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Draft revised Australian Guidelines for the Prevention and Control of Infection in Healthcare submission

Personal Details
This submission reflects the views of
Organisation Name: 
Knox Private Hospital/ Bellbird Private Hospital
Specific Questions
3. Standard and transmission-based precautions: 

3.1.3 Use and management of sharps, safety engineered devices and medication vials

Can a statement about placement i.e. not over general waste bins & height of sharps bins be incorporated  for instance http://www.phsa.ca/Documents/Occupational-Health-Safety/FactSheetGuidanceforLocatingSharpsDisposalContaine.pdf, http://blogs.hcpro.com/osha/2010/07/ask-the-expert-sharps-container-disposal-height/ or https://stacks.cdc.gov/view/cdc/6386/cdc_6386_DS1.pdf Intravascular access devices

Table 16 - Minimising the risk from intravascular access devices by device type

Stage - Maintenance (three comments for this section)

Using chlorhexidine-impregnated sponges at the catheter insertion site for all devices significantly reduces IVD-related blood stream infection and device colonisation - Wording recommended to change from sponges to dressings https://www.ncbi.nlm.nih.gov/pubmed/26979872 or CDC Updated Recommendations on the Use of Chlorhexidine-Impregnated Dressings for Prevention of Intravascular Catheter-Related Infections (2017) https://www.cdc.gov/infectioncontrol/guidelines/pdf/bsi/c-i-dressings-H.pdf (Section 1.1 recommendations)

When using a needleless connector, the hub should be scrubbed to minimise the risk of microbial contamination - even if there is no specific statement on which product or concentration should be used, can there be options put in there i.e. alcohol or alcoholic/chlorhexidine (mostly relating to PIVC, but honestly, just saying it needs to be scrubbed could make someone use a detegent wipe)  http://clinell.com/blog/blog/2017/02/08/caps-off-to-chlorhexidine-for-needleless-connector-disinfection/, https://www.jointcommission.org/assets/1/6/CLABSI_Toolkit_Tool_3-21_Scrub_the_Hub.pdf, https://www.cdc.gov/dialysis/PDFs/collaborative/Protocol-Hub-Cleaning-FINAL-3-12.pdf or https://www.health.qld.gov.au/__data/assets/pdf_file/0025/444490/icare-pivc-guideline.pdf 

Reference incorrect for the needless connector comment - should read 263, currently reads 236.

4. Organisational support: 

4.1.3 Infection prevention and control program

Resource allocation - i.e. minimum ICP aloocation per acuity of hospital and bed size, rather than determined by the scope of the ICP program - as executive will decide this and it really should be decided/managed on workload. The elements of the infection control program from ASCQHC https://www.safetyandquality.gov.au/wp-content/uploads/2012/02/Elements-of-Infection-Control-and-Prevention-Programs-in-Australian-Acute-Hospitals-Mar-2009.pdf

The infection control workload is always increasing, not decreasing, prescriptive requirements would help support staff to complete the tasks as prescribed by the guideleines and standard 3.

Page reviewed: 24 September, 2019