Newsletter Vol Issue October

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Newsletter Vol Issue October Powered By Docstoc
					                             HANDS UP FOR HANDS-ON!
                       Infection Prevention & Control Newsletter
            The purpose of bringing this quarterly newsletter to you is to provide you with information and updates on
                  contemporary infection prevention and control issues that may be relevant to your workplace.
                                   We hope you find the information informative and useful.

                                Introducing our new Team Member...
     Volume 1, Issue 2            We have welcomed a new member, Yvonne Fletcher, to our team. Yvonne has been employed as
       October 2009              an Infection Control Nurse and joined the team in May. Yvonne completed her registered nurse
                                 training at the WA Institute of Technology in 1994. After completing her midwifery certificate at
                                 KEMH in 1988 she moved into day surgery where she has remained for the past 21 years combin-
Inside this issue:               ing a clinical and management role including staff development, OH&S, quality, accreditation and
                                 infection control. Yvonne completed the Graduate Certificate in Infection Control in 2007.
Introducing our new      1       Yvonne brings to the team a wealth of experience in the day surgery setting with particular knowl-
Team Member                      edge and skills in the reprocessing of reusable instruments and equipment, and maintenance of
                                 the associated environment. Welcome to the Hands-On Team Yvonne.
PANVAX® Vaccina-         1
tion Campaign
Hepatitis A & B          2      PANVAX® Vaccination Campaign
                                In response to the recent influ-      The principles for targeting     PRIORITY GROUPS FOR
Gastroenteritis Out-     2
break Checklist                 enza A (H1N1) pandemic, a             groups in Australia include:         VACCINATION
                                national vaccination program
                                                                      1. To prevent disease in those   ♦ People with underlying
Cleaning Re-usable       2      has been initiated by the Com-
Equipment                3
                                                                         people vulnerable to more       chronic medical condit-
                                monwealth. The aim of this
                                                                         severe outcomes.                ions which may make
Personal Protective      3
                                program is to provide free vac-
                                                                                                         them more vulnerable to
Equipment                       cine against pandemic (H1N1)          2. To prevent spread of dis-
                                                                                                         complications from H1N1
                                2009 influenza for all members           ease to the vulnerable by
                                of the community who wish to             vaccinating their contacts.
                                be vaccinated. Vaccinations are                                        ♦ Health care and com-
                                                                      3. To protect those people at
                                scheduled to commence on                                                 munity care workers
                                                                         higher risk of exposure
                                Wednesday 30 September 2009.                                             (including volunteers &
                                                                         because of their work i.e.
                                The initial rollout of the               health care workers.            students).
                                Panvax® H1N1 vaccine will                                              ♦ Indigenous people.
                                                                      4. To protect health care ser-
                                focus on ensuring that people in
                                                                         vices and reduce healthcare   ♦ Pregnant women.
                                the specified priority groups are
                                                                         worker absenteeism.
                                offered the vaccine first. This                                        Vaccinations will take place
                                includes people with existing         5. To mitigate potential eco-    either at your workplace, your
                                underlying medical conditions            nomic impact on the Aus-      GP or a community based
                                who have been identified as              tralian pig industry.         Mass Vaccination Clinic
                                being at highest risk from pan-                                        (MVC).
                                                                      6. To provide herd immunity.
                                demic (H1N1) 2009 influenza.
  REMEMBER...                                                                                          To find out more informa-
                                There will be flexibility to vacci-                                    tion about locations and
 TAKE TIME TO                   nate other people, such as fam-                                        opening hours of the MVCs
                                ily members of those at risk, if                                       visit:
  WASH YOUR                     they wish to be vaccinated.
 HANDS WELL!                                                                                 
Page 2                                                                                           HANDS UP FOR HANDS-ON!

  MANY OF US MAY BE AT       Hepatitis A & B Vaccination - Who Needs It?
   RISK OF COMING INTO                                   Hepatitis A vaccination is recommended for:
  CONTACT WITH HEPATITIS     ♦      All travellers to, and all expatriates living in, moderately to highly endemic areas (including
                                    all developing countries;
         A OR B...
                             ♦      Those whose occupation may put them at risk of acquiring hepatitis A - child day-care &
   WHAT ARE YOU DOING               preschool staff, carers of people with intellectual disabilities, healthcare workers who regu-
                                    larly provide care to Aboriginal & Torres Strait Islander children, plumbers or sewage work-
        ABOUT IT?                   ers and sex workers;
                             ♦      Those whose lifestyle may put them at risk of acquiring hepatitis A - men who have sex with
                                    men, and injecting drug users;
                             ♦      People with intellectual disabilities;
                             ♦      People chronically infected with either hepatitis B or C viruses; and
                             ♦      Patients with chronic liver disease.
                                            Hepatitis B vaccination is recommended for :
                             ♦      Residents and staff of facilities for people with intellectual disabilities;
                             ♦      Healthcare workers, ambulance personnel, dentists, embalmers, tattooists and body –
                             ♦      Others at risk include Police, emergency services staff, funeral workers, staff of child day-care
                                    centres and sex industry workers; and
                             ♦      Household contacts of acute and chronic hepatitis B carriers.

    OUTBREAK!                Gastroenteritis Outbreak Checklist
                             Over the past few weeks, there have been a num-        4. Separate affected & unaffected residents.
 HAVE I TICKED               ber of residential care facilities who have experi-
                                                                                    5. Restrict/discourage/minimise visitors.
                             enced a gastroenteritis outbreak. The following
ALL THE BOXES??              is a quick reference checklist to ensure that the      6. Restrict movement of staff, residents &
                             outbreak is being managed correctly:                      visitors within the facility.
                             1. Inform staff, residents & visitors of the out-      7. Exclude staff with gastroenteritis until at
                                break. Provide information about gastroen-             least 48hrs after resolution of symptoms.
                                teritis & put up advisory notices at appropri-
                                                                                    8. Instruct cleaners on increased/specific clean-
                                ate sites around the facility.
                                                                                       ing requirements.
                             2. Emphasise the importance of frequent &
                                                                                    9. Instruct staff on standard precautions for
                                meticulous hand hygiene for staff, residents
                                                                                       linen handling.
                                & visitors. Provide adequate HH supplies
                                (liquid soap, paper towels, alcohol-based           10. Notify the regional Population Health
                                hand rub).                                              Unit.
                             3. Implement contact precautions including
                                isolation/cohorting and PPE.

  Effective & Appropriate
    Cleaning Prevents
                            Cleaning Re-usable Instruments & Equipment
   Cross Contamination
                            Effective reprocessing of reusable instruments and equipment involves cleaning immediately after
                            use to remove organic residue and either disinfection (heat or chemical) or sterilisation. The proce-
                            dures necessary for the cleaning, disinfection and sterilisation of reusable medical instruments and
                            equipment, and for the maintenance of associated environments in health care facilities, are pro-
                            vided in AS/NZS4187 & AS/NZS4815. Instruments and equipment must be reprocessed to a level
                            appropriate for their intended use.
Page 3

Cleaning Re-usable Instruments & Equipment cont.
The minimum levels of processing and storage requirements for reusable instruments and equip-
ment are based on the following three risk categories of use:
1. Critical site (entry into sterile tissue, cavity or bloodstream) - instruments should be sterile at
time of use. Instruments should be single use and either steam sterilised or low-temperature chemi-
cal sterilised.
2. Semi-critical site (contact with non intact skin or intact non sterile mucosa) - instruments
should be single use or sterilised after each use. If this is not possible, high-level disinfection is the
minimum level of reprocessing that is acceptable.
3. Non-critical site (contact with intact skin) - cleaning alone is generally sufficient for all noncriti-
cal items after every individual use, although either intermediate or low-level disinfection may be
appropriate in specific circumstances.
These recommendations apply to all health care facilities including office-based practices.
                                                                                                             Donning & Removal of PPE
Personal Protective Equipment                                                                                    Sequence Order

The use of personal protec-       ♦ Mask                                ♦ Slide ungloved finger under        PPE ‘ON’      PPE ‘OFF’
tive equipment (PPE) pro-                                                 wrist of remaining glove,
                                  ♦ Protective eyewear                    peel off from inside, creat-
tects healthcare workers from                                             ing a bag for both gloves
                                  ♦ Gloves
exposure to blood or body
                                  1. How to don a gown                  ♦ Discard
substances, non-intact skin
and mucous membranes.             ♦ Opening is in the back              2. Gown removal
PPE should comply with                                                  ♦ Gown front & sleeves are
                                  ♦ Fully cover torso from neck           ‘dirty’; handle by inside/
relevant Australian Stan-           to knees & wrap around
dards. Types of PPE include         back                                   back of gown, unfasten
                                                                          ties, peel gown away from
disposable examination and        ♦ Secure at neck and back               neck and shoulders
surgical gloves, protective
                                  2. How to don a mask
eyewear (glasses, goggles or                                            ♦ Turn contaminated outside
face-shields), surgical face      ♦ Secure on head with ear               surface toward the inside,
                                    loops or ties                         fold or roll into a bundle
masks and respirators (P2
particulate respirator), gowns    ♦ Place over nose, mouth &            ♦ Discard
and plastic aprons. Selection       chin
                                                                        ♦ Perform Hand Hygiene
and utilization of PPE is de-     ♦ Fit flexible nose piece over
                                    nose bridge                         3. Eyewear removal
pendant on the outcome of a
risk assessment. This assess-     ♦ Adjust fit, snug to face and        ♦ Outside of eyepiece is
                                    below chin                            ‘dirty’; handle by earpieces,
ment determines the prob-                                                 grasp earpieces with un-
ability of exposure to blood      ♦ Fit test (to check for air es-        gloved hands, pull away
and body substances, amount         cape around edges of mask)            from face
likely to be encountered, type    3. How to don eye protection          ♦ Place is designated recept-
of body substance involved                                                acle for cleaning
                                  ♦ Position eyewear over eyes &
and probable route of trans-        secure                              4. Mask Removal
mission of the infectious
                                  4. How to don gloves                  ♦ Front of mask is ‘dirty’;
agent. To ensure complete                                                 handle by ear loops/sides,
compliance with PPE, health-      ♦ Insert hands into gloves              remove from face in a down-
care facilities should ensure                                             ward direction, using ear
                                  ♦ Extend gloves over gown               loops
that all necessary items of
                                    cuffs (if wearing long sleeve
PPE are readily available,                                              ♦ Discard
accessible and maintained in                                            5. Perform hand hygiene
                                    Sequence for removing PPE
good working order. Appro-                                                immediately after removing
priate education on correct       ♦ All items must be removed             PPE.
                                    and discarded carefully
use should be provided to all
healthcare workers. Always        1. Glove removal
perform hand hygiene imme-        ♦ Outside of glove is ‘dirty’;
diately before donning and          use glove-to-glove/skin-to-           PPE is single person,
after removing PPE.                 skin handling method
                                                                          single task use ONLY
Sequence for donning PPE          ♦ Grasp edge near wrist, peel
                                    away from hand, turning
♦ Perform hand hygiene              glove inside out, hold in
                                    opposite gloved hand
♦ Gown/apron
Page 4

                                                                                   Our Education Program
                                                                 Hands-On Infection Control offers a                            Training Activities for 2009
                                                                 broad range of education training pro-
    Infection Prevention & Control -                             grams in infection prevention, control                     ♦         Infection Control On-Site Educa-
                                                                 and related areas. Programs can be                                   tion and Training 2009—Schedule
   The Responsibility Is In Our Hands
                                                                 tailored to suit the specific needs of                               of Topics
                                                                 individual organisations, specialties,                     ♦         Infection Prevention Study Day
                                                                 environments and staff/volunteer
            CONTACT US                                           groups.
                                                                                                                                      for Residential Care Staff
                                                                                                                                      September 2009 (Adelaide)
             Phone:       61 8 9227 1132                         These programs can be incorporated                         ♦         Infection Prevention Study Day
                                                                 into existing induction/orientation,                                 for Day Hospital/Procedure
             Fax:         61 8 9227 1134                         inservice, professional development                                  Facilities October 2009 (Perth)
                                                                 and targeted programs for all categories
                                                                 of clinical, support, ancillary and office                 ♦         Infection Prevention Study Day                                                                                               (No. 3) for Residential Care Staff
                                                                 -based staff.
                                                                                                                                      November 2009 (Perth)                          Education can be provided on or off
                                                                                                                            All education topics and Study Day infor-
                                                                 site for your organisation using accred-
                                                                                                                            mation is available on our website.
                                                                 ited trainers & assessors.
                                                                                                                            To schedule your education and training
                                                                                 Our educational
                                                                                                                            needs please contact our staff.
                                                                                 courses have been en-
                                                                                 dorsed by APEC No
                                                                                 070523701 as author-
                                                                                 ised by Royal College of
                                                                                 Nursing, Australia
                                                                 (RCNA) according to approved crite-
                                                                 ria. Attendance attracts RCNA CNE
                                                                 points as part of RCNA’s Life Long
                                                                 Learning Program (3LP).

                          USEFUL WEBSITES & RESOURCES
 Government of Western Human Swine Influenza for Health Providers
 Commonwealth Human Swine Flu for Health Professionals
 Immunise Australia Program
 Gastro-Info & Influ-Info Kits
 Order from National Mail & Marketing 1800 020 103 or
 Email                                                                                  “Hand Hygiene protects the people
 Standards Australia                                                                                               we come into contact with, our fami-
                                                                                                                   lies, the environment, our communi-
                                                                                                                   ties and US!”
 SAI-Global WebShop
 Guidance for Selection & Use of PPE in Healthcare Settings                                                        “HANDS UP FOR HANDS-ON!”

  This newsletter’s purpose is to provide information only. Every effort has been taken to ensure it contains accurate and up-to-date information at the time of publication.
  While our advice and information is professionally sourced and provided in good faith and all care has been taken in preparation of this newsletter, we do not accept legal
  liability or responsibility relating to this newsletter and the information it contains.