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Hi Trish,
I too have had the experience of a proposed water fountain and found these resources useful.– Joseph, Anali (2006). Impact of the environment on infections in healthcare facilities. Concord, CA: Center for Health Design.
– Haupt, TE, Heffernan, RT, Kazmierczak, JJ, Nehls-Lowe, H, Rheineck, B, Powell, C, Leonhardt, KK, Chitnis, AS, and Davis, JP (February 2012). An outbreak of Legionnaires disease associated with a decorative water wall fountain in a hospital. Infection Control and Hospital Epidemiology, 33:2.
– A cluster of nosocomial Legionnaires disease linked to a contaminated hospital decorative water fountain.
Tara N. Palmore, M.D., Frida Stock, B.S, Margaret White, M.S, MaryAnn Bordner, M.S, Angela Michelin, M.P.H, John E. Bennett, M.D, Patrick R. Murray, Ph.D, and David K. Henderson, M.D
Infect Control Hosp Epidemiol. 2009 August ; 30(8): 764768. doi:10.1086/598855.Good luck,
Terri Cripps | Clinical Nurse Consultant – Infection Prevention and Control | SCHN Medical Diagnostics and HIV/Immunology
t: (02) 9382 1876 | f: (02) 9382 2084 | e: terri.cripps@sesiahs.health.nsw.gov.au | w: http://www.schn.health.nsw.gov.au
p: 47140
[cid:image004.jpg@01D0D5A6.105E7E60]
High Street, Randwick 2031, NSW AustraliaPlease consider the environment before printing this email.
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Wilson, Fiona L (TIPCU) (DHHS)
Sent: Thursday, 13 August 2015 8:01 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: water features – outdoorHi Trish, I have been in a similar situation proposed water fountain outside a radiotherapy bunker. At the time, I could not find anything specific that suggested fountains should not be installed in these type of areas. However, we (Infection Control) suggested it was unwise to install a feature near the entrance of such a facility due to 1) the patient population and b) risk of legionella bacteria there have been cases related to fountains overseas. In addition, there are resources involved with ongoing maintenance of the fountain and the water. Upshot was, a sculpture was installed instead.
So you need to look at what type of water feature your organisation is wanting to install and then look at what the risks and ongoing costs would be. And you could always suggest they install a sculpture by a local artist.
RegardsFiona Wilson I Clinical Nurse Consultant
Public Health Services I Department of Health and Human Services
3/25Argyle St Hobart, GPO Box 125 Hobart 7001
Phone (03) 6166 0601| Mobile 0439 014 634 | Fax (03) 6233 0553
Prevention is better than cureFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Horne, Trish (AHS/Burnie) (THS)
Sent: Wednesday, 12 August 2015 8:29 AM
To: AICALIST@AICALIST.ORG.AU
Subject: water features – outdoorHi
Our Organisation is thinking about putting an outdoor water feature in a courtyard of our Cancer Centre. Does anyone have any guidelines specifically relating to water features especially installation and maintenance? I have already accessed AS/NZS 3666 :2011.
Thanks
TrishTrish Horne
CNC Infection Prevention and Control
Rural Inpatient and Community Services
THS-North West Region
1 Strahan Street
Burnie 7320
PH: 0439332276
[cid:image001.png@01D0D4D8.EF4BA180]Standard 3 Preventing and Controlling Healthcare Associated Infections________________________________
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Dear Che,
Thank you for raising this topic as I have issues with this as well.
The Oncology and infectious diseases wards will throw them out after single use.
The ICU will put them in the utensil washer and run a cycle with them in and reuse them if the patient they used them on was not infectious. If the patient is infectious then they dispose of them after single use.
The other wards will clean them with a neutral detergent and reuse them.This has been an historical practice. When I have looked at changing the practice, I have been told that the nursing staff are too busy to clean them out as they use so many of them so it is easier to throw them out.
I would be interested to hear other people’s experience and practices.
Thanks,
Terri Cripps | Clinical Nurse Consultant Infection Control | Sydney Childrens Hospital, Randwick
: (02) 9382 1876 | fax: (02) 9382 2084 | : terri.cripps@sesiahs.health.nsw.gov.au| :www.sch.edu.au| page: 47140—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Che Jarvis
Sent: Thursday, 19 March 2015 3:42 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Non-Sterile Kidney DishesHi,
Just a quick query regarding the use of non-sterile kidney dishes. Does anyone use them as single use, or continue to use them multiple times if cleaned with neutral detergent?
Mainly used for carrying sharps, pre & post injections, administration, etc.Regards
Che Jarvis
Acting CNC Infection Control
Nepean Hospital, NBMLHD
Ph Number: 47 342228
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Hi everyone,
Always on a Friday afternoon!
We have had a great debate here about what sort of precautions Norovirus requires and what sort of isolation room they need to be nursed in.The NSW Ministry of Health Infection Control policy PD2007_036 states:
“Contact and Airborne precautions.
P2 mask when there is potential for aerosol dissemination e.g. patient vomiting or toileting (diarrhoea), disposing of faeces.
Airborne negative pressure room if available and P2 mask
Contact gown/apron, gloves
Ensure consistent environmental cleaning and disinfection.”I have always advised the staff that contact and DROPLET precautions are required if the patient is vomiting or has profuse/explosive diarrhoea. I have also advised that a surgical mask is sufficient (if worn correctly). Our little ones don’t vomit and expel faeces as far as adults do too.
We do not have the luxury of having a negative pressure room for them to be nursed in either as we do not have that many.
I think CDC simply suggests single rooms and contact precautions.Just thought I would ask the other experts out there what they think about this topic?
Also if I advise staff to follow the contact and droplet precautions and surgical mask route, am I going against policy?Any help on this matter would be appreciated. Happy to admit I am wrong!
Terri Cripps | Clinical Nurse Consultant Infection Control | Sydney Children’s Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 |* : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140[cid:image001.jpg@01CED1A1.16EE7830]
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Hi,
We have included sensor taps in our paediatric ICU. It is attached to emergency power, like at the SAN. When the PICU staff wanted to install them, I did some research and read the attached document. I have had no problem with them since they were installed and the staff love them. When they were installed the spout did not meet the criteria of the Healthcare Facility Guidelines so we had to go with a longer spout so that the water did not directly hit the plug hole.
Thanks,
Terri Cripps | Clinical Nurse Consultant Infection Control | Sydney Childrens Hospital
: (02) 9382 1876 | fax: (02) 9382 2084 |( : terri.cripps@sesiahs.health.nsw.gov.au| :www.sch.edu.au| page: 47140—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Fiona de Sousa
Sent: Friday, 1 March 2013 2:20 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Electronic Sensor TapsHi All,
We have included the sensor taps on our emergency power, therefore if power is lost to the building the taps still work. Also when you install them you need to choose the location and type of sensor carefully as the various types perform differently. Following testing of different types our preferred option is a wall sensor mounted directly above the sink. We have had poor experience with sensors located in the base of the water spout (fail to easily) and to the side of the sink (too sensitive when you walk past).
Kind regards,
Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
Mobile: 0408 468 470
Office: (02) 9487 9732
Fax: (02) 9472 8053
Fiona.Desousa@sah.org.au
185 Fox Valley Road, Wahroonga, NSW, 2076—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Jane Barnett
Sent: Wednesday, 27 February 2013 1:47 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Electronic Sensor TapsI agree with comment about loss of power as it clearly then makes them unusable as your back up generator may only support ‘essential’ power needs- we lost both power and water in our EQ though so had to resort to alcohol gel anyway! However, in a private new build facility I’m involved in we’ve planned to install only in theatre scrub bays and procedure room scrub bays partly for these reasons and partly cost. They are installed in our neonatal unit here and there were issues with sensitivity of them initially (triggering when someone walks past) but I’m sure they have improved the design considerably since these were installed (7 years ago).
Jane Barnett
Infection Prevention & Control Nurse Specialist Christchurch Women’s Hospital
3644510 or int 85510
Pager 5200—–Original Message—–
From: ACIPC Infexion Connexion on behalf of Mason, Matt
Sent: Wed 2/27/2013 3:20 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: [ACIPC_Infexion_Connexion] Electronic Sensor TapsHi Sue,
You need to think about how will they work without power. If they are not on the uninterrupted supply then staff will be unable to use them if the power is out. One facility I worked at also had an issue with water temperature with these taps as you could not run them to allow the temperature to increase. This is more of an installation issue rather than a tap issue though. Maintenance and repair costs are also more than hand operated taps and need to be considered over the life of the product.
Cheers MattMatt Mason
RN, BNSci, Grad Dip (Remote Health), M Rural Health, M Adv Prac (Inf Cont), CICPLecturer/Campus Co-ordinator
School of Nursing, Midwifery & Nutrition James Cook University Thursday Island Qld, 4875 AustraliaP: (07) 4069 2670
I: +61 7 4069 2670
F: (07) 4069 2627
E: matt.mason@jcu.edu.au
W: http://www.jcu.edu.au/nursing/JCU CRICOS Provider Code: 00117J
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Hi Rosie,
This is what we use with children who have MRSA:Suitable body washes are either 1% Triclosan (PhisoHex) or a chlorhexidine based wash like Microshield TM 2 or Microshield TM4 (2% chlorhexidine gluconate or 4% chlorhexidine gluconate wash respectively). If however the child has eczema, then a Oilatum Plus* (Benzalkonium chloride 6% w/w, Triclosan 2% w/w, light liquid paraffin 52.5% w/w) should be used instead.
Good luck.
Terri Cripps | Clinical Nurse Consultant Infection Control | Sydney Children’s Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 |* : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140[cid:image001.jpg@01CDBCF1.FF8A8220]
Hi Rosie,
Our facilities policy is to use triclosan 1% for all our MRO patients. I have used chlorhexidene wash as part of a decolonisation protocol too.
Kind regards
Jayne
Jayne O’Connor RN, BSc. Infection control
CNC IPC
Sydney Adventist Hospital
185 fox valley rd
Wahroonga
NSW 2076________________________________
Hello
We have been using 3% hexachlorophene body wash as part of the topical decolonisation therapy for selected MRSA carriers who meet a specific for over 20 years. The supply is no longer available. Suggested alternatives are 1% Triclosan or Chlorhexidene. I wanted to get a feel on what others are using around Australia so hoping you can share the information. It is difficult to measure success but if you have done so it would be great to hear about it.
Regards
Rosie
Rosie Lee
RN. BSc. CICP
Coordinator – Infection Prevention & Management
SMH Service – Royal Perth HospitalPh + 61 8 9224 2805 Fax + 61 8 9224 1989
IMPORTANT NOTICE: The contents of this email (including any attachments) may be privileged and confidential. Any unauthorised use of its contents is expressly prohibited. If you received this email in error, please advise me by reply email or telephoneMessages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.
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Hi,
Having worked in Paediatrics, Special Care and Infection Control I, too, see it from both sides.
Maybe there could be a designated short visiting time for siblings to visit the new baby which would limit the time the new baby was exposed to any potential disease while keeping the family happy, after a quick screening using the tool, from the nurse caring for the baby. Hand Hygiene can always be taught to older children and encouraged at the same time. The sibling then does not feel left out but it would be short so they can’t get too bored. This would require commitment from both the family and the staff. I agree it should be seen as a hospital wide guideline, then the families know the deal to begin with and the nurse is not targeted as being too strict.
One problem I have is families wanting to bring in small babies to visit a child with an infectious disease. Not only immediate family but extended family and visitors as well. When we explain that the child in isolation is infectious and should not be visited by small babies and toddlers, they get upset. Then the staff give in and let them visit. And so the cycle of infection continues. Any tips?
Thanks,
Terri Cripps | Clinical Nurse Consultant Infection Control | Sydney Children’s Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 |* : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140[cid:image001.jpg@01CD74CB.27A60FF0]
[cid:image002.jpg@01CD74CB.27A60FF0]Congrats your first time post worked!!
Thanks Kate for your feedback and as Jane mentioned as well, there are complexities with this issue.
My way of thinking is educate regarding illness and Hand Hygiene. Perhaps a screening tool would be helpful.
Thanks for your input, it is very much appreciated.
Kind regards,
Rebecca O’Donnell | Infection Control Co-ordinator
St Vincent’s Hospital Toowoomba | 22-36 Scott Street TOOWOOMBA 4350
T 07 4690 4042 | F 07 46904400
E rebecca.o’donnell@stvincents.org.au | W http://www.stvincents.org.auP Please consider the environment before printing this email.
This e-mail and any attachments to it (the “Communication”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. The Communication may contain copyright material of St Vincent’s Health & Aged Care (“SVHAC”), or any of its related entities or of third parties. If you are not the intended recipient of the Communication, please notify the sender immediately by return e-mail, delete the Communication, and do not read, copy, print, retransmit, store or act in reliance on the Communication. Any views expressed in the Communication are those of the individual sender only, unless expressly stated to be those of SVHAC. SVHAC does not guarantee the integrity of the Communication, or that it is free from errors, viruses or interference.Hi,
Hope this post works, first time posting!
From working in paediatrics and neonatal ICU, and as an Infection Control Nurse, I see it from both sides. An additional challenge to those already mentioned is keeping young siblings from visiting other cots/ touching trolleys etc. It’s a hard ask to keep a young child contained to a cot space in a more open ICU setting, and as mentioned by Jane, hard to screen for symptoms when they will be either downplayed or infectious prior to actual symptoms presenting. I think having written guidelines that all of the staff are aware of and also information for parents explaining what is expected from the hospital (thus taking some of the “blame” away from the individual nurse at the bedside trying to restrict visiting) and the reasons why visiting of younger siblings might be restricted or not permitted can help. On the other side, it’s so important that younger siblings get to be a part of the new babies life, I’m not sure a complete ban is always necessary. Obviously during an outbreak or with ongoing issues things need to be reviewed and individual facilities face their own challenges that need individual solutions.
From an NICU/ SC environment perspective, the aim is to try and keep things calm and quiet, and this is also a challenge if younger children are spending extended lengths of time there, it does get boring! So perhaps considering the guideline in a broader context of general aims of the unit might help?
Not having worked for a few months now in the area, I can’t quite remember what is actually done in our facility however! Sorry!Kind regards
Kate Herbert, Clinical Nurse
Infection Prevention and Control
Royal Hobart HospitalOn Tue, Aug 7, 2012 at 3:00 PM, Rebecca O’Donnell <Rebecca.O'Donnell@stvincents.org.au> wrote:
Jane I appreciate your input. You have certainly bought up some great points to discuss further. Yes a screening tool may be something to consider. Thank you for sharing your experiences and information.Again your time is very much appreciated.
Kind regards,
Rebecca O’Donnell | Infection Control Co-ordinator
St Vincent’s Hospital Toowoomba | 22-36 Scott Street TOOWOOMBA 4350
T 07 4690 4042 | F 07 46904400
E rebecca.o’donnell@stvincents.org.au | W http://www.stvincents.org.auP Please consider the environment before printing this email.
This e-mail and any attachments to it (the “Communication”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. The Communication may contain copyright material of St Vincent’s Health & Aged Care (“SVHAC”), or any of its related entities or of third parties. If you are not the intended recipient of the Communication, please notify the sender immediately by return e-mail, delete the Communication, and do not read, copy, print, retransmit, store or act in reliance on the Communication. Any views expressed in the Communication are those of the individual sender only, unless expressly stated to be those of SVHAC. SVHAC does not guarantee the integrity of the Communication, or that it is free from errors, viruses or interference.HI Rebecca
Great question, I guess the risk lies with the capability for the department for screening of children who may be visiting the nursery to exclude signs of droplet or gastrointestinal infection? As you know influenza is infectious for two days prior to symptoms.Here at the RCH Bris we have see several cases of ‘hospital acquired’ infection in at risk patients brought in by siblings, children will randomly vomit when they have norovirus and have limited personal hygiene.
In fact 3 years ago we excluded all children under 14yrs from visiting in the inpatient baby area due to the repeated infections brought in this way. Yes this is difficult logistically for parents and siblings and less family centred care but we felt protecting the already compromised infants had to be foremost in our recommendations. We find that visitors/siblings minimise their infections and potential risks as they are so keen to visit with the sick patient and they don’t well understand the consequences to the sick patient.
It is left up to the nurse in charge of the ward in special circumstances to adjust this on a case by case basis such as for those with multiple births.
Also our baby room has ‘viewing’ windows for siblings to see the baby rather than directly visit.In my experience working at NICU and SCN who did not allow any visits from children under 14yrs this screening and control of visitors would then conceivably fall to the nurse at bedside and could potentially create some quite challenging interpersonal situations.
Being creative I would wonder if you could incorporate a infectious symptoms screening tool for use at the bedside, could this require some discussion and or documentation with each group of visitors.
regards
JaneJane Tomlinson RN
Clinical Nurse Consultant
Infection Management and Prevention Service
Royal Children’s Hospital
Children’s HealthQueensland
T: 07 3636 7856 | M: 0408 236 266
| F: 3636 5505
E: jane_tomlinson@health.qld.gov.au
Ground Floor, South Tower
Herston Rd, HERSTON QLD 4029
http://www.health.qld.gov.au/childrenshealth
Jane Tomlinson RN
Clinical Nurse Consultant
Infection Management and Prevention Service
Royal Children’s Hospital
Children’s Health Queensland
T: 07 3636 7856 | M: 0408 236 266
| F: 3636 5505
E: jane_tomlinson@health.qld.gov.au
Ground Floor, South Tower
Herston Rd, HERSTON QLD 4029
http://www.health.qld.gov.au/childrenshealth
Jane Tomlinson RN
Clinical Nurse Consultant
Infection Management and Prevention Service
Royal Children’s Hospital
Children’s Health Queensland
T: 07 3636 7856 | M: 0408 236 266
| F: 3636 5505
E: jane_tomlinson@health.qld.gov.au
Ground Floor, South Tower
Herston Rd, HERSTON QLD 4029
http://www.health.qld.gov.au/childrenshealth
Jane Tomlinson RN
Clinical Nurse Consultant
Infection Management and Prevention Service
Royal Children’s Hospital
Children’s Health Queensland
T: 07 3636 7856 | M: 0408 236 266
| F: 3636 5505
E: jane_tomlinson@health.qld.gov.au
Ground Floor, South Tower
Herston Rd, HERSTON QLD 4029
http://www.health.qld.gov.au/childrenshealth
Jane Tomlinson RN
Clinical Nurse Consultant
Infection Management and Prevention Service
Royal Children’s Hospital
Children’s Health Queensland
T: 07 3636 7856 | M: 0408 236 266
| F: 3636 5505
E: jane_tomlinson@health.qld.gov.au
Ground Floor, South Tower
Herston Rd, HERSTON QLD 4029
http://www.health.qld.gov.au/childrenshealth
Jane Tomlinson RN
Clinical Nurse Consultant
Infection Management and Prevention Service
Royal Children’s Hospital
Children’s Health Queensland
T: 07 3636 7856 | M: 0408 236 266
| F: 3636 5505
E: jane_tomlinson@health.qld.gov.au
Ground Floor, South Tower
Herston Rd, HERSTON QLD 4029
http://www.health.qld.gov.au/childrenshealth>>> “Rebecca O’Donnell” <Rebecca.O'Donnell@STVINCENTS.ORG.AU> 7/08/12 11:23 >>>
Good morning,I would love some feedback regarding restrictions of visitors to Special care nurseries.
Who do you restrict? Other siblings?
I feel as long as Hand hygiene is performed and the visitor is well I personal feel that there is no real significant risk.
Some of our staff feel that in the case of twins, one goes home and one stays in the nursery then the well twin shouldn’t visit as the baby might pose a threat to the babies in Special care (perhaps from a whooping cough point of view).
Thanks,
Rebecca O’Donnell | Infection Control Co-ordinator
St Vincent’s Hospital Toowoomba | 22-36 Scott Street TOOWOOMBA 4350
T 07 4690 4042 | F 07 46904400
E rebecca.o’donnell@stvincents.org.au | W http://www.stvincents.org.auP Please consider the environment before printing this email.
This e-mail and any attachments to it (the “Communication”) is confidential and is for the use only of the intended recipient, and may not be duplicated or used by any other party without the express consent of the sender. The Communication may contain copyright material of St Vincent’s Health & Aged Care (“SVHAC”), or any of its related entities or of third parties. If you are not the intended recipient of the Communication, please notify the sender immediately by return e-mail, delete the Communication, and do not read, copy, print, retransmit, store or act in reliance on the Communication. Any views expressed in the Communication are those of the individual sender only, unless expressly stated to be those of SVHAC. SVHAC does not guarantee the integrity of the Communication, or that it is free from errors, viruses or interference.WARNING : This email contains information, which is CONFIDENTIAL, and that maybe subject to LEGAL PRIVILEGE. This e-mail and any attachments to it (the “Communication”) is confidential and is for the use only of the intended recipient, and may not duplicated or used by any other party without the express consent of the sender. The Communication may contain copyright material of St Vincent’s Health & Aged Care(“SVHAC”), or any of its related entities or of third parties. If you are not the intended recipient of the Communication, please notify the sender immediately by return e-mail, delete the Communication, and do not read, copy, print, retransmit, store or act in reliance on the Communication. Any views expressed in the Communication are those of the individual sender only, unless expressly stated to be those of SVHAC. SVHAC does not guarantee the integrity of the Communication, or that it is free from errors, viruses or interference. Thank-you.
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HI Jayne,
Here is a link to an article I think may help answer your questions.
If you can’t access it, let me know and I can send it to you.
Thanks,
Terri Cripps | Clinical Nurse Consultant Infection Control | Sydney Children’s Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 |* : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140[cid:image001.jpg@01CD603E.F306CB40]
[cid:image002.jpg@01CD603E.F306CB40]Hi All,
We are currently reviewing our CVAD policies and a question arose around the use of sterile gauze and tape for those patients who have allergies to transparent semi permeable dressings. Does anyone have advise on how frequent the gauze & tape should be changed, apart from the obvious soiling etc.
Look forward to your responses.
Kind regards
Jayne
Jayne O’Connor RN, BSc.
Clinical Nurse Consultant- Infection Prevention & Control
Sydney Adventist Hospital,
185 Fox Valley Rd,.
Wahroonga,
NSW 2076.If you are not the intended recipient you are hereby notified that any dissemination, distribution or reproduction of this message
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Hi Fiona,
Lots of building works going on up your way (I know, I live near your hospital!)
Here are some links I have found:http://www.webdietitians.org/cps/rde/xchg/ada/hs.xsl/nutrition_1562_ENU_HTML.htm
http://www.healthdesign.com.au/vic.dghdp/dghdp_content/RDS/formula_room_rds.pdf
http://www.food.gov.uk/multimedia/pdfs/publication/babypowdertoolkit1007
Some from Australia, UK and USA and also WHO.
Given you have quite a busy paediatric ward there, I would go for a separate formula room due to issues of cleanliness, noise, dedicated workbench space when trying to work in a combined area.
I will ask our formula room staff if they have any further info and will send it on.
At Sydney Children’s we have a dedicated formula room and dedicated formula room staff but then we also have quite a large demand!Thanks,
Terri Cripps | Clinical Nurse Consultant Infection Control | Sydney Children’s Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 |* : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140Hi All,
We are currently reviewing the layout of our paediatric ward and I have been asked for advice regarding formula prep rooms and whether this needs to be a dedicated room or can it be combined with a medication room. I have reviewed the Australian Health Facility Guidelines but there is only scant information.
Can those of you who have paediatric facilities please advise what facilities you have for formula prep areas.
Kind Regards,
Fiona De Sousa
Infection Prevention & Control Coordinator
Sydney Adventist Hospital
Fiona.Desousa@sah.org.au
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I like this one too!
Terri Cripps | CNC Infection Control | Sydney Childrens Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 | : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140[cid:image003.jpg@01CD4486.053D1CD0]
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Fowler, Lincoln
Sent: Wednesday, 6 June 2012 5:00 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Aseptic non-touch technique AcronymHi John
Assuming the acronym is to promote using the correct steps I would suggest: LOCATE
L: Location of procedure
O: Order of procedure
C: Cleaning and disinfection
A: Aseptic field established
T: Technique non-touch
(E: evaluate performace)The last is to encourage reflective practice.
Perhaps someone can dream up something better based on this.
Cheers
Lincoln Fowler / Infection Control / CACH
Department of Health
Telephone: +61 8 9224 1407 / Fax: +61 8 9224 1612
Mobile: 0467 771 233
E: Lincoln.Fowler@health.wa.gov.au
L3 WASON, 151 Wellington St, PERTH WA 6000
http://www.health.wa.gov.au
Delivering a Healthy WA________________________________
From: ACIPC Infexion Connexion [mailto:AICALIST@aicalist.org.au] On Behalf Of John Ferguson
Sent: Monday, 4 June 2012 9:46 AM
To: AICALIST@aicalist.org.au
Subject: Aseptic non-touch technique
Importance: HighDear Aicalist members,
As you will know, the new ACSQHC Safety and Quality Standards include these (stretch) requirements:
3.10 Developing and implementing protocols for aseptic non-touch technique
3.10.1 The clinical workforce is trained in aseptic nontouch technique
3.10.2 Compliance with aseptic non-touch technique is regularly audited
3.10.3 Action is taken to increase compliance with the aseptic non-touch technique protocols
It is quite a challenge to put in place a system that goes across all practitioners as I’m sure you know!The resources attached are available from UK (we have them on order).
The Commission would be interested to know about programs around the country that have developed ANTT policies and procedures.
Has anyone started regular auditing (other than say for CL insertion)? If so would you please share your audit tool(s)?
What examples of action taken to increase compliance do you have?
Have people had experience with the above UK resources?In Hunter New England, in addition to central line insertion, we’ve chosen to focus on IV insertion, wound dressing and IV medication preparation as our initial procedures to codify and audit. We already do skills lab training for IV inserters.
We’ve also been throwing around the following guiding principles list for ANTT – would welcome your comments! Could we perhaps come up with a natty acronym for these 5 ‘moments’ of ANTT?
Aseptic non-touch technique (ANTT) : core principles of practice
1. WHERE TO PERFORM the physical environment for the procedure- where should it be performed; what are the situations where it should not be performed?
2. SEQUENCING the most efficient and safest sequencing of procedure preparation and performance needs to be known by the operator and followed closely
3. DISINFECTION- Hands, procedure trolley and the patient procedure site; correct disinfectant, method of application and avoidance of recontamination
4. ESTABLISH AND PROTECT ASEPTIC FIELDS sterile drapes, plastic trays, sterile glove use, correct procedure sequencing and performance
5. NON-TOUCH PROCEDURE TECHNIQUE specific to the procedureThanks!
John
Dr John Ferguson
Chair, Healthcare Infection Advisory Committee, Australian Commission on Safety and Quality in Healthcare
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.orgFrom: Stephen Rowley ANTT [mailto:stephen.rowley@antt.org.uk]
Sent: Monday, 4 June 2012 1:57 AM
To: John Ferguson
Subject: Re: Purchase of ANTT package
Importance: HighDear John,
Thank you for your email and sorry for the slow response. We will post you the ANTT Guideline CD which includes ANTT Audit Tools and the ANTT Practice Framework to the address provided.
To implement ANTT effectively it is important to blend education with practical training. To support this, The Association for Safe Aseptic Practice (ASAP) provides ANTT Accredited training resources to help support training and implementation. The Implementation Pack includes all the resources required to implement ANTT across a large organisation.
We charge a small amount for these resources to help support the ongoing development of ANTT resources. I have attached the Resource List along with a information sheet.
Please let me know if you have any further questions.
Best regards
PatPatricia Fernandes
Administrator and PA to:
Stephen RowleyClinical Director ANTT
stephen.rowley@antt.org.uk
http://www.antt.org.uk
+44 (0)7739 000597Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.
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Dear Fiona,
I have also been confronted with a similar issue recently about the use of medication rooms and extra inclusions in them. Our hospital is building a new building and there have been many discussions about the use of rooms and their functionality. One of the wards wanted to combine the medication room with the handover room and have the room as a dual purpose room to save on space. I objected to this on the grounds of medication safety in regards to distractions whilst drawing up medications and the risk of giving incorrect doses or incorrect medications. Considering that this ward gives post-operative medications and also any premeds as well I felt it was important for the staff to have an environment which would be conducive to the least amount of medication errors possible. I also argued that handover rooms often were rooms where people socialised with food and drink. My objections to having food and drink in a room where medications and equipment were present, and where things are stored and kept as clean as possible, so as not to induce infections to our patients was paramount.
I totally agree with Mattias, common sense and sound reasoning in this situation should be applied. If you need evidence, then the contributions of all who have replied to your email today should be contribution enough.
I did win the battle and the medication room is a sole room dedicated to medication activity only. The staff now also have a nice room to handover and meet in separate from the rest of the ward.
Good luck with your quest.
Terri Cripps | CNC Infection Control | Sydney Children’s Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 |* : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140—–Original Message—–
Dear Fiona, dear Group,
This is yet another example where the call for “Where is the evidence?” is totally misguided and convenience-driven.
This is an issue of workplace safety and very basic hygiene in healthcare and in the workplace. This is a universal rule and applies to any patient treatment area, biomedical laboratory and pharmaceutical preparation area.
It also applies in any first-world healthcare setting that I am aware of.
It is supposed to keep apart items for human consumption (which can be subject to decay or spoilage) and for human medication, which require sterile or aseptic practices.While it is necessary that our actions are underpinned by evidence, it is also necessary that any call for evidence needs to be underpinned by (a) application of common sense and sound reasoning, and (b) by applying the principles of biological plausibility (i.e. is what the evidence suggests consistent with what is known about the biological principles, e.g.
physiology or pathophysiology, of a situation?).Let us bring up a totally hypothetical example. Please note that this is really totally hypothetical and I am not aware of a real incident. Suppose there is a medical director of an intensive care unit. This person wants to have goats and chickens running around the unit, to provide patients with a comfortable surrounding. Would you find real good published evidence (from original research work) that this is — what we are all convinced of — not a good idea? Would you find randomised double-blinded trials providing evidence in this example?
For the above (medication) example, I am not convinced you will find published evidence from original work. If anything, it will be in workplace standards, as was suggested.
This also shows that for well-established pro-safety measures with a long-standing track record, one really needs a reversal of this call for evidence. If a safety measure such as this is in place, and you remove it, it can have (a) either a negative effect, or (b) no effect, i.e. be neutral. If one applies logical reasoning, then the abandoning of such a safety measure cannot have a positive effect on patient and staff safety (think it through yourself). The logical consequence is that people who want to abandon this should come up with good evidence that it is really safe to do so. This is not only a logical requirement, but also one of medical ethics.
Best regards, Matthias.
—
Matthias Maiwald, MD, FRCPA
Consultant in Microbiology
Department of Pathology and Laboratory Medicine KK Women’s and Children’s Hospital 100 Bukit Timah Road Singapore 229899 Tel. +65 6394 1389 Fax +65 6394 1387Glenys.Harrington
@HEALTH.VIC.GOV.A
U To
Sent by: AICA AICALIST@AICALIST.ORG.AU
Infexion cc
Connexion
Re: Medication Rooms29/09/2010 07:27
AMPlease respond to
AICA Infexion
ConnexionFiona,
A pharmacy area is primarily a designated area for the storage of sterile pharmacy stock. The rationale for not having anything “wet” in these areas is to protect the integrity of the stock from becoming wet and hence contaminated.
Facilities for tea and coffee making in a designated pharmacy storage area is likely to result in staff consuming fluids/drinks in the area increasing the risk of hand/ face/mouth contact and the possibility of hand contamination with oral organisms.
Urns should be confined to designated nutrition stations or staff tea room facilities to minimising the risk of contaminating sterile stock.
Regards
Glenys
Glenys Harrington, Infection Control Consultant |Communicable Disease Prevention and Control | Public Health Department of Health | Level 14 50 Lonsdale Street Melbourne Victoria 3000 Australia t. 1300 651 160 (03 909 65123) | f. 03 909 69174 | e.
glenys.harrington@dhs.vic.gov.au | http://www.health.vic.gov.au/ideasFrom: Terry Grimmond
Date: 29/09/2010 08:23 AM
Subject: Re: Medication Rooms
Sent by: AICA Infexion Connexion
Hi Fiona,
I agree with Brenda. However, you are correct – I know of no studies and no citations of incidents or disease transmissions with tea-making. It would be a CDC “Category II – theoretical rationale”.
Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist
Grimmond and Associates
Ph/Fx (NZ): +64 7 856 4042
Mob (NZ): +64 274 365 140
E: tg@gandassoc.com
“This email (including any attachments) is intended only for the use of the individual or entity named above and may contain information that is confidential and privileged. If you are not the intended recipient, you are reminded that any dissemination, distribution or copying of this email or attachments is prohibited. If you have received this email in error, please notify me immediately by return email or telephone and destroy the original message. Thank you.”Hi Fiona,
I would be inclined to disagree with this option. Places where Tea and coffee are made traditionally are not kept in a pristine condition and the medication room should be maintained in a clean environment. I see OH&S issues as well. It would encourage more through put of staff and therefore more distractions whilst medications are drawn up. (therefore increased risk of error) Also hot drinks in an area where people are working is a risk for accidental burn injuries.Brenda Anderson
Infection Control Coordinator
Goulburn Valley Health
Shepparton
—– Original Message —–Hi All,
I have been asked to consider placing a zip urn for hot water access in a medication room. My initial response was it is not appropriate to make tea and coffee in the same room where staff are drawing up medications.
However when I have looked for the evidence to back this up I have had trouble finding any.What do others think about this issue from an infection prevention and control point of view?
Kind Regards,
Fiona De Sousa
Infection Prevention & Control Coordinator Sydney Adventist Hospital
Fiona.Desousa@sah.org.au
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Hi Mary-Rose,
My facility has rooms where you can switch them over from positive to negative pressure which were built 10-15 years ago. I find that on occasion that staff will switch the room to negative pressure when there really was no need to do so (eg with Norovirus!) and this usually occurs over a weekend! We also have 4 dedicated rooms which have positive pressure which are used for our bone marrow transplant patients but I am not sure exactly how effective they are as there is a shared bathroom between each pair.
The previous facility I worked in had negative pressure rooms that were dedicated as such and only the engineering people could turn them off. There was a few rooms in ICU that were able to be switched over but no one was ever taught how to do it and the switches were hidden so only engineering did those ones too (luck really).
The literature that Lindy Ryan suggested is the ones that I have read also and is helpful.
Good luck with the renovations.
Terri Cripps | CNC Infection Control | Sydney Children’s Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 |* : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140________________________________
[Posted on behalf of Mary-Rose Godsell – Moderator]
Dear All,
I have been asked to investigate the possibility of including a room that
can have both negative pressure and then be changed into a positive
pressure isolation room – (so interchangable) for some upcoming
renovation in an ICU and ED.
I haven’t read in the literature or heard of this being a viable option,
however would like to canvass the AICA list to gather some evidence
around this. Also the efficacy of using positive pressure isolation
rooms in the first instance.Thank you
Regards
Mary-Rose Godsell
RGON, AFAAQHC, GDipHSM, CICP, MAdvancedPrac(Infection Control)
South West Infection Control Nurse Consultant
WA Country Health Service‘Hand hygiene reduces the
spread of infection’ph:08) 9722 1490
mobile 04 3996 1015
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You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.auHello Margaret,
My experience with hand hygiene products is a personal one as I am one of those people with allergies. When the hospital that I was working in at the time changed from one brand of chlorhexidine soap to another brand it turned out that I was allergic to the new brand’s preservative contained in the soap that the previous brand had not contained. Since the hospital was not willing to order in the previous brand from the previous supplier but were willing to get in a Triclosan containing soap from the new brand company – my problem was solved. Since changing jobs and hospitals, I was pleasantly surprised to find that my new hospital supplied the Chlorhexidine soap brand that I had previously used with no problem. I have used this brand of Chlorhexidine product recently with no ill effects.
Now having to do hand hygiene assessments on others myself, I follow the same sort of line as Cath Murphy has said in her reply, but I use the tool provided on the Hand Hygiene Australia website and also is on the Clinical Excellence Commission (CEC NSW) website. I also find it difficult to get the staff into a Dermatologist as the GP’s seem reluctant to refer on preferring to treat the staff member themselves.
Thanks,
Terri Cripps | CNC Infection Control | Sydney Children’s Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 |* : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140________________________________
Hello all
I have had a couple of staff who are apparently sensitive to Chlorhexidine products.
Dermatology review is difficult to access in the NT so my question is what do other ICP recommend for hand hygiene in this case. I realise you can’t endorse products but a few clues would be great!Margaret Gleeson | Clinical Nurse Specialist, Hand Hygiene Compliance
Infection Prevention & Management Unit, Royal Darwin Hospital | Department of Health and Families
Rocklands Drive, Tiwi, NT 0811| PO Box 41326, Casuarina, NT 0811
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You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.auHi Beth,
At Sydney Children’s Hospital we ask the staff to stay off duty for 48 hours after the last symptom (diarrhoea or vomit) that they have during an outbreak. At any other time we advise 24 hours after the last symptom if the hospital is not considered to be in an outbreak.
They take sick leave (if they have any).
There is no variance according to where they work or type of work as might be of a risk to the children and to other staff.Thanks,
Terri Cripps | CNC Infection Control | Sydney Children’s Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 |* : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140________________________________
Good afternoon
I am interested in knowing how various health services or facilities managed staff who become ill during a gastroenteritis (norovirus) outbreak.
How long are symptomatic staff recommended to stay off duty?
What type of leave do they take whilst symptomatic and recovering?
If it is deemed a work related illness, what are the parameters/definitions used for this?
Is there a variation in recommendations according to the type and place of employment in the health service?Thank you
BethBeth Bint
CNC Infection Control
The Wollongong HospitalM: 0458 230 562
e beth.bint@sesiahs.health.nsw.gov.auInfection Management and Control Service (IMACS)
Level 1, Lawson House
The Wollongong Hospital
LMB 8808
SCMC NSW 2521
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You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.auHi Jill,
Firstly, I prefer to steer away from wooden toys and playpens, especially in waiting rooms as these tend to be frequented by children with runny noses who are not so sick as to be bedridden and who use the equipment and suck, lick and bite them. It is difficult to clean wooden things as they get wet and do not dry out for quite some time. Bacteria and viruses can live on wooden surfaces for a while if not cleaned adequately.
Any toys that can be wiped over with a neutral detergent for your everyday (non-infectious) type patients to use are great, for example plastic, melamine. Any toys given to the children with infectious diseases we wipe over with alcohol or bleach after cleaning them.
Second – I am sorry but I have no experience with fly strips and would imagine that they are difficult to clean.
If you need any more help with toys let me know.
Terri Cripps | CNC Infection Control | Sydney Children’s Hospital
‘: (02) 9382 1876 | fax: (02) 9382 2084 |* : terri.cripps@sesiahs.health.nsw.gov.au| “:www.sch.edu.au| page: 47140________________________________
Good afternoon all,
I have two questions today…..
Firstly, I was wondering if anyone has suggestions for what is appropriate in the ED waiting room for children.
One of the hospitals we look after currently has a large fixed wooden playpen which is in good condition in their waiting room and I have been asked if this is appropriate.
I have also been asked to suggest suitable toys and what would be appropriate in future should renovations occur.
(The other hospitals we look after do not have equipment available in ED waiting rooms.)
Second, I have been questioned on the use of fly strips in a hospital where they appear to be having a problem at the moment with flies. Any thoughts or suggestions would be greatly appreciated.
Thank you in advance for your experience and advice
Kind
RegardsJill Palmer |CNC, A/Infection Control
Katherine Hospital |Gove Hospital |Tennant Creek Hospital
Department of Health and Families
Giles Street, Katherine, NT 0850 | PMB 73, Katherine, NT 0852
p… (08) 8973 9266| m… 0427394492 | f… (08) 8973 9390
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