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[EXTERNAL] FW: Doffing in virtual orange zone

Home Forums Infexion Connexion [EXTERNAL] FW: Doffing in virtual orange zone

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  • #78774
    Pamela Boon
    Participant

    Author:
    Pamela Boon

    Position:
    Infection Control Manager

    Organisation:
    Goulburn Valley Health

    State:

    || Please note this email has come from an EXTERNAL email account. Please double check the sender before opening any links or attachments ||

    Good afternoon everyone,

    As more patients with COVID are admitted we are required to locate them in rooms that have no built anteroom.
    We are creating a virtual anterooms (Orange Zones) outside the patients room (Red Zone).

    We are having discussions as to whether doffing should occur;

    * outside the patient room (with the door closed behind) – potential of contaminating environment
    * inside the patient room, extend the orange zone to inside – potential for staff scrubs to be contaminated

    I have spent substantial time reviewing the literature for guidelines or information on the risk of each of these options but haven’t found anything definitive.

    I would really appreciate any advice.

    Kind regards,
    Pam

    [image001]

    [image002] [image003] [image004]

    Pamela Boon
    Consultant
    Infection Prevention & Control
    GV Health | Graham Street, Shepparton, Vic 3630
    M: 0428 562 258
    E: Pamela.Boon@gvhealth.org.au

    [image005]

    GV Health would like to acknowledge the traditional custodians of the land on which we live and work and pay our respects to elders past, present and emerging.
    GV Health is committed to embracing diversity and welcomes all people.

    This communication is intended only to be read or used by the addressee. The information contained in this communication may be confidential information. If you are not the intended recipient, any use, interference with, distribution, disclosure or copying of this material is unauthorised and prohibited. The confidentiality attached to this communication is not waived or lost by reason of the mistaken delivery to you. If you have received this communication in error, please destroy it and notify the sender by return email.

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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    #78777
    Lincoln Fowler
    Participant

    Author:
    Lincoln Fowler

    Position:
    Infection Prevention Consultant

    Organisation:
    ACT Ambulance Service

    State:

    OFFICIAL

    Hi Pam
    The evidence for contamination of the scrubs and the transmission of infection from them is limited. Finding a viable viral particle is not the same as having a risk of infection because there is a lack of sufficient viral particles to elicit an infection.
    A risk based approach would be best in this setting.
    Primary risk is inhalation of aerosols so mask wear continues until exited red zone.
    Doffing of gown could occur before exiting red zone as does not really add substantially to the risk.
    Removal of mask would occur in the orange zone where the risk of environmental contamination remains low.

    I hope this helps.

    Kind regards

    Lincoln Fowler

    Infection Prevention and Control Officer
    ACT Ambulance Service
    P. | M.0435 329 378 | E. Lincoln.Fowler@act.gov.au
    9 Amberley Avenue Fairbairn (Majura) ACT 2609| PO Box 158 Canberra City ACT 2601
    [cid:image001.png@01D7C746.B415BA80]

    || Please note this email has come from an EXTERNAL email account. Please double check the sender before opening any links or attachments ||

    Good afternoon everyone,

    As more patients with COVID are admitted we are required to locate them in rooms that have no built anteroom.
    We are creating a virtual anterooms (Orange Zones) outside the patients room (Red Zone).

    We are having discussions as to whether doffing should occur;

    * outside the patient room (with the door closed behind) – potential of contaminating environment
    * inside the patient room, extend the orange zone to inside – potential for staff scrubs to be contaminated

    I have spent substantial time reviewing the literature for guidelines or information on the risk of each of these options but haven’t found anything definitive.

    I would really appreciate any advice.

    Kind regards,
    Pam

    [image001]
    [image002] [image003] [image004]
    Pamela Boon
    Consultant
    Infection Prevention & Control
    GV Health | Graham Street, Shepparton, Vic 3630
    M: 0428 562 258
    E: Pamela.Boon@gvhealth.org.au
    [image005]
    GV Health would like to acknowledge the traditional custodians of the land on which we live and work and pay our respects to elders past, present and emerging.
    GV Health is committed to embracing diversity and welcomes all people.

    This communication is intended only to be read or used by the addressee. The information contained in this communication may be confidential information. If you are not the intended recipient, any use, interference with, distribution, disclosure or copying of this material is unauthorised and prohibited. The confidentiality attached to this communication is not waived or lost by reason of the mistaken delivery to you. If you have received this communication in error, please destroy it and notify the sender by return email.
    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

    Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

    Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au

    To send a message to the list administrator send an email to admin@acipc.org.au

    You can unsubscribe manually from this list by sending ‘signoff acipclist’ (without the quotes) to listserv@aicalist.org.au

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    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

    Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

    Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au

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    #78790
    Elizabeth Smith
    Participant

    Author:
    Elizabeth Smith

    Position:

    Organisation:

    State:

    Hi Pam,

    Great question. See passage from the NHMRC Aust Guidelines below:

    Adapted from CDC Guideline for Isolation Precautions [215].

    Removal of PPE should be done at the doorway (just prior to leaving patients room) or immediately outside patient room.

    Surgical or particulate masks should be removed outside of the patient room or >1 metre from symptomatic patients [87].

    To remove a P2 respirator, remove gloves and gown, perform hand hygiene and step outside the room or into an anteroom. Remove protective eyewear or faceshield before removing and disposing of the respirator in a closed container and performing hand hygiene again.

    At a minimum, hand hygiene should be performed after the removal of gloves as well as after the removal of any other individual item of contaminated PPE.

    Sequencing may differ across healthcare settings and any variations to sequencing should be based on a risk assessment relevant to the setting and task being undertaken. Note that for surgical procedures and dentistry, the sequence for putting on PPE differs. In these situations, masks and protective eyewear are applied first prior to hand preparation. Gown and gloves are then put on (see Section 3.5.3).

    Sequencing may also be different in unique circumstances such as in an Ebola outbreak. When an outbreak is detected, advice from the healthcare facilities Infection Control Team should be followed.

    We have been discussing the same as we consider zones/airflow etc in our RACFs, I like the idea of the virtual anteroom outside the room and I have been working with our maintenance team to ensure quality tape on hand to identify these areas particularly to doff mask and eye protection outside the room.

    Kind regards,
    Elizabeth Smith
    Infection Control Co-ordinator
    NCN Health
    PO Box 252, Cobram 3644
    T. 03 5871 0705/0417107719
    W. https://ncnhealthservices.org.au
    E. Elizabeth.Smith@ncnhealth.org.au

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    [cid:imaged9f001.PNG@cff69867.44b53f51] [cid:image64d709.PNG@7fa83c75.4f830fdc]

    NCN Health acknowledges the Traditional Owners of the land we gather and work on and pay respects to their Elders, past and present. We work together with Aboriginal and Torres Strait Islander peoples to build a health system that listens to their hopes and aspirations and responds to them.

    Elizabeth Smith
    Infection Control Coordinator
    NCN Health
    PO Box 252, Cobram 3644
    T. 03 5871 0705 03 5871 0705
    W. ncnhealth.org.au
    E. Elizabeth.Smith@ncnhealth.org.au

    [cid:image41b51a.JPG@d7e93c30.458e2e10]

    [cid:image4480f5.PNG@247e18cf.47a79122] [cid:imaged94621.PNG@f306a03c.4f8e418f]

    NCN Health acknowledges the Traditional Owners of the land we gather and work on and pay respects to their Elders, past and present. We work together with Aboriginal and Torres Strait Islander peoples to build a health system that listens to their hopes and aspirations and responds to them.

    From: ACIPC Infexion Connexion On Behalf Of Pamela Boon
    Sent: Friday, October 22, 2021 12:07 PM
    To: ACIPCLIST@ACIPC.ORG.AU
    Subject: [ACIPC_Infexion_Connexion] [EXTERNAL] FW: Doffing in virtual orange zone

    || Please note this email has come from an EXTERNAL email account. Please double check the sender before opening any links or attachments ||

    Good afternoon everyone,

    As more patients with COVID are admitted we are required to locate them in rooms that have no built anteroom.
    We are creating a virtual anterooms (Orange Zones) outside the patients room (Red Zone).

    We are having discussions as to whether doffing should occur;

    * outside the patient room (with the door closed behind) potential of contaminating environment
    * inside the patient room, extend the orange zone to inside potential for staff scrubs to be contaminated

    I have spent substantial time reviewing the literature for guidelines or information on the risk of each of these options but havent found anything definitive.

    I would really appreciate any advice.

    Kind regards,
    Pam

    [image001]

    [image002] [image003] [image004]

    Pamela Boon
    Consultant
    Infection Prevention & Control
    GV Health | Graham Street, Shepparton, Vic 3630
    M: 0428 562 258
    E: Pamela.Boon@gvhealth.org.au

    [image005]

    GV Health would like to acknowledge the traditional custodians of the land on which we live and work and pay our respects to elders past, present and emerging.
    GV Health is committed to embracing diversity and welcomes all people.

    This communication is intended only to be read or used by the addressee. The information contained in this communication may be confidential information. If you are not the intended recipient, any use, interference with, distribution, disclosure or copying of this material is unauthorised and prohibited. The confidentiality attached to this communication is not waived or lost by reason of the mistaken delivery to you. If you have received this communication in error, please destroy it and notify the sender by return email.
    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

    Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

    Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au

    To send a message to the list administrator send an email to admin@acipc.org.au

    You can unsubscribe manually from this list by sending ‘signoff acipclist’ (without the quotes) to listserv@aicalist.org.au

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

    Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

    Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au

    To send a message to the list administrator send an email to admin@acipc.org.au

    You can unsubscribe manually from this list by sending ‘signoff acipclist’ (without the quotes) to listserv@aic

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