[Carrie Spinks]

Hello Everyone,

There was many requests for the vaccination consent form discussed in the webinar. This has kindly been shared as a working sample form. The forms are located on the ACIPC website under the Aged Care Templates and Tools – Respiratory Infections and Vaccination –

Link: https://www.acipc.org.au/aged-care/aged-care-ipc-templates-and-tools/

Regards Carrie

[Carrie Spinks]

Question and responses from Kelly Barton – presenter on the CoP

Vaccination:

Do we need to give information about pros and cons of each vaccination on or with the consent form? It’s best practice to, so that you have informed consent. Have attached the ones we use.

Do you ask again for vax consent before the vaccine is given?, because “valid consent must be obtained before administering each individual vaccine dose, according to the Australian Immunisation Handbook”. For the individuals that have capacity, yes. For those who do not no. In saying that no-one is vaccinated against their will – so its distressing to the resident we try again later.

Can we get a sample of this vaccination consent form please? Would love to share and use this for our organisation. Have sent. You may need to customise to your organisation’s requirements though.

AMS:

Where was the antimicrobial drug usage report generated from? Is it from electronic medication management software? From our electronic medication software that is used at our health service for RAC. Not sure if we can mention brands Carrie? BESTmed is what we use.

Governance:

Any suggestions in working with leadership that views IPC as a portfolio rather than a unique role? I would suggest management doing the ACIPC foundations course – which I know is unlikely. Then they would get a proper understanding of the role of IPC. However as that is unlikely to have broad uptake, use the accreditation standards. The strengthened standards that were just released: Strengthened Quality Standards – August 2025 – Australian Government Department of Health, Disability and Ageing Services need to meed these IPC requirements within these to pass accreditation. These requirements cannot be met with a “portfolio”, not unless managers are prepared to take on a decent chunk of the tasks.

Outcome 4.2: Infection prevention and control Outcome statement: The provider must have an appropriate infection prevention and control system. The provider must ensure that aged care workers use hygienic practices and take appropriate infection prevention and control precautions when delivering funded aged care services.
Outcome 5.2: Preventing and controlling infections in delivering clinical care services Outcome statement: The provider must ensure that individuals, aged care workers, registered health practitioners and others are encouraged and supported to use antimicrobials appropriately to reduce risks of increasing resistance. The provider must ensure that infection risks are minimised and, if they occur, are controlled effectively.

IPC lead Role:

How many days do I need a fortnight to do the IPC lead role? We have ours do 1 day per fortnight at each facility. But I guess it really depends on the size of your facility, how many staff and residents.

What is the point of pay grade difference for your IPC staff? Our IPC Lead is paid the highest grade for the EN in Victorian EBA.

How does it go if you’re not onsite during an outbreak? Our senior management team are also expected to effectively manage an outbreak. If there is not IPC or IPC Leads, the NUM is required to do the line lists and communicate with the public health unit. We have a suite of documents & checklists to follow. In Victoria we follow Acute respiratory infection management in residential care facilities | health.vic.gov.au

National National Outbreak Management Guideline for Acute Respiratory Infection (including COVID-19, influenza and RSV) in Residential Aged Care Homes

[Carrie Spinks]

Hi Kavita,

Thank you, a very tricky situation.

Hoping to start up some considerations and discussion.

Consider: Could PPE represent risk and induce staff concerns? Note: PPE is at the bottom of the hierarchy of controls – putting in other measures first may reduce the risk and minimise the use of PPE – hence reducing staff concerns and heightening willingness to work.
See: https://www.safetyandquality.gov.au/sites/default/files/2022-05/using_the_hierarchy_of_controls_in_conjunction_with_infection_prevention_and_-_fact_sheet.pdf
Also: Risk assessing in home care: https://www.agedcarequality.gov.au/sites/default/files/media/quality-and-safety-in-home-services-5-key-areas_0.pdf

MRSA:
Consider where the MRSA is located and how the transmission risk may be contained. i.e. is it in a wound that can be covered – removing transmission risk for staff. Where a wound is covered transmission PPE is not required (only standard precautions), potentially reducing the concerns and fear of staff from transmission. RN/Wound Specialist attending to wound management wear contact precaution (gloves/gown) to attend dressing only.
If the transmission risk cannot be contained i.e. multiple breaks in the skin (with MRSA present) caused by skin condition/scratching, then the cause of the skin condition would need to be treated in the first instance as contact precaution PPE would be required here due to indirect and direct contact transmission. Once the skin condition is healed, the risk is removed and the need for transmission PPE – again as a domino effect, remove the need for transmission PPE and reduce staff concerns/fear.

Shingles:
Pregnant women can not care for a person with Shingles. Only staff that have had the chicken pox vaccine or who have had chicken pox (acquired immunity) should be caring for a person with shingles. 1st lines of defence.

Again, consider looking at when PPE needs to be worn against the risk of transmission. The risks come from the ooze from the pustule sites – potentially contact and airborne transmission; if the pustules have not burst or have scabbed/healed there is no risk. Hence transmission PPE is not required, only standard precautions. (If a person is diagnosed early and on an antiviral for the virus, they are more likely to heal faster.)

If a person has localised shingles on the torso the area can usually be covered with a dry, waterproof dressing and clothes to protect the area – transmission PPE is not required, only standard precautions. Contact precaution PPE (gloves/gown) is only required when the area is exposed – i.e. showering.

Where transmission PPE is not required, it may reduce the concerns and fear of staff and increase willingness to work.

Note: Disseminated shingles = on multiple sites on the body, including the face, is not easy to cover and transmission risk is higher. Here staff should wear contact and airborne (respiratory) precautions with a PFR and eye protection, until all blisters have crusted/healed over.

See the Aged Care Guide pg 80 + pg 82:
https://www.safetyandquality.gov.au/sites/default/files/2024-08/The-Aged-Care-Infection-Prevention-and-Control-Guide.pdf

Regards Carrie

[Carrie Spinks]

Hi Denise,

Just to confirm, staff Influenza and COVID-19 vaccines must be recorded by providers – rather than strongly recommended

See…………….

Responsibilities of residential aged care providers: https://www.health.gov.au/our-work/residential-aged-care/responsibilities-of-providers#mandatory-flu-vaccination-program

Flu and COVID-19 vaccination program
What you need to do:
Your service must take precautions to prevent and control the flu and COVID-19 and minimise infection-related risks. That includes:
-offering free flu vaccinations and COVID-19 vaccinations every year to your staff and volunteers, and keeping records of their vaccinations. From 1 November 2025, vaccinations must be provided in accordance with the The Australian Immunisation Handbook.

COVID-19 vaccination reporting is also addressed here:
COVID-19 vaccination for residential aged care workers: https://www.health.gov.au/our-work/covid-19-vaccines/information-for-aged-care-providers-workers-and-residents-about-covid-19-vaccines/residential-aged-care-workers

The Aged Care Act past and current requires these vaccinations to be recorded.

Regards Carrie

[Carrie Spinks]

Hi Akala,

Please refer to the AS 5369:2023, Reprocessing of reusable medical devices and other devices in health and non-health related facilities: https://www.standards.org.au/standards-catalogue/standard-details?designation=as-5369-2023 – this addresses cleaning processes and equipment for non-critical items such as bed pans and urinals and bowls. The use of detergent cleaning and thermal disinfection.

This may also be of assistance: Reprocessing of reusable medical devices https://www.safetyandquality.gov.au/our-work/infection-prevention-and-control/reprocessing-reusable-medical-devices.

ACIPC dont provide sanitiser product recomendations.

Regards Carrie

[Carrie Spinks]

Hi MoniKa,

Perhaps I can kick off and others will follow in on the conversation

Yes, establishing a protocol to assign dedicated slings to residents with MRO infections requiring lifters is a right approach, as it helps prevent the spread of multi-resistant organisms. This practice minimizes the risk of cross-contamination when transferring residents who are colonized or infected with MROs, particularly when a lifter is necessary, as it involves more contact with the resident and the equipment.

If we look at the hierarchy of control – the first is to eliminate the risk – we do this by having a dedicated sling.

Dedicated slings, along with proper cleaning and disinfection protocols for the lifter, can significantly reduce the chance of transferring MROs from one resident to another

Here is a good QLD resource – appreciate you are in NSW

Multi-resistant organisms Residential care facilities – https://www.health.qld.gov.au/__data/assets/pdf_file/0031/719068/mros-info-sheet-residential-care-facilities.pdf

[Carrie Spinks]

Hi Monika

In response to the cytotoxic management. Hoping some colleagues will have a go at answering the MRO for you.

The risk of cytotoxic exposure is only presented through the body substances of a person on cytotoxic medications – or the medication its-self (and meds would not be given during transfer). It is not a transmissible risk, but an exposure risk. If the person’s body substances – blood, urine, faeces, vomit are contained, (e.g. person is continent, wears incontinence aids, not vomiting, oozing wounds managed) then there is minimal risk to the sling lifter being cytotoxic contaminated and presenting risk. Any special / additional precautions outside routine reprocessing of shared equipment, would not be required.

It’s similar to cytotoxic laundry management – i.e. where there are no body substances – there is minimal risk – the laundering would be undertaken as general laundry.

In the instance that body substances did contaminate the sling it would need to be managed as cytotoxic laundering (contained in soluble laundry bag and on appropriate wash cycle) and washed ASAP. Cytotoxic exposure risks should be void post this laundering process, enabling shared reuse.

The decision to have dedicated slings for residents is ultimatley the organisations – a measure with the aim to minimise risk.

Hope that helps

Regards Carrie

[Carrie Spinks]

Thank you Milja

Great questions.

To note: ACIPC released a position statement: The use of particulate filter respirators (PFR) masks for the management of COVID-19 in healthcare: https://www.acipc.org.au/position-statement-on-pfr-masks-in-covid-19-management/
This recommends the use of respirator masks (N95/P2) during all care of a person with COVID-19.

According to the Aged Care IPC Guide and also the National IPC Guidelines the use of either mask (surgical or respirator N95/P2) in the presence of COVID -19 should be risk assessed.

ACIPC also addressed this same question with ACSQHC late last year – in response they have placed resources on the FAQ section of the Aged Care IPC Guide for which they based this change: https://www.safetyandquality.gov.au/publications-and-resources/resource-library/aged-care-infection-prevention-and-control-guide

Here are the resources provided:

Infection prevention and control in the context of COVID-19: a guideline, 21 December 2023
https://www.who.int/publications/i/item/WHO-2019-nCoV-IPC-guideline-2023.4

P2/N95 respirators & surgical masks to prevent SARS-CoV-2 infection: Effectiveness & adverse effects
https://pubmed.ncbi.nlm.nih.gov/35151628/

Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011621.pub4/full

In regards to PPE for ARI and gastro – recommendation would be that its not one type fits all – but rather the type of PPE should marry with the means of transmission. i.e. if transmission is via contact, PPE should be contact precautions (gloves and long sleeve gown/apron) (scabies, shingles, infected wound, C.diff, gastro); if the transmission is via droplet and contact, PPE should be contact and droplet precautions (gloves, long sleeve gown/apron, eye protection and surgical mask) (Influenza, RSV, risk assessed Norovirus); if the transmission is airborne, PPE should be respirator, eye protection – additional contact precautions may be required (COVID-19, chicken Pox, TB)

The ACSQHC transmission precaution posters are great to identify this: https://www.safetyandquality.gov.au/our-work/infection-prevention-and-control/standard-and-transmission-based-precaution-posters

Hope that helps

[Carrie Spinks]

Hi Jithin,

Great question.

This topic would come under beauty guidelines rather than specific to aged care practices. Irrespective of the setting the guidelines could be used. In Victoria, the
Infection prevention and control guidelines for hair, beauty, tattooing and skin penetration industries can be used: https://www.health.vic.gov.au/infectious-diseases/notices-about-scope-of-registration-and-client-information-sheets.

On pg 60, it states that application brushes: Reusable if product is not capable of harbouring or supporting growth or microorganisms (for example, nail polish, light cured gels, nail primers). Hence, nail polish is not considered a transmission risk and can be shared use.

There are IPC beauty practices that should be considered during application:
Standard precautions
Do not share polish with clients showing signs of nail infections.
Discard contaminated or deteriorated products.
Single person use if known nail, cutical infection – Monitor and label polish bottles.
Include nail polish practices in beauty hygiene policies.

Hope this helps.

Regards Carrie

[Carrie Spinks]

Hi Jonah,

There is a basic template on the ACIPC aged care resource page: https://www.acipc.org.au/wp-content/uploads/2025/07/Infection-Transmission-Precautions-Visitor-Resident-Information.docx It is in word so that you can change it to suit the organisation.

Hope this helps.

Regards Carrie

[Carrie Spinks]

Hi Victoria,

A challenging situation.

Some things Ive tried in the past:

Consider: Undertake a waste managment audit to identify all areas of risk and concern. Feel free to use the aged care template: https://www.acipc.org.au/wp-content/uploads/2024/08/Waste-Managment-Audit-FULL.pdf

Consider: Sharing audit results with the team – take pics and share concerns. Address the consequences of this for others = personal injury, infection transmission, morbidity, incorrect transport, incorrect destruction or land waste placement = contamination of environment – could one day affect them or their family.

Consider: What is in the onboarding and annual education – does this cover waste management with clear defined division of different types of waste – if not can it be included?

Consider: Asking your team (survey or short interview)- what education have they had and what would they need? There involvment will spark an interest for them. While giving you feed back on where a gap may be in learning and education.

Consider: Providing waste education session to regular staff and long term agency, perhaps after a staff meeting ( everyone there) and have it minuted-there is a great VICNISS document that has some great waste flow paths and scenarios that can be used – it is hospital based but sends a clear message. https://www.vicniss.org.au/media/2129/clinical-waste-guidelines-supplement-for-healthcare-staff.pdf

There is also the aged care waste PowerPoint and presentation on the aged care in focus webpage- I am just about to update this next week. : https://www.acipc.org.au/members/ipc-in-aged-care/

Consider: Re posters: they can become just noise – location and positioning are high consideration. Placing what should and should not go in the bin poster above the bin – this will differ in accordance with the bin type. Use red X for no and green tick for yes, use pictures – placing in a table is effective. Ensure the posters are laminated.

Consider: Once you trial a few strategies like above, repeat the waste management audit and see if there is an improvement. If there is share this with your team with praise and recognition. Where further improvement is required, reinforment of practice may be required on the floor by IPC lead or person undertaking IPC or differring strategies put into place.

This is a great tip for the development of aged care IPC resources – thank you. I will aim to have something up in the aged care resource template page next week: https://www.acipc.org.au/aged-care/aged-care-ipc-templates-and-tools/

Good luck

[Carrie Spinks]

Thanks Camilla,

Links fixed – great tip.

[Carrie Spinks]

Hi Camilla,

There are no nationally standardised baseline infection rates for aged care settings in Australia currently published for UTIs, CAUTIs, respiratory infections, skin infections, and gastroenteritis. However, we can draw on the following available data sources and proxy measures for context and benchmarking:

1. NISPAC (National Infection Surveillance for Australian Residential Aged Care) Pilot
A pilot program led by the Doherty Institute and Burnet Institute for routine infection surveillance in residential aged care.

Tracks:
UTIs (with/without catheter)
Gastroenteritis
Respiratory infections
Skin and soft tissue infections
Still in progress: No national baseline published yet, but initial data are being collected for benchmarking.

Doherty Institute – NISPAC: https://www.doherty.edu.au/impact-report-2021/national-infection-surveillance-program-for-aged-care/

2. While comprehensive baselines are lacking, some studies provide point-in-time infection rates. Examples:
Mitchell et al. (2019) – Point prevalence survey in 29 Australian RACFs:
UTIs: 2.2%
Respiratory tract infections: 3.5%
Skin infections: 2.3%
Gastroenteritis: 1.3%

Mitchell, B.G., et al. (2019). Infection control and surveillance in aged care facilities: a national point prevalence study. Healthcare Infection, 24(2), 81–86. https://www.idhjournal.com.au/article/S2468-0451(16)00005-5/pdf

Hope this is of some help.

Carrie

• This reply was modified 2 months, 3 weeks ago by Carrie Spinks.
• This reply was modified 2 months, 3 weeks ago by Carrie Spinks.
• This reply was modified 2 months, 3 weeks ago by Carrie Spinks.
• This reply was modified 2 months, 3 weeks ago by Carrie Spinks.

[Carrie Spinks]

Hi Dianne,

There is quite a bit of research suggesting that artificial nails and nail polish are associated with infection transmission.

The Aged Care IPC Guide pg 53 provides best practice: https://www.safetyandquality.gov.au/sites/default/files/2024-08/The-Aged-Care-Infection-Prevention-and-Control-Guide.pdf
Fingernails: The type and length of fingernails can have an impact on the effectiveness of hand hygiene. Artificial or false nails have been associated with higher levels of microorganisms. Studies have also demonstrated that chipped nail polish may support the growth of organisms on the fingernails. Fingernails should be kept short and clean, and artificial fingernails and nail polish should not be worn.

The Guideline Australian Guidelines for the Prevention and Control of Infection in Healthcare, pg 37 also provides best practice: https://www.safetyandquality.gov.au/sites/default/files/2024-08/australian-guidelines-for-the-prevention-and-control-of-infection-in-healthcare.pdf
The type and length of fingernails can have an impact on the effectiveness of hand hygiene [19] [33]. Artificial or false nails have been associated with higher levels of infectious agents, especially Gram-negative bacilli and yeasts, than natural nails [41] [23] [26] [37] [40] [19] [25] [18]. Fingernails should therefore be kept short (e.g. the length of the finger pad) and clean, and artificial fingernails should not be worn. Studies have also demonstrated that chipped nail polish may support the growth of organisms on the fingernails [57]. It is good practice to not wear nail polish, particularly as chipped nail polish may support the growth of organisms on the fingernail.

The management in a facility/organisation could be achieved via the requirements (as above) being placed in an organisation policy – such as uniform and in HH policies; its also good to have in orientation booklets and role descriptions. The organisation policies are /based/backed by the national guidelines as above. Clear messages to staff surrounding expectations and risks. Discussions can then be had with non compliant staff during performance reviews, if this is a process in the organisation.

Hope this helps.

Carrie

• This reply was modified 3 months, 1 week ago by Carrie Spinks.
• This reply was modified 3 months, 1 week ago by Carrie Spinks.

[Carrie Spinks]

Hi Jeanette,

We are looking at the Strengthened Aged Care Standards and Aged Care Act to guide us in this space. Noting that not only staff requiring screening on entry, but also visitors.

See Draft Standard 4 The Environment – 4.2, pg 26: https://www.agedcarequality.gov.au/sites/default/files/media/guidance-material-for-the-strengthened-aged-care-quality-standards-standard-4.pdf

The Actions and associated activities provide a guide to the expectations of screening and vaccination/immunisation for staff, older persons and visitors.

Each organisation/home is required to develop their own process for screening and collection of data/information – this is due to the diversity of homes.

During COVID-19 temperature checks were undertaken, now post pandemic there are higher levels of community immunity – we see cases without temperature and some times without symptoms. This is the same for other RTI, especially in older persons where temperatures do not present, but they are positive to the pathogen. As a result of this, temperature taking alone is not a reliable source to determine whether someone is well or unwell – we look to collaborative symptom screening. McGeers/Stone Infection Criteria is a good tool to use for this.

Hope this helps

Carrie

• This reply was modified 3 months, 1 week ago by Carrie Spinks.
• This reply was modified 3 months, 1 week ago by Carrie Spinks.

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