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Re: Information re disposal of waste in ICU single rooms and toilet lids

Home Forums Infexion Connexion AS4187 Public Comment Re: Information re disposal of waste in ICU single rooms and toilet lids

#69507
Glenys Harrington
Participant

Author:
Glenys Harrington

Email:
infexion@ozemail.com.au

Organisation:
Infection Control Consultancy (ICC)

State:

Hi Kathy,

Toilet seat lids:

As in your home lids for toilet are probably standard and if closed before flushing will minimise environmental contamination.

I would also be advocating the following for toilets facilities (toilet seat and other high touch areas) in healthcare settings:

routine cleaning and disinfection
more frequent cleaning and disinfection in outbreak settings (i.e. C.difficile, VRE).

Setting up a new hospital:

In terms of setting up a new facility it would be wise to avoid the use of sprayers (also called aerated spray wands) in patient toilet facilities(will send you some pictures directly).

These are hoses with a nozzle which are installed at the back of the toilet and used to rinse out bed pans in the toilet bowl in anteroom toilet/shower facilities (single/multi-bed rooms) and in hoppers ( wall-mounted sinks, with deep basins, large drains, and spray arms that flush like toilets) in dirty utility rooms (see images attached).

I dont believe they are very common in Australian healthcare facilities for patient toilets although in older facilities you may still find hoppers with spray arms in dirty utility rooms.

Sprayers seem to be more common in parts of Canada and the US ( mentioned in some of Carlings publications) and have contributed in outbreaks of C.difficile in Canada Preliminary Findings with C.difficile Outbreak in Cape Breton District Health Authority (CBDHA), 21 April 2011, Department of Health and Wellness, Nova Scotia.

In Quebec it seems that some facilities dont have automated bedpan washers or macerators for processing bedpans. Where such reprocessing machines are not available oxo-biodegradable plastic hygienic bags (bed pan liners) are being used.

A June 2009 Quebec report (Comparative Analysis of Bedpan Processing Equipment) by the Agence dvaluation des technologies et des modes dintervention en sant (AETMIS now INESSS) recommended that staff must not empty bedpans into sinks or toilets and must no longer use spray wands. The report includes options in terms of appropriate reprocessing methods for bed pans and a cost analysis of each option see link.

http://www.hygiecanada.com/img/media/Comparative%20Analysis%20of%20bedpan%20Processing%20Equipment.pdf

Some years ago when reviewing plans to upgraded and retrofit wards we were asked to approve the use of sprayers in patient toilet facilities. The request came from the director of nursing who was from the US and was planning to remove the automated bedpan washers from the wards as they were located outside patient rooms and were very noisy. Because of the risk of environmental contamination they were not approved by infection control and automated bedpan washers were installed in the dirty utility rooms which in the upgrade were located away from patient bedrooms.

ICU and single rooms:

The last ICU renovation I was involved in (2008) was the Alfred health unit in Melbourne Victoria. Predominately single and 2 bedrooms.

You might like to talk to the staff at the Alfred ICU in Melbourne or even better arrange a visit. It is a state of the art 45 bed ICU facility which also has “I-glass” (switchable glass) between some of their single rooms. This glass in its normal form is clear and transparent but when an electric current is passed through it, it becomes opaque. The glass obviates infection control concerns relating to the use of blinds in ICU cubicles and sliding doors which accumulate dust in the runners and are difficult to clean. The glass also allows for easier observation during meal breaks.

The Architects for the ICU were Billard Leece Partnership Pty Ltd Architects & Urban Planners and you can find some picture of the unit at the following link.
http://www.blp.com.au/project-detail.php?pageID165&menuno0

Waste disposal and ICU units:

In this it – into dirty utility rooms located at strategic positions in the unit. No pan sanitiser in rooms or near rooms as they are too noisy especially at night.

Regards

Glenys

Glenys Harrington
Consultant
Infection Control Consultancy (ICC)

PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426

—–Original Message—–

Hi All,
I’m after some information / experience with rebuild and design of Health care facilities and peoples thoughts around toilet lids or No toilet lids. For years I have been told that the toilet lids were removed because of Infection Control. Now with the rebuilds there continues to be great debate around to have a lid or not to have a lid.
So would be interested in other’s experiences.
My other question is around how many of the new ICUs are moving to single rooms and what initiatives people may have put in place around managing disposal of body wastes. these are rooms with no ensuites and the option for a pan rooms is at the furthest point at end of unit.
looking forward to responses.
Regards
kathy

Kathy Dempsey
CNC Infection Control & Hospital Epidemiology Department
ph: 61 2 9845 7501
mobile:0423 000169
pager 27230 (M,T,W,T)
Clinical pager 9868

email: kathy.dempsey@swahs.health.nsw.gov.au

>>> Michael Wishart 10/29/2012 1:09 pm
>>>
[Posted on behalf of Skye Mentjox Moderator]

Hi Michael – I haven’t see this come up on the AICA discussion list but I believe will be of interest to many members.

Please be advised that the period for public comment on the AS/NZ 4187 draft has been extended to Tuesday, 23 January 2013

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Skye Mentjox
Product Manager
Whiteley Corporation
m. 0412068053
e. skye@whiteley.com.au

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