[Roel Castillo]

Hi Teresa

Kindly refer to GDA 17.

https://www.records.nsw.gov.au/recordkeeping/government-recordkeeping-manual/rules/general-retention-and-disposal-authorities/public-health-services-patient-client-records-gda

Cheers

Roel

Roel Castillo
Project Officer SSD
[Chris O`Brien Lifehouse]
Level 5, 119-143 Missenden Road
Camperdown NSW 2050
PO BOX M5 Missenden Road NSW 2050

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*hWK4nY*

Dear Colleagues

I was asked today how long we need to keep the paperwork printed off from the Automatic Flexible Endoscope Reprocessor.
This paperwork shows the cycle number, it identifies the person placing the scope into and taking the scope out of machine, and the scope serial number and all parameters etc.
This print out is stapled to a day sheet(log). This paperwork is the one that I do not know how long we need to keep for (is there a legal requirement – 7years???).

It is a lot of paper and I know that the print outs eventually fade.
Our machines are all automatically recorded and backed up by Sterilogic – so we do have an electronic record of the cycle (the same information that is printed off), and of course the cycle is validated and all parameters are checked on completion of cycle by staff before the scopes are released. The cycle number and scope serial number is entered into the patients file, which we also scan (so we have an electronic version of the patient chart as well). So I feel that if need be, we can track back and get all the necessary information in case of a look back without the paper version.

If anyone can help me I would really appreciate it.
Thank you in advance.

Teresa Lewis
Infection Control and Prevention CNC
Newcastle Endoscopy Centre

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[Roel Castillo]

Hi Barbara
Kindly refer to links, I hope this helps:
http://www.health.wa.gov.au/CircularsNew/circular.cfm?Circ_ID12021
http://www.7sbundle.com/uploads/4/6/4/2/4642325/or_air_contamination_-_edmiston_-_surgery_2005.pdf
http://www.his.org.uk/files/5213/7338/2929/Microbiological_Commissioning_and_Monitoring.pdf
Happy browsing
Cheers
Roel

Roel Castillo
Project Officer SSD
[The Chris O`Brien Lifehouse at RPA]
Level 5, 119-143 Missenden Road
Camperdown NSW 2050
PO BOX M5 Missenden Road NSW 2050

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*hWK4nY*

Hello Everyone,
I am also interested in the required microbiological sampling for the commissioning of new builds. We are planning our commissioning program for early next year and like Rebecca would appreciate your input.

Regards,
Barbara

Barbara May
CNC Infection Control
Hastings Macleay Clinical Network
Ph. 02 55242061
Mo. 0402890677

Are your hands clean? Clean hands saves lives.

Dear All

Can anyone advise of your current practices for the requirement to perform microbiological air sampling following construction of or major refurbishment of operating rooms. The WA policy is based on the 2002 Hoffman paper and I am not aware of any more recent extensive publications on this subject.
A commentary in JHI in 2005 questioned the value of microbiological sampling (Jowitt / Morris), and the Aust HFG recommend it is performed on commissioning but give no acceptable cfu counts. The 2005 Loddon/Mallee text, give various counts for fungi and bacteria and HB 260 does not mention nor do the Australian Infection Control Guidelines.

If anyone can shed some light on the way forward in 2013 it would be appreciated.

Kind Regards

Rebecca

Rebecca McCann Program Manager
Healthcare Associated Infection Unit (HAIU)
Communicable Disease Control Directorate Department of Health
Grace Vaughan House
227 Stubbs Terrace
SHENTON PARK WA 6008
T:08 9388 4859 M:0439 920 819 F:08 9388 4888
E:rebecca.mccann@health.wa.gov.au

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[Roel Castillo]

Hi Glenys
Kindly refer to AS 4187 – 2003 Appendix A. Clause 9.5 – Commercially prepared items.
Cheers
Roel

Roel Castillo
Project Officer SSD
[The Chris O`Brien Lifehouse at RPA]
Level 5, 119-143 Missenden Road
Camperdown NSW 2050
PO BOX M5 Missenden Road NSW 2050

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*hWK4nY*

Dear All,

Can anyone from NSW assist me with locating the following document which is listed as a resources in B1.5.8 in the Australian Guidelines for the Prevention and Control of Infection in Healthcare (2010).

* NSW Health, Health Procurement, Guidelines for Storage and Handling of Pre-Sterilized Consumables

Many thanks in anticipation

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)

PO Box 5202
Middle Park
Victoria, 3206
Australia
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M: +61 404 816 434
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[Roel Castillo]

Hi Glenys

Here’s one from QLD. I don’t know if this helps, happy browsing.
http://www.health.qld.gov.au/chrisp/sterilising/sterile-stock-storage-V1.0.pdf

Cheers

Roel

Roel Castillo
Project Officer SSD
[The Chris O`Brien Lifehouse at RPA]
Level 5, 119-143 Missenden Road
Camperdown NSW 2050
PO BOX M5 Missenden Road NSW 2050

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*hWK4nY*

Dear All,

Can anyone from NSW assist me with locating the following document which is listed as a resources in B1.5.8 in the Australian Guidelines for the Prevention and Control of Infection in Healthcare (2010).

* NSW Health, Health Procurement, Guidelines for Storage and Handling of Pre-Sterilized Consumables

Many thanks in anticipation

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

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[Roel Castillo]

Hi Brenda

Kindly refer to link:
http://www.cec.health.nsw.gov.au/resources/environmental-cleaning-sop/environmental-cleaning
Here are some insights:

a) Cleaning – daily residues checks at random – paying attention to hard to clean and cannulised instruments (logged/recorded)

b) Inspection – dirty items, items for repair/sharpening, electrosurgical testing, missing items/parts of an item, functionality compromises – all documented

c) Assembly – missing parts of an item, random processed sterile item check, end user non-conforming incident reports

Among others give me a ring on or email me if you need to explore further.
I would assume the link would suffice to get you through.
Happy to help.
Cheers
Roel

Roel Castillo
Project Officer SSD
[The Chris O`Brien Lifehouse at RPA]
Level 5, 119-143 Missenden Road
Camperdown NSW 2050
PO BOX M5 Missenden Road NSW 2050

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*hWK4nY*

I am interested to know how people interpret the statement in AS/NZS 4187:2003 Section 7.1

All stages of the sterilization process shall be developed and documented to ensure that the items can be sterilized.
The process shall be reliably reproduced and routinely monitored to the desired probability of a non sterile item.

Routinely monitored (is where I want input) I realize each step will be written up in a policy/procedure manual- but how is the procedure monitored to know the policy is being followed.

All stages are then listed:
(a) cleaning – how is manual cleaning monitored??
(b) Inspection – how is the inspection process monitored??
(c) Assembly – How is the assembly process monitored??
Etc…………….. goes to (k) validation of the process
I realize that the sterilizers and washer/ disinfectors have monitoring mechanisms in place (i.e bowie dick, soil tests etc and these are monitoring the performance of the machines) – I am interested in the process indicators for the manual components of the process?

This is a theme of accreditation standard 3….3.16.1 – quality control systems to monitor each stage of handling or items requiring reprocessing.

I would appreciate any comments or even better – audit tools

Regards
Brenda Anderson

Mrs. Brenda Anderson
Regional Infection Control Consultant
Hume Region Infection Control Resource and Consulting Service
Northeast Health Wangaratta

Northeast Health Wangaratta
Green St, Wangaratta, VIC 3677

Brenda.Anderson@hume.org.au
http://www.nhw.hume.org.au

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[Roel Castillo]

Hi Rachel

http://www.health.qld.gov.au/chrisp/resources/sharps_safety.asp

Cheers
Roel

Roel Castillo
Project Officer SSD

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
[Image removed by sender.]
Level 5, 119-143 Missenden Road
Camperdown NSW 2050
PO BOX M5 Missenden Road NSW 2050

[Image removed by sender.]
[Image removed by sender.][Image removed by sender.][Image removed by sender.][Image removed by sender.]
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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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[Roel Castillo]

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
[The Chris O`Brien Lifehouse at RPA]
Level 5, 119-143 Missenden Road
Camperdown NSW 2050
PO BOX M5 Missenden Road NSW 2050

[Lifehouse Shop]
[Facebook: The-Chris-OBrien-Lifehouse-at-RPA][LinkedIn: The Chris O`Brien Lifehouse at RPA][Twitter: LifehouseRPA][YouTube: LifehouseatRPA]
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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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[Roel Castillo]

Hi Prof

Apologies, I don’t have a big brain. I believe it is more on the IFU (instructions for use). The device limitations/functionality are not stipulated but clearly exceeding recommended usage would be a legal liability when things go wrong. As we all know, tests were done ( in vitro) in company labs, as a requisite to TGA or FDA approval, the irony that continues to be a challenge to the clinical setting (as they are never tested in real working environment). With all due respect, it is sensible to follow device manufacturer’s IFU, the information being available to end user, covers their part of liability. The important aspect of it is obviously patient safety, for a few dollars more.

Always happy to know the results of your tests if it proves the manufacturer’s claim or otherwise.

Cheers
Roel

Roel Castillo
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[The Chris O`Brien Lifehouse at RPA]
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*hWK4nY*

HI Big Brains

I know this is a bit off topic, but can anyone please help me on this? It is driving us nuts here.

1. Where can one see the DATA on WHY we use low sorbing infusion tubing for cyclosporin infusion? (I know the theory, just would like to see the proof :o)) How does absorption vary with dose, rate, time etc?

2. We want to extend use of this tubing for a week instead of 4 days (This would bring it in line with the other infusions).

A colleague believes that the low sorbing tubing would no longer work after X number of days (in this case 4), and therefore if we extend it, the tubing may no longer present absorption.

Yes we have asked the Drug Information Dept and they could not provide any data on this.

Thinking of running some tests ourselves with a friendly biochemist if we can’t get a better answer!

Best regards, Claire

Professor Claire Rickard RN PhD
c.rickard@griffith.edu.au | +61 7 3735 6460 | Skype: clairexm1 | Twitter: IVAD_Research |
http://www.griffith.edu.au/health/centre-health-practice-innovation/research/acute-critical-care/intravascular-devices

Intravascular Access Device Research Group | NHMRC Centre of Research Excellence in Nursing Interventions | Griffith Health Institute | Visiting Scholar: Royal Brisbane & Women’s Hospital | Princess Alexandra Hospital | The Prince Charles Hospital

Research frequently takes me off campus. Please contact Jenny Chan 3735 5406 j.chan@griffith.edu.au or Jo.Wright@griffith.edu.au 3735 4886 with any urgent enquiries.

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[Roel Castillo]

Hi Jenny

Terry is right, additionally include a cleaning protocol in place, as you treat all other equipment (and attachments) for reprocessing.
Happy processing.

Cheers

Roel

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*hWK4nY*

Dear all

We have recently put a “scope buddy” in our endoscopy area (a device that automatically flushes the scope prior to putting in the AFER) . My concern is the suppliers have told the endoscopy staff that “other hospitals” leave the tubing attached to the scope buddy with the low level instrument grade disinfectant through the tubing.

The tubing is reusable and staff have set up a system where the tubing sits in the disinfectant until the next list. Any comments?

Thanks
Jenny
Jenny McCarthy
OR Manager/Infection Prevention and Control Coordinator
Maryvale Private Hospital

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[Roel Castillo]

Hi Carolyn
Hoffman et al 1985 on a study on wedding rings worn by nurses, resembles parallel to your query.
Cheers
Roel

Roel Castillo
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*hWK4nY*

HI all,
Does anyone have any supportive information why staff cannot work in a clinical area, haemodialysis and cannulation of patients, when they are wearing a hand brace?
The hand brace has a material part which wraps around the thumb.
To my thinking this goes against good hand hygiene practices as the brace cannot be cleaned between patients.

With best regards
Carolyn Chenoweth
National Quality Coordinator
NephroCare

Fresenius Medical Care Australia Pty Ltd.
Payneham Dialysis Clinic, 2 Portrush Road,
PAYNEHAM
SA 5070 Adelaide
Australia
T: +61 8 8165 4313
F: +61 8 8336 4833
M: +61 0 407 810 800
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[Roel Castillo]

Hi Sony
The prescribed ventilation parameters delivers the environmental conditions to maintain sterility of processed items. Not all sterile stock rooms have round the clock monitoring of these parameters and values vary from continents. There must be an immediate response based on your risk assessment to correct the deviation, and provide the pristine conditions once again. On the sterility of your processed items however, the packing integrity must be the basis of the sterility of its contents. As long as the packing integrity is not compromised, it remains a qualitative basis of items that have gone through to a validated process of sterilisation, hence sterile. If it is compromised in any way, it is pretty straight forward, or in your own words “easy task”.
Please browse a study in Infection Control Today website, Processed Items Exposed to Extremes in Environmental Conditions, i.e. RH and Temperature for further readings, I couldn’t locate it but there is one, it will be an eye opener.

Cheers
Roel

Roel Castillo
Project Officer SSD
[The Chris O`Brien Lifehouse at RPA]
Level 5, 119-143 Missenden Road
Camperdown NSW 2050
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*hWK4nY*

Dear All,

At present, I am drafting the emergency protocol for dealing the ventilation parameters (relative humidity, temperature) excess the recommended limits of sterile store room.

If packages are visibly wet or damaged (e.g., label peeling due to moisture, or visible moisture on the package), the packaged items should not be used. The contents should be repackaged and sterilized, or discarded if they are single-use medical devices. This scenario is the easy task.

If relative humidity is measured to be greater than upper limit, however, the packages are not visibly wet or damaged. I would like to have your comment for how to handle this particular scenario, whether we would use the questioned packages, or we need to repack and sterilize all the questioned packages.

Yours sincerely,

Sony SO
Nursing Officer, Infection Control Team
Kwong Wah Hospital
HONG KONG SAR, CHINA.
Tel:+ 852 3517-2409 Fax: +852 2332-3348 email:sony@ha.org.hk
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[Roel Castillo]

HI Jennifer

If you could refer to Appendix A, AS 4187:2003 Clause 9.2.1 Rationale.
Happy browsing.

Cheers
Roel

Roel Castillo
Project Officer SSD
[The Chris O`Brien Lifehouse at RPA]
Level 5, 119-143 Missenden Road
Camperdown NSW 2050
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*hWK4nY*

—–Original Message—–

Dear all,

I am currently researching current standards for storing sterile reusable medical devices RMD’s. AS4187 standards require RMD’s to be stored 250mm off the floor, require good ventilation, easily cleaned smooth surfaces, temperature control and a dedicated area. The containers the instruments are placed in are also to be easily cleaned and no rough edges etc. I was of the opinion that the storage containers should be open wire baskets, however I can’t find a source for this and wanted to see if anyone knew where I can find the standards required by the health department? Furthermore should the shelving be open wire shelving as well. I have not been able to find any source that specifically states what type of system is required.

Kind regards

Jennifer Cartwright
Infection Control
Eye Surgery Foundation
Perth WA

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[Roel Castillo]

Hi Kylie
Further, kindly refer to Victoria’s version.
http://ideas.health.vic.gov.au/bluebook/appendix5.asp
Cheers
Roel

Roel Castillo
Project Officer SSD
[The Chris O`Brien Lifehouse at RPA]
Level 5, 119-143 Missenden Road
Camperdown NSW 2050
PO BOX M5 Missenden Road NSW 2050

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*hWK4nY*

Good morning,

I am currently reviewing the contents of our Creutzfeldt Jacob Disease (CJD) spill kit. Could you please let me know (via direct email) what product you have available for cleaning spillage of higher infectivity tissue from patients in either the low or high risk CJD categories.

The current National Guidelines state:

Environmental
Cleaning
Routine containment and cleaning procedures apply unless major contamination with higher-infectivity
tissue has occurred. Spill-Kits containing either 1M sodium hydroxide (NaOH) or 20,000ppm (free chlorine) sodium
hypochlorite should be available in areas of increased risk such as neurosurgery operating rooms,
mortuaries and laboratories. Occupational health and safety recommendations and material safety data
sheets (MSDS) must be available. Expose area with freshly prepared solution for 1 hour and then rinse
with water. Surfaces that cannot tolerate NaOH or sodium hypochlorite should be cleaned using anionic
detergent.

http://www.health.gov.au/internet/main/publishing.nsf/content/AC9448D36D359F50CA2577C40016F0F6/$File/CJDInfectionControlGuidelinesJan2013.pdf

Thanks in advance

Kylie McCarthy
Infection control coordinator
Prince of Wales Private Hospital
Phone 02 9650 4034
Fax 02 9650 4688

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Kylie McCarthy
Infection control coordinator
Prince of Wales Private Hospital
Phone 02 9650 4034
Fax 02 9650 4688

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[Roel Castillo]

Hi Kylie
This might help. Kindly go through to links.
http://www.cdc.gov/ncidod/dvrd/cjd/qa_cjd_infection_control.htm
Cheers
Roel

Roel Castillo
Project Officer SSD
[The Chris O`Brien Lifehouse at RPA]
Level 5, 119-143 Missenden Road
Camperdown NSW 2050
PO BOX M5 Missenden Road NSW 2050

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*hWK4nY*

Good morning,

I am currently reviewing the contents of our Creutzfeldt Jacob Disease (CJD) spill kit. Could you please let me know (via direct email) what product you have available for cleaning spillage of higher infectivity tissue from patients in either the low or high risk CJD categories.

The current National Guidelines state:

Environmental
Cleaning
Routine containment and cleaning procedures apply unless major contamination with higher-infectivity
tissue has occurred. Spill-Kits containing either 1M sodium hydroxide (NaOH) or 20,000ppm (free chlorine) sodium
hypochlorite should be available in areas of increased risk such as neurosurgery operating rooms,
mortuaries and laboratories. Occupational health and safety recommendations and material safety data
sheets (MSDS) must be available. Expose area with freshly prepared solution for 1 hour and then rinse
with water. Surfaces that cannot tolerate NaOH or sodium hypochlorite should be cleaned using anionic
detergent.

http://www.health.gov.au/internet/main/publishing.nsf/content/AC9448D36D359F50CA2577C40016F0F6/$File/CJDInfectionControlGuidelinesJan2013.pdf

Thanks in advance

Kylie McCarthy
Infection control coordinator
Prince of Wales Private Hospital
Phone 02 9650 4034
Fax 02 9650 4688

Please consider the environment before printing this message

Kylie McCarthy
Infection control coordinator
Prince of Wales Private Hospital
Phone 02 9650 4034
Fax 02 9650 4688

Please consider the environment before printing this message

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[Roel Castillo]

Hi Philipa

With all due respect to ASUM, reprocessing of reusable medical and surgical devices and equipment must also comply with AS 4187:2003.
As long as you satisfy the reprocessing requirements for the devices intended use as per Spauldings classification, this process was validated, to ensure the level of cleanliness, degree of disinfection and the sterility assurance level of 10( at least). As far as I know ultrasound probes fall under either the category of semi critical items (being in contact with non-sterile tissue and mucous membranes) shall undergo disinfection (thermal is preferred if available) or non-critical items (being in contact with intact skin) requiring cleaning (mechanical preferred over manual). Please identify intended use and remember this are minimum requirements for reprocessing. Some may need sterilisation, in this regard if you have an SSD just let them reprocess you instruments, their washers doesnt only clean but provide thermal disinfection as well. You have options to sterilise them as best practice entails.
How do you validate your wiping process? Do you do random visual checks/residue checks? Are they being recorded? Do you have a procedure that this process is repeatable every time with the same level of cleanliness?
You can do random tests, that is every other third processed instrument of the third day (or any random design) and do protein/blood/carbohydrate residue checks and document them. What measures do you take in case these checks fail?

For better patient care
Roel

Roel Castillo
Project Officer – SSD
Mob: +61 434 496 829

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Parsons, Phillipa
Sent: Tuesday, 21 May 2013 11:17 AM
To: AICALIST@AICALIST.ORG.AU
Subject: ASUM guidelines and US probe cleaning

Dear All,

I am seeking some assistance with interpreting the ASUM guidelines and their requirements for US probe cleaning.

We are using the Trophon for all intracavity probes and wiping over all other probes used for routine imaging, biopsy guidance etc with a disinfectant wipe. The current wipe in use is not one of the four recommended disinfection methods referred to in their guidelines.
We use probes covers routinely for all interventional procedures or on mucous membranes, wounds etc.

Am I correct in interpreting the ASUM guidelines – that all probes regardless of cover usage must be cleaned in one of the four ways stated by ASUM. Can anyone throw some more light on this issue for me please.

We have received full Imaging reaccreditation and our current practise was not raised as an issue.

Regards

Phillipa Parsons
Infection Prevention and Control Clinical Coordinator
Cabrini Health
183 Wattletree Rd
Malvern Vic 3144
03 9508 1577
0400 369 741
Email: pparsons@cabrini.com.au

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