[Roel Castillo]

Hi Tina

In old AS 4187:2003: . It is Section 12.2.2 of the standard as a warning of possibility of detachment during procedures and can harbour microorganisms as well, thus compromising the sterility of the processed instrument.

I haven’t been updating yet (to the new) but best practice entails nonetheless.

The blade: if it says reusable you can obviously reprocess referring to IFUs, if it’s not (single use) please discard.

Happy marking

Roel

Roel Castillo
Sterilising Services Manager
[Chris O`Brien Lifehouse]
119-143 Missenden Road
Camperdown NSW 2050
PO BOX M33 Missenden Road NSW 2050

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*hWK4nY*

Hello Michael.

I just wanted to ask you or the forum if there are any issues with using identification tape on instruments? I have been told conflicting information concerning this matter.

Also, I have a query regarding surgical saw blades. I have always discarded used surgical saw blades, but was chastised by a rep the other day, who advised that his blades were reusable? I have never reused a surgical saw blade, does anyone in the forum have any insight into this issue, or would it be a manufacturers question?

Thanks in advance for your assistance on these matters

Cheers

Tina Owens
Clinical Manager
Southport Day Hospital

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[Roel Castillo]

Hi Sue

I hope this helps:

http://www.health.qld.gov.au/chrisp/sterilising/sterile-stock-storage-V1.0.pdf

Happy storing

Roel

Roel Castillo
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[Chris O`Brien Lifehouse]
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*hWK4nY*

—–Original Message—–

Hi All,

We are currently reviewing the rooms that contain sterile and non sterile consumables within all of our wards and departments. Only one ward has reprocessed medical devices stored in their storage room.
Do the standards that apply to storage of reprocessed medical devices in sterile store rooms of operating suites, in relation to ventilation, humidity and air exchanges, apply to rooms in wards and departments that contain single use sterile consumables.

Kind Regards,

Sue Flockhart
Infection Prevention & Control
Ballarat Health Services
53204792

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[Roel Castillo]

Hi Beth

Chris O’Brien Lifehouse SSD outsourced cleaning and testing to an independent provider prior to opening.

We will be doing this yearly and prior to opening our operating theatres early next year.

Regards

Roel

Roel Castillo
Sterilising Services Manager
[Chris O`Brien Lifehouse]
119-143 Missenden Road
Camperdown NSW 2050
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*hWK4nY*

—–Original Message—–

Beth

We have recently opened a brand new SSD in Victoria and apart from the required validation of the sterilisers, the only area that we did do air sampling was in our sterile store room where we had Hepa Filtration. In our clean/packing room no microbiological sampling was undertaken as these areas do not have Hepa Filtration.

Happy for you to discuss off-line if you have further questions.

Leanne Houston

Associate Director
INFECTION PREVENTION & CONTROL SERVICE (IPAC)

Eastern Health: Winner of the Premier’s Health Service of the Year Award (Metropolitan) at the 2013 Victorian Public Healthcare Awards

—–Original Message—–

Good Evening

I am someone within the AICALIST brains trust can provide some advice regarding the necessity for microbial sampling of newly constructed SSD. I have not been able to find any reference to this being recommended prior to opening.

Does anyone know of any guidelines that apply to NSW?

Or, national or international references that may indicate that this would be recommended from a best practice point of view.

I would be grateful for any advice within the next few days, if possible.

Thank you
Beth

Beth Bint

Infection Prevention and Control Clinical Nurse Consultant | Infection Management and Control Service Level 1 Lawson House Wollongong Hospital Tel 02 4222 5898 |beth.bint@SESIAHS.HEALTH.NSW.GOV.AU
http://www.health.nsw.gov.au
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[Roel Castillo]

Thanks Marija

Roel Castillo
Sterilising Services Manager
[Chris O`Brien Lifehouse]
119-143 Missenden Road
Camperdown NSW 2050
PO BOX M33 Missenden Road NSW 2050

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*hWK4nY*

—–Original Message—–

Hi Beth,

As far as I am aware any new commissioning of areas such DSS or Operating Theatres, the recommendation from ACORN Standards and AHFG is air-sampling be undertaken on commissioning or when reconstruction work has been undertaken within these areas.

Australasian Health Facility Guidelines states page 653….
900.11.00
+ Conduct air sampling and particle counts and implement a program of regular air sampling in high-risk areas, allowing time for culturing and results and repeat cleaning and testing prior to occupation.

The air count is done to ensure that the area has been cleaned appropriately, including air filters.

Kind Regards

Marija Juraja |Clinical Service Coordinator (CICP) -Infection Prevention & Control Unit| Division of Acute Medicine
t: +61 8 8222 7588| p: 47757|

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—–Original Message—–

Good Evening

I am someone within the AICALIST brains trust can provide some advice regarding the necessity for microbial sampling of newly constructed SSD. I have not been able to find any reference to this being recommended prior to opening.

Does anyone know of any guidelines that apply to NSW?

Or, national or international references that may indicate that this would be recommended from a best practice point of view.

I would be grateful for any advice within the next few days, if possible.

Thank you
Beth

Beth Bint

Infection Prevention and Control Clinical Nurse Consultant | Infection Management and Control Service Level 1 Lawson House Wollongong Hospital Tel 02 4222 5898 |beth.bint@SESIAHS.HEALTH.NSW.GOV.AU
http://www.health.nsw.gov.au
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[Roel Castillo]

So sorry I do apologise we do have a provider.

Cheers

Roel

Roel Castillo
Project Officer SSD

Hi All

Can you please let me inform me of any external providers performing microbial testing for naso-endoscopes, please?

Thanks

Roel

Roel.castillo@lh.org.au

Roel Castillo
Project Officer SSD
[Image removed by sender. Chris O`Brien Lifehouse]
119-143 Missenden Road
Camperdown NSW 2050
PO BOX M33 Missenden Road NSW 2050

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*hWK4nY*

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[Roel Castillo]

Hi Luisa

Kindly refer to:

http://www.healthfacilityguidelines.com.au/
Part D Infection Prevention and Control

Happy browsing
Roel

Dear all,

I was wondering if anyone has a guideline they use in their health service around construction and renovation and the necessity of having infection control consultation during the planning process etc that they would be willing to share

thanks in advance

Kind Regards
Louisa Sasko

Clinical Nurse Consultant (Manager) | IPACS – Infection Prevention & Control Service
Blacktown Mt Druitt Hospital
Tel (02) 9881 8994 | Fax (02) 9881 7408 | Mob 0408 923 789 | Louisa.Sasko@health.nsw.gov.au
http://www.health.nsw.gov.au/

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Roel Castillo
Project Officer SSD
[Chris O`Brien Lifehouse]
119-143 Missenden Road
Camperdown NSW 2050
PO BOX M33 Missenden Road NSW 2050

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

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*hWK4nY*

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[Roel Castillo]

Thanks Terry
Thanks Beth

The SMEs have spoken. To my experience, the disconnect between architects and clinicians will certainly impact on the latter, patient care being compromised. What may I suggest is to sit down and exhaust all possible clinical input before agreeing to the design.

Good luck
Roel

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Beth Bint
Sent: Monday, 17 March 2014 8:37 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Operating theatre design question

Good morning John

The Australian Health Facilities Guidelines illustrates very clearly operational flows and air pressure controls required for operating units refer Part B Health Facility Briefing and Planning: 520 Operating Theatres p 41 to p 44.

Scrub bays must have negative air pressure in relation to the operating theatre which would not be possible if the scrub bays are incorporated in to the theatre room.

Regards

Beth

Beth Bint

Clinical Nurse Consultant | Infection Management and Control Service
Level 1 Lawson House, Wollongong Hospital 2500, NSW
Tel. 02 4222 5869 | Fax. 02 4222 5367 | beth.bint@sesiahs.health.nsw.gov.au

[http://www.health.nsw.gov.au/images/communications/e-signatures/images/NSW-Health-Illawarra-Shoalhaven-LHD.jpg]

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of John Ferguson
Sent: Sunday, 16 March 2014 11:30 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Operating theatre design question

Dear Brains trust

A colleague (a healthcare architect) has been planning the perioperative suite and the surgeons have insisted on placing the scrub bay on the theatre side of the exit bay. See extract from the scheme design drawing below (attached). They seem to believe that the air pressurisation in the theatre will keep water spray/bugs etc out of the main area of the OR. Also they dont want to have to gown then go back out scrub and then return to the theatre through the doors to glove and operate.

Placing scrub bays inside ORs is not a practice that I have seen anywhere else in the world has anyone experience with this please?

My view is that this is not a practice to support but Id be interested in other views and evidence please!

Kind regards
John

Dr John Ferguson
Director, Infection Prevention & Control, Hunter New England Health
Infectious Diseases Physician, Division of Medicine, John Hunter Hospital
Clinical Microbiologist, Hunter Area Pathology, Pathology North
Conjoint Associate Professor, University of Newcastle, Adjunct Professor, University of New England
Locked Bag 1, Newcastle Mail Centre, NSW 2310
Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 | john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org

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Roel Castillo
Project Officer SSD
[Chris O`Brien Lifehouse]
119-143 Missenden Road
Camperdown NSW 2050
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[Roel Castillo]

HI Lynne

Our facility will adopt a digital noticeboard. As all other existing options there are numerous challenges but this limits the IC component. Protocol “cleaning” of monitor surface will be in place. Blue tack has always been an issue with previous work experiences and obviously everyone has dedicated notice boards anyway. So a white/magnetic board where you can have the option to write or post in documents in single plastic protective sheets (discarded at a time when notices is no longer applicable), or for permanent ones can be done in laminates that are easy to wipe clean.

Happy posting

Roel

Hi
Just wondering what approach/opinions people have to notice boards in clinical areas?
Is it better to have a dedicated notice board made from material that does not deteriorate or to have posters etc blue tacked to walls?
Thanks

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Roel Castillo
Project Officer SSD
[Chris O`Brien Lifehouse]
119-143 Missenden Road
Camperdown NSW 2050
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[Roel Castillo]

Hi Jenny

Yes, I agree. As stipulated in the current standard. Although most if not all of us use internal CI anyway, it has always been a better (best) practice for the end users to verify that a packaged item has successfully gone through a sterilisation process.
We use class 5 and sometimes Class 6.

Happy processing

Roel

Dear all – just wondering if you are all using internal chemical indicators in your sterilization packages. . We have used them for years and also have a print out of the run. From my reading of AS 4187 it seems an optional thing “chemical indicator may be used..” AS 4187 8.6.2.2 (b).

We use a Class 4 indicator. Thanks Jenny

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[Chris O`Brien Lifehouse]
119-143 Missenden Road
Camperdown NSW 2050
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[Roel Castillo]

You are right Cathy

I just had the opportunity to set up SSD at a new facility and addressed the requirements of Standard 3.16.1 and 3.17.1. I view it as an overlap between nursing cleaning protocols and SSD. A procedure must be in place however, notwithstanding where the responsibility falls into. Among others:

* Use of manufacturer recommended process/wipe

* Frequency of cleaning

* Responsibility and sign off.
We need to provide an evidence that these medical devices that require cleaning is addressed appropriately.

Happy cleaning

Roel

Roel.castillo@lh.org.au

Roel Castillo
Project Officer SSD

Hi,

I am after information on how other non-acute healthcare settings have prepared for accreditation against the requirements of NSQHSS items 3.16.1 and 3.17.1 which address re-useable devices.

My sense is that these are designed to address IPC / quality standards around reprocessing or re-using sterile or invasive devices and apply to activities around sterilisation, invasive procedures using sterile instruments, scopes etc etc that require re-processing for re-use between patients. (We do not undertake any activity that applies to this)

However has anyone addressed / included in their evidence: cleaning of single patient re-useable non-invasive devices such as nebuliser pots, oxygen masks; or multiple patient re-usable non-invasive equipment such as blood pressure cuffs, tourniquets, oximeter probes etc etc (which of course are cleaned, but do they fall into the accepted definition of a ‘re-useable’ or ‘reprocessable’ device?
I don’t think that this would be caught up under these NSQHSS items but may well be incorrect in my interpretation.

Any feedback / further discussion is appreciated

Best Regards,
Cathi

Cathi Montague RN, MClinNsg, FCENA
Nurse Management Facilitator – Clinical Care Systems Co-ordination

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[Roel Castillo]

Hi Lincoln

Although there are numerous documented evidence on contaminant retention, microbial growth etc. on compromised surfaces of medical devices and not on lead hands I think it is applicable to this scenario as well. Again the good old ” you can’t sterilise what you can’t clean” bible applies, so silicone coated, aluminium or SUDs would be best practice.

Happy processing

Roel

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

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Dear Members
I have been asked to seek others experience with the Lead Hand as used for providing a platform for performing hand surgery.
I am particularly interested in the issue of reprocessing this item. It seems that as the surface of the lead ages it becomes dull and looks pitted. Could it be reliably cleaned and sterilised in this state?
We are considering replacing it with a silicone coated item.
Your thoughts would be appreciated.
Thank you

Lincoln Fowler
Infection Prevention Consultant

Bairnsdale Regional Health Service
http://www.brhs.com.au

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[Roel Castillo]

Hi Maureen

This has always been an interesting issue. The current standard for reprocessing stipulates the measures to ensure this is addressed. Kindly refer to AS/ANZ 4187: 2003: 4.2.3 and 6.1.2.

Cheers

Roel

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

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Hi All

What are your opinions on Flash autoclaves? When I worked in Theatre in London in the 70s it was considered unacceptable to use flash autoclaves as there are significant risks associated with this practice. We made sure we had enough instruments for our booked lists and emergency surgery plus single wrapped extra instruments to replace dropped instruments.

The HICPAC definition is Flash sterilization is a modification of conventional steam sterilization (either gravity, prevacuum, or steam-flush pressure-pulse) in which the flashed item is placed in an open tray or is placed in a specially designed, covered, rigid container to allow for rapid penetration of steam.

I am surprised that any OR in Australia would consider using “flash ” sterilizers rather than purchasing sufficient instruments to meet the needs of the facility. What is your opinion?

Maureen Cremin
Regional Infection Control Coordinator
WACHS Great Southern
Phone 08 9892 2211

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[Roel Castillo]

Hi Sony

We have to consider:

Satisfy Spaulding classification of risk according to intended use at a minimum it only requires cleaning as it comes in contact with intact skin. Do however consider the possibility of exposed skin and the likelihood of contact, thus it requires further reprocessing.

IFUs from manufacturers. These are actually validated in vitro and obviously never tested in an actual clinical setting. I do suggest to stick to recommendations if the risk associated with reprocessing are minimal. As there are implications on the functionality of these accessories for unverified reprocessing methods. Further considerations on allergic reactions to disinfectant chemistries must be taken into account. Neutral disinfectant sprays might be appropriate.

Be aware that, it is our call. Do whatever is applicable to your situation to ensure better patient care.

Happy processing,

Roel

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

Phone: +61 2 85140958
Mobile: +61 434 496 829
Email: Roel.Castillo@lh.org.au
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*hWK4nY*
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Sony SO
Sent: Friday, 29 November 2013 1:50 PM
To: AICALIST@AICALIST.ORG.AU
Subject: How to decontaminate the accessories for Robotic Treadmill

Dear All,

In our Physiotherapy Department, they has purchased a new Robotic Treadmill. This new equipment is a driven gait orthosis that automates locomotion therapy on a treadmill and improves the efficiency of treadmill training.

The Robotic Treadmill has a lot of accessories, including pads, straps, cuffs, belts, harness and/or foot lifters, which are made of fabrics. However, we found some of the accessories would not be disconnected, hence we would not send it for laundry.

The concerned manufacturer recommends us that the questioned accessories would be disinfected by spraying disinfectant on to the items surfaces. I have concerns for the aforesaid decontamination method, and I would like to have your comment.

Thanks for your assistance.

Regards,

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 Fiona

Staff training, procedure/protocol in place, documentation, currency of machine maintenance, among others.
Simply perform a documented random check on the visual cleanliness of the machine ( on a regular basis) hence the provision of an evidence of monitoring. Semi critical endoscopes are performed periodical culture swabs or qualitative swabs, so why not do a random protein/carbohydrate/blood residue tests with appropriate documentations.

Good luck and happy testing.

Roel

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

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*hWK4nY*

Fiona

We too have looked at this machine and have set up a register that tracks the machine and documents the disinfection of the machine between patients, requires names/signature of those responsible for the process. To have some control over the process we requested that these machines be returned to either our ICU or ED where there are dedicated equipment nurses trained in the process. Once disinfected the machine is placed in a clean bag, sealed and labelled.

We have good compliance with documentation however my concern is that there is still room for a machine to be re-used on a ward without being returned and reprocessed if staff are not familiar with the piece of equipment and the requirement for the heat disinfection process between patients.

Leanne

Leanne Houston

Associate Director
INFECTION PREVENTION & CONTROL SERVICE (IPAC)

Hi All,

I have recently been asked to assess a machine that delivers humidified oxygen to patients. It has disposable tubing with the machine itself undergoing a manual clean and a machine generated heat disinfection cycle between patient use.

I would like to hear from others who have this sort of product in their facility regarding how they manage the validation of the cleaning / disinfection process between pateints.
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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