Author Archives: PLR

National HAI PPS update – October 2018

The national healthcare associated infection point prevalence survey (CHAINS) is now in its third months of data collection, with 12 of the 19 participating hospitals having been visited by our Research Assistants, Sophie and Stephanie. Hospitals that have participated to date include:

  • University Hospital Geelong, Vic
  • Bendigo Health, Vic
  • Calvary Hospital, ACT
  • Launceston General Hospital, Tas
  • North West Regional Hospital, Tas
  • The Queen Elizabeth Hospital, SA
  • The Royal Adelaide Hospital, SA
  • The Royal Melbourne Hospital, Vic
  • The Tweed Hospital, Vic
  • Royal Brisbane and Women’s Hospital, QLD
  • Frankston Hospital, Vic

From now until the end of data collection in the last week of November, data will be collected from:

  • Gold Coast University Hospital, QLD
  • Fiona Stanley Hospital, WA
  • Westmead Hospital, NSW
  • The Prince of Wales Hospital, NSW
  • Royal North Shore Hospital, NSW
  • Hornsby Ku-ring-gai Hospital, NSW
  • Alfred Hospital, Vic

Unfortunately due to unforeseen circumstances regarding research activity in Western Australian hospitals, we have had to replace Sir Charles Gairdner Hospital with another site. At late notice, we are grateful to the team at Westmead Hospital NSW who have been able to process the required documentation at speed, and look forward to visiting them soon.

Once again, on behalf of the CHAINS team, sincere gratitude to all site investigators and infection prevention teams at the participating hospitals for their support and work on this exciting project. Some of you are pictured below!

 

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Deb and Stephanie, Redcliffe QLD

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Team Royal Brisbane and Womens, QLD

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Sophie, Marija, Angela and Stephanie, Royal Adelaide and Queen Elizabeth, SA

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Team Royal Melbourne, Vic

National HAI PPS update – August 2018 (2). Data collection has commenced

It is exciting to see data collection for the CHAINS project has commenced. This week marks the third week of data collection. So far Sophie and Stephanie have visited University Hospital Geelong and Bendigo Health, busy collecting data via the electronic survey tool on their mobile devices. The survey tool allows for direct entry into the database to ensure no data loss on devices.

Thank you to the Site Investigators and Clinicians at both sites for their work and warm hospitality. It is greatly appreciated.

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The CHAINS team Stephanie (L) and Sophie (R) with Alison from University Hospital Geelong

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CHAINS team with Mandy and Jane from Bendigo Health

 

National HAI Point Prevalence Survey – August 2018 update

Data collection commencing!!

It has been an exciting month for the National Healthcare Associated Infection Point Prevalence Survey team. Our two Research Assistants, Sophia Robinson and Stephanie Curtis, have commenced their appointments and spent the past month undergoing surveillance training. After rigorously testing the data collection tool, they are now experts in utilising the tool to investigate HAIs and are excited to commence the data collection at our sites.

Site visits for data collection across Australia will commence next week, August 8th and continue until November 30th. We have locked in several dates with sites, starting with Geelong, Bendigo, Launceston, Burnie and Adelaide.

As previously announced, 19 hospitals will be participating in the study, these hospitals are listed below. We sincerely thank all the hospitals for their involvement, particularly the site Principal Investigators who have worked hard to progress ethics approvals and organise the logistics of our visits. We look forward to visiting you all soon!

  • Alfred Hospital, Vic
  • Bendigo Health, Vic
  • Calvary Hospital, ACT
  • Fiona Stanley Hospital, WA
  • Frankston Hospital, Vic
  • Gold Coast University Hospital, QLD
  • Hornsby Ku-ring-gai Hospital, NSW
  • Launceston General Hospital, Tas
  • North West Regional Hospital, Tas
  • Redcliffe Hospital, QLD
  • Royal Brisbane and Women’s Hospital, QLD
  • Royal North Shore Hospital, NSW
  • Sir Charles Gairdner Hospital, WA
  • The Prince of Wales Hospital, NSW
  • The Queen Elizabeth Hospital, SA
  • The Royal Adelaide Hospital, SA
  • The Royal Melbourne Hospital, Vic
  • The Tweed Hospital, Vic
  • University Hospital Geelong, Vic

 

​We will continue to provide updates on the project through this blog and Twitter via @PLR_aus and @1healthau , or for further information please contact either Dr Philip Russo or Professor Brett Mitchell 

 


Stephanie Curtis, Research Assistant, Australian National Healthcare Associated Infection Point Prevalence Survey

National HAI Point Prevalence Survey – April 2018 update

Progress on our National Healthcare Associated Infection Point Prevalence Survey is steady as we move our way through project milestones.

We are excited to have 19 hospitals participating in the study, representing all states and territories except for Northern Territory. Unfortunately we just could not fit NT into our travel schedule given our tight budget and brief timeframe.

Although this might seem like a small number of sites, our sampling method will provide us with confident estimates of the burden of healthcare associated infections in our population.

Project Manager Bridey Saultry is busy working with the Site Investigators at each site  carefully stepping through Site Specific Assessments and Research Contract Agreements. Completion of these forms is crucial so we can then confirm the dates between August and November for data collection at each site. Thank you to all the Site Investigators who have been shepherding these documents through their sites.

In an exciting development, we welcome the appointment of our two Research Assistants Sophie Robinson and Stephanie Curtis to our team. Sophie and Stephanie will be commencing with us in June, ready for data collection in July.

Two great papers describing National HAI Point Prevalence studies have recently been published. Impressive work continues in Scotland by Professor Jacqui Reilly’s team who describe the HAI rate as 4.6%, 2.7% and 3.2% in acute adults, paediatric and non-acute patient groups, respectively. The Scottish team propose a broader population based HAI prevention approach is required to reduce the incidence of community and hospital infections. Meanwhile researchers from the first multi-centre PPS in Japan estimated an overall rate of HAI as 7.7% in their population including paediatrics, neonates and non acute patients.

Australian HAI PPS data is not too far away…

If you have any queries about the PPS study, please use the query from at the bottom of our PPS page

National HAI Point Prevalence Survey – February 2018 update

There have been some recent exciting developments in our planning for Australia’s first national point prevalence survey in over 30 years continues. You may have noticed we are seeking two Research Assistants who will be engaged to collect data from all participating facilities. There are two full time roles for four months available, comprising of one month of surveillance training and use of data collection tools, and three months travelling across Australia to all sites to collect data. If you would like to find out more about these exciting positions, or know somebody who is interested, more information can be found here (applications close 11 March 2018)

Another major development has been the granting of ethics approval through Alfred Heath via the National Mutual Acceptance (NMA) system. The NMA is a system of single scientific and ethical review of multicentre human research projects in public health organisations in, Australian Capital Territory, New South Wales, Queensland, South Australia, Victoria and Western Australia. We have also been granted a separate approval from the Tasmanian Health and Medical Human Research Ethics Committee. Work is now focussed on processing Site Specific Assessments and Research Collaborative Agreements with each site. Thanks to Project Manager Bridey Saultry and all the site Principal Investigators who are working hard on these documents.

We are also in the process of fine tuning the data collection tools. Data will be collected via mobile devices using an online survey tool. As previously noted, our study protocol is based on the European Centers for Disease Control and Prevention protocol. This means that the major outcomes generated from this study will be comparable to those generated from ECDC PPS study’s.

If you have any queries about the PPS study, please use the query from at the bottom of our PPS page

I look forward to our next update.

 

 

Phil

Disclosure: ACIPC Board Director (President Elect)

 

Con(fused)tact precautions

Whilst “festivus”1 is generally a happy time for most of us, unfortunately people still become unwell, and our hospital beds remain occupied. One of the beds in a large Australian acute care facility has accommodated a family friend who has undergone surgery and some moderate rehab after falling at home.

Given some predisposing conditions, the family friend was at risk of acquiring a HAI, and it is disappointing to report they required treatment for various types of HAIs. They were also found to have VRE, and were promptly placed into a single room, under Contact Precautions.

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Whilst this family has much to be sorry and concerned about, what concerns them greatly, and what they have found most upsetting, is the inconsistent information and advice they receive on a daily basis from healthcare workers on the specific precautions that they, as family visitors, must take. Gloves, no gloves, mask, no mask, cloth gown, plastic apron… they have had almost every combination of precautions recommended. They  have even been scolded by a HCW for wearing “inappropriate” attire, whilst all the time directly observing a broad array of PPE adopted by different HCWs as they enter the room. They feel confused, angry, and upset. They lack confidence in the HCW knowledge of what is required, and feel powerless in seeking clarification of what they should be doing.

I find this troubling on several fronts. First, inconsistency. If HCWs caring for patients with MROs are giving family visitors different messages on PPE, then chances are they don’t quite understand what is required to prevent spread (evident by HCW inconsistency in their own PPE). Second, why are family visitors made to feel as though they have endangered the lives of not only their relative, but also of every other patient in the hospital when they are simply doing as they are told. And third, I don’t suspect for one minute that this situation is unique to this ward, hospital, city, or country. This scenario will likely be repeated daily in all types of facilities (see also NOTE below).

As we know, HAI prevention requires multiple interventions all being applied correctly. Whilst the momentum of antimicrobial stewardship in the fight against AMR has rightly attracted much energy, and the importance of environment is emerging , a basic understanding of precautions, and consistency of PPE messaging for HCWS and visitors is surely a simple and measureable intervention we should not lose sight of.

Phil

  1. Seinfeld 1997 – Episode 10, Season 9.

NOTE – this may be due to a lack of robust evidence and debate about Contact Precautions (see here for an example), nevertheless, messages (policy) within a facility should surely be consistent.

 

Some take aways from #ACIPC17 Conference, Canberra

Congratulations to the organisers of ACIPC Conference 2017 Parliament_House_Canberra_Dusk_Panoramain Canberra. Well done to the Conference Committee and the Scientific Committee. A great program and venue adding to the always enjoyable catch up with colleagues local, national and international.

There were many highlights. Due to other commitments, I missed a few of the major plenaries. Nevertheless, I came away with some clear take home messages from those I did get to, here are just a few of them…

  1. An emerging theme from the presentations was that of public reporting and financial penalties (PR&FP) associated with healthcare associated infections (HAIs). The likelihood that Australia needs to accept that these are inevitable for a range of HAIs is clear. In case you missed it, Benjamin Magid presented an excellent talk touching on the Australian Commission for Safety and Quality in Health Care use of what are called Hospital Acquired Complications, that use administrative coding data to detect healthcare associated infections, and which I have blogged about previously.
    One of the many advantages of living and working in Australia and hosting keynotes from the US is that they often provide a window to the future. At various stages, Prof Pat Stone, A/Prof Dev Anderson and Dr Susan Huang all related stories about their experience of PR&FP. From their experience it would seem, at some point in time, the implementation of PR&FPs does eventually turn into a positive for infection prevention (and hence our patients). From what we hear, PR&FPs seem to result in a recognition of infection prevention that subsequently provide opportunities to increase resources. Thats not to say there was no pain during the “journey”, and we should be prepared for that. Although Dev Anderson did argue against the notion of PR&FPs in the final debate, he was quick to tweet afterwards that in fact he does support it! Finally on this point, we should continue to explore better use of existing data if validated, strive to minimise the burden of data collection, and consider whether current HAI definitions are suitable for the PR&FP environment.
  2. The quality of the free papers gets better every year. The addition of the quick poster presentations and the new format of the 3 minute research presentations was a celebration of the excellent research being undertaken in our field. Updates on current studies (e.g. the large and complex REACH project) further added to our awareness of exciting work being undertaken by our colleagues. The next few years will see many of these projects yield new knowledge and fill sessions of conferences to come!
  3. The consumer voice is powerful. The presentation delivered by Mathew Ames left many in the auditorium not only in tears, but also resolute about the work we undertake.
  4. Finally for now, I believe the pop up sessions during lunch were a big winner. Informal yet intimate, a great way to get close to those people who are always hard to find at conferences. A great initiative hopefully here to stay..

But thats just some of my impressions from the sessions I saw. You might have seen something completely different. If so, comment below and let us know…

Looking forward to Brisbane in 2018.

TIP: Next year, if you have trouble remembering the correct Twitter hashtag, think  character count efficiency...save the character count by dropping the “20” from “2018”

#ACIPC18

 

Phil
Disclosure – ACIPC Board member (President Elect) and member of the ACIPC Conference Scientific Committee 2017