[Carrie Spinks]

Hi Michelle,

Great question – Hope this assists.

Aged care is not quite like the acute sector in regard to how we manage MRO.

Signage and precautions are only required if a resident is being isolated for an acute infection. As I’m sure you would agree – there is no benefit to using PPE in a resident’s room if the resident is mobilising around the facility – and we would not isolate a resident for the rest of their lives as a result of an MRO diagnosis.

The first question is – what is the organism and where is it? Precautions and signage are dependent on the risk and means of transmission.

For example:
If the organism is MRSA in a wound and the wound is covered with a dressing – the risk of transmission is low. The only time that contact precaution PPE would be required is when the wound was being dressed or if the dressing came down – at this time the wound is exposed, increasing the risk of transmission. Standard precautions remain consistently. No isolation and no signage required.

Another example:
If the organism is C. diff, but the resident is asymptomatic and the infection not acute – transmission risk is low – no isolation and standard precautions is all that is required. No signage.
If the resident has an active C. diff infection and is symptomatic – risk of transmission is higher – isolation required and standard, contact and droplet precautions are required. Signage to these transmission means is required.

Another example:
If the organism was VRE in the urine and the resident had active UTI symptoms – transmission risk is higher – isolation and standard and contact precautions would be require – increase to standard, contact and droplet if there is droplet risk. Signage in accordance with the transmission means would be required.

If a resident is identified to be colonised with an MRO – transmission risk is low. Isolation is not required, transmission precautions are not required, and signage is not required. Standard precautions remain consistently.

For example:
MRSA located groin or armpit – no signs of active infection.

Agree – Using symbols can be confusing to those not aware of their meaning – i.e. agency or new staff. Using the correct transmission signage is the safest way forward on the door.

Infectious rooms requiring daily clean can be made known to the cleaning staff at the commencement of shift – understanding that these rooms are cleaned last and with TGA approved neutral and disinfectant product.

Feel free to keep the discussion going.

Kind regards Carrie

[Carrie Spinks]

Hi Everyopne,

Here is a great HH resource for assisting others to perform HH by the Aged Care Commission. This may answer the HH question above.

https://www.agedcarequality.gov.au/resource-library/hand-hygiene-helping-others-hand-hygiene

Regards Carrie

[Carrie Spinks]

Hi Kathy

Absolutely and the PowerPoints and resources will all be put up on the website in the aged care CoP webinar resource section.

Be great to see you on in June.

Regards Carrie

[Carrie Spinks]

Hi everyone,

Please be aware that there are many resources now sitting under the ‘resource’ heading on the top of the ACIPC webpage – simply hover over the word and let the drop box come out.

IPC collaborative resources, by country/region and specific settings: https://www.acipc.org.au/
or
Aged Care specifically: https://www.acipc.org.au/aged-care/resources-australasian-aged-care/

No longer do you have to go search it’s all in one easy place.

Kind regards Carrie

[Carrie Spinks]

Hi Catherine,

I can only speak from working in previous organisations.

We had an alert system that came up when first opening the residents electronic file, was quite bold and needed to be closed to move on. All required alerts presented like this – falls risk, cytotoxic treatment etc.

Note: Electronic alerts were only put into place for MRO infections, and these remained whether the infection was active or colonized- i.e. they were never closed off. For active MRO infections, management and precautions were addressed in the infection report. If colonised, then a risk assessment was in place to identify future potential risk of active infection with this MRO, directions as to what to watch, as well as immediate management and precaution measures to implement should active infection present.

Once an electronic infection (of any kind) report had been established, alerts were set within the system for RN follow up – this included infection management, signs and symptoms and antimicrobial review – usually 24hr.

In regard to all other infections, alerts were made through clinical hand overs – both verbal and written for clinical staff. A daily infection alert form was provided to kitchen, laundry, maintenance, cleaning, admin, allied health etc. These forms were provided to teams in the facility morning huddle where there was representation from all areas – form was usually collaborated by the clinical lead or IPC lead or RN in charge. This system was consistent and well known through outbreaks.

Re: The IPC Lead the scope of their role was facility determined – but the expectation of infection management and resident cases oversight, was certainly there.

Hope that is a little helpful

Kind regards Carrie
ACIPC
ACIPC IPC Consultant
Hobart

[Carrie Spinks]

Good afternoon,

Hoping this can help everyone.

ACIPC have a number of national and state/territory collaborated cleaning/disinfection resources/guidelines to address most healthcare settings in the website ‘Resource’ section – see link: scroll down until you get to ‘Environmental Cleaning and Disinfection’ and click the title:
https://www.acipc.org.au/resources/australian-collaborative-health-care/

On Wednesday 16 October 2024 as part of the aged care webinar series, ACIPC is presenting and opening up for discussion: Tips and tricks to managing IPC in environmental services – cleaning, laundry, waste, catering.
https://www.acipc.org.au/acipc-aged-care-community-of-practice-webinar-series/

The ACIPC Foundations IPC and Aged Care IPC short course address environmental cleaning/disinfection processes:
https://www.acipc.org.au/education/

The NHHI – have a number of IPC eLearning modules for aged care – as well as a train the trainer module that may assist:
https://www.safetyandquality.gov.au/our-work/infection-prevention-and-control/infection-prevention-and-control-aged-care

Fact sheet – Principles of Environmental Cleaning Auditing – provides some links to tools within the document.
https://www.safetyandquality.gov.au/resources/principles-environmental-cleaning-auditing-fact-sheet

Kind regards Carrie

ACIPC
ACIPC IPC Consultant
carrie.spinks@acipc.org.au
Hobart

• This reply was modified 2 years, 4 months ago by David Tanedo.
• This reply was modified 1 month, 2 weeks ago by Carrie Spinks.

[Carrie Spinks]

[Cross-posting from Infexion Connexion – Moderator]

Hello all,

I am also interested in this for ALL STAFF as I am working on a Quality improvement project for cleaning in our Hospital which has Aged Care and a Medical Clinic attached.

Kind regards,

Judith Penman

Infection Control Coordinator
Phone: 0260763296

Email: Judith.Penman@corryonghealth.org.au

20 Kiell Street

Corryong
VIC

“Together, Strengthening the Health of Our Community”

[Carrie Spinks]

Dear Yvonne,

Please see a couple of papers that address RAT use and efficiency in residential aged care – note they are dated 2021.

The National COVID-19 Health and Research Advisory Committee provided advice on RAT in various settings.
https://www.health.gov.au/sites/default/files/documents/2022/03/foi-3589-release-documents-austender-contracts-cn3818911-and-cn3806974-evaluation-of-the-rapid-antigen-testing-pilot-in-residential-aged-care-facilities-final-report.pdf

The Australian Government Department of Health undertook a pilot study – Evaluation of the rapid antigen testing pilot in residential aged care facilities: final report
https://www.health.gov.au/sites/default/files/documents/2022/03/foi-3589-release-documents-austender-contracts-cn3818911-and-cn3806974-evaluation-of-the-rapid-antigen-testing-pilot-in-residential-aged-care-facilities-final-report.pdf

Refer to national and state guidelines for RAT requirements, this may help to make your decision on need. It is left to the individual facility to decide but should be risk based and in accordance with COVID 19 transmission in the area – routine testing is not required.

From local perspectives:

ACT Government:
Rapid antigen tests (RATs) for residential aged care facility workers
https://www.covid19.act.gov.au/services-and-support/aged-care/rapid-antigen-tests-rats-for-residential-aged-care-facility-workers
Advice for visitors to aged care facilities
https://www.covid19.act.gov.au/services-and-support/aged-care/advice-for-visitors-to-aged-care-facilities

NSW Government: Advice to residential aged care facilities (RACFs)
See Testing staff for COVID-19 and Visitors sections.
https://www.health.nsw.gov.au/Infectious/covid-19/Pages/racf-latest-advice.aspx

Kind regards Carrie
ACIPC
ACIPC IPC Consultant
Hobart

[Carrie Spinks]

Hi Monika,

In 2022 Melbourne University undertook a study (as per Dept recommendations) into air purifiers. They now provide some great insight into these devices.

Link: https://sgeas.unimelb.edu.au/engage/air-cleaner-guide

Kind regards Carrie

ACIPC
ACIPC IPC Consultant
Hobart

• This reply was modified 2 years, 4 months ago by David Tanedo.

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