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

ID: 
10
Personal Details
This submission reflects the views of
Organisation Name: 
Australian Council on Healthcare Standards
Specific Questions
3. Standard and transmission-based precautions: 

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

Recommendation 11 -  Practical info tab

Disposal of single-use sharps

Second paragraph

Guideline text:  ‘..scalpel blades and other sharp items..’
Suggest further clarification on ‘other sharp items’ as confusion persists in this in the health care setting as to what is appropriate for a sharps container

 3.1.4 Routine management of the physical environment

Recommendation 13 – Practical info tab

Shared clinical equipment

Suggest ‘individual actions’ comment under practical info tab to ensure supply of a combined detergent/individual disinfectant wipes or solution on patient examination trolleys/community health equipment bags to facilitate cleaning of shared clinical equipment such as BP cuffs and digital thermometers between patients

Recommendation 16 - Practical info tab

Transmission pathways
 
Guideline text: ‘Transmission for norovirus infections in healthcare setting mainly occur..’

Suggest spelling/grammar edit:  ‘..healthcare settings mainly occur..’

3.2.3 Droplet precautions

Surgical masks protect the wearer from droplet contamination of the nasal or oral mucosa

Suggest recommended length of time to wear surgical mask before it is rendered ineffective and reference to evidence if available, to prevent prolonged potentially ineffective wearing of masks in healthcare settings and in the community

3.2.4 Airborne precautions

Recommendation 30 - Practical info tab

Under wearing a P2 respirator

Suggest additional comment on observing colleagues and promptly noting ill-fitting masks to be immediately corrected in order to maximise health provider and patient safety

3.3.1 Multi-resistant organisms

Recommendation 32 - Practical info tab

Under Emerging evidence on contact precautions

Second paragraph

Guideline text: Increasingly, some healthcare facilities are focusing on the use of horizontal measures… These include hand hygiene, bathing patients with chlorhexidine and environmental cleaning and disinfection..’

Suggest mapping to recommendation 4.1.4 Risk Management – Recommendation 37 – Key Info and Practical Info tabs on the use of chlorhexidine with reference to literature review titledIs the use of chlorhexidine contributing to increased resistance to chlorhexidine and/or antibiotics?’ page 28 where reference is made to the use of chlorhexidine washes and the consideration of biocidal stewardship.

 

3.3.2.1 Infection control strategies to control/contain an outbreak

Under Patient-care tip

Suggest adding to refer the nominated infection control staff member to patient/family for more in-depth discussions/information if required

Recommendation 34 – Practical Info tab

Transmission pathways

Guideline text:  ‘Transmission for norovirus infections in healthcare setting mainly occur..’

Suggest spelling/grammar edit:  ‘..healthcare settings mainly occur..

3.4.2.3 Intravascular access devicesMinimising the risk from intravascular access devices 

Table 16

Skin preparation

Guideline text: ‘For patients with a history of chlorhexidine sensitivity, use 5% alcohol-based povidone-iodine solution or 10% aqueous povidone-iodine…’

Suggest mapping to recommendation 4.1.4 Risk Management – Recommendation 38 - Practical Info tab with reference to literature review on chlorhexidine sensitivity/reactions and prompting patients ‘for any chlorhexidine reactions/anaphylaxis during the 'allergy history' subjective assessment

Insertion

Guideline text: ‘All healthcare workers who insert IVDs should be appropriately trained or under the supervision of a trained clinician.’

Suggest addition of further comment on training and competence required for cannulation – i.e. accreditation according to facility policy

 

3.4.2.4. Ventilation

Table 17 - Summary of strategies for preventing VAP

Physical strategies

Guideline text: There is no difference in the incidence of VAP between patients who airways..’

Suggest spelling/grammar edit: ‘whose airways’

 




4. Organisational support: 

 

4.1.3 Infection prevention and control program

Resource allocation

Consider addition of counselling service for staff involved in managing outbreak such as viral haemorrhagic fever

4.2.2 Exclusion periods for healthcare workers with acute infections

Recommendation 40 - Practical info tab

Transmission pathways

Guideline text: ‘Transmission for norovirus infections in healthcare setting mainly occur..’

Suggest spelling/grammar edit:  ‘..healthcare settings mainly occur..

 

4.2.5 Exposure-prone procedures

Table 26 - EPPs in specific areas of clinical practice

Paediatric surgery - Non-Exposure Prone Procedure

               Guideline text: Herniorraphy

               Suggest spelling/grammar edit: Herniorrhaphy

Podiatry - Exposure Prone Procedure

                  Guideline text: ‘Procuedures undertaken..’

                  Suggest spelling/grammar edit: Procedures undertaken

 Vascular surgery - Non-exposure Prone Procedure

 Guideline text: ‘.. , stenting or recanalization or arteries’

 Suggest spelling/grammar edit: ‘..stenting or recanalization of arteries’

 Guideline text: ‘Peripheral emolectomy..’

 Suggest spelling/grammar edit: ‘Peripheral embolectomy..’

 

4.4.3 Data collection and management

Under 'The following epidemiologic principles should be applied during healthcare-associated infection surveillance'

Guideline text: ‘analyse data to identify trends that may indicated increased rates of transmission’

Suggest spelling/grammar edit:  Replace with ‘.. that may indicate..’

Guideline text: ‘For further information..... ACSQHC's National HAI surviellance initiative’

Suggest spelling/grammar edit: ‘... ACSQHC's National HAI surveillance initiative’

 

 

 

 

 

 

5. Appendix 1: 

5.2 Risk-management: Case study for glove use and hand hygiene in an office-based practice

Treating risks

Guideline text: ‘The practitioner.. also require contract precautions’

Suggest spelling/grammar edit: The practitioner.. also require contact precautions’

Page reviewed: 24 September, 2019