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Yes, Carol, it was.
Fir those interested, it vas this document from the UK: https://pdfs.semanticscholar.org/8cc8/9fb531d2b5ba454447b19f848c294ae757ed.pdf
Quite an interesting read about operating theatres!Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Thanks Michael, that confirms my thoughts. From memory Humphreys et al discussed overshoes as being of no value.
I would love to hear anybody else’s thoughts.
Cheers
CarolSent from my Samsung Galaxy smartphone.
——– Original message ——–
Hi Carol
Overshoes are not considered to reduce post-operative surgical site infections. From a biological plausibility/epidemiological viewpoint, it is hard to transmit infections routinely from the floor of an OT. But there is a suggestion that the touching of the feet/shoes to apply overshoes contaminates hands (that may not then get appropriately washed!).
The main reason for most staff attending a procedure wearing overshoes over their ‘outside’ shoes is to protect their shoes from splashes. No-body wants their $500 Gucci loafers to be stained with iodine, do they? 🙂
I recently did some consulting in an animal research facility, and the main issue with shoes there was not sterility during procedures, but the tracking of mud and dirt (and other stuff…) from the animal enclosures into the theatres. They had a process of changing from gumboots into disposable boots in an anteroom outside the theatre itself.
I would be comfortable with a no overshoes required policy (we have one here), but you might need to mention mud and dirt from outside (who cleans the shoes? How do you police this?), and have a way to protect those Gucci loafers!
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Dear Brains Trust
What are the latest thoughts on wearing dedicated shoes in the operating theatre?
We are currently looking at our Dress Code and because we are a veterinary hospital, we don’t have change rooms like human hospitals, so we tend to put shoe covers on but I think that is a problem due to potential of contamination of the hands.
I have been led to believe that shoe covers and/or dedicated shoes do not contribute to post-operative infections?
Thoughts?
Cheers
CarolCarol Bradley | Surgery Tutor/Clinical Skills Centre Manager
Associate in Veterinary Education (RVC)
Faculty of Veterinary & Agricultural Sciences (FVAS)
Level 1, Building 418, 250 Princes Hwy, Werribee
The University of Melbourne, Victoria 3010 Australia
T: +61 3 9731 2083 E: cbrad@unimelb.edu.auI acknowledge the Traditional Owners of the land on which I work, and pay my respects to the Elders, past and present.
[cid:image002.jpg@01D31D8F.E823DE70]
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Hi Carol
Overshoes are not considered to reduce post-operative surgical site infections. From a biological plausibility/epidemiological viewpoint, it is hard to transmit infections routinely from the floor of an OT. But there is a suggestion that the touching of the feet/shoes to apply overshoes contaminates hands (that may not then get appropriately washed!).
The main reason for most staff attending a procedure wearing overshoes over their ‘outside’ shoes is to protect their shoes from splashes. No-body wants their $500 Gucci loafers to be stained with iodine, do they? 🙂
I recently did some consulting in an animal research facility, and the main issue with shoes there was not sterility during procedures, but the tracking of mud and dirt (and other stuff…) from the animal enclosures into the theatres. They had a process of changing from gumboots into disposable boots in an anteroom outside the theatre itself.
I would be comfortable with a no overshoes required policy (we have one here), but you might need to mention mud and dirt from outside (who cleans the shoes? How do you police this?), and have a way to protect those Gucci loafers!
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Dear Brains Trust
What are the latest thoughts on wearing dedicated shoes in the operating theatre?
We are currently looking at our Dress Code and because we are a veterinary hospital, we don’t have change rooms like human hospitals, so we tend to put shoe covers on but I think that is a problem due to potential of contamination of the hands.
I have been led to believe that shoe covers and/or dedicated shoes do not contribute to post-operative infections?
Thoughts?
Cheers
CarolCarol Bradley | Surgery Tutor/Clinical Skills Centre Manager
Associate in Veterinary Education (RVC)
Faculty of Veterinary & Agricultural Sciences (FVAS)
Level 1, Building 418, 250 Princes Hwy, Werribee
The University of Melbourne, Victoria 3010 Australia
T: +61 3 9731 2083 E: cbrad@unimelb.edu.auI acknowledge the Traditional Owners of the land on which I work, and pay my respects to the Elders, past and present.
[cid:image002.jpg@01D31D8F.E823DE70]
This email and any attachments may contain personal information or information that is otherwise confidential or the subject of copyright. Any use, disclosure or copying of any part of it is prohibited. The University does not warrant that this email or any attachments are free from viruses or defects. Please check any attachments for viruses and defects before opening them. If this email is received in error, please delete it and notify us by return email.
______________________________________________________________________
This email and any attachments to it (the “Email”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. If you are not the intended recipient of the Email, please notify the sender immediately by return https://clicktime.symantec.com/3WguNAhLAiXJS6EfVbkERV7Vc?uemail%2C%20delete%20the%20Email%2C%20and%20do not copy, print, retransmit, store or act in reliance on the Email. St Vincent’s Health Australia (“SVHA”) does not guarantee that the Email is free from errors, viruses or interference. Emails to and from SVHA or its related entities may be scanned and filtered in locations outside Australia.
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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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[Posted on behalf of member Moderator]
Hi ,
We have asked VMOs to forward us their online hand hygiene certificate for the last 4 years with a 30% return rate. It is getting better but it takes time. Ive even had to sit at the computer with a few of the senior VMOs and go through it.
Good luckJane Howard
Infection Control
Sydney Private Hospital________________________________
From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> on behalf of Helen Roberts <robertsh@SATH.ORG.AU>
Sent: Thursday, 17 October 2019 1:31:49 PM
To: ACIPCLIST@ACIPC.ORG.AU <ACIPCLIST@ACIPC.ORG.AU>
Subject: [ACIPC_Infexion_Connexion] VMO hand hygieneHi everyone,
I have been asked to look at VMOs to undertake an annual mandatory and Hand Hygiene module as part of credentialing process.
Just wondering what other hospitals do?
I have email Hand Hygiene Australia to see what they recommended.
Any suggestion would be appreciated.
Kind regards,
Helen
Helen Roberts
Infection Control
P:
07 4646 3106
|
F:
07 4633 7602
E:
robertsh@sath.org.au
|
W:
http://www.sath.org.au
Post:
PO Box 263, Toowoomba, QLD 4350
Address:
280 North St, Toowoomba, QLD 4350
[cid:image561693.jpg@853736FD.CC41FBB8]
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 Leanne
Whilst there are no exact national guidelines for educational requirement for infection prevention and control professionals, a number of bodies of work have been published in the Australian context around this (eg https://www.idhjournal.com.au/article/S2468-0451(16)30267-X/pdf).
The NHMRC national infection control guidelines (https://www.nhmrc.gov.au/about-us/publications/australian-guidelines-prevention-and-control-infection-healthcare-2019) also have quite a good discussion on the educational requirements for infection control practitioners (section 4.3) and would be a great resource for any facility who is looking to employ an infection prevention and control professional.
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—–Original Message—–
From: ACIPC Infexion Connexion On Behalf Of Kelly Barton
Sent: Monday, 4 November 2019 8:08 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Drawing up IV solutionsHi Leanne,
I think that varies greatly! In my circumstance I was seconded to the position with no experience what so ever. Often in small rural health the person doing infection control just gets an extra hat for whatever reason. I have seen it go hand in hand with theatre roles, quality roles, ADON roles. We are extremely lucky in our region to have 2 regional consultants to play pivotal roles when this occurs and support the novices.
Most of the larger hospitals seem to have very specific requirements.Kelly
I acknowledge the traditional owners of the land on which we work and live, and respect their ongoing custodianship of the land. I pay respect to Aboriginal people, and Elders past and present.Kelly Barton
Infection Prevention & Control Officer
RN BHSc (Nursing). Grad Cert (Infection Control)(Advanced Acute Care). Nurse Immuniser.
Email: kelly.barton@alpinehealth.org.au
Office: 03 5751 9364
Mobile: 0409 885 002
Fax: 03 5751 9396
Address: 30 ODonnell Ave, Myrtleford VIC 3737
Website:www.alpinehealth.org.au
Reduce, re-use, recycle. Please consider the environment before printing this e-mail.—–Original Message—–
From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Leanne Sheppard
Sent: Friday, 13 September 2019 9:41 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Drawing up IV solutionsI have a question about employment as an infection control nurse:
What is the general consensus on appropriate qualifications for an infection control nurse?
What is the minimum qualifications your organisation would employ as an infection control nurse?Leanne Sheppard
BN, MPH, TAE, GDip Adult Ed, GC CFHN
Casual facilitator University of Newcastle Undergraduate nursing program
On Fri, Sep 13, 2019 at 9:32 AM Michael Wishart wrote:
>
> [Posted on behalf of member Moderator]
>
>
>
> Dear team
>
>
>
> I have a question are your staff using drawing up needles to prepare IV flushes and ABs from plastic vials or swabbing the vials with alcohol wipes then direct connecting the syringe to draw up?
>
> I would like to know so I can teach best practice infection control to the students.
>
>
>
> Kind regards
>
> Leanne Sheppard
>
> BN, MPH, TAE, GDip Adult Ed, GC CFHN
>
> Casual facilitator University of Newcastle Undergraduate nursing
> program
>
>
>
>
> ______________________________________________________________________
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> acipclist’ (without the quotes) to listserv@aicalist.org.auMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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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.______________________________________________________________________
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 Deb
ACIPC has Aseptic Technique resources freely available.
https://www.acipc.org.au/aseptic-technique-resources/
Cheers
MichaelMichael Wishart
Infection Control Coordinator
St Vincent’s Private Hospital Northside
Michael.wishart@svha.org.auGet Outlook for Android
________________________________
Hi Deb, we purchased an ANTT model , very simplistic and outlines each step you need to take in terms of running the program & to educate auditors & staff ect
Emma Trippe
Infection Control Consultant[cid:image001.png@01D58E75.8A109CC0]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.auHospitality | Healing | Stewardship | Respect
Continuing the Mission of the Sisters of the Little Company of Mary
This email is confidential and may be subject to copyright and legal professional privilege. If this email is not intended for you please do not use the information in any way, but delete and notify us immediately. For full copy of our Privacy Policy please visit
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Firstly
Thank you so much to those who replied with such great ideas,
I took advice from everyone and created an article talking about our Infection Prevention passion and how we consider it to be a multi-disciplinary effort,
I gave information and advice surrounding pre op to post op measures with some info surrounding post op infection signs
I think it came out well.
Also just checking, has anyone done a course to accredit them for ANNT auditing? I would be interested to hear what is available
Thank you
Deb
Deborah Vos
Infection Prevention & Control Coordinator
Glenelg Community Hospital
5 Farrell St Glenelg South SA 5045
P: (08) 8294 5555
W: http://www.glenelghosp.com.au
[cid:image002.png@01D504DE.6DEA4C60]
Hi Deb & Michael,
These sound like great ideas. Working in general practice I ca say that advice about dressing materials can also be helpful, especially if they are new fancy types of dressing. We dont have easy access to a wide range of dressing unless they are pre-ordered and privately purchased so to set expectations about specialised dressing would also be helpful. General practice under Medicare cannot charge bulk-billed patients for dressing so we often need to get patients to order expensive dressing separately. General Practice already supplies a lot of dressing and bears the cost, which for small business can be very expensive. The GPs & RNs will appreciate your advice.
Kind regards
Karen
Karen Booth
RN BHSCN GAICD
President APNA
Australian Primary Health Care Nurses Association
M: 0411 898 884
Australian Primary Health Care Nurses Association (APNA)
Level 17/350 Queen Street, Melbourne VIC 3000
p: 1300 303 184 f: (03) 9322 9599
president@apna.asn.au | http://www.apna.asn.au[cid:image001.png@01D58B2F.D3F63730]
Hi Deb
What a great opportunity!
As a small surgical hospital, I would suggest you focus on what the GPs would most need to know to help improve patient outcomes. Here are some ideas:
1. You could talk about antibiotic surgical prophylaxis and the guidelines.
2. You could talk about the risk factors for surgical site infections, and how pre-operative preparation can help reduce the risks.
3. You could talk about wound management post op, and reporting of surgical site infections back to the hospital (if that fits in with your infection control plan).
4. You could talk about the facility MRO screening program, and how GPs can help with clearance (if you have a process).There are lots of things that you could talk about, but my preferences would be things that may improve your patients outcomes if the GPs implement or follow them.
Cheers
Michael
Michael 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 |
[cid:image001.jpg@01D58B0E.A1397D00]
[2019 conference email signature]
Hi all,
I am still fairly new to my role as IPC and I find enormous value in reading your emails.
I have been asked to submit an article/item of interest for a newsletter that our hospital plans to publish for local Gps in the area to let them know about our growing range of surgical specialties
We are a small community hospital with no medical patients, only a few surgical patients staying 3-6 nights and day surgery.
I would be appreciative of any ideas,
Thanks in advance
Deb
Deborah Vos
Infection Prevention & Control Coordinator
Glenelg Community Hospital
5 Farrell St Glenelg South SA 5045
P: (08) 8294 5555
W: http://www.glenelghosp.com.au
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Thanks Steven
I think reusable hats would be problematic in some facilities where they have been banned (ACORN recommendation).
My OT NUM noted that some facilities have disposable scrub ‘vending machines’ from which company reps purchase scrubs to wear. Maybe that is something the industry could review as an option?
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Michael,
Yes , it is understood that a fresh set per department (even within the same hospital) would be required. This would be our policy
As indicated, we are also exploring the disposable option, or even reusable branded hats, and hospital issued scrubs.Best regards / Mit freundlichen Gren
Steven Doak
Marketing Manager
Hospital Consumables & AccessoriesDraeger Australia Pty. Ltd.
8 Acacia Place
Notting Hill VIC 3168
Steven.Doak@draeger.com
http://www.draeger.comDrger. Technology for Life
[Title: Facebook] [Title: Twitter] [Title: LinkedIn] [Title: YouTube]
Apologies, Steven, I forgot to ask you to fully identify yourself before I approved this post, although I am sure you are an employee of Draeger…
My response to this idea would be that it would not fit neatly into out scrub uniform policy. We require any person entering the OR suite to change out of clothes that are worn outside the hospital buildings into freshly laundered scrubs. Company reps would need to bring their freshly laundered scrubs with them to change into, and if they visited many hospital in a day this would be problematic.
It is a good idea for identification of company reps, but maybe not with specific scrubs.
Will be interested in further comments, though.
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Afternoon All
We are considering “company scrubs” , branded, to help identify company reps who often work in direct clinical areas where scrubs are worn , especially in the OR.
We would like the group verdict on this proposal.
Issues already consideredClean and correctly fitted scrubs
Regular laundry , with several sets per rep.
Disposable scrubs? …
Best regards / Mit freundlichen Gren
Steven Doak
Hi Marija
Yes, an old chestnut, still causing issues. I have to say upfront, though, that the evidence that scrubs make any difference (in any setting) to reduce infection risk is pretty non-existent. So I consider more an staff aesthetics and protection of clothing issue than an infection n prevention one.
1. Wearing of scrubs in endo and for bronchs is not universal, but staff have the option, when they are done outside the main theatre suite.
2. Bone marrow often biopsied in the ward, and no one has scrubs on. Some are done in Cath lab procedure room, but even then the proceduralists (who is not a cath lab staff member) wears scrubs – they may have a cover gown on rather than scrubs.
3. We have a policy that scrubs are only changed if visibly soiled, or after leaving and re-entering the building (eg walking between hospitals). No cover gowns required when visiting wards, etc, but we try and stop them visiting wards with visibly soiled scrubs!
4. We have designated tea rooms in all procedural areas, so not food outside of these. Staff may have a designated, labelled water bottle (we prefer the non-spill type) within the theatre suite, but not in the actual theatres (difficult to stop our visiting anaesthetists from bringing their drinks in their case and tipping then under their masks during procedures, though… ).
I think because of lack of ‘evidence’ to support any position this will always remain a controversial topic!
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Good afternoon all,
This might be the chestnut that keeps giving but I am just wondering what practices are in place at your healthcare facilities with regard to:
1. The wearing of surgical scrubs for endoscopy, bone marrow biopsy, interventional radiology, thoracic procedure areas which may be co-located within general surgical suite/ zone?
2. Staff changing their scrubs when leaving and re-entering the theatre?
3. Staff consumption of food and beverages within the theatre areas including recovery nurses station?
I know it seems common sense and standards are available, but we are constantly informed to provide the evidence. Just wanting to benchmark with other HCF.
Any feedback/comments greatly appreciated.
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
[cid:image001.jpg@01D4C9F1.E7C51060]
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Apologies, Steven, I forgot to ask you to fully identify yourself before I approved this post, although I am sure you are an employee of Draeger…
My response to this idea would be that it would not fit neatly into out scrub uniform policy. We require any person entering the OR suite to change out of clothes that are worn outside the hospital buildings into freshly laundered scrubs. Company reps would need to bring their freshly laundered scrubs with them to change into, and if they visited many hospital in a day this would be problematic.
It is a good idea for identification of company reps, but maybe not with specific scrubs.
Will be interested in further comments, though.
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Afternoon All
We are considering “company scrubs” , branded, to help identify company reps who often work in direct clinical areas where scrubs are worn , especially in the OR.
We would like the group verdict on this proposal.
Issues already consideredClean and correctly fitted scrubs
Regular laundry , with several sets per rep.
Disposable scrubs? …
Best regards / Mit freundlichen Gren
Steven Doak
Hi Marija
Yes, an old chestnut, still causing issues. I have to say upfront, though, that the evidence that scrubs make any difference (in any setting) to reduce infection risk is pretty non-existent. So I consider more an staff aesthetics and protection of clothing issue than an infection n prevention one.
1. Wearing of scrubs in endo and for bronchs is not universal, but staff have the option, when they are done outside the main theatre suite.
2. Bone marrow often biopsied in the ward, and no one has scrubs on. Some are done in Cath lab procedure room, but even then the proceduralists (who is not a cath lab staff member) wears scrubs – they may have a cover gown on rather than scrubs.
3. We have a policy that scrubs are only changed if visibly soiled, or after leaving and re-entering the building (eg walking between hospitals). No cover gowns required when visiting wards, etc, but we try and stop them visiting wards with visibly soiled scrubs!
4. We have designated tea rooms in all procedural areas, so not food outside of these. Staff may have a designated, labelled water bottle (we prefer the non-spill type) within the theatre suite, but not in the actual theatres (difficult to stop our visiting anaesthetists from bringing their drinks in their case and tipping then under their masks during procedures, though… ).
I think because of lack of ‘evidence’ to support any position this will always remain a controversial topic!
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Good afternoon all,
This might be the chestnut that keeps giving but I am just wondering what practices are in place at your healthcare facilities with regard to:
1. The wearing of surgical scrubs for endoscopy, bone marrow biopsy, interventional radiology, thoracic procedure areas which may be co-located within general surgical suite/ zone?
2. Staff changing their scrubs when leaving and re-entering the theatre?
3. Staff consumption of food and beverages within the theatre areas including recovery nurses station?
I know it seems common sense and standards are available, but we are constantly informed to provide the evidence. Just wanting to benchmark with other HCF.
Any feedback/comments greatly appreciated.
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
[cid:image001.jpg@01D4C9F1.E7C51060]
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Hi Deb
What a great opportunity!
As a small surgical hospital, I would suggest you focus on what the GP’s would most need to know to help improve patient outcomes. Here are some ideas:
1. You could talk about antibiotic surgical prophylaxis and the guidelines.
2. You could talk about the risk factors for surgical site infections, and how pre-operative preparation can help reduce the risks.
3. You could talk about wound management post op, and reporting of surgical site infections back to the hospital (if that fits in with your infection control plan).
4. You could talk about the facility MRO screening program, and how GP’s can help with clearance (if you have a process).
There are lots of things that you could talk about, but my preferences would be things that may improve your patient’s outcomes if the GP’s implement or follow them.
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Hi all,
I am still fairly new to my role as IPC and I find enormous value in reading your emails.
I have been asked to submit an article/item of interest for a newsletter that our hospital plans to publish for local Gp’s in the area to let them know about our growing range of surgical specialties
We are a small community hospital with no medical patients, only a few surgical patients staying 3-6 nights and day surgery.I would be appreciative of any ideas,
Thanks in advanceDeb
Deborah Vos
Infection Prevention & Control Coordinator
Glenelg Community Hospital
5 Farrell St Glenelg South SA 5045
P: (08) 8294 5555
E: d.vos@gchi.com.au
W: http://www.glenelghosp.com.au
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Hi Emma
This was posted on the list in August:
As you are aware, concerns have been raised with the Commission about the application of Standard Australia standard AS/NZS4187:2014 – Reprocessing of reusable medical devices in health service organisations.
The Commission agreed at the June meetings of the IJC and the Private Hospital Sector Committee to conduct a workshop to consider these issues and redraft the current Advisory AS18/07 in the interim.
Please be advised that an amended Advisory AS18/07 – Reprocessing of reusable medical devices in health service organisations was released today. It can be found on our website at the following link – https://www.safetyandquality.gov.au/publications-and-resources/resource-library/as1807-reprocessing-reusable-medical-devices-health-service-organisations
Please contact Margaret Banks on 02 9126 3684 if you have any queries in relation to this matter.
Thank you.
Kind regards,
KatherineKatherine Norden
Manager, Secretariat and Corporate Governance
Australian Commission on Safety and Quality in Health Care
GPO Box 5480 Sydney NSW 2001 | Level 5, 255 Elizabeth Street, Sydney NSW 2000
T (02) 9126 3532 | http://www.safetyandquality.gov.au
[cid:image001.gif@01D03B13.6E23ED10]Follow us on Twitter @ACSQHCCheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Hi Brainstrust,
have the dates re compliance to AS4187 recently changed??
Thanks,
EmmaEmma Trippe
Infection Control Consultant
[cid:image001.png@01D585A0.1CDB66E0]
Calvary Riverina Hospital
Hardy Avenue Wagga Wagga NSW 2650
P: 02 6932 1628
E: Emma.Trippe@calvarycare.org.au
http://www.calvary-wagga.com.auHospitality | Healing | Stewardship | Respect
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Apparently it was widely practiced in the UK at least for taking blood from neonates. But as this study records, it has significant drawbacks. Some resulting in actual patient harm.
http://eprints.bournemouth.ac.uk/5750/1/venepuncture_study.pdf
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]
[2019 conference email signature]From: ACIPC Infexion Connexion On Behalf Of Claire Nayda (SCHN)
Sent: Thursday, 10 October 2019 12:29 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesHi
Ive never heard of or practiced breaking needles in any Paeds setting.Claire Nayda | A/CNC Infection Prevention & Control | Microbiology
t: (02) 9845 0534 | p: 6820 | e: claire.nayda@health.nsw.gov.au | w: http://www.schn.health.nsw.gov.auFrom: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Michael Wishart
Sent: Thursday, 10 October 2019 1:14 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesHi Hannah
Please explain why needles have to be broken for paediatrics. In this patient population, I would be very concerned about manipulation of any clinical device (such as a needle) and the potential to cause the patient harm because the device had been damaged or changed.
I would reinforce the need to use specific devices where necessary, rather than staff trying to change an existing device. How would facility or a practitioner defend harm caused through a device that had been changed?
Any manipulation of a sharp, whether prior to, during or after use, should definitely be avoided.
Too often we make choices that we are not in a position to make because we did not consider the risk (or thought the risk was too small to be of concern). But altering medical devices is way beyond the engineering, ergonomics and clinical safety expertise of most of us.
Apologies for the rant; I have strong views on this. And its my view, at least, and I would welcome further comment from others
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]
[2019 conference email signature]From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Brien, Hannah
Sent: Thursday, 10 October 2019 11:47 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesWhat about the breaking off of needles for paediatrics!!
Hannah Brien
Infection Control Clinical Nurse
Phone:07 4052 8029From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Michelle Fernandez (NSW Ambulance)
Sent: Thursday, 10 October 2019 11:00 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesHi Sam,
As per Michaels response below, bending needles increase the risk of sharps injury. Here are a few documents that reference bending as an increased risk of sharps injury.:
https://www.cdc.gov/sharpssafety/pdf/WorkbookComplete.pdf (page 10)
Injection safety at primary health care level in south-western Saudi Arabia: https://ciap.ovidds.com.acs.hcn.com.au/discover/result?acc=36422&logSearchID=34195713&pubid=6057-medline%3A19554992
Effect of changing needle disposal systems on needle puncture injuries: https://ciap.ovidds.com.acs.hcn.com.au/discover/result?acc=36422&logSearchID=34195713&pubid=6057-medline%3A3644804
Kind regards,
Michelle
Michelle Fernandez
CNC | Manager, Infection Control | Clinical Systems Integration
Part time work days: Wednesday, Thursday, Friday
Balmain Road, ROZELLE NSW 2039
p: 02 9320 7868 | m: 0429 926 505 | f: 02 9320 7729 | Michelle.Fernandez@health.nsw.gov.au
http://www.ambulance.nsw.gov.au
[cid:image002.png@01D37B37.BA4491B0]
Follow NSW Ambulance on: [cid:image003.png@01D37B37.BA4491B0] [cid:image004.png@01D37B37.BA4491B0]From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Michael Wishart
Sent: Thursday, October 10, 2019 9:07 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesHi Sam
In my understanding no manipulation of sharps is recommended because of the risks of either sharps injury or damage to the sharp resulting in harm to the patient (eg needle breaking off inside patient). Even manipulating clean needles may result in an exposure if the manipulation is done using gloves contaminated with blood or body fluid.
Where needles are required to have angled tips, there should be specifically manufactured needles used for this, rather than manipulation of the needles.
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]
[2019 conference email signature]From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Sam Dickson
Sent: Wednesday, 9 October 2019 8:17 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesHi Brains Trust,
what are your thoughts on ‘bending’ CLEAN needles for anaesthetic or ophthalmic procedures? I’m currently reviewing our ‘Sharps Handling Procedure’ and it was suggested that ‘bending’ should be added to the procedure. In my research ‘bending’ is not supported by any standard/guideline. Your thoughts appreciated….Kind regards
Sam Dickson
E+E Hospital
VictoriaOn Mon, 7 Oct 2019 at 12:24, Lesley Lewis <Lesley.Lewis@nhw.org.au> wrote:
Dear all,
Safety devices for recapping needles have been on the market for many years.
Recapping needles by hand is a risky practice (and habit) that should not be encouraged for any needles clean or used (a one size fits all approach)Fiona raises a good question and I too am interested to hear if there is any literature and evidence validating the risk of chemical exposure (medications/drugs) to clinical staff through aerosol and splash when priming syringes and other equipment.
How can the risk be managed?
Is recapping the only possible risk management method?
Are there any alternative methods?
If the risk is serious should fume cabinets have a place in ward medication rooms?As noted in the original post a needle (blunt or otherwise) should never be recapped. The recommendation against recapping needles is clearly articulated in the national IPAC guidelines.
Page 2 and on page 51: Statutory Requirement. 7. It is good practice to follow safe sharp handling practices including: not passing sharps directly from hand to hand keep handling to a minimum not recapping, bending or breaking needles after use.
Page 51: In dentistry, recapping or disassembling sharps may be unavoidable. If so, a risk assessment must be undertaken and safety devices should be used where appropriate[89].
Page 52: Certainty of the Evidence. This advice is based on limited evidence, but on sound theoretical principles and supported by expert advice. National and international guidelines are consistent in the advice regarding the importance of the safe use and disposal of sharps. The Epic Guidelines[78] recommend that sharps should not be passed directly from hand to hand, and that needles must not be bent, broken or recapped.
Regards,
Lesley Lewis
Regional Infection Control Consultant HRICRCS Program
Tel: (03) 57 225486 Lesley.Lewis@nhw.org.auFrom: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Angela Carvosso
Sent: Friday, 4 October 2019 11:01 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesHi Fiona,
I personally recap just to remove the needle from the syringe as I was taught to never touch the coloured hub. The premise of not recapping is to prevent transmission of infection via needlestick from needles used on people. A risk analysis would indicate that as the needle has not been used on a person then it is safe to recap.
Regards Angela Carvosso
RN Warwick HospitalSent from Mail for Windows 10
________________________________
From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> on behalf of De Sousa, Fiona M <fiona.de.sousa@THS.TAS.GOV.AU>
Sent: Wednesday, October 2, 2019 4:28:46 PM
To: ACIPCLIST@ACIPC.ORG.AU <ACIPCLIST@ACIPC.ORG.AU>
Subject: [ACIPC_Infexion_Connexion] FW: Sharps Safety and Recapping Drawing up NeedlesHi All,
We are currently having discussions about how to safely draw up medications and whether it is suitable to recap a blunt fill drawing up needle to expel air from a syringe.
One side of the argument is that the blunt fill is recapped so that when air is expelled the contents are not aerosolised. The other side is that a needle (blunt or otherwise) should never be recapped.
I would be interested to know other peoples thoughts and what evidence if any you have for this.
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_controlIPCU By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms
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Hi Hannah
Please explain why needles have to be broken for paediatrics. In this patient population, I would be very concerned about manipulation of any clinical device (such as a needle) and the potential to cause the patient harm because the device had been damaged or changed.
I would reinforce the need to use specific devices where necessary, rather than staff trying to change an existing device. How would facility or a practitioner defend harm caused through a device that had been changed?
Any manipulation of a sharp, whether prior to, during or after use, should definitely be avoided.
Too often we make choices that we are not in a position to make because we did not consider the risk (or thought the risk was too small to be of concern). But altering medical devices is way beyond the engineering, ergonomics and clinical safety expertise of most of us.
Apologies for the rant; I have strong views on this. And its my view, at least, and I would welcome further comment from others
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]
[2019 conference email signature]From: ACIPC Infexion Connexion On Behalf Of Brien, Hannah
Sent: Thursday, 10 October 2019 11:47 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesWhat about the breaking off of needles for paediatrics!!
Hannah Brien
Infection Control Clinical Nurse
Phone:07 4052 8029From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Michelle Fernandez (NSW Ambulance)
Sent: Thursday, 10 October 2019 11:00 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesHi Sam,
As per Michaels response below, bending needles increase the risk of sharps injury. Here are a few documents that reference bending as an increased risk of sharps injury.:
https://www.cdc.gov/sharpssafety/pdf/WorkbookComplete.pdf (page 10)
Injection safety at primary health care level in south-western Saudi Arabia: https://ciap.ovidds.com.acs.hcn.com.au/discover/result?acc=36422&logSearchID=34195713&pubid=6057-medline%3A19554992
Effect of changing needle disposal systems on needle puncture injuries: https://ciap.ovidds.com.acs.hcn.com.au/discover/result?acc=36422&logSearchID=34195713&pubid=6057-medline%3A3644804
Kind regards,
Michelle
Michelle Fernandez
CNC | Manager, Infection Control | Clinical Systems Integration
Part time work days: Wednesday, Thursday, Friday
Balmain Road, ROZELLE NSW 2039
p: 02 9320 7868 | m: 0429 926 505 | f: 02 9320 7729 | Michelle.Fernandez@health.nsw.gov.au
http://www.ambulance.nsw.gov.au
[cid:image002.png@01D37B37.BA4491B0]
Follow NSW Ambulance on: [cid:image003.png@01D37B37.BA4491B0] [cid:image004.png@01D37B37.BA4491B0]From: ACIPC Infexion Connexion [mailto:ACIPCLIST@ACIPC.ORG.AU] On Behalf Of Michael Wishart
Sent: Thursday, October 10, 2019 9:07 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesHi Sam
In my understanding no manipulation of sharps is recommended because of the risks of either sharps injury or damage to the sharp resulting in harm to the patient (eg needle breaking off inside patient). Even manipulating clean needles may result in an exposure if the manipulation is done using gloves contaminated with blood or body fluid.
Where needles are required to have angled tips, there should be specifically manufactured needles used for this, rather than manipulation of the needles.
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]
[2019 conference email signature]From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Sam Dickson
Sent: Wednesday, 9 October 2019 8:17 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesHi Brains Trust,
what are your thoughts on ‘bending’ CLEAN needles for anaesthetic or ophthalmic procedures? I’m currently reviewing our ‘Sharps Handling Procedure’ and it was suggested that ‘bending’ should be added to the procedure. In my research ‘bending’ is not supported by any standard/guideline. Your thoughts appreciated….Kind regards
Sam Dickson
E+E Hospital
VictoriaOn Mon, 7 Oct 2019 at 12:24, Lesley Lewis <Lesley.Lewis@nhw.org.au> wrote:
Dear all,
Safety devices for recapping needles have been on the market for many years.
Recapping needles by hand is a risky practice (and habit) that should not be encouraged for any needles clean or used (a one size fits all approach)Fiona raises a good question and I too am interested to hear if there is any literature and evidence validating the risk of chemical exposure (medications/drugs) to clinical staff through aerosol and splash when priming syringes and other equipment.
How can the risk be managed?
Is recapping the only possible risk management method?
Are there any alternative methods?
If the risk is serious should fume cabinets have a place in ward medication rooms?As noted in the original post a needle (blunt or otherwise) should never be recapped. The recommendation against recapping needles is clearly articulated in the national IPAC guidelines.
Page 2 and on page 51: Statutory Requirement. 7. It is good practice to follow safe sharp handling practices including: not passing sharps directly from hand to hand keep handling to a minimum not recapping, bending or breaking needles after use.
Page 51: In dentistry, recapping or disassembling sharps may be unavoidable. If so, a risk assessment must be undertaken and safety devices should be used where appropriate[89].
Page 52: Certainty of the Evidence. This advice is based on limited evidence, but on sound theoretical principles and supported by expert advice. National and international guidelines are consistent in the advice regarding the importance of the safe use and disposal of sharps. The Epic Guidelines[78] recommend that sharps should not be passed directly from hand to hand, and that needles must not be bent, broken or recapped.
Regards,
Lesley Lewis
Regional Infection Control Consultant HRICRCS Program
Tel: (03) 57 225486 Lesley.Lewis@nhw.org.auFrom: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Angela Carvosso
Sent: Friday, 4 October 2019 11:01 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesHi Fiona,
I personally recap just to remove the needle from the syringe as I was taught to never touch the coloured hub. The premise of not recapping is to prevent transmission of infection via needlestick from needles used on people. A risk analysis would indicate that as the needle has not been used on a person then it is safe to recap.
Regards Angela Carvosso
RN Warwick HospitalSent from Mail for Windows 10
________________________________
From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> on behalf of De Sousa, Fiona M <fiona.de.sousa@THS.TAS.GOV.AU>
Sent: Wednesday, October 2, 2019 4:28:46 PM
To: ACIPCLIST@ACIPC.ORG.AU <ACIPCLIST@ACIPC.ORG.AU>
Subject: [ACIPC_Infexion_Connexion] FW: Sharps Safety and Recapping Drawing up NeedlesHi All,
We are currently having discussions about how to safely draw up medications and whether it is suitable to recap a blunt fill drawing up needle to expel air from a syringe.
One side of the argument is that the blunt fill is recapped so that when air is expelled the contents are not aerosolised. The other side is that a needle (blunt or otherwise) should never be recapped.
I would be interested to know other peoples thoughts and what evidence if any you have for this.
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_controlIPCU By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms
________________________________
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Hi Sam
In my understanding no manipulation of sharps is recommended because of the risks of either sharps injury or damage to the sharp resulting in harm to the patient (eg needle breaking off inside patient). Even manipulating clean needles may result in an exposure if the manipulation is done using gloves contaminated with blood or body fluid.
Where needles are required to have angled tips, there should be specifically manufactured needles used for this, rather than manipulation of the needles.
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]
[2019 conference email signature]From: ACIPC Infexion Connexion On Behalf Of Sam Dickson
Sent: Wednesday, 9 October 2019 8:17 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesHi Brains Trust,
what are your thoughts on ‘bending’ CLEAN needles for anaesthetic or ophthalmic procedures? I’m currently reviewing our ‘Sharps Handling Procedure’ and it was suggested that ‘bending’ should be added to the procedure. In my research ‘bending’ is not supported by any standard/guideline. Your thoughts appreciated….Kind regards
Sam Dickson
E+E Hospital
VictoriaOn Mon, 7 Oct 2019 at 12:24, Lesley Lewis <Lesley.Lewis@nhw.org.au> wrote:
Dear all,
Safety devices for recapping needles have been on the market for many years.
Recapping needles by hand is a risky practice (and habit) that should not be encouraged for any needles clean or used (a one size fits all approach)Fiona raises a good question and I too am interested to hear if there is any literature and evidence validating the risk of chemical exposure (medications/drugs) to clinical staff through aerosol and splash when priming syringes and other equipment.
How can the risk be managed?
Is recapping the only possible risk management method?
Are there any alternative methods?
If the risk is serious should fume cabinets have a place in ward medication rooms?As noted in the original post a needle (blunt or otherwise) should never be recapped. The recommendation against recapping needles is clearly articulated in the national IPAC guidelines.
Page 2 and on page 51: Statutory Requirement. 7. It is good practice to follow safe sharp handling practices including: not passing sharps directly from hand to hand keep handling to a minimum not recapping, bending or breaking needles after use.
Page 51: In dentistry, recapping or disassembling sharps may be unavoidable. If so, a risk assessment must be undertaken and safety devices should be used where appropriate[89].
Page 52: Certainty of the Evidence. This advice is based on limited evidence, but on sound theoretical principles and supported by expert advice. National and international guidelines are consistent in the advice regarding the importance of the safe use and disposal of sharps. The Epic Guidelines[78] recommend that sharps should not be passed directly from hand to hand, and that needles must not be bent, broken or recapped.
Regards,
Lesley Lewis
Regional Infection Control Consultant HRICRCS Program
Tel: (03) 57 225486 Lesley.Lewis@nhw.org.auFrom: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Angela Carvosso
Sent: Friday, 4 October 2019 11:01 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sharps Safety and Recapping Drawing up NeedlesHi Fiona,
I personally recap just to remove the needle from the syringe as I was taught to never touch the coloured hub. The premise of not recapping is to prevent transmission of infection via needlestick from needles used on people. A risk analysis would indicate that as the needle has not been used on a person then it is safe to recap.
Regards Angela Carvosso
RN Warwick HospitalSent from Mail for Windows 10
________________________________
From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> on behalf of De Sousa, Fiona M <fiona.de.sousa@THS.TAS.GOV.AU>
Sent: Wednesday, October 2, 2019 4:28:46 PM
To: ACIPCLIST@ACIPC.ORG.AU <ACIPCLIST@ACIPC.ORG.AU>
Subject: [ACIPC_Infexion_Connexion] FW: Sharps Safety and Recapping Drawing up NeedlesHi All,
We are currently having discussions about how to safely draw up medications and whether it is suitable to recap a blunt fill drawing up needle to expel air from a syringe.
One side of the argument is that the blunt fill is recapped so that when air is expelled the contents are not aerosolised. The other side is that a needle (blunt or otherwise) should never be recapped.
I would be interested to know other peoples thoughts and what evidence if any you have for this.
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_controlIPCU By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms
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Oh, and I should have clarified: the seroma would have to be at the incisional site of the surgery, not at a drain or other stab wound or other distal site, to meet the SSI criteria for NHSN.
Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Hi Holly
This is from the CDC website, referring to the NHSN definition for SSI:
Surgical Site – Hematomas and Seromas
The fact that wounds can be labeled in various ways by different physicians is the reason that criteria rather than labels or diagnoses are used for SSI determinations. If a wound described as a hematoma or seroma meets an SSI criterion (for example, an organism is identified from a hematoma) it must be reported as an SSI.
https://www.cdc.gov/nhsn/faqs/faq-ssi.html
Hope that helps.Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Dear Brains Trust,
A question has cropped up in relation to seroma and surgical site infections.
If one develops post-surgery, would it be classified as a complication and if it cultured an organism, then and would you class it as a SSI?
Does anyone know of any evidence to support this or not?
Thank you in advance for your wisdom.
Kind Regards,
Holly
Holly Dodd
Infection Prevention and control Clinical Nurse Consultant
Sydney Adventist Hospital | 185 Fox Valley Road, Wahroonga, NSW 2076
Monday- Thursdayp: +61 2 9847 9433 | f: +61 2 9473 8053 | m: +61 408468470 | e: Holly.Dodd@sah.org.au
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Hi Holly
This is from the CDC website, referring to the NHSN definition for SSI:
Surgical Site – Hematomas and Seromas
The fact that wounds can be labeled in various ways by different physicians is the reason that criteria rather than labels or diagnoses are used for SSI determinations. If a wound described as a hematoma or seroma meets an SSI criterion (for example, an organism is identified from a hematoma) it must be reported as an SSI.
https://www.cdc.gov/nhsn/faqs/faq-ssi.html
Hope that helps.Cheers
MichaelMichael Wishart | Infection Control Coordinator, CICP-E
St Vincent’s Private Hospital Northside | 627 Rode Road CHERMSIDE QLD 4032
T +61 7 3326 3068 | F +61 7 3607 2226
E michael.wishart@svha.org.au |
W https://www.svphn.org.au[cid:image001.jpg@01D46C86.4CDB6090]
[2019 conference email signature]Dear Brains Trust,
A question has cropped up in relation to seroma and surgical site infections.
If one develops post-surgery, would it be classified as a complication and if it cultured an organism, then and would you class it as a SSI?
Does anyone know of any evidence to support this or not?
Thank you in advance for your wisdom.
Kind Regards,
Holly
Holly Dodd
Infection Prevention and control Clinical Nurse Consultant
Sydney Adventist Hospital | 185 Fox Valley Road, Wahroonga, NSW 2076
Monday- Thursdayp: +61 2 9847 9433 | f: +61 2 9473 8053 | m: +61 408468470 | e: Holly.Dodd@sah.org.au
http://www.sah.org.au[Description: Description: SAH_EntitySignature2017][Description: Description: Description: 5 moments hand hygiene]
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_____________________________________________________________________
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Hi Helen
I know I have recently seen a document on this, but I cant recall where!
From a biological plausibility perspective, alcohol is a great instantaneous skin disinfectant. The addition to chlorhexidine to alcohol improves the residual activity markedly, but does not necessarily improve actual disinfection. So, for any device that remains at the venepuncture site (eg a peripheral IV cannula), a 2% chlorhexidine plus alcohol preparation is the preferred disinfectant for insertion and management.
For routine venepuncture to draw blood for analysis, for swabbing access ports of IV lines, or for any other procedure that does not need a residual effect, 70% alcohol is sufficient.
Hopefully someone else can actually cite a study or guidelines this is actually spelled out in.
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]
[2019 conference email signature]From: ACIPC Infexion Connexion On Behalf Of Helen Scott
Sent: Monday, 23 September 2019 12:44 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: [ACIPC_Infexion_Connexion] skin prep prior to venepunctureHi all,
Can anyone tell me where I can find some info on using CHG impregnated alcohol swabs for skin prep prior to blood collection/venepuncture. Page 15 of PD2019_040 states skin cleansing for all other device insertions is CHG + alcohol. Do you translate this as being venepuncture too, seeing as we are inserting a device into a vein?Thanks,
Helen.Helen Scott
A/Clinical Nurse Consultant Infection Prevention & Control
Clinical Governance Unit Far West LHD
Broken Hill Health Service, Thomas Street
Broken Hill, NSW, 2880
Tel (08) 8080 1331 | Mob 0427 671 755 | Email helen.scott1@health.nsw.gov.au
[Far West Health Jobs]This message is intended for the addressee named and may contain confidential information. If you are not the intended recipient, please delete it and notify the sender.
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