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Hi Tenzin
Happy for you to contact me, my mobile is best
Regards
Robyn[cid:image001.png@01D8CCCC.8F4702E0]Robyn Russell RN, CICP-P
Client Safety & Quality Consultant
34 Molesworth Street, North Adelaide SA 5006
T. (08) 8224 7851
M. 0424 167 101
F. (08) 8267 2690
http://www.helpinghand.org.auThank you everyone for taking time to response with best practice. I really appreciate each one of you for your response and sharing your best practice and they are valuable. Thank you in particular to Robyn for your reassurance and sharing the observation tool which I was not aware of and this will be a great tool for me to apply during my next HH observational audit. I could see that you have a work number, if you okay with it, can I touch base to ensure I am on a right track?
Wow! I really love this platform. How did I get so lucky 🙂Have a good afternoon everyone
Kind regards
Tenzin Chokey
IPC Lead
Life Care SASent from Yahoo Mail for iPhone
On Monday, September 19, 2022, 11:57 am, Robyn Russell <00000057244f6faa-dmarc-request@AICALIST.ORG.AU> wrote:
Hi Tenzin
I agree 100% re 4 moments in aged care – a RACF resident does not neatly sit within a boundary such as a room or patient area as they would in a hospital setting
There are many shared spaces, such as dining rooms, activity areas, cafes etc
At my organisation we combine moments 4 and 5 as you describe
Based on the Canadian Ontario Health ‘Just clean your hands’ (long term care) program https://www.publichealthontario.ca/en/health-topics/infection-prevention-control/hand-hygiene/jcyh-ltch or https://www.youtube.com/watch?vWQKu7V2sy64 , they have some amazing resources for an aged care setting
SA Health adapted the tool we developed at my organisation based on the Ontario model for use by providers who do not contribute to the NHHI
This tool more accurately reflects an aged care setting
Instead of identifying Moments 1, 2, 3 etc we assess against opportunities observed and whether HH was undertaken
Initially we developed posters and education focussing on the 4 moments, but over time most signage reflects the standard 5 moments for HH.
I don’t really get hung up on 4 / 5 moments, I talk to the opportunities which is observing HH being undertaken prior to and after any care / person / environment contact
IA bit hard to explain in an email sorry
At the end of the day our focus is on improving hand hygiene practice ensuring improved resident outcomes
Tenzin, I am happy to chat if you want more information
Regards
Robyn
[cid:image003.png@01D8CCCC.8F511500]Robyn Russell RN, CICP-P
Client Safety & Quality Consultant
34 Molesworth Street, North Adelaide SA 5006
T. (08) 8224 7851
M. 0424 167 101
F. (08) 8267 2690
http://www.helpinghand.org.auHi All
I am fairly new to the role as a centralised IPC lead. Prior to taking on the role, in the recent time my organisation had adopted 4 moments of hand hygiene instead of 5 moments and the rationale behind this is 5 moments apparently doesn’t support aged care setting. If we are to apply a 5 moments, we must either have a ABHR at each resident’s bedside or alternatively all staff would need to carry hand gel with them. The posters were changed from 5 moments to WHO 4 moments.
This was not something that I have implemented, but was there in place. When I started our HH audit, my audit template was based on 4 moments. However, recent SA health online infection course that all aged care workers required to complete still has 5 moments. I find this quite misleading for the staff given there are now 2 different instructions to follow. I was wondering if other organisation follow 4 or 5 moments. If 5, how do you make sure this is followed correctly by staff.
I would really appreciate some response.
Tenzin Chokey
Infection Prevention and Control Lead
Life Care SA
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Hi Tenzin
I agree 100% re 4 moments in aged care – a RACF resident does not neatly sit within a boundary such as a room or patient area as they would in a hospital setting
There are many shared spaces, such as dining rooms, activity areas, cafes etc
At my organisation we combine moments 4 and 5 as you describe
Based on the Canadian Ontario Health ‘Just clean your hands’ (long term care) program https://www.publichealthontario.ca/en/health-topics/infection-prevention-control/hand-hygiene/jcyh-ltch or https://www.youtube.com/watch?vWQKu7V2sy64 , they have some amazing resources for an aged care setting
SA Health adapted the tool we developed at my organisation based on the Ontario model for use by providers who do not contribute to the NHHI
This tool more accurately reflects an aged care setting
Instead of identifying Moments 1, 2, 3 etc we assess against opportunities observed and whether HH was undertakenInitially we developed posters and education focussing on the 4 moments, but over time most signage reflects the standard 5 moments for HH.
I don’t really get hung up on 4 / 5 moments, I talk to the opportunities which is observing HH being undertaken prior to and after any care / person / environment contact
IA bit hard to explain in an email sorryAt the end of the day our focus is on improving hand hygiene practice ensuring improved resident outcomes
Tenzin, I am happy to chat if you want more informationRegards
Robyn[cid:image001.png@01D8CC1A.364F43D0]Robyn Russell RN, CICP-P
Client Safety & Quality Consultant
34 Molesworth Street, North Adelaide SA 5006
T. (08) 8224 7851
M. 0424 167 101
F. (08) 8267 2690
http://www.helpinghand.org.auHi All
I am fairly new to the role as a centralised IPC lead. Prior to taking on the role, in the recent time my organisation had adopted 4 moments of hand hygiene instead of 5 moments and the rationale behind this is 5 moments apparently doesn’t support aged care setting. If we are to apply a 5 moments, we must either have a ABHR at each resident’s bedside or alternatively all staff would need to carry hand gel with them. The posters were changed from 5 moments to WHO 4 moments.
This was not something that I have implemented, but was there in place. When I started our HH audit, my audit template was based on 4 moments. However, recent SA health online infection course that all aged care workers required to complete still has 5 moments. I find this quite misleading for the staff given there are now 2 different instructions to follow. I was wondering if other organisation follow 4 or 5 moments. If 5, how do you make sure this is followed correctly by staff.
I would really appreciate some response.
Tenzin Chokey
Infection Prevention and Control Lead
Life Care SASent from Yahoo Mail for iPhone
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Hi there
We use a discrete green dot sticker on a residents door name plate, which indicates infection
This directs all staff to read the care plan for specific infection transmission IP&C informationThis is fairly standard across a number of aged care providers
Regards
Robyn[cid:image001.png@01D8217F.56721570]Robyn Russell RN, CICP-P
Client Safety & Quality Consultant
34 Molesworth Street, North Adelaide SA 5006
T. (08) 8224 7851
M. 0424 167 101
F. (08) 8267 2690
http://www.helpinghand.org.au
[cid:image002.jpg@01D8217F.56721570]Im quite sure using colour coding is better signage.
Green for no infectious, yellow or orange for mild& mod and red is for very infectious. Maybe stickers or paintings.
Betty Maesua.
IPC TL NRH -Solomon Islands.Attention!: This email originated from outside of the organization (SIG). Do not click links or open attachments unless you recognize the sender and know the content is safe.
Signage colour coded breaks down misunderstandings when multi cultures exist in the one setting, makes things clear. We have used beetles on doors, flowers, single large print words red and blue colour to clarify zones pictures of gowns each. Keep it simple, keep it bright put it everywhere, compliance is the aim. PPE is defence, communication and vigilance is strength.
Brian Moore RN
Qld Standing Covid Surge Team Team Lead.On Fri, 11 Feb 2022, 10:41 am Vanessa Davis, <vanessa.awd@gmail.com> wrote:
Dear Clever People
I work in a residential aged care and am trying to convince my boss that having clear signage outside a potentially infectious or confirmed infectious residents room (ie on the door) is best practice.All I can find is SHOULD on page 120 of the Aust Guidelines for Prevention & Control of Infection in Healthcare.
I appreciate any assistance re using any other information to support my argument.
Many thanks in advance
Vanessa Watkins
RN, QM & IPC Lead
Donwood Community Aged Care
Croydon Vic
(03) 9845 8500
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Hi Helen
We have had wall mounted ABHR in all of our 10 memory support units installed nearly 3 years ago
Most facilities were very concerned at the time about the very issue you raisedWe decided that in the event there is a resident either trying to drink the ABHR or constantly using or interfering with the wall mounted unit, that the staff could remove the refill pack from any unit
In this time we have not had any resident incidents related to the ABHR, nor have any sites had to empty the wall mounted unitSo no specific research paper, but our experience if that assists
Regards
Robyn[http://www.helpinghand.org.au/hhsig.png]Robyn Russell
Client Safety & Quality Consultant
34 Molesworth Street, North Adelaide SA 5006
T. (08) 8224 7851
M. 0424 167 101
F. (08) 8267 2690
http://www.helpinghand.org.au
[cid:image002.jpg@01D6C312.0A1E3DB0]Hello all
I wondered if anyone has specific research into the installation of wall mounted ABHR units in wings for residents with dementia. Much of the research or reported cases of people drinking ABHR relate to individual bottles of solution and not from wall mounted units. W are currently looking the installation across all of our units and wondered if anyone has undertaken a risk assessment of this or had experience/opinions of this. We naturally want to balance the safety risk for the confused resident with the risk of not have suitable hand hygiene methods available from an IPC perspective.
Kind regards,
Helen Finlay
National Manager Infection Control
t 0427 110 668 | 03 8518 7356
e hfinlay@regis.com.au | w http://www.regis.com.auLevel 2, 615 Dandenong Road, Armadale VIC 3143
[cid:image001.png@01D6C30E.0D158180]
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Thanks everyone for your responses
It is great to have the evidence for what clearly is not best practice
I appreciate your time in responding and finding the research to back up my recommendationsRegards
Robyn[http://www.helpinghand.org.au/hhsig.png]Robyn Russell
Client Safety & Quality Consultant
34 Molesworth Street, North Adelaide SA 5006
T. (08) 8224 7851
M. 0424 167 101
F. (08) 8267 2690
http://www.helpinghand.org.au
[cid:image002.jpg@01D6C276.EBBD4EB0]Hi Robyn,
I think lack of toilet lids is a very common occurrence across both aged and acute care! We had the same issue in our aged care facilities, and it took quite a bit of convincing to get the gloves out of the bathroom. But I eventually did and was also able to put ABHR in every room. Plume from flushing is definitely a thing – see attached articles – has made me rather strict at home with getting the kids to flush with the lid down!Aerosol Generation by Modern Flush Toilets David Johnson,Robert Lynch,Charles Marshall,Kenneth Mead &Deborah Hirst Pages 1047-1057 | Received 28 Mar 2013, Accepted 14 May 2013, Accepted author version posted online: 18 Jun 2013, Published online:05 Jul 2013 https://doi.org/10.1080/02786826.2013.814911
Toilet plume aerosol generation rate and environmental contamination following bowl water inoculation with Clostridium difficile spores. Kathleen A.N. Aithinne, MS, Casey W. Cooper, MS
Robert A. Lynch, PhD, David L. Johnson, PhD Published: December 14, 2018 DOI: https://doi.org/10.1016/j.ajic.2018.11.009Also bathroom sinks are not a clinical hand basins and should not be used for healthcare workers to wash their hands (this was part of my argument to get ABHR in every room)- even in aged care. https://www.safetyandquality.gov.au/our-work/healthcare-associated-infection/national-infection-control-guidelines page: 225
Happy to chat if you need.
Kind regards,
Kelly
I acknowledge the traditional owners of the land on which we work and live, and respect their ongoing custodianship of the land. I pay respect to Aboriginal people, and Elders past and present.[cid:image001.png@01D6C23C.98699190]
Kelly Barton
Infection Prevention & Control Officer
RN BHSc (Nursing). Grad Cert (Infection Control)(Advanced Acute Care). Nurse Immuniser. Cert IV T&A
P Reduce, re-use, recycle. Please consider the environment before printing this e-mail.Hi there
Hoping you can post this question for meA number of our residential sites store gloves in holders in the resident ensuite
I am looking for any evidence that identifies the risk of contamination to the gloves and boxes they are stored in, from toilet flushing (we don’t have lids in the main to allow for toilet seat raises to be in place)
My other concern is that staff then use the resident hand basin in the ensuite to undertake hand hygiene before and after glove useFor the same reason of contamination of the environment from toilet flushing and different levels of personal hygiene of residents I want to remove gloves from ensuites
I am having difficulties locating the evidence needed to convince managers that gloves should be located at clinical hand basins or with the wall mounted ABHR stations in corridor areasI understand in acute settings gloves are generally wall mounted by the clinical hand basin in the patient’s room, but we only have hand basins in the ensuite.
We generally do not have ABHR in each resident room for the safety of residents living with dementia
We also try our best to provide a home like environment, not cluttered with clinical equipment.I hope this makes sense
Kind regards
Robyn[http://www.helpinghand.org.au/hhsig.png]Robyn Russell
Client Safety & Quality Consultant
34 Molesworth Street, North Adelaide SA 5006
T. (08) 8224 7851
M. 0424 167 101
F. (08) 8267 2690
http://www.helpinghand.org.au
[cid:image001.png@01D6C18B.FD9AE4D0]________________________________
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Hi Vanessa
We are not in Victoria so it might be different
Any resident with respiratory symptoms waiting a COVD swab result is under transmission based precautions
All PPE waste is disposed of in general waste as per the CDNA Guidelines (although I have not checked the latest version to see if this has changed)Regards
Robyn[http://www.helpinghand.org.au/hhsig.png]Robyn Russell
Client Safety & Quality Consultant
34 Molesworth Street, North Adelaide SA 5006
T. (08) 8224 7851
M. 0424 167 101
F. (08) 8267 2690
http://www.helpinghand.org.au
[cid:image002.jpg@01D69D72.C9A9CF70]Dear All
We are having a lot of discussion at our Residential Aged Care Facility about waste management in the above scenario.Currently we are of course isolating every resident who has signs/symptoms of COVID. We are also isolating any resident who has been to the ED or admitted into hospital for a non-covid related illness on their return who are asymptomatic – just in case.
What we can’t agree on is how to manage the waste.
The guidelines clearly state, any waste produced by a suspect case MUST be treated as potentially infectious. But it doesn’t say how to manage waste if we are just being over cautious.The problem stems from, lack of storage space of clinical waste waiting for collection in a non-outbreak situation and of course the cost of treating waste as clinical waste when it may not end up being clinical waste once we have confirmation that our returned resident DOES NOT have COVID post receipt of swab results on day 1 and day 5.
Wondering what other Aged Care Facilities are doing when being cautious. Of course, all true clinical waste is disposed of appropriately. My question is about what might not be clinical waste in the interim.
Many thanks to everyone.
Vanessa Watkins
Quality Manager
Donwood Community & Aged Care
Croydon, Victoria
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Hi Rebecca
Thanks so much for responding
I have tried them but at this stage they are not sure they can supply the amount we need, especially after the new Emergency Directions for RACFs came out yesterdayHopefully they can clarify soon
Regards
Robyn[http://www.helpinghand.org.au/hhsig.png]Robyn Russell
Client Safety & Quality Consultant
34 Molesworth Street, North Adelaide SA 5006
T. (08) 8224 7851
M. 0424 167 101
F. (08) 8267 2690
http://www.helpinghand.org.au
[cid:image001.png@01D67257.258BF9E0]From: ACIPC Infexion Connexion On Behalf Of Rebecca Turner
Sent: Friday, 14 August 2020 2:33 PM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Sourcing face masks for residential aged careCAUTION: This email originated from outside of the organisation. Do not click links or open attachments unless you recognise the sender and know the content is safe.
Hi Robyn,
We have sourced a local supplier of our faces masks.
The South Australian procurement has been helpful in providing PPE we have been unable to access including gloves; they may be of assistance.Information is available via: HealthPSCMSCOCustomerService@sa.gov.au
Kind regards,
Rebecca Turner
Executive Residential Manager
Boandik
101 Lake Terrace East
MOUNT GAMBIER SA 5290
Phone: 0887257377From: ACIPC Infexion Connexion <ACIPCLIST@ACIPC.ORG.AU> On Behalf Of Robyn Russell
Sent: Friday, 14 August 2020 11:47 AM
To: ACIPCLIST@ACIPC.ORG.AU
Subject: [ACIPC_Infexion_Connexion] Sourcing face masks for residential aged careHello brains trust
In SA, new Emergency Management (RACF) Directions have been put out requiring all Care Workers, Nursing, Allied Health and Medical staff to wear face masks in residential care facilities when social distancing can not be achieved
It is unclear at this point what assistance we will be provided sourcing these masks from SA Health
We have calculated for our organisation (800+ residential beds) we will need approximately 11,000 masks a week
Our PPE contractors have been unable to supply our previous orders for masks, so we have no hope of securing these numbers on a weekly basis
We have also tried alternate suppliers we have sourced PPE fromIm not sure what ACIPC group rules are in place re my request, but I am after any leads from within this group for sourcing TGA approved face masks / potential suppliers
Please delete my email if this request sits outside of group guidelinesMany thanks
Robyn[http://www.helpinghand.org.au/hhsig.png]Robyn Russell
Client Safety & Quality Consultant
34 Molesworth Street, North Adelaide SA 5006
T. (08) 8224 7851
M. 0424 167 101
F. (08) 8267 2690
http://www.helpinghand.org.au
[cid:image001.png@01D67230.ADE5BF00]________________________________
This e-mail may contain confidential information which may also be legally privileged. Only the intended recipient(s) may access, use, distribute or copy this e-mail. If this e-mail is received in error, please inform the sender by return e-mail and delete the original. If there are doubts about the validity of this message please contact the sender by telephone. It is the recipient’s responsibility to check the e-mail and any attached files for viruses.
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MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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