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Hi Sue,
We manage all OE’s through Infection Control, happy to share if you want to contact me off-line.
Cheers,Tracy
Tracy Sloane RN, M. Adv Prac (Infection Control) Hons, CICP
Senior Infection Control Consultant
Dandenong Hospital, Monash Health
T (03) 95548173 F (03) 95541905
E tracy.sloane@monashhealth.org—–Original Message—–
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Sue Flockhart
Sent: Wednesday, 11 November 2015 2:17 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Occupational ExposuresHi all,
I am hoping that you might be able to assist me. We are currently revising the model in which my health service currently manages occupaitonal exposures. The current model involves the recipient of an exposure visiting the emergency department for assessment. Infection prevention and control (IPAC) will then complete all followup. The model we are considering is a ‘nurse led’ occupational exposure management program based within IPAC.
I am wondering what models other health facilities currently work (success of same) with to manage occupational exposures and if you would be willing to share that information.Thank you in advance.
Sue Flockhart
Manager, IPAC & Staff health
Ballarat Health ServicesMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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Hi Kathy,
At Monash Health we mandate completion of the declaration form so if a HCW has had it elsewhere or refuse vaccination they can document it there. HCW who refuse vaccination are required to wear a surgical mask if within a metre of a patient for the flu season. There is significant executive and management support and our rates have dramatically improved.
Cheers,Tracy
Tracy Sloane RN, M. Adv Prac (Infection Control) Hons, CICP
Senior Infection Control Consultant
Dandenong Hospital, Monash Health
T (03) 95548173 F (03) 95541905
E tracy.sloane@monashhealth.orgHi Kathy
Where I am is small and we have a significant part time/casual workforce. We found that MANY of our staff had been vaccinated elsewhere and weren’t letting us know. We sent out a text message to all our part time and casual nurses asking them to contact me if they had received their flu vax elsewhere. We increased our compliance by over 10%!
Kirsten Amos
Nurse Consultant
Infection Prevention and Control
Gippsland Southern Health ServicesThanks Cathy,
I agree that getting the managers to assist is the way to get buy-in, but I also like your idea of a prize draw – might hit up my exec for something good next year.Regards
KathyKathy Taylor- Infection Control Manager
The Wesley Hospital | 451 Coronation Drive, Auchenflower QLD 4066
t: 07 3232 7558 |m: 0427 607 812 | f: 07 3232 6043 |e: katherine.taylor@uchealth.com.auKatherine, we have had a lot of support from the executive team to achieve our current rate of 79%. We have broken down all staff into ward /departments lists and the managers were receiving weekly updates of progress within their department. As the number of vaccinated staff increased we then narrowed it down to those who have not been vaccinated. All unit managers were expected to assist us in ensuring that every staff member has either been vaccinated or has signed the declaration form formally declining the vaccine. We have around 950 staff on 2 sites for purposes of the influenza campaign. We have a major prize draw at the end of the season for staff who have been vaccinated. This has been in place for several years and alone didn’t assist that much in reaching our target. Last year we failed to reach 75% so the strategies this year really worked. It has, of course, come with the expense of great time and effort on the behalf of the infection control staff who are both nurse immunisers.
Cathy Mowat
Infection Control
Central Gippsland Health Service
Sale VictoriaDear AICALIST members,
From July last year any new starters at our hospital sign that they agree to have the vaccines that are recommended in the Australian Immunisation Handbook for their designation, and now our executive are toying with the idea of making influenza vaccination compulsory for all of our staff next year.With a lot of effort this year -lots of flu jab clinics, lollypops & bright stickers for ID swing tags on vaccination, “grab a snag & get a jab” BBQ lunch, free pizza lunch for wards/areas with compliance above 80% – we have a compliance rate of 72% of staff either vaccinated or who have signed an opt-out form declaring that they have been offered the influenza vaccine, but decline for whatever reason. I think this compliance rate is pretty good – certainly better than the compliance in previous years.
I would like to know what everyone else is doing out there. What has worked and what has not?
Is influenza vaccination compulsory at your facility? Is it something your exec team is considering?
What do you consider to be an acceptable vaccination rate in your healthcare facility?
Is there any penalty for staff who are not vaccinated, e.g. unimmunised staff wearing mask at work during winter?
Regards
KathyKathy Taylor- Infection Control Manager
The Wesley Hospital | 451 Coronation Drive, Auchenflower QLD 4066
t: 07 3232 7558 |m: 0427 607 812 | f: 07 3232 6043 |e: katherine.taylor@uchealth.com.au_________________________________________________________________
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Hi Barbara,
We use only water with the microfibre cloths and mops…happy to discuss off line.
Cheers,
Tracy
TracyTracy Sloane RN, M. Adv Prac (Infection Control) Hons, CICP
Senior Infection Control Consultant
Dandenong Hospital, Monash Health
T (03) 95548173 F (03) 95541905
E tracy.sloane@monashhealth.orgHello Everyone,
I am keen to find out from those Infection Prevention & Control colleagues who use micro fibre cleaning items (mops, cloths) at their facilities and whether you use these items with a disinfectant cleaning agent for hard surfaces (eg floors, bench tops, bed rails).In particular has the disinfectant cleaning agent affected the micro-fibre cleaning items and if so what strategies you implemented to address this? Are there micro-fibre cleaning items that are compatible with disinfectant cleaning agents?
Thank you in advance for your responses.
Kind regards,
BarbBarbara May
CNC Infection Prevention and Control | Hastings Macleay Clinical Network
PO Box 2466, Port Macquarie NSW 2444
Tel 02 5524 2061| Fax 02 5524 2061| Mob 0402890677 | Barbara.May@ncahs.health.nsw.gov.auClean hands saves lives – are your hands clean?
________________________________
This message is intended for the addressee(s) named and may contain confidential information. If you are not the intended recipient, please delete the message and any attachments and notify the sender. Views expressed in this message are those of the individual sender, and are not necessarily the views of NSW Health or any of its entities.
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Hi Rachel,
Happy to talk offline about this.
Cheers,Tracy
Tracy Sloane RN, M. Adv Prac (Infection Control) Hons, CICP
Senior Infection Control Consultant
Dandenong Hospital, Monash Health
T (03) 95548173 F (03) 95541905
E tracy.sloane@monashhealth.orgHi Glenys,
Thanks so much for your comments! It is certainly interesting to me to see if there are outcomes may be able to be described in terms of costs for cleaning rather than reduction in HAIs, but it will be really interesting to see if others can share.
Cheers
Rachel……………………………………………………………………………..
Rachel Thomson
Nurse Unit ManagerInfection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658Level 4, H Block
48 Liverpool Street
Hobart, 7000Hi Rachel,
With the evidence for environmental cleaning and disinfection the main outcome if you were using any new infection control strategy would be a decrease in the acquisition of MROs (i.e. MRSA, VRE and Acinetobacter & Clostridium difficile).
Haven’t heard of any decrease in MROs acquisitions at site/s where it is being used (although happy to be corrected) and as per the abstract previously posted this strategy may not have good activity against C.difficile. This would be a problem in the setting of hospital transmission.
It seems this microfiber (used daily) steam (used only on discharge) is primarily a “facility lead cleaning program” rather than a targeted infection control strategy. The cost and time savings associate with this strategy primarily relate to savings generated as a result of replacing 2-step cleaning and disinfection program.
There was a nice publication from the Geelong ICT which showed that 2-step cleaning and disinfection was not necessary – have included the abstract for those who may not have seen it.
Am J Infect Control. 2013 Mar;41(3):227-31. doi: 10.1016/j.ajic.2012.03.021. Epub 2012 Sep 13.
The effectiveness of a single-stage versus traditional three-staged protocol of hospital disinfection at eradicating vancomycin-resistant Enterococci from frequently touched surfaces.
Friedman ND1, Walton AL, Boyd S, Tremonti C, Low J, Styles K, Harris O, Alfredson D, Athan E.
Author information
Abstract
BACKGROUND:
Environmental contamination is a reservoir for vancomycin-resistant enterococcus (VRE) in hospitals.
METHODS:
Environmental sampling of surfaces was undertaken anytime before disinfection and 1 hour after disinfection utilizing a sodium dichloroisocyanurate-based, 3-staged protocol (phase 1) or benzalkonium chloride-based, single-stage clean (phase 2). VRE colonization and infection rates are presented from 2010 to 2011, and audits of cleaning completeness were also analyzed.
RESULTS:
Environmental samples collected before disinfection were significantly more likely to be contaminated with VRE during phase 1 than phase 2: 25.2% versus 4.6%, respectively; odds ratio (OR), 7.01 (P < .01). Environmental samples collected after disinfection were also significantly more likely to yield VRE during phase 1 compared with phase 2: 11.2% versus 1.1%, respectively; OR, 11.73 (P < .01). Rates of VRE colonization were higher during 2010 than 2011. Cleaning audits showed similar results over both time periods.
CONCLUSION:
During use of a chlorine-based, 3-staged protocol, significantly higher residual levels of VRE contamination were identified, compared with levels detected during use of a benzalkonium chloride-based product for disinfection. This reduction in VRE may be due to a new disinfection product, more attention to the thoroughness of cleaning, or other supplementary efforts in our institution.Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426Hi Glenys,
Yes I found that one in my research to date. I am interested in the experience of Australian Healthcare facilities, and I particularly interested in the impact (if any) on HAIs. It will be interesting to see if anyone can share some outcome data aligned to this practice change.
Thanks & speak soon
Rachel……………………………………………………………………………..
Rachel Thomson
Nurse Unit ManagerInfection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658Level 4, H Block
48 Liverpool Street
Hobart, 7000Hi Rachel,
This research publication may be of interest/use.
J Hosp Infect. 2012 Oct;82(2):114-21. doi: 10.1016/j.jhin.2012.06.014. Epub 2012 Aug 15.
Clinical and cost effectiveness of eight disinfection methods for terminal disinfection of hospital isolation rooms contaminated with Clostridium difficile 027.
Doan L1, Forrest H, Fakis A, Craig J, Claxton L, Khare M.Abstract
BACKGROUND:
Clostridium difficile spores can survive in the environment for months or years, and contaminated environmental surfaces are important sources of nosocomial C. difficile transmission.
AIM:
To compare the clinical and cost effectiveness of eight C. difficile environmental disinfection methods for the terminal cleaning of hospital rooms contaminated with C. difficile spores.
METHODS:
This was a novel randomized prospective study undertaken in three phases. Each empty hospital room was disinfected, then contaminated with C. difficile spores and disinfected with one of eight disinfection products: hydrogen peroxide vapour (HPV; Bioquell Q10) 350-700 parts per million (ppm); dry ozone at 25 ppm (Meditrox); 1000 ppm chlorine-releasing agent (Actichlor Plus); microfibre cloths (Vermop) used in combination with and without a chlorine-releasing agent; high temperature over heated dry atomized steam cleaning (Polti steam) in combination with a sanitizing solution (HPMed); steam cleaning (Osprey steam); and peracetic acid wipes (Clinell). Swabs were inoculated on to C. difficile-selective agar and colony counts were performed pre and post disinfection for each method. A cost-effectiveness analysis was also undertaken comparing all methods to the current method of 1000 ppm chlorine-releasing agent (Actichlor Plus).
FINDINGS:
Products were ranked according to the log(10) reduction in colony count from contamination phase to disinfection. The three statistically significant most effective products were hydrogen peroxide (2.303); 1000 ppm chlorine-releasing agent (2.223) and peracetic acid wipes (2.134).
CONCLUSION:
The cheaper traditional method of using a chlorine-releasing agent for disinfection was as effective as modern methods.
RegardsGlenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426Hi all,
We are currently undertaking a major review in relation to environmental hygiene within our own organisation. As part of this we are considering the potential infection control outcomes relating to the introduction of novel cleaning processes, with a particular interest in steam and microfibre cleaning. I am aware of the body of work being led by a number of health services, including Southern Health, but I am particularly interested in any recorded impact on patient outcomes as a result of introducing steam and microfibre cleaning by other healthcare services.
In our organisation we publicly report on a number of surveillance data including
* MRSA acquisitions (colonisation and infection) [these are reported to our State surveillance unit although not publicly reported at this time]
* VRE acquisitions (colonisation and infection)
* MRGN acquisitions (colonisation and infection)
* SAB, including HCA as separate from Community Onset
* Clostridium difficile infection, in particular HCA
I attach for the interest of subscribers the link to the publicly reported HCAI data in Tasmania, which our hospital data.
http://www.dhhs.tas.gov.au/__data/assets/pdf_file/0013/161023/Surveillance_Report_No_21_Quarter_1_2014.pdfMy question is; are any list members able or willing to share with me their HCAI data both before and after introducing steam and microfibre cleaning?
I would be happy to receive replies off-line if this enquiry.
Thanks
Rachel……………………………………………………………………………..
Rachel Thomson
Nurse Unit ManagerInfection Prevention & Control Unit
Royal Hobart Hospital
Tasmanian Health Organisation-South
*: 03 62227882/8658Level 4, H Block
48 Liverpool Street
Hobart, 7000________________________________
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