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Terry Grimmond

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  • in reply to: Single Use vs Reusable Pt Equipment #70703
    Terry Grimmond
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    Author:
    Terry Grimmond

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    tg@GANDASSOC.COM

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    Hi Cath,
    I had not heard of a movement back to single use items so I will be interested to hear members’ responses on this topic. For oldies like me it has been interesting to see the disposable/reusable “cycle” over the decades.

    * in the 60’s we reused needles, glass syringes, gowns, etc, to reduce procurement costs;

    * in the 70’s the cost of labour to process reusables (and modern technology enabling economic production of disposables) moved us to disposables;

    * In the 80’s and 90’s waste disposal costs together with environmental impact of disposables, caused many to move to reusables again;

    * Now with staff shortages, in-house processing of reusables is being re-examined (NB. processing by external contractors can still be economical, e.g. reprocessing single-use medical devices saves USA hospitals $300m annually.
    As you point out, there have been relatively few evidence-based articles implicating disease transmission with either protocol.
    The decision to use disposables or reusables must be evidence-based encompassing patient and staff safety, labour costs, procurement costs, and environmental impact. I look forward to members’ comments

    Best regards, Terry

    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
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    Happy new year all

    As you may know there’s a subtle movement in Australia towards more widespread adoption of single-use items such as venepuncture tourniquets, lower limb surgical tourniquets, BP cuffs and ECG leads. Tom Gottlieb recently did some elegant research on venepuncture tourniquets and AT ACIPC 2013 Karen Vickery presented new perspectives on biofilm on reusable equipment. Single-use items have been adopted widely in the US for some years and recommendations to that effect are included in many Standards published by relevant professional associations eg AORN.

    Whilst appreciating that demonstrating causality between reusable equipment and transmission of colonising organisms or infection is difficult either is biologically plausible. There are also issues of non-cleaning, lack of clarity about who’s role it actually is to clean reusable equipment, how frequently they need to be cleaned or reprocessed etc. These issues have plagued us for at least 3 decades that I know of and likely longer. I’m wondering what others in Australia and beyond think about single-use pt care items

    So my questions are:

    1. Has any ACIPC colleague successfully built a business case to convert their facility to single-use pt equipment? If so who was involved in that process?;

    2. Which pieces of pt equipment do folks think are most in need of single-use alternative options?;

    3. Other than price, storage, supply and environmental/waste issues and lack of detailed science what other factors would need to be addressed to help convince you or your organisation’s decision makers to invest in specific single-use equipment?.

    I’d be grateful for any discussion here or as PMs on the email address below. If anyone is interested in my further work around this issue please email me.

    Regards
    Cath

    Dr Cathryn Murphy RN MPH PhD CIC
    Executive Director
    Infection Control Plus Pty Ltd
    Cath@infectioncontrolplus.com.au

    Adjunct Professor
    Griffith University, School of Nursing and Midwifery
    http://www.infectioncontrolplus.com.au

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    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Email:
    tg@GANDASSOC.COM

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    Hi Michael,
    I agree. In some jurisdictions/institutions, sharps definition (along with “..could penetrate human skin”)… includes “… or puncture waste bags”. i.e. IV spikes and other sharp-edged items that might puncture/rupture a yellow bag with resultant potential for blood/OPIM leakage onto handlers.
    T.

    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 Verily

    The problem with this question is it is local legislation and local waste management regulation specific. It will depend upon what your state legislation requires, and also what your local waste management regulations (eg local council area or landfill site) requires.

    In principle, the ‘spigot end’ of an IV giving set is not a sharp designed to penetrate skin, or to be used for that purpose, and thus may not meet the definition for sharp in some jurisdictions. But your local legislation and regulations may have specific guidance for this, so that should be your first line of enquiry.

    Most regulations allow facilities to develop their own polices with in the guidance of the regulations. Thus, if you want to consider all IV administration sets as clinical waste, it can be a facility decision. You could not decide to allow used clinical sharps to be placed in general waste, though, if this would be a breach of the regulations.

    Hope these thoughts help.

    Cheers
    Michael

    Michael Wishart
    CNC Infection Control
    Holy Spirit Northside Private Hospital
    627 Rode Road, Chermside, Qld 4032
    t: (07) 3326 3068 | f: (07) 3607 2226
    e: Michael.Wishart@hsn.org.au
    w:www.holyspiritnorthside.org.au
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    [cid:image001.jpg@01CEE44A.88CD6CC0]

    Dear All

    I wonder if anyone out there can assist with a good response to feedback to staff regarding this question I am so often asked. I have tried with reason to advise however I would appreciate any further input from out there to address this issue:

    The question:

    ‘During one of the COPS meetings a question was raised around how to appropriately dispose of peritoneal dialysis fluid and whether the spigot of an IV line is classified as a sharp. Some wards believe that if they separate a used IV bag from the line, they must cut the spigot end off and put this in the sharps bin and dispose of the rest of the line in the clinical waste bin. I was hoping to get some clarification on these issues so I can feed it back to the COPS group.’

    Thanks for your assistance.

    Regards

    Verily Thomas
    Clinical Nurse Consultant | Infection Prevention and Control
    SWSLHD-Bankstown/Lidcombe Hospital
    Eldridge Road, Bansktown.NSW 2200
    Tel 02 97228000 pager 28230
    Tel 02 9722 8633 | Fax 02 9722 7822 | verily.thomas@sswahs.nsw.gov.au
    http://www.health.nsw.gov.au

    [cid:image001.jpg@01CEE214.AD0A9BE0]
    LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
    HAND HYGIENE SAVES LIVES

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    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Email:
    tg@GANDASSOC.COM

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    Dear Kylie,
    There are no national or state regulations stipulating Sharps Container (SC) height in Australia (nor elsewhere that I know of) but there are guidelines. At outset we should agree that it is height of SC aperture in Q. Here are my findings on the matter…
    The correct height for SC is one at which staff can safely view down in to the aperture to ensure it is clear and to facilitate safe deposit of sharps and correct activation of tray/door (if present).

    The Australasian Health infrastructure Alliance shows the aperture of the wall-mounted SC to be approximately 1.3m off the floor in Acute Patient Bays (http://www.healthfacilityguidelines.com.au/standard_components_lz.aspx), however heights above 1.2m are associated with increased sharps injuries (SI) to HCW (Weltman et al ICHE 1995;16:268-274).
    My research indicates that a safe, wall-mounted aperture height is 1.1m – 1.2m above floor level. Epidemiological evidence confirms that staff risk far exceeds child injury risk and at this height I have yet to see a child SI cited.

    Historically, SC were placed at “ergonomic height for staff to safely use” – there was no ‘recommended height from floor’. However, the fear of child access caused SC to be raised to non-ergonomic heights to the point where numerous SI to HCW have been reported because they could not see that:

    * a tray/door had activated correctly

    * the aperture was clear

    * the SC was not overfilled;

    * a sharp was not retained in the vestibule (throat) of a tray/door SC;

    * or that a sharp was protruding from the aperture
    NB. Karen Daley the President of American Nurses Association said she acquired HIV and HCV through an SI because the SC was mounted too high.
    I have written to CDC’s NIOSH to inform them their 1998 guideline on Evaluation, Selection and Use of SC (http://www.cdc.gov/niosh/docs/97-111/ ) needs updating as they recommend a height of “52-56 inches” (1.32 – 1.42m). They will discuss this at the next, yet to be scheduled review.
    SC height is compounded in countries with short-stature staff and also compounded in developed countries where nurse shortages have been filled with staff emigrating from Asia, Phillipines, Mexico, etc – all short-stature countries.

    Finally, sharps containers need be mounted to accommodate an institution’s shortest staff, not their average staff.

    I hope this is helpful to you.

    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
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    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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    in reply to: Re: Sharps #70297
    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Email:
    tg@GANDASSOC.COM

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    Hi Franciska,
    It is pretty well accepted internationally that ALL sharps, whether safety engineered devices or not, must be discarded into a sharps container, for the very reason you stated (in USA OSHA have ruled on this). This would include retractable lancets.

    Regards, Terry

    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
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    Hi All,

    I just would like to clarify something please, the little retractable lancets (we use to prick the skin for blood when checking blood sugar level) is classified as a sharp. Correct me if I’m wrong, but I’ve always discard them in a sharps container, they didn’t use to be retractable and I’ve come across faulty ones.

    I know, something like this should be the obvious, write? This question came about after someone told me that they discard it in a general bin?? (the retractable ones)

    Kind Regards

    Franciska Ferreira
    INFECTION PREVENTION & CONTROL /WOUND MANAGEMENT CONSULTANT
    Burnside War Memorial Hospital
    120 Kensington Road, Toorak Gardens, SA 5056
    t: 08 8202 7222 f: 08 8407 8573 e: fferreira@burnsidehospital.asn.au

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    in reply to: % sharps engineered device use #70276
    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Email:
    tg@GANDASSOC.COM

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    Thanks Michael,

    Just for clarity, I include IV catheter insertions (and exclude scalpels/sutures) so have clarified Q below. Would you mind putting this answer out to members please.

    “Of all hollow bore needles/butterflies/IV catheters used on patients throughout your hospital, what % would be ‘safety engineered devices’ and what % of those would be correctly activated after use?”

    Regards, Terry

    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 Terry

    Difficult to answer empirically as this is not a statistic I maintain, but best guess for here would be probably 60 -70% of our sharps used in wards (eg non-procedural areas) are safety devices (needle/syringe, peripheral IV access cannulas).

    Of these safety devices I would think the majority are correctly activated after use, probably running about 90%. The majority of peripheral IV access cannulas automatically sheath on insertion (passive), but our needle/syringe safety devices require active manual activation, and we do get reports of activation failure, so they at least try to activate them! Not all of our S/C or IM injection needle/syringes are safety (pre-filled syringes mostly non-safety, and larger volume syringes with needles are non-safety here – staff do not like the 5 ml or larger safety syringes of the type we use so we do not have them available).

    Procedural area sharps are much more problematic, as scalpels, suture needles and many reusable cannulas/trocars are not readily available (or acceptable) as safety devices. The % in procedural areas would be much lower, probably around 20% at most of the total sharps used (pure guess!). Since the majority of peripheral IV cannulas used in procedural areas are passive safety devices, and there is very little use of safety needle/syringes, the activation rate would be very high. Not really sure what % of sharps would be procedural vs ward based, sorry.

    I would also be interested to know whether this would be a common scenario in many facilities currently. Bring on some legislation requiring more attention to safety sharps!

    Cheers
    Michael

    Michael Wishart
    CNC Infection Control
    Holy Spirit Northside Private Hospital
    627 Rode Road, Chermside, Qld 4032
    t: (07) 3326 3068 | f: (07) 3607 2226
    e: Michael.Wishart@hsn.org.au
    w:www.holyspiritnorthside.org.au
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    Hi Michael,

    With sharps safety device legislation under current consideration, I wonder if members could hazard an answer to this Q – am happy for answers to come direct to me at tg@gandassoc.com.
    “Of all needles/butterflies used on patients at your hospital (Rx, phlebotomy, etc) what % would be ‘safety engineered devices’ and what % of those would be correctly activated after use?”
    I had one reply of “33% and 90%” and that surprised me.

    Best regards, Terry

    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.”

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    in reply to: Antibacterial spray for theatre shoes #70267
    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Email:
    tg@GANDASSOC.COM

    Organisation:

    State:

    Hi all, My Oops – I meant to say remove OR shoes (as toilet appears to be outside OR). Having said that, I agree with Michael and TerryM – footwear is v. low on IC risk. No need to “spray”.
    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 Sara,
    I’ve not noted this as an issue for infection transfer. If surgeons wear overshoes, and remove them prior to going to toilet, I can’t see an infection issue. Or am I missing a potential issue?
    Regards, Terry
    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
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    Good Morning all,

    Some of the surgeons have suggested that it would be a good idea to spray their shoes after going to the bathroom etc. prior to re-entering the theatre. Therefore the theatre Manager has asked me what could be used, so I am asking if any of you follow this practice at all and if so suggestions on brands via private email would be greatly appreciated.

    Thank you for any thoughts on this matter

    Regards

    Sara

    Sara Godden
    Infection Control Coordinator – CICP
    Acting Stomal Therapy Nurse
    Brisbane Private hospital
    259 Wickham Terrace
    Brisbane QLD 4000
    Sara.Godden@healthscope.com.au

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    in reply to: Antibacterial spray for theatre shoes #70262
    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Email:
    tg@GANDASSOC.COM

    Organisation:

    State:

    Hi Sara,
    I’ve not noted this as an issue for infection transfer. If surgeons wear overshoes, and remove them prior to going to toilet, I can’t see an infection issue. Or am I missing a potential issue?
    Regards, Terry
    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.”

    Good Morning all,

    Some of the surgeons have suggested that it would be a good idea to spray their shoes after going to the bathroom etc. prior to re-entering the theatre. Therefore the theatre Manager has asked me what could be used, so I am asking if any of you follow this practice at all and if so suggestions on brands via private email would be greatly appreciated.

    Thank you for any thoughts on this matter

    Regards

    Sara

    Sara Godden
    Infection Control Coordinator – CICP
    Acting Stomal Therapy Nurse
    Brisbane Private hospital
    259 Wickham Terrace
    Brisbane QLD 4000
    Sara.Godden@healthscope.com.au

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    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Email:
    tg@GANDASSOC.COM

    Organisation:

    State:

    Thanks Cath,

    Great session, great support for a watershed motion. And a great suggestion re all of us writing to each member who spoke – if you track down their email addresses would you mind sharing them with us?

    Best regards, Terry

    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.”

    Today in the Federation Chamber sensible bipartisian behaviour and good reason from twelve Members supporting Coalition MP Dr Mal Washer’s last private member motion and the first ever to address needlestick and sharps injuries. This motion has the potential to eliminate up to 30,000 of these potentially life-threatening workplace injuries sustained by Australian healthcare workers each year. As a nurse sustaining multiple sharps and Needlestick injuries over a 30-year plus career and as a long-term researcher and advocate for mandating availability of safety engineered sharps devices that eliminate this risk, my faith in Australian politics has been somewhat restored. Too bad Australia lags at least a decade behind the US and several years behind Canada and Europe until legislation mandating safety engineered sharps devices is promulgated.

    If any ACIPC members or others are interested in accessing a recording of the very interesting debate you can follow this link to request a copy. http://www.aph.gov.au/News_and_Events/Watch_Parliament/How_do_I_request_a_copy_of_Parliamentary_proceedings Within 6 hours I had received unique access to a downloadable version of the debate. It was interesting live and compelling watching post event.

    The 12 MPs who spoke in support of Dr Washer’s motion are listed below. There would be great merit in the College and individual members writing or contacting these politicians to express our thanks and to request their ongoing support and commitment beyond today and September’s election. If we remain silent on this issue we may well lose this one chance which is the first one I’ve experienced in more than 25 years in the field.

    * Graham Perrett. Member for Moreton, QLD
    * Hon. Judi Moylan, Member for Pearce, WA
    * Tony Zappia, Member for Makin, SA
    * Craig Thomson, Member for Dobell
    * Jill Hall, Member for Shortland
    * Jane Prentice, Member for Ryan, QLD
    * Michael McCormack, Member Riverina
    * Hon. Shayne Neumann, Sec For Health and Ageing
    * Dr Dennis Jensen, Member for Tangley
    * Nick Champion, Member for Wakefield SA
    * Darren Chester Member for Gippsland,
    * Nola Marino, Member for Forest

    Professor Cathryn Murphy RN MPH PhD
    Executive Director
    Infection Control Plus Pty Ltd
    West Burleigh, Queensland
    http://www.infectioncontrolplus.com.au
    [cid:image001.jpg@01CE7104.995119C0][cid:image002.jpg@01CE7104.995119C0][cid:image003.jpg@01CE7104.995119C0]

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    in reply to: re aerosoling of cytotoxic waste #70066
    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Email:
    tg@GANDASSOC.COM

    Organisation:

    State:

    Hi Christine,

    I’ve reviewed literature on risk in handling cyto wastes and aerosols (together with skin and mucous membrane contact) is certainly a mode of contact with cyto drugs (CD). However aerosol risk (i.e. fine spray/mist) appears only to be a risk among staff diluting/drawing liquid formulations, or if vessels container CD are dropped and break.
    The literature states that cyto risk “hierarchy” descends from manufacturer to pharmacist to nurse to waste handler. There were no cases of CD illnesses in waste handlers reported.
    Some CD can sublime from the powder state at room temperature but I could find no evidence that foot-pedal bins generated aerosols or that CD bins needed emptying daily or that bins in use for longer increased aerosolisation risk.

    Hope this helps.

    Kind regards, Terry

    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
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    Hi,

    We have recently changed to a reusable waste bin system including Cytotoxic waste. Can anyone give me any information on aerosoling of cytotoxic waste – I have queries from staff re if the bins are not filled nd emptied in one day.
    Thanks

    Christine Lawson | RN

    Quality and Risk Manager | Caboolture Private Hospital
    Caboolture Private Hospital
    McKean Street, CABOOLTURE QLD 4510
    t: 07 5495 9418
    e: LawsonC@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au
    [cid:image001.jpg@01CE61F5.A434AB40]

    [cid:image002.jpg@01CE61F5.A434AB40]

    [cid:image003.jpg@01CE61F5.A434AB40]

    [cid:image004.jpg@01CE61F5.A434AB40]

    [cid:image005.jpg@01CE61F5.A434AB40]

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    [cid:image007.jpg@01CE61F5.A434AB40]

    [cid:image008.jpg@01CE61F5.A434AB40]

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    in reply to: Sewage contamination of ambulance station #69893
    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Email:
    tg@GANDASSOC.COM

    Organisation:

    State:

    Hi Kate,

    CDC do not advise microbiological sampling unless an infection issue needs investigating. Having said that, sewerage flood is not your everyday occurrence! However, as an environmental surface, thorough cleaning with water and detergent will render it decontaminated, and addition of a disinfectant will give the staff added assurance.

    Regards,

    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
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    —–Original Message—–

    I am seeking advice about checks that could be done to an ambulance station to ensure health and safety of staff as well as patient safety, following a sewage contamination of the station (half a metre of raw sewage through most of the station). Stock and equipment disposal and thorough cleaning has already occurred as well as new plaster board walls, flooring and coverings installed as was necessary.

    Are there any guidelines around this sort of occurrence? Would micro sampling of surfaces or air sampling be necessary or appropriate?

    Ambulance stations are rest quarters for staff. They also store sterile and other stock, and are the location where patient care equipment is cleaned.
    Thanks in anticipation.

    Kate Hipsley
    Ambulance Service of NSW

    Sent from my iPhone
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    in reply to: Public Toilets – Individual Urinal Versus Trough #69278
    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Email:
    tg@GANDASSOC.COM

    Organisation:

    State:

    Hi Fiona,

    As a user of both for many decades, and a microbiologist for almost as many, I had to come in on this one!

    I have seen no evidence as to increased infection risk with either mode, nor can I epidemiologically or scientifically differentiate between the two as a risk.

    In making your choice, I suspect it should not be based on infection risk (I propose there is nil), but would be based on:

    o Cleaning workload (somewhat related to aim of user; but also related to splash which is definitely greater with Floor troughs)

    o Preferences of users

    single urinals pose less hassle for “elbow room” and are more preferable (at least to me)

    Floor troughs are now somewhat old fashioned – virtually all airports are single urinals these days.

    So, in summary, I would go with the flow 🙂 and install single urinals.

    Best regards, Terry

    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
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    Hi All,

    We are currently considering bathroom furniture for male toilets and there is a debate over floor troughs versus wall mounted single urinals. I have been told that the floor mounted trough poses a greater infection control risk for the spread of infection than the wall mounted urinal but am unsure why this is. Has anyone else looked at this issue for their facility and what was the outcome?

    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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    in reply to: Re: Vale Clinton Dunkley #68576
    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Email:
    tg@GANDASSOC.COM

    Organisation:

    State:

    Thanks Michael for letting us know. This is a great shock to me and no doubt to his family and colleagues. If there is a way, could AICA please pass on to his family our condolences and prayers.

    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
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    Michael could you please put out the information below on the AICA list

    Dear Colleagues ,
    It is with great sadness to inform you that Clinton Dunkley passed away Tuesday 22nd March. Many of you will know Clinton from his work in Infection Control from his time at St. Vincent’s Hospital Melbourne, Senior Program Advisor Infection Control Department of Health Victoria, and more recently the Operations Manager for VICNISS Coordinating Centre. A funeral service has been booked for 1.15 pm Monday 28th March at Springvale Crematorium, followed by refreshments. Please see tomorrows Melbourne newspapers for more details.

    John Greenough | Infection Control Consultant
    St Vincent’s | 41 Victoria Parade Fitzroy VIC 3065
    t: +61 3 9816 0632 | t: +61 3 9288 4704 | f: +61 3 9288 4068 | http://www.svhm.org.au

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    in reply to: Medication Rooms #68453
    Terry Grimmond
    Participant

    Author:
    Terry Grimmond

    Email:
    tg@GANDASSOC.COM

    Organisation:

    State:

    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
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    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
    185 Fox Valley Road, Wahroonga, NSW, 2076

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