[Thomson, Rachel EA (THS)]

Thank you to all those that have responded to my question in relation to meal delivery to patients under transmission-based precautions.

I would still appreciate further responses if people would be kind enough to consider my questions below. I am fundamentally interested in how acute hospitals perceive and manage the risks associated with delivery of meals and drinks to patients under transmission-based precautions.

I note with interest that the CDC have relatively recently made a clarification to when to don PPE (February 2017) by saying
One important change is the recommendation to don the indicated personal protective equipment (gowns, gloves, mask) upon entry into the patient’s room for patients who are on Contact and/or Droplet Precautions since the nature of the interaction with the patient cannot be predicted with certainty and contaminated environmental surfaces are important sources for transmission of pathogens.

Again, look forward to any further responses! My questions again below 🙂

Kind regards
Rachel

Hi all,

Our organisation has recently completed a pilot Quality project on mealtime assistance. This “Protected Meal Time” project identified a number of barriers to adequate nutrition including that those patients under transmission-based precautions are often not receiving timely access to meals and morning tea/ supper etc.

Based on this pilot project, we are considering ways to improve patient access to meals etc. To assist us in our discussions would you please consider the following questions for your organisation and respond via return email at your earliest convenience.

This project was undertaken in an Acute Tertiary facility, thus I am most interested in the practices of other Acute or Tertiary facilities.

* Do catering staff deliver meals into the rooms of patients under the following transmission-based precautions

o Contact ONLY (e.g. Clostridium difficile, MROs etc.) Yes/ No

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet ONLY (e.g. Bordetella pertussis, Meningococcal etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet and Contact (e.g. Viral gastroenteritis, Influenza etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Airborne (e.g. TB, Chickenpox, measles etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Airborne and Contact (e.g. Varicella zoster [chickenpox] etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

* Any other comments about strategies you have implemented to support effective nutrition for isolated patients?

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hello

Answers in red .

Regards,

Glynis Tudor
Infection Control Coordinator
Holmesglen Private Hospital
http://www.holmesglenprivatehospital.com.au

[HGPH – ED Early 2017 – Email Signature]

Hi all,

Our organisation has recently completed a pilot Quality project on mealtime assistance. This “Protected Meal Time” project identified a number of barriers to adequate nutrition including that those patients under transmission-based precautions are often not receiving timely access to meals and morning tea/ supper etc.

Based on this pilot project, we are considering ways to improve patient access to meals etc. To assist us in our discussions would you please consider the following questions for your organisation and respond via return email at your earliest convenience.

This project was undertaken in an Acute Tertiary facility, thus I am most interested in the practices of other Acute or Tertiary facilities.

* Do catering staff deliver meals into the rooms of patients under the following transmission-based precautions

o Contact ONLY (e.g. Clostridium difficile, MROs etc.) Yes/ No

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet ONLY (e.g. Bordetella pertussis, Meningococcal etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Droplet and Contact (e.g. Viral gastroenteritis, Influenza etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc.

o Airborne (e.g. TB, Chickenpox, measles etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc. nursing staff only allowed entry

o Airborne and Contact (e.g. Varicella zoster [chickenpox] etc.)

* If Yes

* Do they wear PPE (Yes/ No)

* If no

* Who delivers the meals/ drinks etc. nursing staff only allowed entry

* Any other comments about strategies you have implemented to support effective nutrition for isolated patients? Although catering staff are meant to deliver to patients on TBp ( excluding airborne), compliance and understanding of the PPE is patchy. Education given frequently, but remains a problematic area!

Many thanks in advance for your replies

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

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[Thomson, Rachel EA (THS)]

Hi Fiona,

We have a local audit tool that can be used by staff in units. It does not, however, track linen movements throughout the organisation so may not be what you are looking for. I am happy to share though if you want to contact me off-line.

Cheers
Rachel

..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

: 03 6166 7882/ 6166 8658

Mobile: 0400 718 574
Email: rachel.thomson@dhhs.tas.gov.au

Level 4, H Block
48 Liverpool Street
Hobart, 7000

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Rick De Sousa
Sent: Friday, 16 June 2017 8:18 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Linen audit tool

Hi All,

I am currently looking for an audit tool to audit linen storage and movement within the healthcare setting. I was wondering if anyone has something they would be willing to share?

Kind regards,

Fiona De Sousa

RN – Newcastle Private Hospital
CNS – Infection Prevention Service, HNE Health
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[Thomson, Rachel EA (THS)]

Hi Sonja,

There was publication of a very helpful infection control joint statement produced in 2011. Link below
http://www.publish.csiro.au/hi/HI11011

A very helpful part of this publications states as follows
In summary, ABHR remains the agent of choice for hand hygiene. Gloves should be used during the care of patients with CDI, to minimise spore contamination. If hands become soiled, or gloves have not been used, then hands must be washed with soap (or an antimicrobial soap) and water. Hands should then be dried thoroughly with paper towels.

I hope this assists?

Kind regards
Rachel
……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hello all,

I’m interested in how healthcare facilities go about Clostridium positive patients and Hand Hygiene products. As ABHR is not efficient with C-diff, we advise staff to mainly use water and soap for their 5 moments of hand hygiene rather ABHR, especially when leaving patient and patient environment. Also emphasising daily cleaning of high touch areas with sporicidal product.
Now it came to my attention, that ward manager completely removing ABHR from C-diff positive patients environment and expect staff to only use water hand soap for their HH. This is an issue on our ICU ward and I’m currently working on a practical advice/solution.
I’m greatly appreciating any practical help/advice.
Regards
Sonja

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

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[Thomson, Rachel EA (THS)]

Hi Cate,

The following information might be of interest to you

We do not have a formal protocol at this time. However, for those services using iPads as part of their service delivery we provide the following instructions.

Recommendations:

1. Disinfect the device before and after patient/ family interface with an approved agent as per the protocol for non-critical items

Mobile devices are considered noncritical items because they should come into contact with intact skin. Noncritical items are unlikely to transmit infectious agents directly to patients; however, they contribute to secondary transmission by contaminating health care provider hands.

2. Hand hygiene before and after use of the mobile device in accordance with the 5 Moments

Cross contamination between patients may occur via the hands of the HCW after they have touched a contaminated mobile device.

3. Set automatic reminders for cleaning on the mobile device

Provide a regular, standardized schedule for the reduction of bioburden from the barrier on the device.

4. Consider using a waterproof or water-resistant barrier over the device – this may be as simple as an inexpensive clear disposable bag/cover or a more robust case.
Many mobile devices have plastic screen protectors, and plastics are very susceptible to cleaning degradation. Using a waterproof or water-resistant case enables wet disinfection without damage to device.

An interesting publication – Journal of Hospital Infection 87 (2014) 77e83 – looked at the role of disinfection with materials with residual efficacy. This had some interesting points that you might like to consider

I hope this information assists.

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

I would interested as well, particularly any info on Ipads and hand held devices
cheers
Cate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517737
e … cate.coffey@nt.gov.au http://www.nt.gov.au/health

Our Vision: Better health outcomes for all Central Australians
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Hi all

Does anyone have a policy specifically for cleaning mobile computers/electronics like tablets in ward settings? Specifically keen on policies that look at cleaning after use in patient rooms/between patients.

Just don’t want to reinvent the wheel if I don’t have to. If anyone is willing to share their policy I would be grateful. Email me directly if you want.

Thanks
Michael

Michael Wishart
Infection Control Coordinator

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

General waste unless it meets the criteria for clinical (blood body fluids etc.):) Have a great weekend!

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi all,
I recently was hanging out in a metro hospital with my Dad, who happens to have VRE. I noticed that the waste bin in his room was not a clinical waste bin and that the waste generated in the room was just being regarded as general waste. There is not much in the literature that I could find about evidence that waste from rooms with patients positive for MRO are an infectious risk. Infact, I found the opposite : The risks associated with sharps injuries are well recognised and quantified (CDC 2013). However the same cannot be said about individuals acquiring a significant infection from contact with non-sharps clinical waste. In fact, existing research has shown that hospital clinical waste is no more infective than general household waste(Collins & Kennedy 1992; Phillips 1999). In Pandur, Raylee A. Clinical waste in home healthcare: Navigating the swamp [online]. Australian Nursing and Midwifery Journal, Vol. 22, No. 3, Sep 2014: 39. Availability: ISSN: 2202-7114. [cited 19 Aug 16].

2014 industry code of practice for the management of biohazardous waste (including clinical & related wastes)7 Ed’s definition of biohazardous waste (h) Waste from patients known to have, or suspected of having a communicable disease. P4.

So my question is, what are you all doing? Do you treat waste form patients with MRO’s rooms as clinical or general?

I look forward to hearing from you!
Kelly

Kelly Barton
Infection Prevention & Control Officer

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[Thomson, Rachel EA (THS)]

Hi Cate,

I would suggest that you refer to the Standard Components provided as part of the resources within the Australasian Health Facility Guidelines.

https://healthfacilityguidelines.com.au/standard-components

On referring to the recommendations for ensuite bathrooms there is clear evidence that a small standard toilet roll holder is what is drawn in all ensuite Room Layout Sheets for single, double or 4 bed shared ensuite toilet facilities (described as ‘dispenser toilet paper’)

I think that you would do well to refer your design team to these standard components. I agree that the risk may generally be minor, but think in a broader risk management context that toilets and bathrooms should be regarded as being of higher risk for transmission of important pathogens and recognise that cleaning of complicated larger dispenser may be problematic and potentially ineffective sometimes.

Hope that helps you in your quest of the big issues 🙂

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

Please note that my number has changed from 8th March 2016 to
*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi everyone,
I have request by builders to put jumbo toilet roll holders – that hold large round rolls- in ensuite rooms on a new ICU build. My thoughts are no it is an infection control risk but I thought I would ask my more experience learned colleagues in case you have done this?.
Yep sure am covering the big issues today!!!

Cate Coffey | Clinical Nurse Consultant
Infection Prevention and Control Unit | Central Australia Health Service
Northern Territory Government
Alice Springs Hopsital, Gap Rd, Alice Springs
GPO Box 2234, Suburb, NT Postcode
p … 08 89517737
e … cate.coffey@nt.gov.au http://www.nt.gov.au/health

Our Vision: Better health outcomes for all Central Australians
Our Values: Community at the Centre | Equity and Integrity | We are Accountable | We are Relevant Today and Ready for Tomorrow | We are Committed to High Quality Care | We Value our Partnerships

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[Thomson, Rachel EA (THS)]

Hi Kerry,

Here is the tool that we are about to launch in our region.

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

Please note that my number has changed from 8th March 2016 to
*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Dear Colleagues
Our organisation is finalising our CPE Policy and management plan and wondering if anyone has an Infection Status Screening Tool that is used on presentation to an Urgent Care Centre or Emergency Department and on admission that you would like to share?

Currently our Emergency Care Patient Record asks the question of recent overseas travel Yes / No and Date which obviously lacks detail.

Thankyou

Regards Kerry

[cid:logoaa8363]

Kerry Addlem
Infection Control Coordinator
Charlton Campus
PO Box 159, Charlton, Victoria 3525
Phone : 5477 6867 Mobile : 0419 534 673 Fax : 5491 2010
Email : kerry.addlem@ewhs.org.au
Web : ewhs.org.au

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[Thomson, Rachel EA (THS)]

Hi Daniela,

We are currently trialling an invasive devices tracking sheet as well. It is focussed on indwelling rather than all invasive devices. This form has been designed to replace one that purely focussed on IVDs. We have tried to eliminate free text and have included prompts to plan for removal/replacement of all devices including IDCs.

In relation to your specific questions

* How do staff undertake a daily review of an IDC and how do they know when the device is due for change or removal?
On the new form we are trialling staff must record when a device is due for change or removal – this includes IDCs. This form is used to assist with bedside handover. It must be completed each shift as relevant

* Is your documentation electronic or written and does it feature prompts?
Paper based bedside form, no specific prompts but staff are to record when a device is due for change/removal

* Do you have patient education materials regarding these devices?
Not specifically at present

* How do you address IV line labelling in your organisation?
We use a dressing with a date/ time of insertion label

* What systems do you have in place to ensure best practice is being maintained by staff?
This form has a barcode and will be fully auditable with the ability to provide feedback on use and compliance

If you think our form we are trialling may be of interest you are welcome to let me know and I would be happy to share it with you off line, even though it is still being developed.

Kind regards
Rachel
……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

Please note that my number has changed from 8th March 2016 to
*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Dear colleagues,

We are currently reviewing best practice management of peripheral intravenous cannulas (PIVCs), central venous access devices (CVADs), and indwelling urinary catheters (IDCs).

We are interested to know what interventions and strategies other health care services have in the multidisciplinary care of these devices and how such practices are sustained.
For instance:

* How do staff undertake a daily review of an IDC and how do they know when the device is due for change or removal?
* Is your documentation electronic or written and does it feature prompts?
* Do you have patient education materials regarding these devices?
* How do you address IV line labelling in your organisation?
* What systems do you have in place to ensure best practice is being maintained by staff?
Your feedback on successful interventions in the care of PIVCs, CVADs and IDCs (we are interested in any aspects of this and not limited to the questions above) is most appreciated.

Please feel free to contact me directly via my contact information below.

With thanks in advance,
Daniela

Daniela Karanfilovska
Clinical Nurse Consultant
Infection Prevention & Healthcare Epidemiology

t 03 90762819 m 0427 703769
e D.Karanfilovska@alfred.org.au

Alfred Health
55 Commercial Road
Melbourne VIC 3004
PO Box 315 Prahran
VIC 3181 Australia
[cid:808501323@06042016-059C]
Alfred Health incorporates The Alfred, Caulfield Hospital and Sandringham Hospital
http://www.alfredhealth.org.au

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[Thomson, Rachel EA (THS)]

Hi Jayne,

At the RHH we introduced a recognition award scheme some years ago. Most recent years we have awarded a ‘Certificate of Achievement’ to both the most improved unit across our organisation during the past 12 months as well as an award to the unit achieving the highest compliance overall during this time. We only do it annually in conjunction with World HH day, thus we have the greatest number of services to choose from. We always get our CEO or someone from senior executive to be involved and present the award in the main entry of the hospital. We also had them framed so that a unit could display this for visitors etc. to see to promote HH.

We have also commenced a recognition program for our auditors whereby at the end of the year whereby we present them with a certificate of achievement. As HHA state to maintain your registration as an approved auditor you need to collect at least 100 moments, we give these certificates to those auditors who meet or exceed that total . We actually state how many moments they collected. This is a really simple way of saying thank you to people. I have attached my own certificate as an example.

We have kept it pretty simple!

Hope that helps. Have fun.

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

Please note that my number has changed from 8th March 2016 to
: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

—–Original Message—–

Dear Colleagues,

Just wondering if anyone has an annual hand hygiene award that is awarded to ward/department, and if so what are your criteria for selecting the winners?
We are about to award for the first time in our annual awards, but want the selection to be correct as it is not just about improvement but consistency of improvement, we don’t want to put staff off improving on hand hygiene compliance who have had good results but maybe have not been consistent!! Does that make sense???

Anyway happy to hear your advise:)

Kind regards
Jayne

Jayne OConnor RN, BSc.Inf.Cont.
IPC Co ordinator
Sydney Adventist Hospital
185 Fox valley Rd,
Wahroonga 2076

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[Thomson, Rachel EA (THS)]

Hi Kelly,

At the Royal Hobart Hospital and within the Southern area of the Tasmanian Health Service we have developed a training program for auditors consistent with our preferred approach, which is ANTT. Thus, we have trained a reasonably large number of auditors across the organisation with a requirement for each service to provide at least 1-2 staff to be trained as auditors. The audits are then undertaken in two ways by the local auditors;

* Assessments for new staff in their area as required following completion of on-line education to assess ‘competence’. We have trained staff in nursing, allied health some medical as well (high-risk services DCCM and NPICU at the present time)

* Limited ‘snap-shot’ ANTT auditing over a month twice-yearly. Whilst the total number of twice-yearly ‘snap-shot’ auditing in the local area is quite small, overall we obtain some hundreds of audits from our health service. We believe that this is useful in measuring improvements overall. We have recently reviewed this auditing framework to ensure that auditing includes nursing and medical and, where relevant, allied health.

Our auditors are sourced primarily from the practice development unit (Nurse Educators) who have been very engaged in our program from the outset, as well as Standard 3 Portfolio Holders. Our main role then becomes one of training and supporting ANTT Assessors and coordinating the reporting and feedback from the program.

Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South

Please note that my number has changed from 8th March 2016 to
*: 03 6166 7882/ 6166 8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Hi Kelly,

I wonder about the validity of such audits in terms of the Hawthorn effect.

Wouldn’t it be more appropriated and less time consuming to assess competency by doing just-in-time peer review on employment and bi-annually or annually?

Regards

Glenys

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

While HH audits can be time consuming, I find them paling in comparison in the time it takes to audit Aseptic Technique, where “moments” for our health service can go for well over 30 minutes. I’m wondering how other health services manage their Aseptic Technique audits. I can spend a whole day auditing and only get 5-6 audits done.

Kelly

Kelly Barton
Infection Prevention & Control Officer
Monday- Friday
P Reduce, re-use, recycle. Please consider the environment before printing this e-mail.

Thank you Mary-Louise for your response re Graves et al study and the variances.

The concerns of biased data reported for hand hygiene compliance is worth noting and I too agree with your comments here.

Costs associated with the efforts to report HH data as required which detracts from some of the critical day to day requirements of the IC nurse need further review.

Thank you
Michelle

Michelle Bibby
Infection Prevention Australia
Michelle@infectionprevention.com.au
+429071165

Dear Ramon and Glenys

Graves et al study relies on the accuracy of the 2 pivotal variables: SAB and hand hygiene compliance. The accuracy of the latter is serious limited. Our report in the Medical Journal of Australia (Med J Aust 2014; 200 (9):534-537. http://dx.doi.org/10.5694/mja13.11203) concluded the HHA program reports rates that have been biased upwards by very few high performers.

The conclusion from our findings and Graves et al is:

(1) SAB respond to multiple interventions and hand hygiene is only one of these.
(2) hygiene compliance rates have not reached a tipping point to reduce SAB and this tipping point is a long way off because
(3) the hand hygiene compliance rates are inaccurate.

It is important to have a national HH program. But the expense of the current program is too high when the cost of audits provides flawed data that reinforces a misguided belief that our hospitals are performing HH well.

Mary-Louise

Professor Mary-Louise McLaws

Professor of Epidemiology in Healthcare Infection and Infectious Diseases Control

http://research.unsw.edu.au/people/professor-marylouise-mclaws

SPHCM SAMUELS BUILDING

UNSW AUSTRALIA, SYDNEY NSW 2052 AUSTRALIA

CRICOS Provider Code 00098G

________________________________
Colleagues

The study by Graves et al. reports a range of interesting findings, and raises many issues regarding hand hygiene for broader consideration. The College is examining the paper and is preparing a media release for release in the coming days.

Kind regards,
Ramon

Professor Ramon Z Shaban
PRESIDENT

Australasian College for Infection Prevention and Control

GPO Box 3254, Brisbane Qld 4001

On 25 February 2016 at 21:16, Glenys Harrington <infexion@ozemail.com.au> wrote:
Dear All,

Find attached the following publication (February 9, 2016).

* Graves et al. Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia. PLoS ONE 11(2): e0148190. doi:10.1371/journal.

The analysis was undertaken on data from 6 Australian states:

* In 2/6 states there was a 1% chance it was cost effective

* In 1/6 states there was a 26% chance it was cost effective

* In 1/6 states there was a 80% chance it was cost effective and

* In 2/6 a 100% chance it was cost effective.

Interesting figure showing cost increases and cost savings by state (fig 2).

Also some interesting points in the discussion.

Shame there was “No useable pre-implementation” data available for Victoria and hence was not able to be analysed.

Given the findings of the analysis it raises the following questions for governments:

* Shouldn’t the program be scaled back and some of the money be spent on other initiatives to reduce hospitals associated infections(HAIs)?

* Shouldn’t the program be scaled back to reduce the infection control workload associated with the program which is currently overwhelming and taking ICPs away from other core infection control activities?

A press release by the College about the findings of this study and the views of the college in terms of the allocation of limited resources would be timely.

regards

Glenys

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

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[Thomson, Rachel EA (THS)]

Hi Giulietta,

1. What is the most common type of P2/N95 mask that you provide?

Are you asking for a brand? Happy to give this off-line

2. How many types and sizes do you have available?

We make available 5 different masks as a routine.

* small and medium of one brand (“duck-bill” style)

* small and regular in another (“duck-bill” style)

* another different style only available in one size (flat-front style)

3. Do you routinely fit test your staff?

Yes – we offer fit-test training to clinical and support staff as relevant.

a. If so, when and by which method?

* We use a Qualitative approach, bitrex as first agent

* We use a train the trainer model, with a focus on those units at services who most frequently require the use P2 Happy to give more detail if you want off-line

b. When do you re-test?

* Attempted annually, but in reality new staff, staff with any facial changes (self-identified) etc. are done annually and others as resources permit. Some services do manage to achieve annual for all with this model.
Kind regards
Rachel

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

________________________________

CONFIDENTIALITY NOTICE AND DISCLAIMER
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[Thomson, Rachel EA (THS)]

Hi Jan,

I posed this question to our Statewide Dental service Quality Manager. I copy a prcis of her reply below;

Hi Rachel,

Creating aseptic fields is something that we have been looking at and forms part of the ANTT training. From our perspective, to create an aseptic field we are implementing the wrapping of our exam kits and surgical & elevator kits in kimguard; thus when unwrapped creates an aseptic field on the bracket tray. We also use the inner of the steri-pouch to create a micro-aseptic field.

The use of dental bibs is traditionally what we have all used, but they don’t provide/create an aseptic field as they are not sterile and as a paper product have the potential to shed fibres. As such we are moving away from their use.

Kind regards,

Robyn

Robyn Nikolai
Manager Safety and Quality |Oral Health Services Tasmania
Department of Health and Human Services
GPO Box 125, Hobart, TAS, 7001 | p. 03 6166 5402 | f. 03 6214 5490 |

……………………………………………………………………………..
Rachel Thomson
Nurse Unit Manager

Infection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658

Level 4, H Block
48 Liverpool Street
Hobart, 7000

Dear all
I have a question relating to maintaining aseptic technique in Dental clinics. What do you use on the chair side tray as a sterile field to place the reprocessed instruments on. Does it depend on the nature of the dentistry being performed?
There seems to be differing opinions here in our Dental service about what is the best setup, with one team using Sterile Tray Liners and the others using bibs as tray liners
Thanks Jan

Jan Roberts RN,MPH
Infection Prevention & Control
Community Based Services, ACT Health
(W) 61745352
(M) 0435966792
(E) janL.roberts@act.gov.au
or communityinfectioncontrol@act.gov.au

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