[Thomson, Rachel EA]

Hi Glenys,

We do not keep the surface wet necessarily, although on occasion some items remain wet for a time. My understanding is that it is the presence of the chlorine salts at the correct concentration that effects the kill organisms on the cleaned surface. I would be interested in comments on this understanding from either you or another list member.

Cheers
Rachel

Rachel Thomson

Nurse Unit Manager
Infection Prevention & Control Unit
Royal Hobart Hospital
E: rachel.thomson@dhhs.tas.gov.au

Subject:

Hi Rachel,

How do you keep the surface/s wet to achieve a 10minute contact time?

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

Hi Vicki,

At the RHH we use a combined detergent and sodium hypochlorite disinfectant solution at 1000ppm (commercially prepared solution). We use this as a 1 or 2 two-step agent. We clean and disinfect the room and associated items with the product and then rinse susceptible surfaces after a minimum 10 minute contact time. I would be happy to provide more detail re specifics if you would like to contact me directly.

Kind regards
Rachel

Rachel Thomson

Nurse Unit Manager
Infection Prevention & Control Unit
Royal Hobart Hospital
E: rachel.thomson@dhhs.tas.gov.au

Subject:

Hi all, was wondering what other facilities are using for disinfecting the extreme risk areas

3.3.1 Extreme risk areas
The functional areas in this category represent areas that pose the greatest risk of
transmission of infection. Patients in these areas are very susceptible to infection or are
undergoing highly invasive procedures. In addition surgical instruments and stock are
stored in these areas. Cleaning outcomes must be achieved through the highest level of
cleaning intensity and frequency.
The use of disinfectants as part of routine cleaning is only required in10;
* Extreme Risk areas;
* As part of outbreak management; and
* Terminal cleaning following an MRO/infectious disease in any functional area.
For the use of an environmental cleaning disinfectant for any other reason staff must
contact the ICP for advice and approval that is based on the risk of contamination to
patients and others.

Vicki Denyer

Clinical Nurse Consultant | Infection Prevention & Control Unit
Lismore Base Hospital
Tel 02 6620 2385 | vicki.denyer@ncahs.health.nsw.gov.au

[Description: cid:image001.png@01CE7F1B.E103A4C0]

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[Thomson, Rachel EA]

Hi Vicki,

At the RHH we use a combined detergent and sodium hypochlorite disinfectant solution at 1000ppm (commercially prepared solution). We use this as a 1 or 2 two-step agent. We clean and disinfect the room and associated items with the product and then rinse susceptible surfaces after a minimum 10 minute contact time. I would be happy to provide more detail re specifics if you would like to contact me directly.

Kind regards
Rachel

Rachel Thomson

Nurse Unit Manager
Infection Prevention & Control Unit
Royal Hobart Hospital
E: rachel.thomson@dhhs.tas.gov.au

Subject:

Hi all, was wondering what other facilities are using for disinfecting the extreme risk areas

3.3.1 Extreme risk areas
The functional areas in this category represent areas that pose the greatest risk of
transmission of infection. Patients in these areas are very susceptible to infection or are
undergoing highly invasive procedures. In addition surgical instruments and stock are
stored in these areas. Cleaning outcomes must be achieved through the highest level of
cleaning intensity and frequency.
The use of disinfectants as part of routine cleaning is only required in10;
* Extreme Risk areas;
* As part of outbreak management; and
* Terminal cleaning following an MRO/infectious disease in any functional area.
For the use of an environmental cleaning disinfectant for any other reason staff must
contact the ICP for advice and approval that is based on the risk of contamination to
patients and others.

Vicki Denyer

Clinical Nurse Consultant | Infection Prevention & Control Unit
Lismore Base Hospital
Tel 02 6620 2385 | vicki.denyer@ncahs.health.nsw.gov.au

[Description: cid:image001.png@01CE7F1B.E103A4C0]

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[Thomson, Rachel EA]

Hi Roel,

I find this discussion really interesting!

We purchase a well-known brand of disposable sharps containers and these units come with instructions for securing to a wall and they recommend the current NIOSH standards which are that the opening should be 52-56 inches (or approximately 1300-1400mm). I have looked at the AHFG Room Layout sheets you mention and note that the recommended height for the opening is 1100mm (couldn’t see the reference to the 900mm height). I am intrigued to know why the AHFG chose such a low height as 900mm and on what this was based. Anyone aware of this decision making process?

We are currently having a sharps container audit undertaken by the company we obtain our containers from and I have sought their advice and input to this discussion. I will post again when I have information from them.

Cheers
Rachel

Rachel Thomson

Nurse Unit Manager
Infection Prevention & Control Unit
Royal Hobart Hospital
E: rachel.thomson@dhhs.tas.gov.au

Hi Kylie
Sharps containers should be fixed at a height between 900mm and 1100mm, as per the Australasian Health Facility Guidelines Standard Components Room Layout Sheets for; Dirty Utility 10m2, Patient Bay – Recovery, Stage 1, and Patient Bay – Resuscitation.
Cheers
Roel

Roel Castillo
Project Officer SSD
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Level 5, 119-143 Missenden Road
Camperdown NSW 2050
PO BOX M5 Missenden Road NSW 2050

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*hWK4nY*

UNCLASSIFIED
Good Afternoon,

I was wondering where it is actually written that wall mounted sharps containers should be below eye level and minimum height 1.1m so as out of reach of young children, can anyone advise?

Much appreciated.

Regards,

Kylie Long

Flight Lieutenant
Infection Prevention and Control
Clinical Governance & Projects
Garrison Health Operations Branch
Joint Health Command
Department of Defence

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[Thomson, Rachel EA]

Hi Margaret,

In my home state of Tasmania this issue was considered at a state level for nursing staff during a recent state hospitals uniform review. A decision was taken to make the clinical nursing staff uniform have mandatory short sleeves, this was not based on advice from our state infection control service, and from my perspective very interesting that the focus was on nursing uniform rather than all healthcare workers! The advice from infection prevention and control staff was that rather than stipulating short sleeves for nursing staff that the key advice related to the relative impediment that long sleeves may cause to performing hand hygiene.

I have copied and include some of the wording from my own hospitals Uniform Policy and our Tasmanian Hand Hygiene Policy FYI.

RHH Dress Code Protocol “Infection Control” (extract):

* Long sleeves must be rolled above the elbows when providing direct patient care.

* All items such as neck-chains, neck ties, scarfs, lanyards, glasses on chains etc must be secured to prevent cross infection.

* Items that are not laundered daily (i.e. cardigans/jumpers) shall not be worn whilst delivering direct patient care/services

* Protective barrier uniforms should be removed before leaving the workplace ie aprons, shoe covers etc.

DHHS Hand Hygiene Policy (extract)
All Care Staff/Healthcare Workers are to be ‘bare below the elbows’ when providing clinical care/performing hand hygiene to meet their infection control and hand hygiene obligations. This means:

* Bracelets, wrist watches and rings with stones or ridges must not be worn when providing clinical care. A single flat ring/band may be worn but must not interfere with effective hand hygiene practice.

* Long ties, lanyards and long sleeved shirts must not interfere with effective hand hygiene practice. Retractable (or similar) ID card holders are recommended in place of lanyards and should be cleaned regularly.

* Nails should be kept short and clean and nail polish should not be worn. Artificial nails (gel or acrylic) must not be worn by any Care Staff/Health Care Workers with direct patient contact.

* Any breached skin (cuts, dermatitis or abrasion) must be covered with a waterproof film dressing. Staff with dermatitis should report for evaluation as per local protocols.

Hope this is of some help. Good luck!!

Kind regards
Rachel

Rachel Thomson

Nurse Unit Manager
Infection Prevention & Control Unit
Royal Hobart Hospital
E: rachel.thomson@dhhs.tas.gov.au

Can anyone contribute to some feedback I received from a staff member regarding new uniforms being introduced at our facility? For the first time, we are giving staff the option of having a 3 quarter sleeve, both care staff and registered/enrolled nurses. One RN stated that she had been informed at an acute facility that 3 quarter sleeves are not permitted because of Infection Control issues. I have looked up the National Guidelines and in there it states:

Given that there is limited evidence available to support many routine practices intended to reduce infection risk, practice is based on decisions made on scientific principles. Some activities, such as performing hand hygiene between administering care to successive patients, have a credible history to support their routine application in preventing cross-infection. Others, such as some uniform and clothing requirements, have more to do with the ethos of quality care and workplace culture than with a proven reduction of cross-infection.

From that I came to the conclusion that there is no evidence against having a variance in uniform style. Also given the work carried out in residential care vs acute care, my thoughts were that there is limited cross infection risk.

If anyone has any other thoughts, responses welcome

Regards

Margaret Byrne RN BN

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[Thomson, Rachel EA]

Thanks Michael (and Matt),

I will happily approach ACIPC and bring this idea forward!

Cheers
Rachel

Rachel Thomson

Nurse Unit Manager
Infection Prevention & Control Unit
Royal Hobart Hospital
Ph: 03 62227882/8658
E: rachel.thomson@dhhs.tas.gov.au

[cid:image001.png@01CDC320.02F087A0]
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
Sent: Thursday, 15 November 2012 10:42 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Observational Audit Tools for IV Cannulation

Hi Rachel

I really think sharing such tools is a great idea!

Unfortunately Infexion Connexion does not support attachments, so unless any files are hosted elsewhere, we cannot share them through this list.

Maybe ACIPC could be approached to develop a portal that resources could be uploaded to, and then links could be posted on the list?

Cheers
Michael Wishart
ACPCI Infexion Connexion Administrator

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Thomson, Rachel EA (DHHS)
Sent: Thursday, 15 November 2012 8:31 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Observational Audit Tools for IV Cannulation

Hi Rhea and others,

So here is a thingit seems to me that quite a number of people may have a genuine interest in looking at your tool as discussed in a number of forums including the recent IC day in Melbourne. I wonder if you would be willing to post the tool through the Infexion Connexion list? Maybe others might like to do a similar thing so that people can build on their resources, share etc. Just a thought!!

Cheers for now
Rachel

Rachel Thomson

Nurse Unit Manager
Infection Prevention & Control Unit
Royal Hobart Hospital
Ph: 03 62227882/8658
E: rachel.thomson@dhhs.tas.gov.au

[cid:image001.png@01CDC313.CF515020]
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Helen Scott
Sent: Thursday, 15 November 2012 8:34 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Observational Audit Tools for IV Cannulation

Hi, Can I also please have a look,
Thanks,

Helen Scott
Infection Control Co-ordinator |
Nurse Educator |
Nepean Private Hospital
Kingswood, NSW.
Tel 02 4725 8758 | helen.scott@healthscope.com.au

Please consider the environment before printing this message

>>> On 14/11/2012 at 5:08 pm, in message , “Moore, Genevieve (Health)” wrote:
Hi Rhea
Can you please share these audit tools with me also as I have looking for an audit tool for IV for a while
Thanks
Genevieve

Genevieve Moore

Diabetes Educator

Clinical Placement Coordinator

Infection Control Link Nurse

Southern Flinders Health – Crystal Brook Campus
Country Health SA Local Health Network
Edmund Terrace
Crystal Brook SA 5523

Tel: (08) 8636 1164

Fax: (08) 8636 2077
Email: Genevieve.moore@health.sa.gov.au

This email may contain confidential information, which also may be legally privileged. Only the intended recipient(s) may access, use, distribute or copy this email. If this email is received in error, please inform the sender by return email and delete the original. If there are doubts about the validity of this message, please contact the sender by telephone. It is the recipients responsibility to check the email and any attached files for viruses.

________________________________
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of MARTIN, Rhea
Sent: Wednesday, 14 November 2012 16:19
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Observational Audit Tools for IV Cannulation

Hi Craig,
Would be happy to share audit tool with you. We use two, one audits insertion (use this in ED where there is plenty of action) and the other is a ward based audit tool which looks at management of IVs on the ward
Rhea

Rhea Martin
Manager Infection Control Team
Austin Health
Studley Rd., Heidelberg
Victoria, Australia 3084
Phone 9496 5801
Page 2556
Mobile 0407 806 299

From: Craig Boutlis [mailto:Craig.Boutlis@SESIAHS.HEALTH.NSW.GOV.AU]
Sent: Wednesday, 14 November 2012 16:37
To: MARTIN, Rhea
Subject: FW: Observational Audit Tools for IV Cannulation

Hi Rhea,

I’m pretty sure that you would be on this email list but I thought I should forward this to you just in case. Would you be happy to share the audit tool that you presented at the recent Melbourne Infection Control education day? If so, would you mind cc’ing me in too?

The NSW policy is out for review at the moment and I’m going to make sure that I contribute that we should be moving to credentialling statewide along the lines of your program (thanks for making me aware of it).

Craig

________________________________
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Joe-Anne Bendall
Sent: Wednesday, 14 November 2012 4:12 PM
To: AICALIST@AICALIST.ORG.AU
Subject: [ACIPC_Infexion_Connexion] Observational Audit Tools for IV Cannulation
Hi everyone

I have a very keen medical officer who wants to be a champion for improving IV cannula insertion. Does anyone have an observational audit tool they would like to share?

I have an observational audit tool for aseptic technique wound dressing I would be willing to swap for IV cannula insertion!

Thanks

Joe

Joe-anne Bendall
Infection Prevention and Control CNC
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
Sydney 2000

Phone: 93827199
Mobile: 0418984255
Fax: 93827510
Page: 21552

Joe-Anne.Bendall@sesiahs.health.nsw.gov.au

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[Thomson, Rachel EA]

Hi Rhea and others,

So here is a thingit seems to me that quite a number of people may have a genuine interest in looking at your tool as discussed in a number of forums including the recent IC day in Melbourne. I wonder if you would be willing to post the tool through the Infexion Connexion list? Maybe others might like to do a similar thing so that people can build on their resources, share etc. Just a thought!!

Cheers for now
Rachel

Rachel Thomson

Nurse Unit Manager
Infection Prevention & Control Unit
Royal Hobart Hospital
Ph: 03 62227882/8658
E: rachel.thomson@dhhs.tas.gov.au

[cid:image001.png@01CDC313.CF515020]
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Helen Scott
Sent: Thursday, 15 November 2012 8:34 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Observational Audit Tools for IV Cannulation

Hi, Can I also please have a look,
Thanks,

Helen Scott
Infection Control Co-ordinator |
Nurse Educator |
Nepean Private Hospital
Kingswood, NSW.
Tel 02 4725 8758 | helen.scott@healthscope.com.au

Please consider the environment before printing this message

>>> On 14/11/2012 at 5:08 pm, in message , “Moore, Genevieve (Health)” wrote:
Hi Rhea
Can you please share these audit tools with me also as I have looking for an audit tool for IV for a while
Thanks
Genevieve

Genevieve Moore

Diabetes Educator

Clinical Placement Coordinator

Infection Control Link Nurse

Southern Flinders Health – Crystal Brook Campus
Country Health SA Local Health Network
Edmund Terrace
Crystal Brook SA 5523

Tel: (08) 8636 1164

Fax: (08) 8636 2077
Email: Genevieve.moore@health.sa.gov.au

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From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of MARTIN, Rhea
Sent: Wednesday, 14 November 2012 16:19
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Observational Audit Tools for IV Cannulation

Hi Craig,
Would be happy to share audit tool with you. We use two, one audits insertion (use this in ED where there is plenty of action) and the other is a ward based audit tool which looks at management of IVs on the ward
Rhea

Rhea Martin
Manager Infection Control Team
Austin Health
Studley Rd., Heidelberg
Victoria, Australia 3084
Phone 9496 5801
Page 2556
Mobile 0407 806 299

From: Craig Boutlis [mailto:Craig.Boutlis@SESIAHS.HEALTH.NSW.GOV.AU]
Sent: Wednesday, 14 November 2012 16:37
To: MARTIN, Rhea
Subject: FW: Observational Audit Tools for IV Cannulation

Hi Rhea,

I’m pretty sure that you would be on this email list but I thought I should forward this to you just in case. Would you be happy to share the audit tool that you presented at the recent Melbourne Infection Control education day? If so, would you mind cc’ing me in too?

The NSW policy is out for review at the moment and I’m going to make sure that I contribute that we should be moving to credentialling statewide along the lines of your program (thanks for making me aware of it).

Craig

________________________________
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Joe-Anne Bendall
Sent: Wednesday, 14 November 2012 4:12 PM
To: AICALIST@AICALIST.ORG.AU
Subject: [ACIPC_Infexion_Connexion] Observational Audit Tools for IV Cannulation
Hi everyone

I have a very keen medical officer who wants to be a champion for improving IV cannula insertion. Does anyone have an observational audit tool they would like to share?

I have an observational audit tool for aseptic technique wound dressing I would be willing to swap for IV cannula insertion!

Thanks

Joe

Joe-anne Bendall
Infection Prevention and Control CNC
Sydney Hospital and Sydney Eye Hospital
8 Macquarie St
Sydney 2000

Phone: 93827199
Mobile: 0418984255
Fax: 93827510
Page: 21552

Joe-Anne.Bendall@sesiahs.health.nsw.gov.au

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[Thomson, Rachel EA]

Hi Michael,

Indeed a very interesting and often vexed topic for Infection Control! I also have ethical issues around providing second rate treatment to patients infected or colonised with an MRO by basing treatment decisions on their MRO status rather than their clinical need. How often do I hear the excuse that a patient had to be put last “because of infection control”?

We have been working with our theatre staff recently to research and review the approach to things such as relative placement on a theatre list when the patient has an MRO or other transmissible infectious condition. One of the issues that we clearly identified is not related to management of the MRO, rather it is poor compliance with standard precautions by medical staff (anaesthetic staff in particular it appears). This includes things such as diving a soiled hand/glove into the “Waterloo” trolley for intubation/anaesthesia, thus contaminating other items in this trolley. When you interrogate the decision to place patients with known MROs last on a list is more likely because staff are unable to consistently comply with basic infection control measures rather than a clear evidence base around the risk if basic controls can be implemented/adopted.

We considered these challenges and have really had to consider how to get consistent buy in from the medical staff and how to prevent breaches, the solution is not yet clear to me and really the major challenge is getting compliance with standard precautions within the operating suite. As I say, we have finally agreed that whilst the measures you put in place around the “known” risk might be relatively robust we are still left with questions about the risk associated with a patient whose MRO status is not known. Our protocol is not yet finalised but I would be happy to share the draft document with you or any other list subscriber. By the way, we expressly do not recommend that a patient with a known MRO colonisation/infection be placed last on the procedural list! I would welcome any comments or feedback from members if I make this available. Please let me know if you would like a copy of our draft protocol for the management of patients with MRO in theatre.

Cheers
Rachel

Rachel Thomson
Nurse Unit Manager
Infection Prevention & Control Unit
Royal Hobart Hospital
E: rachel.thomson@dhhs.tas.gov.au

—–Original Message—–

Hi all

Just trying to see what the current thoughts are in regard to management of patients with multi resistant organisms in procedural areas. Do most facilities still have ‘special cleaning’ after procedures on patients colonised or infected with MRSA, ESBL and MRGN’s? I would assume that most facilities would still have special cleaning following procedures on patients colonised or infected with VRE.

In my opinion, provided we have a good process for cleaning the immediate environment between cases, ‘special cleaning’ for MRSA / ESBL / MRGN is not necessary, and these organisms should be easily removed with normal cleaning techniques. The opportunities for widespread environmental colonisation from patients in procedural areas where patient movement is severely controlled is reasonably low, unlike in ward accommodation situations. VRE as an environmentally hardy organism requires a different approach, however. Does anyone else use this approach?

Also, should all MRO patients always be placed last on a list?

Any expert opinions out there?

Thanks
Michael

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3326 3523
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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[Thomson, Rachel EA]

Hi Craig,

Please see the attached excerpt from our CSD Manager.

“The Operating Suite at the RHH uses all disposable tubing. The
anaesthetic machine components from the Operating Suite CSD thermally
disinfect in the meile which we have thermo coupled to the computer and
kept as a record. It also has a print out to verify the process has
reached thermal disinfection which is checked by the CSD Technicians.
All masks are put through the meile as well as the laryngoscope blades
for ED, DCCM and the Operating Suite. We do not autoclave any
anaesthetic equipment.

The meile has specific connections in its removable carriage to
reprocess all anaesthetic bags and masks. We also put all resus bags
through the meile. We use disposable tubing each time when we put
together a kit.

I hope this will help with your query?”

I trust this is helpful?

Kind regards

Rachel

Rachel Thomson

Nurse Unit Manager

Infection Prevention & Control Unit

Royal Hobart Hospital

E: rachel.thomson@dhhs.tas.gov.au

________________________________

Behalf Of Anderson, Craig (Health)

Hi All

We are reviewing our Relative Anaesthesia (NO2/O2) circuit reprocessing
protocol. The circuit comprises an autoclavable nasal mask and tubing x2
(delivery and scavenging tubes) which are connected to a mixing manifold
and high volume suction respectively. How do people deal with
reprocessing these circuits particularly cleaning the inside of the
tubing?

Regards

Craig Anderson

Craig Anderson
Infection Control And Staff Health

Adelaide Dental Hospital
Frome Road

Adelaide

South Australia 5011

T: +61 8 8222 8364

F: +61 8 8222 8273
E: craig.anderson@health.sa.gov.au

W: http://www.sadental.sa.gov.au

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[Thomson, Rachel EA]

Hi Michael,

The Royal Hobart Hospital has recently implemented a protocol in
relation to MRGNs after pretty extensive work and consultation by our ID
and Micro team. We have updated our screening protocol in-line with
this. Simply put this is what we do

Screening in relation to MRGNs;

* Patients directly transferred from an overseas hospital

* Patients who have been admitted overnight to an overseas
hospital within the past 12 months

* Patients directly transferred from an intra-state or
inter-state intensive care unit

We only recommend isolation for those patients who are direct transfers

We classify our MRGNs as follows (and therefore look for the following);

* Acinetobacter spp. isolates intermediate/resistant to any
carbapenem

* Pseudomonas aeruginosa isolates resistant to at least 3 of the
following:

o Anti-pseudomonal carbapenem (meropenem, imipenem or doripenem)

o Gentamicin AND tobramycin

o Piperacillin/tazobactam AND ticarcillin/clavulanic acid

o Ciprofloxacin

o Ceftazidime AND cefepime/cefpirome

* Enterobacteriaceae isolates (excluding Salmonella and Shigella
spp.):

o intermediate/resistant to any Carbapenem

OR

o resistant to ampicillin/amoxycillin AND first generation
cephalosporins AND at least 3 of the following:

* Gentamicin AND tobramycin

* Ciprofloxacin OR norfloxacin

* Ceftriaxone OR ceftazidime

* Amoxycillin-clavulanate AND either ticarcillin-clavulanate or
piperacillin-tazobactam

* Any Gram-negative organism identified to have a transmissible
resistance mechanism such as:

o extended spectrum beta-lactamase (ESBL)

OR

o carbapenemase (including metallo-beta-lactamases (MBL) and
Klebsiella pneumoniae carbapenemases (KPC))

* Any other Gram-negative organism at the discretion of the
Medical Director of the Infection Prevention and Control Unit (or
delegate) – Hedging our bets here 🙂

Hope this is of assistance and interest. I would love to know what
other centres are doing!!

Cheers

Rachel

Rachel Thomson

Nurse Unit Manager

Infection Prevention & Control Unit

Royal Hobart Hospital

E: rachel.thomson@dhhs.tas.gov.au

________________________________

Behalf Of Michael Wishart

Hi all

Have a question about who is screening for what in regard to
multiresistant gram negatives on admission. I mainly want to know about
routine screening on admission to an acute facility on transfer from
another facility, not specifically what you screen for in high risk
units like ICU or dialysis, but all information is welcome!

Specifically, does anyone look for plasmid-mediated Amp-C betalactamase
producers in routine rectal screens?

Thanks

Michael (and yes, I have moved jobs yet again!)

Michael Wishart

CNC Infection Control

Holy Spirit Northside Private Hospital

627 Rode Road, Chermside, Qld 4032

t: (07) 3326 3068 | f: (07) 3326 3523

e: Michael.Wishart@hsn.org.au

w:www.holyspiritnorthside.org.au

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[Thomson, Rachel EA]

Hi all,

I also value the questions and comments from our ID colleagues on this
matter. The need for rigorous and critical consideration of newer
technologies is so important and the right questions so clearly need to
be asked!

On another matter which is largely unrelated but I would value any
comments that either Lindsay, Matthias or any other ASID member might be
willing to make relates to a sporicidal wipe system for disinfection of
non-lumened scopes, which uses a patented chlorine dioxide agents
(Tristel). These wipes are currently being promoted by a company in
Australia and adopted by some centres. I harbour grave concerns in
relation to this product and its use. Would it be possible to have this
request cross-posted to the asid-ozbug members as I wonder what view is
held in this community in relation to this product? Specifically, I
wonder if there is comment that any ID person might make on the use of a
sporicidal agent applied by a “wipe” rather than through an automated
system and the apparent absence or any validation for a
clean/disinfection process?

I look forward to some possible replies/responses

Kind regards

Rachel

Rachel Thomson

Nurse Unit Manager

Infection Prevention & Control Unit

Royal Hobart Hospital

E: rachel.thomson@dhhs.tas.gov.au

________________________________

Behalf Of Gerald Chan

Thanks Matthias for further identifying the many gaps in the eWater
system and their “research”.

It is alarming to note that Austin Health’s approval was not sought
(from its clinical departments) as the company often quotes its use
there in marketing its product.

I have declined their request to allow my organisation’s letterhead to
be used by them for the informal random swabs they’d conducted in our
catering department.

As mentioned to the rep then, there will obviously be a microbial count
reduction noted in the swab results (post-eWater) as we are not dealing
with plain water but either hypochlorous acid/hydrochloric acid or
caustic soda (depending on which tap the “water” is from).

That plus vigorous scrubbing of the surfaces to be swabbed when eWater
was applied.

I think with the discussion points raised, there is an obvious lack of
supporting evidence to pursue a trial at this stage.

Thanks Matthias and Lindsay for your feedback.

Kind regards,

Gerald

Gerald Chan

Coordinator Infection Control

St John of God Murdoch Hospital
100 Murdoch Drive
MURDOCH. WA 6150

P: 9366 1552

M: 0405 495 906 (7804)
F: 9311 4685

E: Gerald.Chan@sjog.org.au

W: http://www.sjog.org.au/murdoch

Murdoch

facebook facebook.com/stjohnofgodmurdoch

twitter twitter.com/sjgh_murdoch

>>> “GRAYSON, Lindsay” 26/06/2012 12:44
PM >>>

Dear All,

Further to Matthias’ email… His point #16 is correct – namely that
neither Infection Control nor Infectious Diseases know anything about
eWater and have never been asked to assess it, let alone approve it!!
Until this email I had never heard of eWater.

Needless to say, we are currently investigating how Austin Health
“approved eWater”, but it was not via any clinical department. I will
report back since it may be a lesson for others.

Thanks Matthias

Kind regards

Lindsay

Prof. M. Lindsay Grayson
Infectious Diseases Department,
Austin Health
Department of Medicine, University of Melbourne
Studley Rd., Heidelberg, VIC 3084
Australia

________________________________

Dear Colleagues,

The topic of the eWater System appeared on both the ACIPC and OzBug
e-mail lists (I overlooked the ACIPC one initially) and I thought it
would be worth writing a somewhat more detailed joint reply to both
lists.

I have previously posted (to ACIPC) on what seemed a similar technology,
the ActiveIon device.

I have looked at some of the available information concerning the eWater
System, and even though I cannot make any final conclusions, I have a
number of questions and issues of concern that I would like to share. If
I were to look at purchasing the device, these would be some of the
points that I would look at more closely.

(1) The description is that the system performs electrolysis of an NaCl
solution and creates two solutions, one a (probably weak) bleach (NaOCl)
and/or hypochlorous acid (HOCl) solution (not sure which one
predominates), the other a sodium hydroxide (NaOH) solution. The bleach
solution — according to the description — is microbicidal and can be
used for disinfection, including disinfection in the food industry, in
hospitals, even hand antisepsis. The NaOH solution — according to the
description — is for cleaning.

(2) The question comes: What would be the difference between using the
eWater system and just buying bleach and/or hypochlorous acid itself,
which are cheap standard chemicals that are easily available?

(3) Has the system been tested by a manufacturer-independent (!)
disinfectant testing laboratory with relevant expertise? Experience
tells us that one cannot solely rely on manufacturer-provided test
reports or manufacturer claims when it comes to disinfectants —
preferable would be at least two independent test reports from
experienced reputable labs.

(4) Has the system been tested by any of the available standardised
testing protocols for surface disinfection (or other types of
application, depending on the intended use)? There are, for example, US
ASTM standards and European EN standards. The EN standard for surface
disinfection is EN 13697, and such tests are typically done in
variations (a) with or without organic load (“dirty conditions”) and (b)
with or without mechanical action (simulating the wiping).

(5) If, for example, antimicrobial activity would fail in the presence
of organic load, then a prior cleaning step would become highly
critical. Organic load is, of course, an issue in the food industry,
where one of the advertising targets lies.

(6) FYI, disinfectant testing and assessment is usually done in two
steps, step 1 is testing in suspension — like the MBC (minimum
bactericidal concentration) for antibiotics – and step 2 is testing
under simulated practice conditions, e.g. surface disinfection on a
carrier.

(7) Has any testing employed experimental controls that — in terms of
biological plausibility — leave no other conclusions than what the
machine produced killed the microorganisms and not (!) some other part
of the application? (In the ActiveIon example, the microbial reduction
achieved by one testing lab was similar to what one would expect from
applying plain inactive water and wiping, but such a control was
omitted).

(8) Is there a way to make sure that the disinfectant concentrations
coming out of the machine are kept consistent and in an antimicrobially
active range to fulfill their purpose? Meaning how are concentrations
monitored and ensured that there is active disinfectant? Is there a
testing method provided to measure the concentrations in daily use (in
analogy to checking fridge temperatures in labs on a daily basis as part
of quality control)? Apparently, electrodes age over time and may
deliver electrolysis less consistently. Is there experience with
stability of not only disinfectant concentration but also microbicidal
activity over the intended period of machine usage (I presume years)?
Also, how long are the prepared solutions stable after electrolysis and
before application?

(9) The company address given on the website is an Australian one, but
it is unclear to me if they are a distributor or the manufacturer. Some
of the documentation appears to be from Japan; this may indicate that
the Australian address may be a distributor.

(10) I saw two “research” publications on the website, both looked like
research papers, but none had proper bibliographic information (journal
name, year, volume, etc.). (I found one of these subsequently, with
journal information, by putting the title into PubMed).

(11) A table on the website showing microbial test results (citing an
article published in Japanese) misspelled quite a number of bacterial
names. If someone claiming to have microbiological expertise is unable
to spell some of the most common bacterial names, this should ring alarm
bells.

(12) On the eWater website, there are three linked documents from RMIT
University (origin: School of Civil Engineering). One is a brief
Executive Summary, another a more comprehensive multi-page document,
another what appears to be a conference poster. The Executive Summary
appears to focus on cost, environmental and social factors, the bigger
document has “report final” in its file name but has oblique “draft”
written over the pages and no authors specified. The microbiology part
is dubious. All three are written in a very positive tone, raising the
question whether they might be industry-sponsored.

(13) The claim that the system can “sterilise” medical instruments
appears unsubstantiated. From a solution like the one described, one
would expect at best (!) high-level disinfection, but not sterilisation.
Even claims for high-level disinfection would have to be substantiated
by standardised testing, and it should be specified what types of
instruments can be treated and under which conditions.

(14) It is proposed to use the electrolysed water for hand hygiene, but
it is unclear to me how it should be useful for that purpose. NaOCl
(bleach) is genuinely unsuitable (!) for hand hygiene, because in higher
concentrations it would be damaging to hands and in lower concentrations
it would take too long to kill microorganisms (alcohol hand rubs produce
several log reduction in about 30 sec). Again, results from standardised
tests would be needed.

(15) The main target is apparently the food industry, but it is also
promoted for hospitals. Even if the product were “only” intended for the
food industry, one would still expect that the system should fulfill
basic claims concerning antimicrobial efficacy. Both industries are
critical in terms of preventing infections.

(16) The company advertises with an endorsement from Austin Health. That
would raise the question whether Austin’s Infection Control Department
and/or Lindsay Grayson’s group has seen and/or endorsed this, or whether
the company only liaised with scientifically untrained personnel, such
as the housekeeping or kitchen department. The latter would be quite
inappropriate. (We had an occasion here where a manufacturer tried to
market a new product by circumventing the Infection Control Committee
and went straight to Housekeeping).

I think that this system should be properly investigated by an
institution or authority with the competency and clout to do this before
it is used in the healthcare and food industry.

Best regards, Matthias.

—

Matthias Maiwald, MD, FRCPA

Consultant in Microbiology

Adj. Assoc. Prof., Natl. Univ. Singapore

Department of Pathology and Laboratory Medicine

KK Women’s and Children’s Hospital

100 Bukit Timah Road

Singapore 229899

Tel. +65 6394 8725 (Office)

Tel. +65 6394 1389 (Laboratory)

Fax +65 6394 1387

kkh

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[Thomson, Rachel EA]

Hi all,

Strange things happen – clearly this technology is being marketed quite
heavily at present as my organisation has also had an approach and are
giving serious consideration to this technology. I felt I would like to
put my views out there having now thought about this during the last
week.

I hate being seen as the “negative” ICP, but I really harbour concerns
over rapidly adopting newer approaches/technologies without giving due
consideration to the risks, which I think is one of our central
challenges! I summarise my thoughts on this matter below

*Validation – any system which relies on high-level disinfection
through any method, either heat or chemical, would do well it seems, to
be one that is able to be validated. I am unaware that this system of
wipes is, as yet, able to provide validation for each “cycle” as it
relies rather on pure compliance with a system
*Test environment vs clinical environment – the system has been
validated in approved test conditions, as you would expect any system to
be. This generally means products are tested against target organisms
in controlled laboratory conditions. This far from reflects the reality
of a busy clinical setting where use may not reflect the test
environment. Issues that may influence the effectiveness of the system
include;

*The concentration of the biocidal agent reaching all
parts of the surface of the item (certainly inhibited by residual
bioburden)
*The contact time allowed for the biocidal agent being
sufficient (a human controlled system rather than an automated system)
*The actual organisms present on the device, the inoculum
of these pathogens and whether the challenge testing was focussed on all
relevant pathogens.

*The conditions of use – I think this is almost the most
important question or concern I have with a manual system with no
validation. A system that relies on ALL users using the system of
manual wiping perfectly, without deviation and without the assurance of
a validation should be a concern to those who focus of safer patient
systems – especially as the focus of the marketing is the “speed” of
disinfection.

These concerns may be able to be answered but I feel strongly that
manual systems such as this should be subject to higher levels of
scrutiny and that where the system is adopted that these questions
should be thoroughly and completely answered to the satisfaction of
those briefed with such responsibility.

Kind regards

Rachel

Rachel Thomson

Nurse Unit Manager

Infection Prevention & Control Unit

Royal Hobart Hospital

E: rachel.thomson@dhhs.tas.gov.au

________________________________

Behalf Of VANDERLINDE, Liz

Dear Jayne

Would this be the Tristel Wipes System? AshMed are canvassing all
hospitals I believe. We have a trophon EPR and prcessor. We have been
canvassed but I am a little trepiditious despite the supporting
literature re introducing. Would love it if you would be happy to share
your protocol?….and any other feedback/evidence of efficacy etc.

Cheers

Liz Vanderlinde
Infection Control Officer
North West Private Hospital

Brickport Road, Burnie TAS 7320, Australia
T +61 3 6432 6022 F +61 3 6431 6158
E Liz.Vanderlinde@healthecare.com.au
W

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Behalf Of Jane Barnett

Hi

We introduced this into our radiology dept for the US probes over a year
ago now and it seems to work well. The previous processes were really
inadequate for these items and the chlorine dioxide does achieve high
level disinfection options without exposure to staff of liquid
chemicals. The company provided good training to the staff who carry
this out plus we ensured that there were laminated instruction charts
with all mobile equipment e.g. used in our gynae emergency area.

Happy to share the protocol if you contact me.

Jane Barnett

Clinical Nurse Specialist

Infection Prevention & Control

Christchurch Women’s Hospital

Private Bag 4711, Christchurch

Infection Prevention and Control is Everyone’s Business

Behalf Of Fiona de Sousa
disinfection

Hi All,

I have been asked to review a new cleaning and disinfection system for
reprocessing transvaginal ultrasound probes especially those used in IVF
related pregnancies where chemical residues are a high concern.

The system consists of three separate pre-packaged wipes (a cleaner, a
disinfectant and a rinse wipe) which I believe is currently used in he
UK. The active ingredient in the disinfectant wipe is chlorine dioxide
in aqueous solution.

Has anyone got any experience with this type of system that they would
be willing to share with me?

Kind Regards,

Fiona De Sousa

Infection Prevention & Control Coordinator

Sydney Adventist Hospital

Fiona.Desousa@sah.org.au

185 Fox Valley Road, Wahroonga, NSW, 2076

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[Thomson, Rachel EA]

Hi Glenys,

I would like to take this opportunity to personally thank you, the VICPA
video project team and, of course, the amazing participants in this
video; Glen and Penny, for this truly remarkable video. I saw this
video at APSIC and was astounded by its impact. We have our new cohort
of interns for 2012 commencing orientation in 2 weeks and I will be
showing the participants this video. Again, my congratulations and
thanks to you and your colleagues for this fantastic Australian
resource.

Kind regards

Rachel

Rachel Thomson

Nurse Unit Manager

Infection Prevention & Control Unit

Royal Hobart Hospital

E: rachel.thomson@dhhs.tas.gov.au

________________________________

Behalf Of Glenys Harrington
a Person’s Life and Family. Produced by The Victorian Infection Control
Professionals Association (VICPA)

Dear All,

To support infection control professionals in their infection prevention
and control initiatives the Victorian Infection Control Professionals
Association (VICPA) has developed a storytelling video with the
assistance and support of a family who share their experience and the
impact that acquiring a hospital associated infection has had on their
lives.

The video was launched at The 5th International Congress of the Asia
Pacific Society of Infection Control (APSIC), 8-11 November 2011,
Melbourne, Australia

and we include a link to the abstract:
http://www.apsic2011.com/abstract/223.asp

The VICPA Video Project Team would like to share the video with the
infection control community. The team request that if you display the
video on your hospital web page (intranet or internet) or in your
infection control educational material that the title of the video and
VICPA acknowledgement as outlined below be included:

Glen’s Story

How Hospital Associated Infections Can Impact on a Person’s Life and
Family.

Produced by The Victorian Infection Control Professionals Association
(VICPA)

The video can be accessed at the following web pages and links.

Australian Infection Control Association(AICA) – home page
http://www.aica.org.au/

Hand Hygiene Australia(HHA) – video files
http://www.hha.org.au/ForHealthcareWorkers/education.aspx#VideoFiles

The Australian Commission on Safety and Quality in Health Care (ACSQHC)
– Healthcare Associated Infection (HAI)
http://www.safetyandquality.gov.au/internet/safety/publishing.nsf/Conten
t/PriorityProgram-03

Regards

Glenys Harrington

VICPA Video Project Team Coordinator

Glenys Harrington

Consultant

Infection Control Consultancy (ICC)

PO Box 5202

Middle Park

Victoria, 3206

Australia

H: +61 3 96902216

M: +61 404 816 434

infexion@ozemail.com.au

ABN 47533508426

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[Thomson, Rachel EA]

Hi Lyndall,

I fully agree with Lyn’s comments below. The company have the
obligation to undertake specific research. At the Royal Hobart Hospital
we comply with the requirement specified in AS/NZ 4187 1.5 WARNING: DO
NOT REPROCESS EX-PLANTED MEDICAL/DENTAL DEVICES. I fail to see how your
organisation could support an alternate directive from a surgeon in this
matter.

Good luck!

Kind regards

Rachel

Rachel Thomson

Nurse Unit Manager

Infection Prevention & Control Unit

Royal Hobart Hospital

E: rachel.thomson@dhhs.tas.gov.au

________________________________

Behalf Of Lyn A. Golden

Our (a public hospital) policy is also that these Items not be
processsed after removal. Perhaps you could use the line that your
health service is not registered to reprocess single use items?

I believe that it is up to the companies to do a research project on the
impact of wear and tear on the implants which would need ethical
approval and strict guidelines on the use and dispoasal of the implants
once removed from the body.

Lyn

Lyn Golden

Infection Prevention & Control Manager

Echuca Regional Health

Helping Everyone To Be And Stay Healthy

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________________________________

Behalf Of Lyndall Finn

Hello all

Despite a clear hospital policy in regard to the ‘Handling and Disposal
of Explanted Items and Human Tissue’ some of the orthopaedic surgeons
continue to request that metal plates, screws and prosthesis be
reprocessed in CSSD.

One of the surgeons has recently written to the hospital stating that
the reason for these ongoing reprocessing requests is that:

‘It is relevant to examine explanted prostheses to gain further
understanding of wear patterns, bone ingrowth or the lack of ingrowth,
and metal or polyethylene failure. These items do not pose a threat.
They are routinely examined in similar manner in Public Institutions,
after sterilization.’

I strongly support the hospital’s policy that the explanted items should
not be reprocessed but the surgeon is adamant that this practice
routinely occurs in many public hospitals.

I would really appreciate feedback from other hospitals in regard to
this issue.

Lyndall Finn RN/RM Grad Dip Infectious Disease / Population Health
Infection Control Consultant
The Burnside War Memorial Hospital Inc.
120 Kensington Road

Toorak Gardens

South Australia 5065

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[Thomson, Rachel EA]

Hi all,

The issue of environmental hygiene is clearly on the national radar at
present. I would suggest that the NHMRC IC guidelines have indeed
helped to open debate in relation to management of the environment. I
would dare to suggest that the document, especially section B5.1 has
potentially raised more questions than it answers. Not a bad thing, but
creating fertile ground for ongoing discussion and research. As a
Manager in an acute care hospital the recommendations spelt out in the
guidelines are, at a practical level, difficult at best and impossible
at worst. For example the simple recommendation to clean AHR dispensers
“daily and between patient use” is difficult to interpret and I
personally wonder about the risk represented by such static items.

I would like to commend the TICA who under Brett’s stewardship have
embarked on raising this very issue at the upcoming TICA conference. I
would suggest that this area is a topic that not only could be, but
should be firmly placed on the National Agenda and would see a place for
the AICA and the Commission to engage coal face clinicians and to
support a research agenda in this critical (and often under rated)
domain.

Kind regards

Rachel

Rachel Thomson

Nurse Unit Manager

Infection Prevention & Control Unit

Royal Hobart Hospital

E: rachel.thomson@dhhs.tas.gov.au

________________________________

Behalf Of Mitchell, Brett (TIPCU)
Precautions model

Thanks John
Yes a long overdue debate on a complicated issue.

I would make a few points:
– I think the term environmental disinfection is misleading and prefer
environmental hygiene
– Evidence for the role of the environment in both HAI transmission and
reduction is improving and I suspect more will shortly be coming.
Although I am initially in favour of a concept to include environmental
hygiene as part of SP, we must be confident of the evidence base. If we
don’t we will end up on the same situation we have had with other IC
issues.
– The NHMRC guidelines may ‘hedge their bets’, but in fact it is a major
step forward when talking about issues such as the frequency of cleaning
based on risk and frequently touched objects (Section B5.1). It is now
for other to prove/disprove these recommendations through research. No
other guideline has gone as far as this before (in relation to this
specific issue of frequency). Terminology used in other guidelines
(including the CDC) such has as ‘frequent’ or ‘regular’ are meaningless
when trying to argue the point for increased levels of cleaning for
example.
– routine management of the environment is included in SP in the NHMRC
guidelines, but I think you are talking about more than that.

If we go down the route of significantly increasing the profile and
importance of environ hygiene then we need to consider/be prepared for
– evidence to support it
– cleaning frequencies
– cleaning products – choice
– who cleans what
– recommendations for staffing
– recommendation for evaluating cleanliness

Many aspects of the above are progressing quickly. Thanks John for
raising this important issue. Personally, I agree that the role of the
environment is critical in HAI prevention and reduction.

Brett Mitchell
Tasmania Infection Prevention & Control Unit
DHHS

—–Original Message—–
disinfection as part of Standard Precautions model

Precautions model

Dear All,

In NSW there is current debate about the role of environmental
disinfection. My view is that we should mandate the routine cleaning AND
DISINFECTION of near patient touch sites, bathrooms and toilets. This
requirement forms part of the CDC 2007 Isolation guideline Standard
Precautions model which is arguably the basis for IPC practice around
the world.

The NHMRC IC Guideline hedges its bets with a uninterpretable
requirement (below) under use of disinfectants to determine whether
there is uncertainty about the nature of soiling on the surface!! This
is a nonsense. We know from many sampling studies that the near patient
surfaces are frequently contaminated with MROs etc and also that
unadequate management of env hygiene leads to increased risk of MRO
acquisituion in patients managed later in the same room (see attached
recent review for a summary of the evidence).

Over to you all! This is an issue, along with fomite management (clean
between is not good enough!) that I think is overdue for local debate!
Should we start to talk in detail about “Environmental Hygiene” (rather
than Env Cleaning) as a companion standard to Hand Hygiene under
Standard Precautions?

Kind regards
john
John Ferguson
Infectious Diseases Physician and Microbiologist,
Hunter New England Health, John Hunter Hospital, Newcastle
Conjoint Associate Professor, University of Newcastle
Tel 61 2 49214444, Fax 61 2 49214440, Mobile 0428 885573

CDC 2007 Excerpt (p60 under Fundamental elements needed to prevent
transmission of infectious agents in healthcare settings):

“Cleaning and disinfecting non-critical surfaces in patient-care areas
are part of Standard Precautions. In general, these procedures do not
need to be changed for patients on Transmission-Based Precautions. The
cleaning and disinfection of all patient-care areas is important for
frequently touched surfaces, especially those closest to the patient,
that are most likely to be contaminated (e.g., bedrails, bedside tables,
commodes, doorknobs, sinks, surfaces and equipment in close proximity to
the patient) 11, 72, 73, 835. The frequency or intensity of cleaning may
need to change based on the patient’s level of hygiene and the degree of
environmental contamination and for certain for infectious agents whose
reservoir is the intestinal tract 54. This may be especially true in
LTCFs and pediatric facilities where patients with stool and urine
incontinence are encountered more frequently. Also, increased frequency
of cleaning may be needed in a Protective Environment to minimize dust
accumulation 11. Special recommendations for cleaning and disinfecting
environmental surfaces in dialysis centers have been published 18. In
all healthcare settings, administrative, staffing and scheduling
activities should prioritize the proper cleaning and disinfection of
surfaces that could be implicated in transmission. During a suspected or
proven outbreak where an environmental reservoir is suspected, routine
cleaning procedures should be reviewed, and the need for additional
trained cleaning staff should be assessed. Adherence should be monitored
and reinforced to promote consistent and correct cleaning is performed.”

NHMRC excerpt:
Recommendation
11 Routine cleaning of surfaces

Grade

Clean frequently touched surfaces with detergent solution at least
daily, and when visibly soiled and after every known contamination.
Clean general surfaces and fittings when visibly soiled and immediately
after spillage.

GPP

Use of disinfectants
In acute-care settings where there is uncertainty about the nature of
soiling on the surface (e.g. blood or body fluid contamination versus
routine dust or dirt) or the presence of MROs (including C. difficile)
or other infectious agents requiring transmission-based precautions
(e.g. pulmonary tuberculosis) is known or suspected, surfaces should be
physically cleaned with a detergent solution, followed or combined with
a TGA-registered disinfectant with label claims specifying its
effectiveness against specific infectious organisms.

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[Thomson, Rachel EA]

Hi Lyn,

We also adopted the Trophon system at the RHH in 2009. Our organisation
utilised the European data to support introduction of the system and
after due consideration our Infection Control Committee supported
purchase of a number of units.

The systems have been well accepted and apart from a few teething
problems with one unit we have experienced no ongoing issues and are
happy with the simplicity and broad acceptance by staff of this system.

Please feel free to contact me again individually if you wish.

Kind regards

Rachel

Rachel Thomson

Nurse Unit Manager

Infection Prevention & Control Unit

Royal Hobart Hospital

E: rachel.thomson@dhhs.tas.gov.au

________________________________

Behalf Of Lyn A. Golden

We currently use OPA in a GUS system to process semi critical intra
cavity ultrasound probes: Radiology department would like to change to a
system that uses nebulised hydrogen peroxide.-Nanosonics Trophen EPR

Does anyone have any comments? Have you used H2O2 as a disinfectant? Is
there proof of disinfection by aerosoled particles?

Cheers Lyn

Lyn Golden

Infection Prevention & Control Manager

Echuca Regional Health

P 03 54855340

F 03 54825478

Helping Everyone To Be And Stay Healthy

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