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Hi Kelly
I certainly can share my experience on the respiratory human Metapneumovirus as one that I have not seen in the 10 years I have been in infection control. We also recovered from a HMPV virus outbreak on one of our wards and all I can say is that the activity of all viruses regardless has had a shift in the last year or two.
Most of our patients had low grade temperatures and cough. Based on the past activity of HMPV it was not notified to IP&C as it was considered an organism that was not required to be routinely notified to IP&C but rather to the wards. I find this a problem as not all IC processes are followed by the book regardless of how you beat down in trying to getting them done as this is not usually considered a priority in patient care on most cases. However, from its current activity and who knows what else happens in the future it probably should be considered a notifiable organism to IP&C just like any other respiratory virus i.e. influenza. There should be more standardised and clear cut guidelines on how these organisms should be managed as an outbreak is a clear indicator of person to person transmission. Sometimes even a change in activity by the lab should be enough to bring out that trigger to the IPU.
What we noted when dealing with this virus that is usually self-limiting and has never resulted in an outbreak until now in our facility is that it was also very debilitating to the patients that it affected and took a longer time to clear. Mind you most of these patients were non-acute rehabilitating patients so the impact on their recovery and limiting services like utilising a shared gym and keeping them secluded were a challenge in itself.
What we also noticed and I am sure others have too is that the viruses including RSV are on the increase resulting in more healthcare associated transmission than I have ever seen before should we ignore this or should these be the types of emerging organisms of significance that we should be taking note of as I am sure we are all recovering from this debilitating flu season we certainly wouldn’t have the capacity to control when they got out of hand. What is currently not clear is how long we could isolate the patients and safely de-isolate as there are no clear guidelines for this so all we relied on was fever and cough which we know can go on for a while. However, apart from this and not understanding how long transmission can go on for we kept affected patients in the same area did not admit any new patients to the cohort rooms for a while(this was achievable as they were long stay patients)-this could be a challenge where there is a high turnover of patients.
I would also appreciate if there is anyone out there with clear evidence based protocols to manage such patients that they would share the information with us as well. We finally got over the outbreak after 6 confirmed cases and monitoring of all patients within the unit who became may have developed symptoms. It took us close to 2 weeks of monitoring, screening, isolation, education and cleaning to finally stop having any confirmed cases for HMPV as most of the confirmation was some days apart- and also taking into consideration the maximum recommended incubation period of 7days.What I also found and have read is some of these viruses can complicate any opportunistic infections particularly patients colonised with MRO’s would be interesting to see if there is any conclusive evidence out there relating to this claim.
In other words, keep an eye out for these organisms that are emerging and proving to be greater in the IP&C world.
Kind 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
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LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVESHi Collective Brains Trust,
We currently have a respiratory outbreak in one of our residential aged care facilities and one of our staff has come back positive for Human metapneumovirus infection. I am wondering if anyone has had experience with this that could share your wisdom. Rest of the PCR’s are still pending. Any help would be greatly appreciated.
Regards,
KellyKelly Barton
Infection Prevention & Control Officer
Monday- Friday
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Well done Alfred Health that video is fantastic:), good job keep it up hand hygiene promotion certainly needs a boost to another level keeping up with the times from “clean your hands”.
Shout out all the way from Bankstown Hospital.
Kind 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
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LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVESOne of my hand hygiene auditors sent me this this YouTube link, which they saw on social media. Not sure if many ICP’s would have seen this yet.
Well done Alfred Health Infection Control Team! 🙂
https://www.youtube.com/watch?vG6z5-RikOsg&featureyoutu.be
Cheers
MichaelMichael Wishart
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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It is interesting indeed that even though this being said the majority of patients presenting to acute care facilities and now an even greater burden on healthcare than healthcare associated staphylococcus aureus (MRSA & MSSA) blood stream infections seem to come from the community with a significant number of these coming from long term care residential facilities.
Makes me wonder whether these infections are being costed to, LTCRF or to acute care facilities, just saying.Isnt this the whole idea of decolonisation to9 prevent simple colonisations turning into life threatening and debilitating infections?
Kind 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
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LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVESThis recently published study on nursing home MRSA in Switzerland demonstrated a screening and decolonisation programme had no effect on MRSA carriage rates.
Great to see such a negative study published from the non-acute sector.
Cheers
MichaelMichael Wishart
Infection Control CoordinatorA 627 Rode Road, Chermside QLD 4032
P (07) 3326 3068 | F (07) 3607 2226 | E michael.wishart@svha.org.au | W http://www.hsnph.org.au
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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[Description: cid:image002.jpg@01CE8EA5.483A6E60]
LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVESFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry Grimmond
Sent: Friday, 31 October 2014 11:51 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Ebloa WasteHi Sony,
I agree with you. But for countries who have harmonized with UNTDG Model Recommendations, Ebola is Category A UN2814. It is not Clinical Waste UN3291. The national law steps in and CDC and DoH recommendations are over-ruled. As happened in USA last month where DOT over-ruled CDC on this issue.
Best regards, Terry
Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist
Grimmond and Associates
Ph (NZ): +64 7 855 3212
Mob (NZ): +64 274 365 140
E: terry@terrygrimmond.com
[Twitter_logo_blue]: @terrygrimmond
W: http://terrygrimmond.com
[cid:image003.gif@01CFF50D.6D9958E0]
“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.”From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Sony SO
Sent: Friday, October 31, 2014 12:58 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Ebloa WasteDear All,
The issue of using single clinical bag for handling infectious materials i.e. clinical waste is addressed in the CDC guidelines-Guidelines for Environmental Infection Control in Health-Care Facilities http://www.cdc.gov/~HCF_03.pdf, details are as follows:
point I, (3), page 119, which states: A single, leak-resistant biohazard bag is usually adequate for containment of regulated medical wastes, provided the bag is sturdy and the waste can be discarded without contaminating the bags exterior.
Point G, (3), page 100, which states: Single bags of sufficient tensile strength are adequate for containing laundry, but leak-resistant containment is needed if the laundry is wet and capable of soaking through a cloth bag.1264
Furthermore, with reference to international guidelines related to clinical waste management(Table 1), practices of double bagging of waste is not recommended.
Lastly, practices of double-bagging of items from isolation rooms is not considered as an infection control measure, for details, please refer to:
Maki DG, Alvarado C, Hassemer C. Double-Bagging of Items from Isolation Rooms Is Unnecessary as an Infection Control Measure: A Comparative Study of Surface Contamination with Single-and Double-Bagging. Infection Control. 1986; 7(11): 535-7. Available from: http://www.jstor.org/stable/30146425
Regards,
Sony SO
Nursing Officer, Infection Control Branch (Team 2)
Centre for Health Protection
office phone: +852 2125-2922; fax: +852 3523-0752
HA email sony@ha.org.hk; DH email no_icb4@dh.gov.hk
Please consider the environment before printing this e-mailTable 1: international guidelines for handling clinical waste
1. Biohazard Waste Industry Australia and New Zealand (BWI) (formerly ANZCWMIG). (2007). Industry Code of Practice for the Management of Clinical and Related Wastes. Retrieved 11 August 2010 from http://www.epa.sa.gov.au/xstd_files/Waste/Code%20of%20practice/Code%20of%20Practice%206th%20Edition.pdf
2. UK Department of Health. Environment and sustainability Health Technical Memorandum 07-01: Safe management of healthcare waste Retrieved August 2014 from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/167976/HTM_07-01_Final.pdf
3. Uk Health & Safety Executive. (2009). Carriage of Dangerous Goods Manual-Carriage of clinical waste Retrieved 11 August 2010 from http://www.hse.gov.uk/cdg/manual/clinical/index.htm
4. World Health Organization WHO. (2008). Safe Management of Wastes from Health-Care Activities. Retrieved August 2014 from http://apps.who.int/iris/bitstream/10665/85349/1/9789241548564_eng.pdf
5. (2003)201410http://www.moh.gov.cn/mohyzs/s3576/200804/18353.shtml
6. (1997)(97) 201410http://wm.epa.gov.tw/medicalwaste/Documents/HandBook39all3.pdfFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
Sent: Friday, October 31, 2014 5:20 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Ebloa Waste[This message is posted on behjalf of Belinda Henderson, ACIPC President. Note that this issue has been discussed through the ACIPC Executive Council at National and State/juristictional level. ICPs are urged to check with their state/juristiction authorities and local waste contractors regarding any local impact of this issue Moderator]
We want to update our members on the issue of Ebola Waste transport in Australia. One of our members, Terry Grimmond, has been working with authorities to develop a practical, safe and legal packaging solution so we asked him to summarise where Australia is at.Thank you Belinda,
Many ACIPC members will have seen the Oct 3 CDNA/AHPPC recommendations for double-bagging Ebola waste and transporting it as clinical waste1 (i.e. shipping as UN 3291). These recommendations are sound and evidence-based.
However, what many may not know is that the Australian Dangerous Good Code (ADG)2 requires substances known or reasonably expected to contain a Category A Infectious Substancein any form (e.g. Ebola waste) to be packaged according to ADG P620 requirements, which require:a 95k Pa pressure-tested, leakproof primary receptacle that is sealed and placed inside a:
leakproof secondary receptacle containing absorbent material, sealed and placed inside:
a rigid outer container certified to ADG 9m drop, Rod Impact, and Water-spray tests.
The issue is, P620 packaging is designed for specimens, cultures, etc and no P620 packaging exists for large Category A items such as waste bags, mattresses, etc.
If waste companies pick up Ebola waste in anything other than P620 packaging, they would be breaking the law. Alternative packaging systems must be approved as safe as ADG P620.
Submissions need be made to the competent authority (CA) in each state (no Federal CA) and an approval in one state is not applicable in another, so multiple submissions need be made.
With the CDNA recommendation (double-bag and handle as clinical waste (CW), the medical waste firm SteriHealth saw the compliancy issue early (same occurred in USA with CDC and DOT) and retained me to work with CA to develop a triple-packaging system of equivalent safety to ADG. The Biohazard Waste Industry is also working with CA to obtain packaging approvals.
I worked with WorkCover NSW for several weeks and, after developing a leakproof sealing system for CW bags, and consultation with Westmead Hospitals IPs (Kath Dempsey, Jo Tallon), we have developed a triple-packaging system we believe is of equal safety to ADG P620. Multi-sized systems will need be approved but in this instance I submitted a system with a high chance of approval so that at least one system was available.
WorkCover NSW hope to release their decision tomorrow [31 October Moderator]. Hopefully an approval in NSW will make submissions easier and faster in other states.
Yesterday [29 October Moderator] I spoke with Prof Lyn Gilbert, Head of Ebola Task Force and Prof Chris Baggoley, Chief Medical Officer, Australian Dept of Health and they have scheduled the item for discussion this week to examine means of expediting the submission process Australia-wide.
Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist, Grimmond and Associates
terry@terrygrimmond.com1. Ebola Virus Disease (EVD). CDNA NATIONAL GUIDELINES FOR PUBLIC HEALTH UNITS 3 Oct 2014. Communicable Disease Network Authority, Australian Department of health. http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-ebola.htm/$File/EVD-SoNG.pdf.
2. The Australian Dangerous goods Code Ed 7.3(2014). http://www.ntc.gov.au/heavy-vehicles/safety/australian-dangerous-goods-code/.
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Hi All
This has been a very worrying issue especially considering that what we are most concerned about is blood and body fluids with EBV.We have taken care of the entry side of it but the waste management bit I am not so sure may be wrong.
Is the waste not hazardous if it is not properly treated as in autoclaved, incinerated or treated in any other way to render it nonhazardous? Does our clinical waste guidelines cover this as it would be concerning if this waste is not properly disposed of and ends up being a problem with community spread, just saying. Still trying to figure out which waste it fits under really particularly where the quality of some of the clinical waste bags is not very ideal, as in paper thin, with incidents of body fluid exposure due to tears especially when the bags are very heavy.
Just a thought I have tried to look under the EPA guidelines nothing much coming up on infectious waste would be good to know what the majority are doing.- http://www.cdc.gov/vhf/ebola/hcp/medical-waste-management.html
Kind 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[Description: cid:image002.jpg@01CE8EA5.483A6E60]
LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVESFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Terry Grimmond
Sent: Friday, 31 October 2014 11:51 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Ebloa WasteHi Sony,
I agree with you. But for countries who have harmonized with UNTDG Model Recommendations, Ebola is Category A UN2814. It is not Clinical Waste UN3291. The national law steps in and CDC and DoH recommendations are over-ruled. As happened in USA last month where DOT over-ruled CDC on this issue.
Best regards, Terry
Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist
Grimmond and Associates
Ph (NZ): +64 7 855 3212
Mob (NZ): +64 274 365 140
E: terry@terrygrimmond.com
[Twitter_logo_blue]: @terrygrimmond
W: http://terrygrimmond.com
[cid:image003.gif@01CFF50D.6D9958E0]
“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.”From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Sony SO
Sent: Friday, October 31, 2014 12:58 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Ebloa WasteDear All,
The issue of using single clinical bag for handling infectious materials i.e. clinical waste is addressed in the CDC guidelines-Guidelines for Environmental Infection Control in Health-Care Facilities http://www.cdc.gov/~HCF_03.pdf, details are as follows:
point I, (3), page 119, which states: A single, leak-resistant biohazard bag is usually adequate for containment of regulated medical wastes, provided the bag is sturdy and the waste can be discarded without contaminating the bags exterior.
Point G, (3), page 100, which states: Single bags of sufficient tensile strength are adequate for containing laundry, but leak-resistant containment is needed if the laundry is wet and capable of soaking through a cloth bag.1264
Furthermore, with reference to international guidelines related to clinical waste management(Table 1), practices of double bagging of waste is not recommended.
Lastly, practices of double-bagging of items from isolation rooms is not considered as an infection control measure, for details, please refer to:
Maki DG, Alvarado C, Hassemer C. Double-Bagging of Items from Isolation Rooms Is Unnecessary as an Infection Control Measure: A Comparative Study of Surface Contamination with Single-and Double-Bagging. Infection Control. 1986; 7(11): 535-7. Available from: http://www.jstor.org/stable/30146425
Regards,
Sony SO
Nursing Officer, Infection Control Branch (Team 2)
Centre for Health Protection
office phone: +852 2125-2922; fax: +852 3523-0752
HA email sony@ha.org.hk; DH email no_icb4@dh.gov.hk
Please consider the environment before printing this e-mailTable 1: international guidelines for handling clinical waste
1. Biohazard Waste Industry Australia and New Zealand (BWI) (formerly ANZCWMIG). (2007). Industry Code of Practice for the Management of Clinical and Related Wastes. Retrieved 11 August 2010 from http://www.epa.sa.gov.au/xstd_files/Waste/Code%20of%20practice/Code%20of%20Practice%206th%20Edition.pdf
2. UK Department of Health. Environment and sustainability Health Technical Memorandum 07-01: Safe management of healthcare waste Retrieved August 2014 from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/167976/HTM_07-01_Final.pdf
3. Uk Health & Safety Executive. (2009). Carriage of Dangerous Goods Manual-Carriage of clinical waste Retrieved 11 August 2010 from http://www.hse.gov.uk/cdg/manual/clinical/index.htm
4. World Health Organization WHO. (2008). Safe Management of Wastes from Health-Care Activities. Retrieved August 2014 from http://apps.who.int/iris/bitstream/10665/85349/1/9789241548564_eng.pdf
5. (2003)201410http://www.moh.gov.cn/mohyzs/s3576/200804/18353.shtml
6. (1997)(97) 201410http://wm.epa.gov.tw/medicalwaste/Documents/HandBook39all3.pdfFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
Sent: Friday, October 31, 2014 5:20 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Ebloa Waste[This message is posted on behjalf of Belinda Henderson, ACIPC President. Note that this issue has been discussed through the ACIPC Executive Council at National and State/juristictional level. ICPs are urged to check with their state/juristiction authorities and local waste contractors regarding any local impact of this issue Moderator]
We want to update our members on the issue of Ebola Waste transport in Australia. One of our members, Terry Grimmond, has been working with authorities to develop a practical, safe and legal packaging solution so we asked him to summarise where Australia is at.Thank you Belinda,
Many ACIPC members will have seen the Oct 3 CDNA/AHPPC recommendations for double-bagging Ebola waste and transporting it as clinical waste1 (i.e. shipping as UN 3291). These recommendations are sound and evidence-based.
However, what many may not know is that the Australian Dangerous Good Code (ADG)2 requires substances known or reasonably expected to contain a Category A Infectious Substancein any form (e.g. Ebola waste) to be packaged according to ADG P620 requirements, which require:a 95k Pa pressure-tested, leakproof primary receptacle that is sealed and placed inside a:
leakproof secondary receptacle containing absorbent material, sealed and placed inside:
a rigid outer container certified to ADG 9m drop, Rod Impact, and Water-spray tests.
The issue is, P620 packaging is designed for specimens, cultures, etc and no P620 packaging exists for large Category A items such as waste bags, mattresses, etc.
If waste companies pick up Ebola waste in anything other than P620 packaging, they would be breaking the law. Alternative packaging systems must be approved as safe as ADG P620.
Submissions need be made to the competent authority (CA) in each state (no Federal CA) and an approval in one state is not applicable in another, so multiple submissions need be made.
With the CDNA recommendation (double-bag and handle as clinical waste (CW), the medical waste firm SteriHealth saw the compliancy issue early (same occurred in USA with CDC and DOT) and retained me to work with CA to develop a triple-packaging system of equivalent safety to ADG. The Biohazard Waste Industry is also working with CA to obtain packaging approvals.
I worked with WorkCover NSW for several weeks and, after developing a leakproof sealing system for CW bags, and consultation with Westmead Hospitals IPs (Kath Dempsey, Jo Tallon), we have developed a triple-packaging system we believe is of equal safety to ADG P620. Multi-sized systems will need be approved but in this instance I submitted a system with a high chance of approval so that at least one system was available.
WorkCover NSW hope to release their decision tomorrow [31 October Moderator]. Hopefully an approval in NSW will make submissions easier and faster in other states.
Yesterday [29 October Moderator] I spoke with Prof Lyn Gilbert, Head of Ebola Task Force and Prof Chris Baggoley, Chief Medical Officer, Australian Dept of Health and they have scheduled the item for discussion this week to examine means of expediting the submission process Australia-wide.
Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist, Grimmond and Associates
terry@terrygrimmond.com1. Ebola Virus Disease (EVD). CDNA NATIONAL GUIDELINES FOR PUBLIC HEALTH UNITS 3 Oct 2014. Communicable Disease Network Authority, Australian Department of health. http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-ebola.htm/$File/EVD-SoNG.pdf.
2. The Australian Dangerous goods Code Ed 7.3(2014). http://www.ntc.gov.au/heavy-vehicles/safety/australian-dangerous-goods-code/.
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Hi Sony
It is quite interesting this topic has come up when one of the most useful tools to make my life easier is the use of my handy iPad.
Here is a solution I came up with today. If you simply place your ipad in a disposable plastic sleeve or if you want to be even more inventive place it in a clear document wallet without its other protective difficult to clean covers, it provides an easy solution to simply dispose of the sleeve or wipe down the document wallet which will not impact on your iPad and yet still allow you easy use and access to technologically support equipment to make life easier for the already over worked ICP.
I had to squint a little with the red cover but I guess with a clear document sleeve will do the job and cost nothing but a few cents.
Hope this helps.
Kind 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[Description: cid:image002.jpg@01CE8EA5.483A6E60]
LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVESFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Sony SO
Sent: Wednesday, 16 July 2014 2:09 PM
To: AICALIST@AICALIST.ORG.AU
Subject: decontaminated iPads -used in clinical areasDear All,
With reference to Apple website related to cleaning Apple products http://support.apple.com/kb/HT3226#ipads, proposed cleaning methods are as follows
To clean iPad, unplug all cables and turn off iPad (press and hold the Sleep/Wake button, and then slide the onscreen slider). Use a soft, slightly damp, lint-free cloth. Avoid getting moisture in openings. Don’t use window cleaners, household cleaners, aerosol sprays, solvents, ammonia, abrasives, or cleaners containing hydrogen peroxide to clean iPad. iPad has an oleophobic coating on the screen; simply wipe iPad’s screen with a soft, lint-free cloth to remove oil left by your hands. The ability of this coating to repel oil will diminish over time with normal usage, and rubbing the screen with an abrasive material will further diminish its effect and may scratch your screen.
The above mentioned cleaning procedures implicate that use of any disinfectant is NOT allowed. And in infection prevention and control perspective, we consider using soft, slightly damp, lint-free cloth is not a decontamination method. If contaminated iPad is not disinfected, transmission risk will be increased. If disinfectant is used i.e. not following manufacturers written instructions, we may lose manufacturers warranty.
Any advice would help me out of my predicament.
Yours sincerely,
Sony SO
Nursing Officer, Infection Control Branch (Team 2)
Centre for Health Protection HONG KONG SAR, CHINA
http://www.chp.gov.hk/tc/cindex.html
office phone: +852 2125-2922; fax: +852 3523-0752
HA email sony@ha.org.hk; DH email no_icb4@dh.gov.hk
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Hi Kathy
I have reviewed this mattress and have provided you with a risk assessment made with this bed,WHS and patient safety features fantastic , from the IC perspective…..need careful review prior to consideration.
Kind 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[Description: cid:image002.jpg@01CE8EA5.483A6E60]
LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVESHi All,
I’m interested if anyone has any experience or any information with the Hill Rom – HR 900 SSR electronic bed. Obviously am particularly interested in any identified Infection Issues. I would also welcome any other feedback on any other electronic bed .
Thank you in advance for any feedback.
Cheers
KathyKathy Dempsey
Clinical Nurse Consultant / CoManager
Infection Prevention & Control
PO Box 533, Wentworthville NSW 2145
Tel (02) 9845 7501 | Fax (02) 9845 9148 | Mob 0423 000 169 | kathy.dempsey@health.nsw.gov.au
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Hi All
I too have been following the trail and find it quite interesting the thoughts going around. It is not in its entirety based on how disposable curtains reduce or contain the spread of infection but also what other infection control preventative measures are put into place. From personal experience cloth curtains on their own have their own issues in regards to how they could possibly even though not proven but with a little bit of common sense the fact that when contaminated HCW’s hands are in contact with these and then start contaminating the patients environment yada yada yada.
Interestingly, just as much as we still get very little literature isolating the role of the environment vs. the contribution of the human element in cross contamination(Cdiff,VRE, norovirus survival and contamination rates) can we then justify because there is no scientific based evidence that there is no cross contamination? What I find a treasure with the disposable curtains is the following:
1. Reduction in energy costs due to ongoing laundering requirements(thinking green)
2. Reduction in water usage and waste generated from such procedures(thinking green)
3. Overtime there may be some cost savings based on the need to undertake such cost cutting measures(that all depend too on how often these(cloth) curtains are washed)
4. Less WHS issues in regards to injuries to our domestic staff.
5. Time saving so that cleaners/domestic staff can actually concentrate on more important things such as ….cleaning the environment.
6. Changing of curtains may be obvious however, the quality of cleaning especially when done under great pressure cannot be measured accept as we know it when we start having outbreaks which on most occasions are difficult to isolate how they originate.
However, like anything it is not the product that makes the difference but in essence the human element/ component that is vital to succeeding in reducing cross contamination such as good hand hygiene compliance and of course good environmental cleaning practices in combination with everything else. Nothing is ever successful working in isolation and no method is ever superior to the other if it is used in isolation.
Just saying with respect of course to other professionals views to issues with the environment. This is called the call of desperacy to either resort fully to our old time basics or otherwise utilise whatever technology we can find to assist our cause as it may not be a winning race for us in the technology advancement department. The battle with multi resistant organisms is never ending and so far I haven’t heard that we are winning with what we already have in place, might be wrong.
Kind 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[Description: cid:image002.jpg@01CE8EA5.483A6E60]
LET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVESHi All,
Have a small issue – Disposable curtains/screens!
Would appreciate feedback from areas that are using the disposable curtain/screens in their facilities
The issue is around cost of linen vs disposable curtains/screens.
We have trialed & like what we have but those who watch the pennies are questioning their use.
Originally we brought them into our ED because the poor terminal cleaning staff were frantic with attending the cleaning ( which involves the replacement of curtains).
The NUM of ED was indicating at this particular incident -that there were three ambulances waiting to off load patients onto ED beds which were being held up by the terminal cleaning required.Amongst other actions taken regarding this issue in ED-was the implementation of the disposable curtains.
Now the question being asked is who else in other health areas has disposable curtains/screens & where are they ( ie high risk areas).
Much appreciate any assistance with this.
Thank you
Vicki Denyer
Clinical Nurse Consultant | Infection Prevention & Control Unit
Lismore Base Hospital
Tel 02 6620 2385 | vicki.denyer@ncahs.health.nsw.gov.au________________________________
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Thank you all for all the useful comments and information much appreciated.
Kind Regards
Verily Thomas
Clinical Nurse Consultant | Infection Prevention and Control
SWSLHD-Bankstown/Lidcombe HospitalEldridge Road, Bansktown.NSW 2200
Tel 02 97228000 pager 28230Tel 02 9722 8633 | Fax 02 9722 7822 | verily.thomas@sswahs.nsw.gov.au
http://www.health.nsw.gov.auLET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVES
From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Sue Atkins
Sent: Monday, 18 November 2013 3:04 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: How to appropriately dispose of used IV lines/drainage bags/systemsVerily,
In NSW the “mandatory” document for public health services is:
Document Number PD2005_132
Publication date 25-Jan-2005 (due for update in 2016)Sharps:
“Sharps: Any object capable of inflicting a penetrating injury, which may or may not be
contaminated with blood and or body substances. This includes needles and any other
sharp objects or instruments designed to perform penetrating procedures”
Pharmaceutical waste:
Consists of pharmaceuticals or other chemical substances specified as regulated goods in
the Poisons and Therapeutic Goods Act 1966. This includes any substance that is
specified in a Schedule of the Poisons List under that Act, as well as any therapeutic good
which is unscheduled. Pharmaceutical waste includes expired or discarded pharmaceuticals
and filters or other materials contaminated by pharmaceutical products.
Clinical waste:
Bulk body fluids and blood;
Visibly blood stained body fluids and visibly blood stained disposable material
and equipment;Consider the following when determining policy for your organisation over and above the requirements in the above document:
*If the spike remains encased in the bag is it an object capable of inflicting a penetrating injury?
*If you cut the spike off, is this an occupational/ consumer safety risk – during the action of cutting/ removing the spike/spigot, and/or if not correctly disposed of as a sharp?
*If blood or bulk body fluids (peritoneal dialysis bags) is present, should manipulation occur, or should you leave the spike/spigot intact and discard directly as clinical waste or if additives present then pharmaceutical waste?
*In relation to other IV products requiring a giving set to administer: In some states/territories hydration fluids (such as saline/dextrose) and nutritional fluids/TPN (both without additives) are not clinical or pharmaceutical waste and may be discarded as general waste.Regards
SueSue Atkins
Regional Infection Control Consultant | CICP | Service & Workforce Development | Grampians Region
Department of Health | 35 Armstrong Street South, Ballarat, Victoria, 3350
p. 03 5333 6023 | f. 03 5333 6093 | m. 0438 227 989
e. sue.e.atkins@health.vic.gov.au | http://www.grhc.org.auFrom:
Terry Grimmond
To:
Date:
18/11/2013 12:51 PM
Subject:
Re: How to appropriately dispose of used IV lines/drainage bags/systems
Sent by:
ACIPC Infexion Connexion
________________________________
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.”From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU ] On Behalf Of Michael Wishart
Sent: Monday, November 18, 2013 1:40 PM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: How to appropriately dispose of used IV lines/drainage bags/systemsHi 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
MichaelMichael 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
Please consider the environment before printing this emailFrom: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU ] On Behalf Of Verily Thomas
Sent: Friday, 15 November 2013 2:09 PM
To: AICALIST@AICALIST.ORG.AU
Subject: How to appropriately dispose of used IV lines/drainage bags/systemsDear 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.auLET’S KEEP OUR HOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVES_____________________________________________________________________
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Hi Sony
I agree with Jo we do the same here at Bankstown we try to cohort like strains of MRSA and VRE as much as we possibly can especially as we have only recently started isolating patients with Van A here at Bankstown.
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 97227822 | verily.thomas@sswahs.nsw.gov.au
http://www.health.nsw.gov.auLET’S KEEP OURHOSPITAL ENVIRONMENT CLEAN
HAND HYGIENE SAVES LIVES—–Original Message—–
Hi Sony,
Currently at Westmead Hospital we do have both Van A and Van B VRE patients and we do isolate them separately upon the advice of our ID specialists.
Cheers,
Jo
Jo Tallon
CNC/Co Manager Infection Prevention & Control Unit
Pager 09868
Phone 98459192
Mobile 0423 000 169
Fax 98459148
jo.tallon@swahs.health.nsw.gov.au
________________________________________
Hello Sony, Even if that were the case, (and none of my ID specialists have said we should), we do not have the resources to separate the two types of patients.
RitaCNC Infection Control | Hornsby & Ku-ring-gai Health Service Palmerston Road, Tel 02 9477 9232 | Pager 52533| rroy@nsccahs.health.nsw.gov.au http://www.health.nsw.gov.au
>>> Sony SO 17/08/2013 11:50 am >>>
Dear all,I would like to know whether patients with VRE VAN A need to be seperated isolation with VRE VAN B case
Regards,
SONY SO
Nursing Officer Infection Control Team
KWONG WAH HOSPITAL
HONG KONG SAR CHINA
tel. 852-3517-2409***************************************************************************
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