[Wishart, Michael]

Hi Janet

My question would be what kind of ‘effect’ are you examining. Psychological impact? Environmental contamination? Transmission?

Thanks
Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

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Morning all,

I have been asked to pose the following question to the list by Kaye Rolls, the Knowledge Management CNC Intensive Care Co-ordination and Monitoring Unit. NSW
What are the most relevant variables to consider when interpreting studies on the effect of isolation of MRO patients?

Your answers can be sent to the list and I can forward them to Kaye or alternatively email her directly on Kaye.Rolls@swahs.health.nsw.gov.au

thank you

Janet Masters
Project Officer
Intensive Care Best Practice Project
ICCMU

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[Wishart, Michael]

Thanks John

For those who may have difficulty navigating the Commissions website, the direct link to this document is:

http://www.safetyandquality.gov.au/internet/safety/publishing.nsf/Content/prog-HAI_Surveillance#report

[ Just in case the link breaks in the email, here is a shortened link:
http://tinyurl.com/6fapuwj ]

Cheers
Michael
Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private Hospital
Newdegate Street, Greenslopes QLD 4120
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Dear Carien

The 2008 Surveillance review (available via the Commission for SQ website ) has an extensive chapter on costing of HAI written by Nick Graves. That would be a good starting point and provides estimates of cost.

kind regards
john

John Ferguson
Infectious Diseases Physician and Microbiologist,
Hunter New England Health, John Hunter Hospital, Newcastle
Conjoint Associate Professor, University of Newcastle
Tel 61 2 49214444, Fax 61 2 49214440, Mobile 0428 885573

________________________________________
Hi,

Does anyone know of a generic formula or assessment tool to calculate the cost of HAIs?

Kind regards,
Carien Coleman

Carien Coleman|Infection Control CNC
The Sunshine Coast Private Hospital
Syd Lingard Drive| BUDERIM QLD 4556
PO Box 5050 | Maroochydore BC QLD 4558
T: (07) 54303245 | F: (07) 5430 3436
E: carien.coleman@uchealth.com.au

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[Wishart, Michael]

Oops, broke the link in the email, maybe…

A short one to try: http://tinyurl.com/3nxgg25

Cheers
Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

Infection Prevention is Everybody’s Business

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—–Original Message—–
Behalf Of Wishart, Michael
education in infection prevention

APIC have launched a new public education campaign to help educate on
the dangers of healthcare associated infections, and how to prevent
them.

http://www.apic.org/Content/NavigationMenu/PracticeGuidance/Topics/Patie
ntSafetyAwarenessWeek/Patient_Safety_Aware.htm

It will be interesting to see if anything like this is proposed within
Australia for patient education about healthcare infection prevention
with Australian healthcare facilities. Will Australian healthcare
facilities be happy to encourage patients to question their care
provision?

Cheers
Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
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[Wishart, Michael]

Hi Ruth

We looked at some similar devices here, and I was concerned that these devices use a ‘sheath’, which means the device part covered by the sheath (that enters mucous membrane area) would need high level disinfection between uses. Never really resolved this, as manufacturer stated it was not a sheath, so we were all set to do some clinical testing of contamination of the device under the hard plastic cover in use, when the doctors decided to buy a difference scope that was fully sterilisable, so we dropped the whole thing.

I had mixed opinions from colleagues about this when I posted to this list in March last year, so will be interested in further comments here. You can see that thread if you search ‘sheath’ in the website archives.

Cheers
Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

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Hi all,
I would appreciate input for this query from my cross-Tasman colleagues.

I am currently working in an acute care tertiary hospital and the emergency department has recently purchased a new videolaryngoscope – The Glidescope. It has a digital camera incorporated in the blade which displays a view of the vocal cords on a monitor. This instrument has been on the market for a number of years originating from Canada. I am told that some Australian facilities uses it too.

The model we have purchased uses a single use blade that fits snugly (clicks into place) and is totally enclosed. – that is there is no opening in the plastic blade at the end.

My question is for any one that is familiar with this piece of equipment. Are you satisfied that the single use blades negate the need to high-level disinfect the video baton that inserts into these blades. The product rep suggests that routine high-level disinfection of the baton is not required between cases and that the baton need only be wiped down with detergent and a 70% alcohol wipe if necessary. The baton is capable of being high-level disinfected if it is visibly contaminated but this is not usually undertaken routinely.

Apparently it is routine practice worldwide to accept the single use blades as an adequate precaution to prevent cross infection between patients.

Any opinions or advice would be appreciated.

Regards

Ruth

Ruth Barratt
Clinical Nurse Specialist – Infection Prevention and Control
Christchurch Hospital
New Zealand

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[Wishart, Michael]

Not sure what happened with my previous reply, sorry, My phone didnt seem to post very well!! Try again

Hi Joanna

We have also asked this question, in regard to washing leads in sleep studies room hand basins. We could not find any specific guidance, but were told that it is considered “best practice” for the rationale of contaminating hand basin drains with pathogens.

I would also like to hear from anyone who has thoughts on this, or even better, has some studies to support or refute this concept.

Thanks
Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

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From: AICA Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Joanna Harris
Sent: Friday, 21 January 2011 9:15 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: [AICA_Infexion_Connexion] Guidelines for Clinical Hand basins and Laundering of Patient clothing in hospitals

Hi Fiona,
Thanks for that. Beth is away today so I thought Id clarify our enquiry on the clinical hand wash basins:

Were specifically enquiring as to whether anyone is aware of Australian guidance stipulating that clinical hand wash basins are used for hand hygiene and hand hygiene alone ie cannot be used for the disposal of any other liquid waste (such as denture pot contents, wash bowl contents etc) or the cleaning of items such as dentures, medicine pots, enteral feeding equipment etc. We have been unable to find such a statement in our NSW, Commonwealth or AHFG reading.

The reason for asking about the washing machines is that the arguments about discriminating against patients who have no family / friends / other way to get their personal items laundered, particularly for our haem / onc fairly long term people who live a distance away, do have credence and our volunteers are particularly concerned. We want to be sure that any laundry facilities we do have comply with AS/NZS 4146 as stipulated in the IC policy and so are developing an audit tool and business rules etc.

I hope this clarifies the enquiry.
Jo

Nurse Manager, Infection Management and Control Service (IMACS)

Level 1, Lawson House
The Wollongong Hospital
LMB 8808
SCMC NSW 2521

Ph: 02 4222 5892 or 4222 5898
Fax: 02 4222 5367

From: AICA Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Fiona de Sousa
Sent: Friday, 21 January 2011 9:15 AM
To: AICALIST@AICALIST.ORG.AU
Subject: Re: Guidelines for Clinical Hand basins and Laundering of Patient clothing in hospitals

Hi Beth,

Refer to the Australasian Health Facility Guidelines, Part D- Infection Prevention and Control http://www.healthfacilityguidelines.com.au/

This document provides information on the four different types of basins required in a hospital and their specific uses. Also the AHFG provide room layout standard components sheets which also tell you what type of hand basin is required including its purpose.

Although you may not be undertaking any renovations / building works the infection prevention and control section is still sound advice and is mandatory for NSW (it is listed in the front of the NSW Health PD2007_036).

I cant help you on the laundering of patient clothing as we specifically removed all patient washing machines and clothes dryers a number of years ago.

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

________________________________________
From: AICA Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Beth Bint
Sent: Thursday, 20 January 2011 3:08 PM
To: AICALIST@AICALIST.ORG.AU
Subject: [AICA_Infexion_Connexion] Guidelines for Clinical Hand basins and Laundering of Patient clothing in hospitals

Hi All

Clinical Hand Basins
Does any one know of any Australian guidelines/standards/policies that state: clinical hand basins are only to be used for hand hygiene purposes?

Laundering of Patient Clothing Guidelines
Does anyone have a local policy/procedure/guideline for the laundering of patient clothing within a healthcare facility that you would like to share?

Thank you
Beth

Beth Bint | Clinical Nurse Consultant Infection Prevention and Control,
Infection Management and Control Service (IMACS)
The Wollongong Hospital|| ph +61 2 4222 5869 page 182 via switch+61 2 4222 5000| beth.bint@sesiahs.health.nsw.gov.au

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[Wishart, Michael]

Hi Wendy

Comments from our CSD NUM

“The company that supplies our wraps provided transport trays free of
charge (if you buy their product) for moving the trays between CSD and
theatre. This has reduced the instances of holes and splits
significantly. We also had to decant some company orthopaedic trays as
the feet and bottom corners caused splitting.

It was suggested (rep) that some hospitals use sponge on the corners of
orthopaedic containers, but I did not like that idea.”

Cheers
Michael

Michael Wishart | GPH – Infection Control Coordinator
Infection Prevention is everyone’s business!

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

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—–Original Message—–
Behalf Of Beckingham, Wendy

Currently at the Canberra Hospital we are experiencing problems related
to the surgical wrap developing small holes and splits.

I am wondering has anyone else had issues around this in their CSD or
Operating Rooms. If any one has had this issue I am wondering f you
would share your solution to resolve this.

Would love to hear from you on this matter

Wendy Beckingham
CNC Infection Control
The Canberra Hospital
pager 50390 or phone 43695

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[Wishart, Michael]

Hi Wendy

In many ways I agree with Prue here, although I am not sure her medical
ward would be considered sub-acute, as by definition they would have an
acute illness (unless it was a convalescent medical ward or something).
In my view, it all depends on where your sub-acute area is, and how it
is staffed. We often have this discussion with rural and remote
facilities that have attached residential care areas to their acute
treatment facilities. What we normally advise is that if staff are
shared commonly between areas, and patients at risk of actual infection
(versus colonisation) may be managed by the same staff as handling
patients in a sub-acute care during the same shift, then we would be
concerned about potential for cross transmission.

We treat our rehab unit in this way, as even though it is in a separate
building it shares staff with acute wards, so they use the same
precautions for MRO’s as the acute wards do.

If a sub-acute or non-acute setting is stand alone and no staff sharing
to acute occurs for the same shift, it is all about actual risk of
infection for that patient group, and can often be managed without
routine contact precautions for colonised patients.

Cheers
Michael

Michael Wishart | GPH – Infection Control Coordinator
Infection Prevention is everyone’s business!

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

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—–Original Message—–
Behalf Of Prue Wright
acute in caring for MRO’s

Dear Wendy,

We have only recently closed our medical ward, which I assume you would
have defined as “sub-acute”. We have an acute surgical ward and post
natal also. As post caesarian section patients are nursed on post
natal, they need to be classified as surgical.

When the medical ward was still open; patients with confirmed MROs were
treated with full precautions; just as they are in the surgical ward. We
could not risk HAIs in any of our patients, and are very aware of our
higher risk surgical areas.

So – in a nutshell – our policy for MRO management is across the board.

Hope this is some help

Regards

Prue Wright

Infection Control Coordinator
Hurstville Private

—–Original Message—–
Behalf Of Beckingham, Wendy

Dear Colleagues

I am wondering does anyone have a policy in the way you care for
patients with MRO’s in a acute versus subacute unit.

In saying this a definition to cover sub acute has also been difficult
to come by and am wondering if anyone can help this as well.

Wendy Beckingham
CNC Infection Control
The Canberra Hospital
pager 50390 or phone 43695

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[Wishart, Michael]

Sorry, link was possibly broken in my email.

Or even the journal article abstract: http://tinyurl.com/2f5beaa

Michael Wishart | GPH – Infection Control Coordinator
Infection Prevention is everyone’s business!

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
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—–Original Message—–
Behalf Of Wishart, Michael
‘non-invasive ventilation’

Article from Hong Kong suggests healthcare associated airborne
transmission of influenza from a patient undergoing ‘non-invasive
ventilation’. This reaffirms the current requirements for respiratory
precautions for patients undergoing aerosol-generating procedures where
influenza is known or suspected.

Cheers
Michael

From:
http://www.infectioncontroltoday.com/news/2010/11/hong-kong-hospital-rep
orts-possible-airborne-influenza-transmission.aspx
Direct contact and droplets are the primary ways influenza spreads.
Under certain conditions, however, aerosol transmission is possible. In
a study published in the current issue of Clinical Infectious Diseases,
available online, the authors examined such an outbreak in their own
hospital in Hong Kong.
On April 4, 2008, seven inpatients in the hospital’s general medical
ward developed fever and respiratory symptoms. Ultimately, nine
inpatients exhibited influenza-like symptoms and tested positive for
influenza A. The cause of the outbreak was believed to be an influenza
patient who was admitted on March 27. He received a form of non-invasive
ventilation on March 31, and was then moved to the intensive care unit
after 16 hours. During that time, he was located right beside the
outflow jet of an air purifier, which created an unopposed air current
across the ward.
“We showed that infectious aerosols generated by a respiratory device
applied to an influenza patient might have been blown across the
hospital ward by an imbalanced indoor airflow, causing a major
nosocomial outbreak,” says study author Nelson Lee, MD, of the Chinese
University of Hong Kong. “The spatial distribution of affected patients
was highly consistent with an aerosol mode of transmission, as opposed
to that expected from droplet transmission.
“Suitable personal protective equipment, including the use of N95
respirators, will need to be considered when aerosol-generating
procedures are performed on influenza patients,” Lee adds. “Avoiding
such procedures in open wards and improving ventilation design in
healthcare facilities may also help to reduce the risk of nosocomial
transmission of influenza.”

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate Street, Greenslopes QLD 4120
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[Wishart, Michael]

Hi all

Further to this expression of interest for an ICP in Singapore, the email address for Dale Fisher is dale_andrew_fisher@nuhs.edu.sg

Cheers
Michael Wishart
AICA Infexion Connexion Administrator

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
e: WishartM@ramsayhealth.com.au | w: http://www.ramsayhealth.com.au

________________________________________

Senior Infection Control Nurse Required at National University Hospital, Singapore

An interesting position has just been created in Singapore. Many of you will be aware of our MRSA programme including universal active surveillance. Furthermore we have endemic highly resistant Gram negatives as well as frequent issues arising in the management TB, chicken pox, VRE, C difficile etc

We are seeking expressions of interest from those suitably qualified and experienced to join our team. While “hands on” work would be important the main role will be to mentor and supervise a number of our team who are quite junior.

We remain somewhat flexible but at this stage are considering a 2 year post. It goes without saying that this person should have good people skills and be adaptable to the changes one would experience and observe working in a 1000 bed Asian hospital.

If you wish to be considered please email me your cv and a cover letter.

Many thanks

Dale Fisher;
Senior Consultant and Head of infectious diseases
Chair of infection control

Posted to AICALIST by –

Dr John Ferguson
Hunter New England Health
Newcastle, NSW

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[Wishart, Michael]

Hi Kathy

We currently treat these the same as ESBL’s, that is, single room and contact precautions, clearance based on 3 negative rectal swabs after all wounds healed/devices removed and off antibiotics. We do alert them and re-screen and use contact precautions on re-admission, pending clearance.

We are seeing higher numbers of multi-resistant gram negatives than MRSA’s now, both for healthcare associated and from the community..

Cheers
Michael

Michael Wishart | GPH – Infection Control Coordinator

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________________________________________

Hi to all,
We are seeing more of these resistant isolates and are interested in hearing if others are seeing a similar trend. Is anyone willing to share their current practices,policyor thoughtsforpatients identified with aMetallo beta lactamase,plasmid mediated Amp C beta lactamase or Meropenem resistant Pseudomonas aeruginosa colonisation or infection? Do you initiate contact precautions? What clearance criteria do you use?

Regards
Kathy

Kathy Taylor
Infection Control Manager
The Wesley Hospital
PO Box 499,
Toowong, Qld 4066
07 3232 7558
katherine.taylor@uchealth.com.au

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[Wishart, Michael]

I just re-read Cath’s original question, and find I need to emphasize
that my understanding is that waterless scrubbing should only be used on
CLEAN hands. Thus, the first scrub of the day should be with ‘soap and
water’ (whether the first scrub requires an antimicrobial seems to be
debatable if waterless scrubbing is used prior to the first case). The
obvious rationale for this is to remove any debris from the hands prior
to the use of the waterless scrub.

I have seen some EU guidelines for use of waterless scrubbing in OT but
can’t seem to find them currently. Can anyone direct Cath to some
guidelines for waterless scrubbing?

Thanks
Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate St, Greenslopes QLD 4120
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—–Original Message—–
Behalf Of Cath Murphy

Dear AICA, ACSQHC and ACORN Colleagues

I have been asked about the suitability of using “waterless surgical
scrubs” as an alternative to the first ‘soap and water’ wash of the day
in the operating theatre or surgical procedural unit. Does anybody know
if this is common? Acceptable? Widespread and based on credible evidence
or policy?

Any commentary welcomed. Thanks.

Cath

Assoc. Prof Cathryn Murphy RN PhD CIC
CNC Infection Control
Gold Coast Health Service District
Robina Hospital
Gold Coast

http://www.icp.au.com

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[Wishart, Michael]

Hi Cath

There is no fee for completion of the QH online competency, but there is
a fee for the GENCA Fundamentals course, and there are several other
providers that have what are considered equivalent fee-paying courses.

Not sure how GENCA evaluated the content of the QH online or fee-paying
courses, but I will ask someone from GENCA to comment on your question
and see what response I get.

The fundamental issue is that there are key components of knowledge that
can be assessed in regards to endoscope reprocessing, and that is what
this Position Statement targets. There have been many critical incidents
involving endoscope reprocessing that could have been avoided if
endoscope reprocessing staff had had a more comprehensive understanding
of risks and risk abatement with reprocessing endoscopes.

I personally am not sure exactly how we could apply this to our current
infection control practice setting, given that I do not believe we have
yet clearly defined which infection control practices are those which
must be performed with specific methods (which is what the GENCA
statement addresses). We may have practices that apply to some clinical
procedures (eg central line bundles, surgical bundles) but they are not
actually infection control practitioner practices, if you understand my
distinction here. Maybe we could recommend minimal levels of knowledge
that ICP’s could possess in AICA position statements, although I am
unclear if this has already been partially addressed in the AICA
Standards.

This may indeed be an area the AICA Credentialing Committee could target
for future research. In my opinion, at least.

Cheers
Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate St, Greenslopes QLD 4120
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—–Original Message—–
Behalf Of Cath Murphy
reprocessing of felxible scopes

This is an interesting development. I am assuming it could mirror AICA’s
possible intentions to make recommendations regarding its AICA.

Is anyone able to advise if there is a fee associated with completing
the training and how GENCA has validated the learning package content?
Was there a largescale comprehensive practice analysis of GENCA’s
members work performed or was the package merely the work of GENCA or
QLD Health experts?

I’m also curious as to how GENCA intends to enforce the Position and if
a member is unable to commit to undertaking the training would GENCA
deny that person membership (which would seem crazy from a strategic and
financial point of view).

The whole issue of certification/ credentialing and on-going education
is an interesting one and in the US has lead to substantial review and
consideration of the most appropriate model that brings positive
improvements for patients.

There are also substantial administrative burdens associated with
promoting such a position.

None of these issues are new to AICA and it is very interesting to see
how continuing competence is measured and moulded in Australia and
beyond and in different specialities.

Thanks for sharing this with AICA members.

Regards

Cath

Cath Murphy RN PhD
Clinical Nurse Consultant
Infection Control
Robina Hospital

—–Original Message—–
Behalf Of Claire Boardman
reprocessing of felxible scopes

No doubt some of you may already have seen this but just in case please
find information relating to the GENCA Position statement.

The Gastroenterological Nurses College of Australia have published a
Position Statement for Education Requirements for Personnel Reprocessing
Flexible Endoscopic Equipment.

The Statement is available at the following link:
http://www.genca.org/images/stories/PDFs/publications/positionstatements
/position_statement_education_requirements.pdf

Claire Boardman
AICA President

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[Wishart, Michael]

[Posted on behalf of Joanna Harris – Moderator]

I’m looking forward to members’ responses to this one.
We had a very brief look at these last year – for our ICU – after the manager lost his cool when half of his very expensive newly purchased curtains got lost in the laundry, and the others came back looking dreadful because the fabric cannot go through our laundry’s ironing machine…………..
These curtains are very widely used in the UK nowadays, and look very smart. They also have the advantage of a place to write the date so you can tell when curtains were last changed (in the UK there are guidelines to tell people how often they should be changed according to the risk category of the setting).
I’m thinking they must be a lot cheaper over there though (a bigger market perhaps) as our senior exec just wouldn’t bear the cost of approx $50-$60 each.

Jo

Joanna Harris
Nurse Manager, Infection Management and Control Service (IMACS)

Level 1, Lawson House
The Wollongong Hospital
LMB 8808
SCMC NSW 2521

Dear All,

Does anyone use disposable antimicrobial patient curtains or disposable shower curtains?

If so, has the product met expectations?

Is there any information available re: cost, recycling, infection control benefits?

Regards,
Angela Conte
Infection Control
Balmain Hospital

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[Wishart, Michael]

Oops. The previous link didn’t parse correctly. Try this short link to
access the draft CDC Guidelines for Norovirus outbreaks.

http://tinyurl.com/25m2urk

Thanks
Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate St, Greenslopes QLD 4120
t: 07 3394 7919 | pager 047 | f: 07 3394 7985
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—–Original Message—–
Behalf Of Wishart, Michael
Guidelines

CDC have released a draft GUIDELINE FOR THE PREVENTION AND CONTROL OF
NOROVIRUS GASTROENTERITIS OUTBREAKS IN HEALTHCARE SETTINGS

It is available at:
http://www.cdc.gov/hicpac/pdf/norovirus/HICPAC_Norovirus_FR_Ver_05_20_10
_clean.pdf

One of the points I find interesting is that they do not recommend a
surgical mask should be routinely worn by all staff caring for suspected
viral gastroenteritis in symptomatic patients, to reduce staff exposure
to potentially infective aerosols. They have the following
recommendation:

3.C.2.a Use a surgical or procedure mask, and eye protection if there is
a risk of splashes to the face during the care of patients, particularly
among those who are vomiting. (Category IB)

In practice, I do not think staff will actually be able to put on a mask
in a timely manner every time the patient commences vomiting and the
staff are in close vicinity. (“oh, just wait a minute whilst I get my
mask on!”)

How many other facilities encourage all staff having direct patient
contact to wear a surgical mask routinely in the care of all symptomatic
patients in a suspected gastroenteritis outbreak?

Thanks
Michael

Michael Wishart | GPH – Infection Control Coordinator

GPH – Quality & Safety Unit (Infection Control) | Greenslopes Private
Hospital
Newdegate Street, Greenslopes QLD 4120
t: 07 3394 7919 | f: 07 3394 7985
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[Wishart, Michael]

[Posted on behalf of John Ferguson – Moderator]

Dear Mary-Rose

At HIS meeting 3 or 4 yrs ago I heard described such a room design
together with a detailed experimental evaluation conducted to prove it
worked. It involved a positive pressure anteroom (with filtered air
going in) and air egress via the ensuite that was entered from within
the room. For a while they had a building design note available. But
this has gone and I’ve made another search without success (might be
worth a pubmed look)

This may help- some discussion of CDC requirements and the design
elements of isolation rooms-

http://books.google.com.au/books?idq_Q_ncugJX4C&pgPA1003&lpgPA1003&dq
%22positive+pressure+anteroom%22+isolation&sourcebl&otsCmEJM6Q1DP&sig
qQzUZQmjW6nQQnynLPsNmQvrjJg&hlen&ei3G8lTIumPNCGcYHXzKYC&saX&oibook_
result&ctresult&resnum1&ved0CAYQ6AEwAA#vonepage&q%22positive%20pres
sure%20anteroom%22%20isolation&ffalse

I will make enquiries to the Univ group that manages the Australasian
facility guidelines

best wishes

John

Reply from Aus Fac Guideline head at UNSW Jane Carthey below to append
to my reply

John, good to hear from you. The official line here in Oz is not to go
with the changeable pressure rooms as they are considered unreliable.
However I have just got back from Europe and have seen examples there
that seemed to work just fine – I think it was in the Netherlands. You
may be able to get further information from Joram Nauta at Dutch TNO
(Dutch Centre for Health Assets and Architecture) who organised our tour
and the conference I attended – very helpful chap!

Dr John Ferguson
Director, Infection Prevention and Control Unit
Microbiologist and Infectious Diseases Physician
Hunter New England Health Service
Locked Bag 1, Newcastle, NSW 2310, Australia
tel 61 2 49214422, fax 61 2 49214440

Go to http://www.hicsiganz.org for ANZ healthcare infection control resources
and networking.

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