[Robert Robinson]

Hi Anna
Certainly not recommending bins with lids (pedal bins, swing top bins) for the reason they break, become easily contaminated and extra cleaning is required.
Bins with no lids are easier for users to dispose of waste safely. If there is a concern regarding bins certain residents then you will need to do a risk assessment.

We have suggested to ACFs across our district to contact your supplier (if you have one) or go down to a hardware store and buy a suitable size bin.
You will still need to use appropriate colour (eg: General or clinical) plastic bin liners.
If you are using these for PPE in an outbreak, you may want a larger 50 litre bin as these fill up quickly rather than a smaller waste tidy bin.
One ACF in our district have no lids on bins in staff / communal areas (size vary and appropriate for their location) but for residents in their rooms; it is their choice.

There are references I have forward to you previously but except for the large mobile garbage bins and clinical sharp bins, I am not aware of a requirement that bins discussed above must have lids (or not).

Regards

Robert Robinson

Clinical Nurse Consultant, Nepean Blue Mountains LHD | Infection Prevention and Control
Nepean Hospital, PO Box 63, Penrith 2751
Tel (02) 4734 2228 | Fax (02) 4734 2517 | Mob 0439 881 749 | robert.robinson@health.nsw.gov.au

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Hi would anyone have any information on the types of bins suitable for discarding of PPE. I have looked at many infection control guides but none mention types of bins.

As a small facility with limited resources we have generally used bins with a swing lid ( then the lids go missing!) though this way rubbish is easier to discard! and we also have pedal operated bins but I find their life is short in comparison to the cost!.
Auditors from the Accreditation Agency have said best practice was the use of pedal bin. Infection control officers who audited my facility from the local health district told me bins with no lids was better but have not been able to provide written evidence either. While doing the Foundations course one of the film clips produced by the Tasmanian Government showed PPE being discarded into a bin without a lid. Does that mean for training its ok but in other situations it’s not??

Looking forward to any replies.

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[Robert Robinson]

We do not have ABHR in the decontamination area as staff prefer to wash their hands, but they do have them in the packing / clean areas.
Agree with Terry’s comments. SSD staff also roam the wards delivering sterile package items and are encouraged / educated to do hand hygiene in these clinical areas as required. They are aware not to handle the sterile packs if hands are wet from hand washing or not dry after using ABHR.
Clinical staff come to SSD to pick up sterile packages and also handling these sterile packs in ward areas where we do have moisturisers located. We do educate clinical staff to always check the integrity of a sterile packaged item to ensure it is not compromised before use.

Regards

Robert Robinson

Clinical Nurse Consultant, Nepean Blue Mountains LHD | Infection Prevention and Control
Nepean Hospital, PO Box 63, Penrith 2751
Tel (02) 4734 2228 | Fax (02) 4734 2517 | Mob 0439 881 749 | robert.robinson@health.nsw.gov.au

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I have been waiting for Terry’s comments as it is probably a surprise to some that our CSSD world is always changing.

In the past I would have had a blanket ban on ABHR in CSSD, often being horrified seeing several bottle of ABHR sitting on the sink in the “dirty” decontamination area. I still believe that ABHR should not be available in the decontamination area as there is a likelihood of dirty hands after removal of gloves, however I now agree that they can have a role in the clean areas such as the packaging area and sterile store.

I would have the following provisos:

That staff applying ABHR allow the solution to dry completely before handling instruments or packaging.

That staff receive sufficient education to understand that ABHRs work on clean hands and if their hands are dirty from a particular task they have performed before handling instruments or packs that they find a nearby sink and wash their hands before applying an ABHR.

In my role I am involved in the review of the structure of CSSD’s and in the past would have always recommended a hand washing sink in the packaging area or sterile store but in recent times this is no longer considered essential and sometimes it is considered a risk if close to the packaging area due to splashing and increased plumbing risk. Often there is a hand hygiene sink outside the clean area that staff should use before they enter a clean area and the ABHR is a supplement.

The challenge is the Infection Control Team selecting an ABHR which has the right concentration of alcohol and also provides staff with some protection from regular use.

The main risk to sterile packaging is a dirty and poorly ventilated environment, rough handling, dirty or wet hands.

Best wishes

Sylvia

Sylvia Morris
Sterilising and Reusable Medical Device Reprocessing State Coordinator
Infection Control Service
Health Regulation and Protection
Department for Health and Wellbeing/Government of South Australia
Level 3 Citi Centre 11 Hindmarsh Square Adelaide SA 5000

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Hi Everyone,

My response to being told that you can’t use ABHR in CSSD is ‘where’s the evidence?’

If you read the ingredients of liquid soap you will also find it contains emollients.

I remember vividly watching a demonstration at a polypropylene sterilisation wrap factory of the impact of liquid soap in the permeability of the product when applied directly to the surface. However – who would ever think to apply liquid soap to a sterilisation wrap?

Long story short, they wouldn’t and the hand hygiene process would ensure that clean, dry hands are no risk to the sterile barrier.

Therefore I am of the opinion that YES, CSSD staff can use an ABHR when appropriate in the CSSD workspaces, as long as they use the product correctly and ensure their hands are dry before touching sterile barrier systems and RMDs.

If CSSD staff can’t use an ABHR because there’s an emollient in it, then it follows that anybody touching a CSSD produced sterile package should not be allowed to use ABHR.

IF someone has evidence to the contrary – please share.
Kind Regards
Terry McAuley
Director
MSc Medical Device Decontamination

PO BOX 2249, Greenvale VIC Australia 3059

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This correct most ABHR have an emollient of some description which may compromise sterile wrap. CSSD staff should have available a handwashing sink.

Liz Vanderlinde
Infection Prevention Control Co-ordinator
North West Private Hospital
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Hello – just after some advice on using the 70% alcohol hand rub in CSSD. I was under the impression it would be acceptable to use but my CSSD staff have said they were told as it has a moisturiser component it can’t be used. I am aware that straight moisturiser can’t be used during the shift – any thoughts?
Thanks
Jenny

Kind regards,
Jenny McCarthy
Operating Room Manager/Infection Prevention and Control Coordinator
Maryvale Private Hospital
PO Box 348, Morwell, 3840
286 Maryvale Rd. Morwell, 3840
T +61 3 5132 1283 | F +61 3 5132 1281
E jenny@maryvaleph.com.au

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[Robert Robinson]

Hi Vicki
We are going through a redevelopment and last year successfully argued to have a Class N isolation room in our new planned endoscopy unit.
HCFG part D there is reference to procedural areas (bronchoscopy rooms and sputum induction rooms)
Happy to discuss details
Regards

Robert Robinson

Clinical Nurse Consultant, Nepean Blue Mountains LHD | Infection Prevention and Control
Nepean Hospital, PO Box 63, Penrith 2751
Tel (02) 4734 2228 | Fax (02) 4734 2517 | Mob 0439 881 749 | robert.robinson@health.nsw.gov.au

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Hi All,
We are currently in the process of a new build & I have been notified that there is no inclusion of negative pressure air conditioning within the new Endoscopy unit.

I have been informed that Australian Health Facility Guidelines do not require negative pressure within endoscopy units, despite bronchoscopies revealing TB in some cases

Is there any Endoscopy Units that have negative pressure incorporate in either their stand-alone units or those that are attached ( via corridors ) to their theatres

Many thanks

Vicki Denyer

Vicki Denyer
Clinical Nurse Consultant | Infection Prevention and Control
Infection Control Unit Lismore Base Hospital
‘ 02 6620 2385 ?Fax: 02 66 202287
* vicki.denyer@health.nsw.gov.au

Infection Prevention & Control is Everyone’s Business

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