for loss or damage which may arise from your receipt of this e-mail. Our liability is limited to resupplying any affected attachments.______________________________________________________________________
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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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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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Hi Elena
Obviously carpeted floors are not the preferred floor coverings in acute care areas, but they are seen to be more attractive floor coverings for public and waiting areas.
But my understanding is that the requirement for not placing ABHR over carpet was because hand *rubs* are very liquid, and will drip when used onto the floor. I once worked in a hospital that had carpet in its ICU, and we trialled a hand *rub* and the drips stained the carpet very badly! So we switched to a hand *gel* product that did not drip, and the problem went away. You might also find some hand *foam* products are almost non-drip in use as well, so carpeted areas are not an issue.
I would encourage you to look at various alcohol based hand sanitiser products in different formulations, and test them in your carpeted areas to see if they do, indeed, create a stain issue or not. But I would also encourage you to also pursue use of a TGA approved product for use in healthcare, rather than an unregulated ‘supermarket’ product, for the reasons outlined by a previous poster.
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]
Hi Donna,
I am very interested in non – alcohol based hand rubs as we have a hand hygiene station within our foyer. The flooring is carpet and I am aware Hand hygiene Australia recommend ABHR dispensers should not be located over carpeted areas, unless the area is protected by active sprinklers. Sprinklers have not been installed.
We would like to encourage hand hygiene upon entering the building.
Any advice would be appreciated.Elena Donaghy
Manager of Clinical Education & Infection Control
e: Elena.Donaghy@shq.org.au | ph: 08 9227 6177 | f: 08 9227 6871
shq.org.auHi Donna,
Thank you for this. I am also interested to find a supplier of non-alcohol based hand rub, (brand names would be useful) to use within the correctional facility as alcohol based hand rubs are not permitted.Regards
Rebecca Curr | Clinical Nurse Specialist Immunisation
Public Health Unit | Central Australia Health ServiceNorthern Territory Government
Demountable Buiding, 6 Gap Rd, Alice Springs
GPO Box 721 Alice Springs, NT 0871.p … 08 8951 9505
f … 08 8951 7900
e … rebecca.curr@nt.gov.au
w… http://www.nt.gov.au/healthUse or transmittal of the information in this email other than for authorised NT Government business purposes may constitute misconduct under the NT Public Sector Code of Conduct and could potentially be an offence under the NT Criminal Code. If you are not the intended recipient, any use, disclosure or copying of this message or any attachments is unauthorised. If you have received this document in error, please advise the sender. No representation is given that attached files are free from viruses or other defects. Scanning for viruses is recommended.
Hi Everyone,
I have been asked by two different groups this week about non-alcohol based hand sanitisers. My initial thoughts were that, in accordance with all hand hygiene guidance for healthcare settings that I can find, alcohol-based hand rubs are the only acceptable products available. That non-alcohol based hand rubs haven’t undergone EN1500 testing and therefore shouldn’t be used.
I have subsequently been advised by one of the groups asking me about the product they current use (a non-alcohol based hand rub) that the product has achieved EN1500 certification. They will be providing me with this product information next week.
In the interim, I was interested to know if any other ICPs etc have either experience or knowledge of non-alcohol based hand rubs, their use (in a healthcare setting) and efficacy.
I realise we can’t use product names (I am happy for you to contact me directly (email below) if you wish to), but I am very interested to hear people’s thoughts/advice/experience on this topic. One of the groups was particularly keen to know about appropriateness in relation to coronavirus so your thoughts on that would also be appreciated.
Regards,
DonnaDonna Cameron
Infection Control Consultant
T +61 (0) 3 8344 3574 (Monday, Wednesday & Friday); +61 (0) 3 9096 5233 (Tuesday & Thursday)
donna.cameron@unimelb.edu.au
Microbiological Diagnostic Unit Public Health Laboratory
The Peter Doherty Institute for Infection and Immunity
792 Elizabeth Street | Melbourne | Victoria | Australia | 3000
doherty.edu.au
[cid:image001.gif@01D589CC.0CFE8C40][cid:image002.gif@01D589CC.0CFE8C40]
[cid:image003.gif@01D589CC.0CFE8C40]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 acipclist@acipc.org.au
To send a message to the list administrator send an email to admin@acipc.org.au
You can unsubscribe manually from this list by sending ‘signoff acipclist’ (without the quotes) to listserv@aicalist.org.au
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 acipclist@acipc.org.au
To send a message to the list administrator send an email to admin@acipc.org.au
You can unsubscribe manually from this list by sending ‘signoff acipclist’ (without the quotes) to listserv@aicalist.org.au
________________________________
—-DISCLAIMER—-
This message (including any attachments) may be confidential and is intended solely for the use of the individual to whom it is addressed. If you are not the intended recipient, any use, disclosure or copying of this document is strictly prohibited. If you have received this document in error, please notify the sender by return e-mail and delete this message from your system. Before opening or using this e-mail and attachments, please scan them for viruses and defects. The Family Planning Association of Western Australia (Inc.) does not accept any liability for loss or damage which may arise from your receipt of this e-mail. Our liability is limited to resupplying any affected attachments.______________________________________________________________________
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 acipclist@acipc.org.au
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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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Hi Deb
We have had a few incidences of eye ‘splashes’ due to fluid hitting the forehead or side of face and running into the eyes when wearing protective glasses during surgery. Even though protective eyewear is available that has wrap around side protection it doesn’t make it watertight, and if you get enough fluid or fluid under high enough pressure the glasses won’t necessarily protect against exposure from fluid in the eyes. Same goes with visors on masks.
Goggles with a good seal and headset faceshields seem to be the best, but staff seem to be less likely to wear these for all procedures.
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]
[cid:image005.png@01D5C601.F77FEA40]
Hello Infection Prevention teams
For those involved in the follow-up of blood and bodily fluids exposures amongst clinical staff, have you encountered any episodes of PPE failure associated with your supplies of protective eyewear?
Happy to hear from you offline if preferred.
Many thanks
Deb Rhodes
The Royal Women’s Hospital | Locked Bag 300 | Cnr Grattan St & Flemington Rd, Parkville VIC 3052
Days working: Mon-Fri | Pager: #52791
P: +61 3 83452791
Deb.Rhodes@thewomens.org.au | http://www.thewomens.org.au[RWH084 Flu Campaign 2019 Email Banner 800×320 FA v2]
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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.
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For those who don’t like extra clicks, here is the ACIPC position statement in PDF.
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]
[cid:image005.png@01D5C601.F77FEA40]
Members – The following Position Statement has been issued today and is available on the College website.
[Header Image]
6 February 2020
The Australasian College for Infection Prevention and Control
Novel Coronavirus 2019 (2019-nCoV) Statement
The Australasian College for Infection Prevention and Control (ACIPC) recognises the extraordinary efforts of many members and colleagues in the infection prevention field in dealing with the challenges of the novel coronavirus (2019-nCoV).
ACIPC support a coordinated and considered response, and recommends members follow direction from the Australian Government Department of Health and jurisdictional health departments.
ACIPC is well represented at the Government level in developing strategies for this outbreak, ensuring the infection prevention and control information provided is appropriate. These recommendations are constantly under review and subject to change as new information about the virus is revealed.
To ensure updated and appropriate guidelines are followed, we encourage all members to seek guidance from the following resources
Australian Government ACT NSW NT QLD SA TAS VIC WA Smart Traveller
NZ Ministry of Health
WHO
Furthermore, ACIPC strongly reject misinformation being spread among the public which can lead to false assumptions about members of our culture-diverse population and cause unnecessary distress. Members are urged to call out and shut down all racism and xenophobia.
In unison with the recent statement from colleagues of the Australasian Society for Infectious Diseases (ASID), ACIPC once again call for the establishment of a national centre of disease control to coordinate and centralise responses in these times.
A/Prof Phil Russo
President
______________________________________________________________________
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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.
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Hi Nicky
That’s a great point and should be part of the risk assessment when considering options other than masks. Surgical ‘plume’ is a known threat for aerosol transmission of viruses and if no local exhaust is available when performing diathery or other smoke/aerosol procedures higher filtration, well fitting masks/respirators should be used.
Cannot stress how important specific risk assessment is when changing standard protective measures.
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 |
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________________________________
Dear All,
As a scrub RN in a Day surgery this is very topical for me. I have been off this week so find the ideas given so far sound most appropriate, wonderful to have access to such a wealth of knowledge. However I also think it’s important mention the risks for the aseptic team that comes from surgical plume. And just for interest I understand P2 (similar to N95?) masks are worn in ORs refer to ACORN Standards 15th edition 2018. I also understand that when using diathermy, for example, warts of a HVP positive patient ,these type of masks should be worn and fitted correctly and this surgery is still done in some Day Hospitals. If I have this wrong please let me know. Interesting what can be transferred by surgical plume and not all ORs have surgical plume evacuators on hand.
Thank you once again for the information.
Nicky Whitehouse
Scrub/scout RN
Ipswich Day Hospital.On 1 Feb 2020, at 9:31 am, Michael Wishart <Michael.Wishart@SVHA.ORG.AU> wrote:
Hi Terry
My thought to conserve appropriate use of mask would to look at alternative forms of protection for staff, based on risk. For example scrub team at the table should be given priority. For circulating and anaesthetic staff, face shields or visors may be appropriate with the shortage of masks.This would obviously need to be reviewed with the level of air contamination risk of the surgery (eg prosthetic implants) but would still send the message that staff protection in the OT is important.
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 |
Get Outlook for Android
________________________________Hi Everyone,
We are experiencing difficulty in having orders filled for surgical masks.
My question was not about access to N95 masks for us in the OR just the usual Type 2 and Type 3 masks that we need to wear when working in the Operating Room during surgical procedures to protect the patient from the scrub teams respiratory tract flora and to protect the scrub team from exposure to blood and body substances.
Hopefully that provides clarification re my question.
Kind Regards
Terry McAuley
Director
MSc Medical Device Decontamination
PO BOX 2249, Greenvale, VIC Australia 3059
[cid:image001.png@01D5D8E1.7C78F240]
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Hi Terry- am I missing something here? Why are theatre staff using N95 masks in the OR?
Sent from my iPhone
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On 31 Jan 2020, at 4:26 pm, Lincoln Fowler <Lincoln.Fowler@calvary-act.com.au> wrote:
Hi Terry
Maybe there are some useful ideas in this article:
https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.htmlLincoln Fowler
Infection Control and Staff Health Coordinator CBPH
Infection Prevention, Control & Staff Health Department[cid:image001.jpg@01D5D842.BA05EF90]Calvary
Public Hospital Bruce
Cnr Belconnen Way & Haydon Drive Bruce ACT 2617
PO Box 254 Jamison Centre ACT 2614
P: 02 6245 3117 F: 02 6201 6702
E: lincoln.fowler@calvary-act.com.au
http://www.calvary-act.com.auHi Everyone,
I am hearing about mask shortages and this is impacting on my Day Surgery clients, as they are being told that their orders may not be able to be filled because demand is outstripping supply.
Consequently, I am being asked what strategies could be implemented to conserve masks to avoid running out and not being able to perform surgical procedures.
There are obvious conservation strategies we could implement such as anaesthetic team members not wearing masks unless in close proximity to the sterile field or at risk from aerosols or plume; wearing the same mask for more than one patient for short cases such as ophthalmic surgery etc; however I am concerned that if we enact these interim conservation measures there will be push back to correct usage of surgical masks when we return to business as usual.
Do the brains trust have any thoughts re this or other conservation strategies that are being implemented in other Operating Suites?
Kind Regards
Terry McAuley
Director
MSc Medical Device Decontamination
PO BOX 2249, Greenvale, VIC Australia 3059
[cid:image001.png@01D5D825.FB0424C0]
I endeavour to achieve a sensible work-life balance: There is no need to reply to this email from you outside of your normal working hours. Please expect the same from me.
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Hi Terry
My thought to conserve appropriate use of mask would to look at alternative forms of protection for staff, based on risk. For example scrub team at the table should be given priority. For circulating and anaesthetic staff, face shields or visors may be appropriate with the shortage of masks.
This would obviously need to be reviewed with the level of air contamination risk of the surgery (eg prosthetic implants) but would still send the message that staff protection in the OT is important.
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 |
Get Outlook for Android
________________________________Hi Everyone,
We are experiencing difficulty in having orders filled for surgical masks.
My question was not about access to N95 masks for us in the OR just the usual Type 2 and Type 3 masks that we need to wear when working in the Operating Room during surgical procedures to protect the patient from the scrub teams respiratory tract flora and to protect the scrub team from exposure to blood and body substances.
Hopefully that provides clarification re my question.
Kind Regards
Terry McAuley
Director
MSc Medical Device Decontamination
PO BOX 2249, Greenvale, VIC Australia 3059
[cid:image001.png@01D5D8E1.7C78F240]
I endeavour to achieve a sensible work-life balance: There is no need to reply to this email from you outside of your normal working hours. Please expect the same from me.
CONFIDENTIAL COMMUNICATION: The information contained in this message may contain confidential information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or duplication of this transmission is strictly prohibited. If you have received this communication in error, please notify us by telephone or email immediately and return the original message to us or destroy all printed and electronic copies. Nothing in this transmission constitutes an agreement of any kind unless otherwise expressly indicated.
Hi Terry- am I missing something here? Why are theatre staff using N95 masks in the OR?
Sent from my iPhone
Maryvale Private Hospital acknowledges the traditional owners of country, the Gunaikurnai nation, and recognises their continuing connection to land, waters and culture.
We pay our respects to their Elders past, present and emerging.[cid:SignatureMPH_c3098e90-9dc7-415d-877d-27e2a4e7930c.jpg]
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On 31 Jan 2020, at 4:26 pm, Lincoln Fowler <Lincoln.Fowler@calvary-act.com.au> wrote:
Hi Terry
Maybe there are some useful ideas in this article:
https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html
Lincoln Fowler
Infection Control and Staff Health Coordinator CBPH
Infection Prevention, Control & Staff Health Department[cid:image001.jpg@01D5D842.BA05EF90]Calvary
Public Hospital Bruce
Cnr Belconnen Way & Haydon Drive Bruce ACT 2617
PO Box 254 Jamison Centre ACT 2614
P: 02 6245 3117 F: 02 6201 6702
E: lincoln.fowler@calvary-act.com.au
http://www.calvary-act.com.auHi Everyone,
I am hearing about mask shortages and this is impacting on my Day Surgery clients, as they are being told that their orders may not be able to be filled because demand is outstripping supply.
Consequently, I am being asked what strategies could be implemented to conserve masks to avoid running out and not being able to perform surgical procedures.
There are obvious conservation strategies we could implement such as anaesthetic team members not wearing masks unless in close proximity to the sterile field or at risk from aerosols or plume; wearing the same mask for more than one patient for short cases such as ophthalmic surgery etc; however I am concerned that if we enact these interim conservation measures there will be push back to correct usage of surgical masks when we return to business as usual.
Do the brains trust have any thoughts re this or other conservation strategies that are being implemented in other Operating Suites?
Kind Regards
Terry McAuley
Director
MSc Medical Device Decontamination
PO BOX 2249, Greenvale, VIC Australia 3059
[cid:image001.png@01D5D825.FB0424C0]
I endeavour to achieve a sensible work-life balance: There is no need to reply to this email from you outside of your normal working hours. Please expect the same from me.
CONFIDENTIAL COMMUNICATION: The information contained in this message may contain confidential information intended only for the use of the individual or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution or duplication of this transmission is strictly prohibited. If you have received this communication in error, please notify us by telephone or email immediately and return the original message to us or destroy all printed and electronic copies. Nothing in this transmission constitutes an agreement of any kind unless otherwise expressly indicated.
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This is a good article to refer people to. Some of the information is a few days old now, but the overall message is still good:
https://insightplus.mja.com.au/2020/3/the-2019-novel-coronavirus-what-do-we-know-so-far/
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]
[cid:image005.png@01D5C601.F77FEA40]
And quite a useful map which is updated in close to real time as reports are confirmed.
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
Cheers
Michael Wishart
ACIPCList Moderator
Michael Wishart | Infection Control Coordinator, CICP-ESt 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
Get Outlook for Android________________________________
Forwarded from OzBug with thanks.
Michael Wishart
ACIPCList ModeratorA few clinical points have emerged from various briefings that might be of interest to ID physicians assessing returned travellers from China. (Correct as of last night, obviously the situation is changing rapidly)
* Fever reported in almost all cases (in the cases where this is reported), even those with relatively mild clinical presentations (this may reflect a selection bias in who gets tested)
* Other symptoms in varying proportions include cough, fatigue, productive cough, chest discomfort, dyspnoea, sore throat, headache
* Almost all cases so far have had a travel history to Wuhan city, and most cases have been linked to two districts within Wuhan (Jianghan and Huangpi). Two cases in Guangzhao had contact with confirmed cases.
* Incubation period – average 7 days, most cases 4-10 days, longest compatible with data 14 days
* Chinese authorities are maintaining surveillance on over 800 contacts, many in-country public health interventions (public messaging, transport screening, ban on non-essential public gatherings, disinfection).
* Significant numbers of “suspected” cases in other countries under investigation.
* The influenza season is in underway in China (mostly A/H3 and B/Vic) – influenza activity seems higher so far than in the last 3 seasons.
Smart Traveller was updated last night with a warning about nCoV today, and there is a Dept of Health website:https://www.health.gov.au/news/novel-coronavirusWHO resources: https://www.who.int/health-topics/coronavirus
* Case definition likely to be updated.
* Home care guidelines may be useful
Happy Chinese New Year – gong hei fat choy!
—
You received this message because you are subscribed to the Google Groups “Ozbug” group.—
Allen Cheng, MB BS, FRACP, MPH, MBiostat, PhD
Director
Infection Prevention and Healthcare Epidemiology Unit, Alfred Health
Professor of Infectious Diseases Epidemiology
School of Public Health and Preventive Medicine, Monash University
Infectious Diseases Physician
Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University______________________________________________________________________
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And quite a useful map which is updated in close to real time as reports are confirmed.
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
Cheers
Michael Wishart
ACIPCList ModeratorMichael Wishart | Infection Control Coordinator, CICP-E
St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
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Forwarded from OzBug with thanks.
Michael Wishart
ACIPCList ModeratorA few clinical points have emerged from various briefings that might be of interest to ID physicians assessing returned travellers from China. (Correct as of last night, obviously the situation is changing rapidly)
* Fever reported in almost all cases (in the cases where this is reported), even those with relatively mild clinical presentations (this may reflect a selection bias in who gets tested)
* Other symptoms in varying proportions include cough, fatigue, productive cough, chest discomfort, dyspnoea, sore throat, headache
* Almost all cases so far have had a travel history to Wuhan city, and most cases have been linked to two districts within Wuhan (Jianghan and Huangpi). Two cases in Guangzhao had contact with confirmed cases.
* Incubation period – average 7 days, most cases 4-10 days, longest compatible with data 14 days
* Chinese authorities are maintaining surveillance on over 800 contacts, many in-country public health interventions (public messaging, transport screening, ban on non-essential public gatherings, disinfection).
* Significant numbers of “suspected” cases in other countries under investigation.
* The influenza season is in underway in China (mostly A/H3 and B/Vic) – influenza activity seems higher so far than in the last 3 seasons.Smart Traveller was updated last night with a warning about nCoV today, and there is a Dept of Health website:https://www.health.gov.au/news/novel-coronavirus
WHO resources: https://www.who.int/health-topics/coronavirus
* Case definition likely to be updated.
* Home care guidelines may be usefulHappy Chinese New Year – gong hei fat choy!
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Allen Cheng, MB BS, FRACP, MPH, MBiostat, PhD
Director
Infection Prevention and Healthcare Epidemiology Unit, Alfred Health
Professor of Infectious Diseases Epidemiology
School of Public Health and Preventive Medicine, Monash University
Infectious Diseases Physician
Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University______________________________________________________________________
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Hi Kylie
Just want to make a distinction between aerosol (plume) inhalation and droplet spread. Normal surgical masks do not require a ‘seal’ and therefore much of the inspired air in drawn in around the mask filter. For true aerosol inhalation you need a mask where air is only drawn in through the filter material, and so need a seal. Beards will make a seal very difficult. if you need to protect from aerosols, not just droplets, then you may need to consider full face respirators (eg PAPR) ro protect bearded staff.
Beard nets help stop shedding of hairs onto surfaces rather than protect against droplets or aerosols.
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
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Hi everyone,
I was considering the need to wear a mask to prevent the inhalation of aerosols generated while conducting dental treatment (with a handpiece/ultrasonic). I would imagine a hairnet wouldnt solve this issue or maybe theres a net/mask resource around that does both?
Its more to do with the aerosol inhalation issue rather than containing flyaway hairs.
Thanks KylieKylie Robb
MHSM (Clinical Leadership), CICP-P
Practice Services Manager
Australian Dental Association NSW Branch
Level 1, 1 Atchison Street, St Leonards, New South Wales 2065
t: 02 8436 9936 m: 0438 628 664
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Hi All,
Not to confuse matters but is the beard net worn in theatres ( if person is scrubbed) for all types of beards or just beards not covered by mask ect?
Thanks EmmaEmma Trippe
Infection Control Consultant
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Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
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http://www.calvary-wagga.com.auHospitality | Healing | Stewardship | Respect
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http://www.calvarycare.org.au.Hi Kylie
There are things called beard nets! We have a staff member in theatre who wears one (his beard is for cultural reasons)
They are often worn in the food (preparation) areasGood luck
jo
Joanne Cocks | Infection Control Coordinator
St Vincents Melbourne | PO Box 2900 | 41 Victoria Parade, Fitzroy VIC 3065
t: +61 3 9231 4069 | f: +61 3 9231 4068 http://www.svha.org.au[Description: Description: email signature_envision]
Hi everyone,
Im looking for a policy or information that can provide guidance on how a dental practitioner/dental assistant could manage with a larger beard?
My instant thought is that a mask would struggle to fit over it, and with the likelihood of frequent and routine generation of aerosols the beard would have to go. Are there hairnets or other resources that could work to support the health care worker to keep the beard, yet still manage the infection control risk?What if the beard is worn for cultural reasons? Does culture trump infection control?
Thanks a lot for considering this, I would value any insights.
Kylie
Kylie Robb
MHSM (Clinical Leadership), CICP-P
Practice Services Manager
Australian Dental Association NSW Branch
Level 1, 1 Atchison Street, St Leonards, New South Wales 2065
t: 02 8436 9936 m: 0438 628 664
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Hi John
This recent paper in Infection, Disease and Health may help you evaluate such a system.
Use of a radiopharmaceutical multidose dispenser for positron emission tomography: Risk assessment and mitigation measures for infection prevention
Daniela Karanfilovska, Ruth Martin, Howard Barton, Kenneth S. Yap, Allen Cheng
In Press, Corrected Proof, Available online 3 January 2020https://www.sciencedirect.com/science/article/abs/pii/S2468045119301051
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 https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[cid:image005.png@01D5C601.F77FEA40]
From: ACIPC Infexion Connexion On Behalf Of GREENOUGH, John
Sent: Thursday, 16 January 2020 8:29 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Multi use contrast injections.Hi Wendy,
The units contain both normal saline, and contrast multi dose components.Kind regards,
John Greenough
Manager – Infection Control Department[logo_austin]
03 9496 6625Level 7, Harold Stokes Building
145 Studley Road, Heidelberg
PO Box 5555, Victoria, 3084Share [linkedin] https://www.youtube.com/watch?v=
From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of nursewendy10
Sent: Wednesday, 15 January 2020 10:10 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: [ACIPC_Infexion_Connexion] Multi use contrast injections.Hi,
I can’t speak officially as a infections control delegate for my unit but I am a medical imaging nurse. Do you mean the IV contrast as a multi use or a normal saline bolus multi use injection?
Wendy Naylor R.N.
Medical Imaging Department,
Sunshine Coast University Hospital.
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Thanks to Jenny Robson and Mona Schousboe for the lab perspective in this. And thanks to all others who have agreed this could be an issue we need to be aware of.
We have two separate types of microbiological testing here, required by two different agencies.
1. Endoscope testing (as a QA activity to ensure cleaning is appropriate) is required by GESA/GENCA Infection Control in Endoscopy 2010 (havent yet seen the draft revision, has anybody?), and includes testing for CRE post use on known CRE patients (as per 2017 consensus guidelines). Endoscope microbiological testing is not mentioned in AS/NZS 4187 per se (only as general part of a review of storage of RMDs I would suggest).
2. Testing of the rinse water for AERs is recommended by both, but GESA/GENCA only refer to microbiological monitoring of rinse water to ensure sterility, whereas AS/NZS 4187 looks at rinse water with regard to its suitability to contact RMDs, not just microbial content (hence the extra testing required), similar to that required in CSSD. I am sure Standards Australia have some good references for the need for endotoxin testing in these environments.
To me, it looks like, as long as your path lab follows appropriate processes for testing (as per the required standards) and is accredited for the type of testing required, it should be fine. It would be prudent to check what tests they are using, and ensure these are as the relevant standard or guideline requires.
Both Jenny and Mona mentioned testing for M. chimaera in cardiac heater-coolers, and this is another example of the difficulties in getting testing done appropriately, as I believe most environmental labs have difficulty isolating M. chimaera specifically.
It would be nice to have some consistency of guidelines for testing in endoscopy, so hopefully the revision of the GESA/GENCA Infection Control in Endoscopy document will help with this, not create even more confusion!
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 https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
From: ACIPC Infexion Connexion On Behalf Of Mona Schousboe
Sent: Monday, 6 January 2020 11:52 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Lab accreditation for water testing?I agree with Jenny Robson that the issue of environmental testing is not black or white. For testing of endoscopes, there are good and regularly updated guidelines. What was the history behind the requirements for endotoxin testing, and what was the research into the general availability of the test? While mycobacterial testing already is concentrated in specialist TB laboratories, atypical mycobacteria like M marinum is isolated on the general microbiology benches. Research into new pathogens like was required for Heater-Cooler Units water analyses was performed in TB laboratories, not in environmental laboratories. We have not even touched on the problems of organisms resistant to metals such as copper. We found the M chimaera was isolated from a Heater-Cooler Unit sample with a very high concentration of copper. We started environment testing for legionella pneumophila in hospital hot water systems in the 1980es- and published results many times. The requirements for environmental testing accreditation, with the associated high cost, was not because we could not culture for environmental Legionella, but because of IANZ (the NZ equivalent of NATA) require different programmes for water testing than the direct human specimen. They have no plan for swabs from showerheads. I wonder if the accreditation authorities should be more conscious of the cost of accreditation and become more versatile in the programmes they offer to Microbiology Laboratories.
Kind regards
Mona Schousboe
FRCPA, MPH
ChristchurchOn Mon, Jan 6, 2020 at 12:55 PM Michael Wishart <Michael.Wishart@svha.org.au> wrote:
[Posted on behalf of Dr Robson, with thanks Moderator]Hi Michael et al
Thought I would pass on that there is limited NATA accreditation available for Human Pathology labs in the environmental testing arena (see page 10 of 15 in the SoA).
For example our lab has NATA accreditation for environmental testing as below. It does not however fulfil all the requirements of AS/NZS4187:2014 (endotoxin testing).Additionally the ACQSHC and MTAC recommendations for Heater Cooler Unit mycobacterial testing (but not hetertrophic bacterial counts) can only be performed in Human Pathology Clinical Lab. The culture requirements for non-rapidly growing mycobacteria (e.g chimera) cannot usually be performed in environmental testing laboratories.
Currently there is an RCPAQAP module available for Human pathology laboratory laboratories to perform endoscope testing and moves afoot to also possibly introduce a QAP for Mycobacterial testing to satisfy heater cooler unit requirements. To have NATA accreditation for a particular test the laboratory is required to be enrolled in a formal QAP programme or if not available a laboratory exchange programme.
Kind regards
Dr Jenny Robson
Sullivan Nicolaides Pathology
From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Mandy Davidson
Sent: Monday, 6 January 2020 8:14 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: [External] Re: [ACIPC_Infexion_Connexion] Lab accreditation for water testing?Michael,
I agree, I dont think you are being pedantic at all. Normally everything is fine until there is a problem, i.e., you get an unexpected result. Then starts the usual cascade of events where you try to figure out why you have the result that you do. Is it a collection error, a testing error or and is it real?
If you are not dealing with an accredited lab, this is going to make it challenging to progress. Another issue that I have recently come across, is that it is not only an accredited lab that matters, but also that the test performed is NATA accredited as well AND to the standard specified.
My recent experience is with the requirement for Atypical mycobacteria testing or NTM. There are not many labs that actually perform this test as per the recommended methodology set out in ISO 15883-4 (see Annex E for detail). The water samples were sent to an accredited Environmental Laboratory, however as I was reviewing the results, I happened to read the fine print of the report and discovered that this was not a NATA accredited test. Then when we got a positive result, it became challenging to know what action to take, as there is always pressure to continue to use the equipment.
As a side point, because the decision usually on which lab to use is often a financial one, I recently received some great advice. If you are going to use a lab that is not accredited, then ensure that it is documented in your organisations risk register. I would also include actions to take when you do have a positive result.
Have a great day and good-luck.
Mandy Davidson
RN; GCert Inf Pre & Cont; MPHTM; Cert III Sterilisation; Cert IV TAE; Immunisation cred; CICP-A
Clinical Nurse Consultant 4187 Implementation project
Infection Prevention & ControlT
07 4433 1873 | 0402 987 432
E
Mandy.Davidson@health.qld.gov.au
W
http://www.health.qld.gov.au/townsvilleTownsville Hospital and Health Service
100 Angus Smith Drive, Douglas, QLD 4814Townsville Hospital and Health Service acknowledges the Traditional Owners of the land, and pays respect to Elders past, present and future.
From: ACIPC Infexion Connexion On Behalf Of Michael Wishart
Sent: Thursday, 19 December 2019 11:51 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: [ACIPC_Infexion_Connexion] Lab accreditation for water testing?Hi all
Have a question. Like many of us, we have been microbiologically testing rinse waters from endoscopes and automated endoscope reprocesors (AERs) as per the GENCA/GESA guidelines for many years, via our human pathology testing lab. The lab has always maintained that it does these tests for us as a favour (although we do pay ), as they are not NATA accredited to perform environmental testing, and that is what these tests actually are.
Now that the final advisory for AS/NZS4187:2014 has been released from the ASCQHC, and there is a definite requirement to perform water testing for these AERs by December 2021, we also have to consider endotoxin testing (which our human pathology lab does not do), and possibly some chemical purity tests (dependent upon AER manufacturer advice). Now we should probably consider whether all of the final rinse water testing should be done by a lab accredited by NATA for this purpose (eg an environmental testing lab), despite some of the components of testing are already being done by our human pathology lab.
AS/NZS4187: 2014 amendment 2:2019 has the following tests required for final rinse water in AERs:
Total viable count 10 cfu/100 mL
Pseudomonas aeruginosa Not detected/100 mL
(Atypical) Mycobacterium sp Not detected/ 100 mL
Chemical purity (as per manufacturer)
Endotoxin 30 EU/mLOf those, we already routinely perform the first three with our human pathology testing accredited lab. Not sure what methods they currently use (the standard is very specific), so would need to check that as well.
So, the question becomes: should we send ALL of our final rinse water specimens to an environmental testing accredited lab? Does anyone know if the NSQHS Standards accreditors will care which lab does what test, or they will look at the specific of the accreditation of the lab doing the testing, to measure compliance to this requirement of AS/NZS4187:2014?
This is not an issue in CSSD as our human pathology lab has always declined to process those water samples, so we already have an environmental lab processing those specimens.
Any thoughts or discussion would be valued. Am I being too pedantic about this, and no-one will care provided we get water tested?
Thanks
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
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[Posted on behalf of Dr Robson, with thanks – Moderator]
Hi Michael et al
Thought I would pass on that there is limited NATA accreditation available for Human Pathology labs in the environmental testing arena (see page 10 of 15 in the SoA).
For example our lab has NATA accreditation for environmental testing as below. It does not however fulfil all the requirements of AS/NZS4187:2014 (endotoxin testing).[cid:image001.png@01D5C475.8F43A350]
Additionally the ACQSHC and MTAC recommendations for Heater Cooler Unit mycobacterial testing (but not hetertrophic bacterial counts) can only be performed in Human Pathology Clinical Lab. The culture requirements for non-rapidly growing mycobacteria (e.g chimera) cannot usually be performed in environmental testing laboratories.
Currently there is an RCPAQAP module available for Human pathology laboratory laboratories to perform endoscope testing and moves afoot to also possibly introduce a QAP for Mycobacterial testing to satisfy heater cooler unit requirements. To have NATA accreditation for a particular test the laboratory is required to be enrolled in a formal QAP programme or if not available a laboratory exchange programme.
Kind regards
Dr Jenny Robson
Sullivan Nicolaides PathologyMichael,
I agree, I don’t think you are being pedantic at all. Normally everything is fine until there is a problem, i.e., you get an unexpected result. Then starts the usual cascade of events where you try to figure out why you have the result that you do. Is it a collection error, a testing error or and is it real?
If you are not dealing with an accredited lab, this is going to make it challenging to progress. Another issue that I have recently come across, is that it is not only an accredited lab that matters, but also that the test performed is NATA accredited as well AND to the standard specified.
My recent experience is with the requirement for Atypical mycobacteria testing or NTM. There are not many labs that actually perform this test as per the recommended methodology set out in ISO 15883-4 (see Annex E for detail). The water samples were sent to an accredited Environmental Laboratory, however as I was reviewing the results, I happened to read the fine print of the report and discovered that this was not a NATA accredited test. Then when we got a positive result, it became “challenging” to know what action to take, as there is always pressure to continue to use the equipment.
As a side point, because the decision usually on which lab to use is often a financial one, I recently received some great advice. If you are going to use a lab that is not accredited, then ensure that it is documented in your organisations risk register. I would also include actions to take when you do have a positive result.
Have a great day and good-luck.
Mandy Davidson
RN; GCert Inf Pre & Cont; MPHTM; Cert III Sterilisation; Cert IV TAE; Immunisation cred; CICP-A
Clinical Nurse Consultant – 4187 Implementation project
Infection Prevention & Control[cid:image001.png@01D3A192.E1513890]
T
07 4433 1873 | 0402 987 432
E
Mandy.Davidson@health.qld.gov.au
W
http://www.health.qld.gov.au/townsvilleTownsville Hospital and Health Service
100 Angus Smith Drive, Douglas, QLD 4814
[Facebook-Icon] [Twitter-Icon] [Linkedin-Icon]
Townsville Hospital and Health Service acknowledges the Traditional Owners of the land, and pays respect to Elders past, present and future.Hi all
Have a question. Like many of us, we have been microbiologically testing rinse waters from endoscopes and automated endoscope reprocesors (AERs) as per the GENCA/GESA guidelines for many years, via our human pathology testing lab. The lab has always maintained that it does these tests for us as a ‘favour’ (although we do pay… 🙂 ), as they are not NATA accredited to perform environmental testing, and that is what these tests actually are.
Now that the final advisory for AS/NZS4187:2014 has been released from the ASCQHC, and there is a definite requirement to perform water testing for these AERs by December 2021, we also have to consider endotoxin testing (which our human pathology lab does not do), and possibly some chemical purity tests (dependent upon AER manufacturer advice). Now we should probably consider whether all of the final rinse water testing should be done by a lab accredited by NATA for this purpose (eg an environmental testing lab), despite some of the components of testing are already being done by our human pathology lab.
AS/NZS4187: 2014 amendment 2:2019 has the following tests required for final rinse water in AERs:
Total viable count 10 cfu/100 mL
Pseudomonas aeruginosa Not detected/100 mL
(Atypical) Mycobacterium sp Not detected/ 100 mL
Chemical purity (as per manufacturer)
Endotoxin 30 EU/mLOf those, we already routinely perform the first three with our human pathology testing accredited lab. Not sure what methods they currently use (the standard is very specific), so would need to check that as well.
So, the question becomes: should we send ALL of our final rinse water specimens to an environmental testing accredited lab? Does anyone know if the NSQHS Standards accreditors will care which lab does what test, or they will look at the specific of the accreditation of the lab doing the testing, to measure compliance to this requirement of AS/NZS4187:2014?
This is not an issue in CSSD as our human pathology lab has always declined to process those water samples, so we already have an environmental lab processing those specimens.
Any thoughts or discussion would be valued. Am I being too pedantic about this, and no-one will care provided we get water tested?
Thanks
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]
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Hi Jenny
Depending on which state your facilities are in (which is why this infirmation is useful) there may be mandatory requirements for ice machine testing for Legionella, so best to ask your local health department for advice.
We only allow individual ice cube dispensing systems in our wards (no chest-type ice machines), and our haematology and oncology areas have no ice machines at all and have to freeze water from 0.5 micron filtered taps separately.
We test ice machines on a rotational basis with all other water sources (taps, ahower head, etc) in accordance with our state health department guidelines.
You will need a regular and thorough preventative maintenace program for any ice machines as well.
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 |
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Good Afternoon, Seeking opinions on ice machines across a large public health service.
Do you use them, what alternatives do you have for patient drinks etc or for other uses .
Also, what testing schedules do you have for legionella?
Many thanks
Jenny Breen
Clinical Nurse Consultant______________________________________________________________________
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Hi Martie
Apologies for my assertion milk banks were now TGA regulated. That was based on a discussion some years ago, and I thought TGA had included donated human breast milk as a tissue under their regulations (see http://www1.health.gov.au/internet/main/Publishing.nsf/Content/D94D40B034E00B29CA257BF0001CAB31/$File/Donor%20Human%20Milk%20Banking%20in%20Australia%20paper%20(D14-1113484).docx ), but on further investigation I see that did not eventuate.
As long as there are good standards, state-based or even facility-based, on which donor human breast milk is managed, I believe we are unlikely to see major cross infection.
All of your questions are good ones, and further information about the actual incidents and investigations would be useful for us as infection prevention and control professionals, but, sadly, this may never make it into the public arena due to the litigation process.
But, to me, it does reinforce, indeed, that basic cleaning and sanitisation of all items coming into contact with donor human breast milk, is so very critical.
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 |
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[2019 conference email signature]Hi Michael,
I have some experience with the breast milk bank (BMB) in Victoria.
The BMB was required to adhere strictly to the Victorian Human Tissue Act and the Victorian Food Act.
I am sure the requirements for other states will be equally as stringent.
I am unclear as to how the TGA should be involved in the regulation of a BMB if the state requirements are so stringent.
Would you please elaborate?My reading of the article is that the contamination occurred in the nursery with an accepted practise (within that unit) of hand washing measuring equipment at the cot side rather than in the pasteurisation/bottling & dispensing process from the BMB.
The take home message for me would be ensure an effective cleaning process is in place that meets food handling requirements.What I find worrying in the news item is that the source of pseudomonas is not clearly stated.
The measuring device is washed by hand so does this imply there is contamination in the tap water or are the devices stored in such a way to facilitate contamination?
Did they genotype the pseudomonas?
Would such a long standing seemingly insidious practise of hand washing a measure be missed by our Infection Control teams?
What other potentially dangerous but small practises are missed?
Lots of questions with this one!!! I am sure the legal case will sort out these details.Meanwhile 3 babies did not make it home.
It underlines the importance of good Infection Control practises.Maree
Maree Sommerville
Infection Control Consultant
VICNISS Coordinating Centre
Doherty Institute | Level 2
792 Elizabeth St Melbourne VIC 3000
T: +61 3 9342 9362 | F: +61 3 9342 9355 | http://www.vicniss.org.auThis tragedy in the US will be of interest to those with facilities with neonatal and maternity units.
The regulation of breast milk ‘banks’ under the TGA will help to prevent this sort of issue within Australia, hopefully.
Another reminder that basic cleaning and disinfection of equipment is never to be taken for granted.
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
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Hi Annie
I am not sure there is any real evidence to support use of IV cannulation trolleys to reduce IV related infections (although who knows what research AVATAR are doing!), but in regards to standardisation of equipment used for cannulation it is a great idea.
You will need to ensure that there is a mechanism to ensure the trolley contents are kept up to date and ‘other’ items are not added, though, otherwise the utility is reduced.
Oh, and make sure the right people can access them! We had a great IV trolley that was locked in a medication room that the in-house medical officers couldn’t access. So they never bothered to get someone to get it out for them!
Cheers
Michael Wishart
Infection Control Coordinator
St Vincent’s Private Hospital NorthsideMichael Wishart | Infection Control Coordinator, CICP-E
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Hi Annie,
You should consider contacting the Avatar Group in Brisbane, or visit their website.
Kindest
Caroline Shelverton
FlomatrixGet Outlook for iOS
________________________________Hi,
Im setting up a suite a cannulation trolleys and I am wanting to confirm, with evidence that ours are correct and ensure best practice.
I would appreciate any assistance.
Thanks
AnnieAnnie Zeitz
Nursing Chief Of Modality
P (08) 8402 4401 | M 0410 877 800 | F (08) 8402 4430
Dr Jones & Partners Medical Imaging
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