[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 3 weeks, 6 days ago by Carrie Spinks.
• This reply was modified 3 weeks, 5 days ago by Carrie Spinks.
• This reply was modified 3 weeks, 5 days ago by Carrie Spinks.
• This reply was modified 3 weeks, 5 days 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 1 month, 1 week ago by Carrie Spinks.
• This reply was modified 1 month, 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 1 month, 2 weeks ago by Carrie Spinks.
• This reply was modified 1 month, 2 weeks ago by Carrie Spinks.

[Carrie Spinks]

Thank you Penny,

A great topic and great suggestion.

To note: Perri is presenting this month in the COP webinar series on just this topic:

Wednesday 18 June 2025, 2.00PM AEST Speaker: Perri Waddell, Gerontology Nurse, Aged Care Manager and ACIPC Facilitator

IPC Train the Trainer – education skills
The Aged Care IPC Lead (or person responsible for IPC) has a range of responsibilities as determined by the ACQCS. Providing ongoing assessment of staff capability and education is a core function of the role. There is a gap between knowledge gained from completing an IPC course and teaching ability. This presentation explores ways to train the trainer by giving IPC Leads (or person responsible for IPC) some training tools to sustainably embed and advance IPC in aged care.

Register: https://us02web.zoom.us/webinar/register/WN_ApvwYg9kRICGFoFL8Yb6Jg#/registration

[Carrie Spinks]

Hi Anitha,

Thanks for your question:

The Guidelines for the public health management of gastroenteritis outbreaks due to norovirus or suspected viral agents in Australia (2010) – pg 49 + Aged care Noro management.
https://www.health.gov.au/sites/default/files/documents/2020/03/norovirus-and-suspected-viral-gastroenteritis-cdna-national-guidelines-for-public-health-units-guidelines.pdf

Isolation period in the older person is 72hrs after symptoms have ceased for residents and 48hrs for staff

Appendix 5.5 – Aged Care checklist- see the first page and isolation period
https://www.health.gov.au/sites/default/files/documents/2020/03/norovirus-and-suspected-viral-gastroenteritis-cdna-national-guidelines-for-public-health-units-appendix-5-5-self-audit-site-visit-check-list-for-aged-care-facilities.pdf

Hope that helps

Kind regards Carrie

• This reply was modified 1 month, 3 weeks ago by Carrie Spinks.
• This reply was modified 1 month, 3 weeks ago by Carrie Spinks.
• This reply was modified 1 month, 3 weeks ago by Carrie Spinks.

[Carrie Spinks]

On behalf of Mark Rigby

Hi Loida

While purple gloves are routinely used in oncology units, I think in an aged care context it would be more critical to simply ensure the gloves used are acceptable for handling cytotoxics and that there are appropriate “purple bins/bags” for these gloves to be disposed of into. There does not appear to be any guidelines specifying the required color of the gloves.

EviQ is a fantastic resource for all things oncology. There is a section on PPE and some links to state based guidelines. https://www.eviq.org.au/clinical-resources/administration-of-anti-cancer-drugs/188-safe-handling-and-waste-management-of-hazardou#personal-protective-equipment-ppe

Also, a google search for cytotoxic gloves will help identify suppliers who specify gloves that are suitable for use when handling cytotoxics.

Hope this helps

Mark Rigby

Infection Prevention Consultant

Credentialled Infection Control Professional – Advanced (CICP-A)

B.Pharm

Victorian Infection Prevention Services (VICIPS)

Mobile: 0417544117

Email: mark@vicips.com.au

Website: vicips.com.au

At VICIPS we work flexibly. I’m sending this message now at a time that suits me. I don’t expect you to read, action or respond out of your regular working hours.

• This reply was modified 1 month, 3 weeks ago by Carrie Spinks.
• This reply was modified 1 month, 3 weeks ago by Carrie Spinks.

[Carrie Spinks]

Hi Loida (Eunice),

Great question.

In aged care cytotoxic exposure can occur during drug administration and in the management of body fluids and contaminated items from body fluids. Hence protection for care staff, resident carers (as appropriate) , cleaners (bathroom cleaning), laundry staff (washing body fluid contaminated clothing items) all needs to be considered – PPE will vary depending on the task and exposure risk.

In regards to guidelines, these are state/territory based and local policies are reflected from these. So it depends where you are located as to where I could guide you.

Purple identifies cytotoxic risk and clearly disingishes between what is being handled. However, if the blue gloves provide cyctoxic protection and staff etc are safe, then there should be little concern of colour (the colour of these gloves is close to purple – the use of white or black nitrile gloves in this setting can be avoided).

The focus should be on the used PPE items going into a purple, symboled cytoxic waste bag so that it can be transported (inhouse and externally) and distroyed safely and correctly. Incinaration temps are higher for cytotoxic waste to ensure destruction.

Hope this is helpful

Regards Carrie

[Carrie Spinks]

Hi Mel

The ACIPC website under the aged care space has a lot of resources to develop education, it also has tools and templates for use. The aged care in focus has presentations that can be used for staff education as well. https://www.acipc.org.au/aged-care/

The Department also have training resources (scroll to the bottom) https://www.health.gov.au/topics/aged-care/managing-respiratory-infection/infection-prevention-and-control-in-aged-care#training-resources

Theb Australian Commission also have Infection prevention and control for aged care eLearning modules https://www.safetyandquality.gov.au/our-work/infection-prevention-and-control/hand-hygiene-and-infection-prevention-and-control-elearning-modules/infection-prevention-and-control-aged-care-elearning-modules

Hoping these may help to start you off.

Regards Carrie

[Carrie Spinks]

Hi Peggy,

Victorian guideline on CPO for long-term residential care facilities may be agreat place to start too.

Link:https://www.health.vic.gov.au/infectious-diseases/victorian-guideline-on-cpe-for-long-term-residential-care-facilities-version-11

Regards Carrie

[Carrie Spinks]

Hi Rosemarie,

The reprocessing of reusable medical equipment toolbox also guides to the manufacturers in structions

Reusable equipment cleaning and reprocessing toolbox
https://www.acipc.org.au/wp-content/uploads/2024/11/Reusable-Equipment-cleaning-toolbox-2024.pdf

Cheers Carrie

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