eBulletin October 2006 Edition 23
In this Edition:
Reminders:
! Type 2 Data Submission:
Quarter 2 Reports were released in October 2006. The deadline for data to be forwarded to the VICNISS Coordinating
Centre for Quarter 3, 2006 is Tuesday, 31st October 2006.
The corresponding report is then due to be posted mid-December 2006.
! Type 1 Data Submission:
Quarter 2 Reports were released in October 2006. The deadline for data to be forwarded to the VICNISS Coordinating
Centre for Quarter 3, 2006 is Friday, 3rd November 2006.
The corresponding report is then due to be posted mid-December 2006.
Key Dates: For more information on deadlines and dates, please visit the
Key Dates
(Opens in new window) page on our website.
VICNISS International Conference Award - Asia Pacific Society of Infection Control (APSIC), July 2007 Kuala Lumpur
As announced at the launch of our Year 4 Annual Report, the VICNISS Coordinating Centre, in conjunction with the
Victorian Partnership in Advanced Computing (VPAC) is offering an International Conference award.
The VICNISS International Conference award aims to facilitate attendance by one Infection Control nurse at
the International Congress of the Asia Pacific Society of Infection Control (APSIC), July 2007 Kuala Lumpur.
The award is only available to those who have an Oral Presentation accepted for the conference. The award
will fund one economy airfare (to the value of $1500) and full conference registration to APSIC 2007.
To view the terms and conditions of the award, please see the
VICNISS Application Form (PDF File 
35kb, opens in new window)
The closing date for applications to VICNISS is Friday 1st June 2007.
To view details of this conference, go to www.apsic2007.com/.
Abstracts for APSIC 2007 close on 14 February 2007.
VICNISS Coordinating Centre wish to acknowledge and are very grateful for the support of VPAC with this award.
VICPA/VICNISS Journal Club
In collaboration with VICPA, the inaugural VICPA/VICNISS Journal Club will be held on Friday 17th
November 2006, commencing with breakfast at 0800. Please see the VICNISS website news page for more details.
If you would like to come, please RSVP so that we may cater adequately for participants by Monday
13th November to Kylie Berry, VICNISS Coordinating Centre. Phone: 03 9342 2605 or email:
VICNISS @ mh.org.au
Next year VICPA & VICNISS will be co-hosting 6 sessions held bi-monthly that will be held at hospitals around
Melbourne.
For further enquiries please contact VICPA
Education Officer, Lorraine Wilson at lorrainew @ fmh.com.au.
Please join us in making this a successful joint initiative between VICPA and VICNISS.
Hospital Infection Society Conference 2006
Two VICNISS Coordinating Centre staff are currently attending the sixth International Conference of the
Hospital Infection Society in Amsterdam. The Director of the VICNISS Coordinating Centre, Dr Mike Richards,
was invited to speak at a plenary session on “International Perspectives of HCAI Surveillance”. Presenting
on behalf of the NHSN at CDC was Ms Teresa Horan, with Dr Petra Gastmeier presenting the European
perspective, and Tony Howard the UK perspective.
Also, Claire Boardman presented a poster titled “Infections Following Orthopaedic Surgery – Robbing
Peter To Pay Paul?” on the costs associated with infections following hip replacement. Following review
of the posters by an independent panel at the conference, this poster, and another VICNISS poster titled
“The VICNISS Smaller Hospital Infection Control Surveillance Program: An Update Report” were selected for
inclusion in "poster rounds" by conference experts.
Also, congratulations to Elizabeth Gillespie, Sterilisation and Infection Control Coordinator Southern
Health, who presented her oral paper on “Risk stratification for patients undergoing colorectal surgery in Australia”.
We look forward to hearing all about the conference on their return.
Changes to the Therapeutic Guidelines Antibiotic - Version 13 2006
A new version of the Therapeutic Guidelines Antibiotic (Version 13 2006) has recently been released.
There are some changes to recommendations for antibiotic prophylaxis for surgery which will affect the
assessment of surgical prophylaxis. If you do not have access to a copy at your hospital we would recommend
purchasing one as there have been a number of changes. The main changes can be summarised as follows:
1. Hernia repair - previously the guidelines recommended no prophylaxis without prosthetic material; and the
same regimen as for colorectal surgery for hernia repairs where prosthetic material was used. The new recommendation
is the same (i.e. none) for repairs without prosthetic material, and Cephalothin OR Cephazolin for repairs with
prosthetic material.
2. Cardiac surgery - where vancomycin is indicated the new recommendation is to use vancomycin PLUS gentamicin.
3. Hysterectomy - previously an alternative recommended antibiotic was cefotetan; in the new guidelines it has
been replaced by cefoxitin.
4. CSEC - previously no recommendation for elective CSEC without membrane rupture. Prophylaxis is now
recommended for all CSEC, elective and emergency. Recommended antibiotics remain the same.
5. Vascular surgery: where there are indications for vancomycin the new recommendation is to use vancomycin
PLUS gentamicin as for cardiac surgery.
In terms of timing and duration the recommendations are basically the same. There are some extra notes
about when to consider vancomycin prophylaxis.
We will aim to have all the assessments updated by the first antibiotic prophylaxis report in 2007.
These guidelines are also available via the Clinicians Health Channel website
at www.health.vic.gov.au/clinicians/index.htm under “Therapeutic Guidelines”.
Type 1 SSI - Changes to Ventricular Shunt (VHSN) and Craniotomy (CRAN) Data Requirements
As you are aware, VICNISS methodology is based on NNIS. When VICNISS commenced, NNIS presented data that
indicated extra risk factors collected on these procedures allowed for the development of a risk model resulting
in an infection ratio, similar to that used for C-section. With this in mind, VICNISS included fields on the
data collection forms on these extra risk factors.
Recent correspondence with Ms Teresa Horan at NHSN CDC indicated that CDC were unable to develop a strong
risk model to allow for calculation of an infection ratio.
As a result of this, VICNISS have decided to cease collection of extra risk factor data for Ventricular
Shunt (VHSN) and Craniotomy (CRAN) procedures.
This means that if you are doing surveillance on these procedures, there is no need to use the specific
Ventricular Shunt (VHSN) and Craniotomy (CRAN) forms. Form 1.1 can now be used.
Type 1 Education Workshop
"Introduction" workshops are held to assist the number of new infection control nurses that have joined VICNISS participating
sites, or for those existing nurses that would like a refresher. Content for the workshop included introductions to HAI surveillance,
and VICNISS surveillance methodology (SSI and ICU), instruction on the basic and modified risk index and SIR for CSEC and AB prophylaxis,
and understanding and interpreting reports.
| DATE: | Tuesday, 14th November 2006 |
| TIME: | 10.00am - 2.00pm (lunch provided) followed by a User Group |
| VENUE: | VICNISS, 10 Wreckyn St, North Melbourne
(click here for a Map, PDF File
88kb, opens in new window) |
Register your interest in attending the Education Workshop by RSVP to vicniss @ mh.org.au.
Type 1 User Group
The next User Group will focus on Surgical Site Infections and Case Finding - applying the definitions to difficult
cases. Users have been invited to present their most difficult surgical site cases to the group for discussion and consensus. This
initiative has commenced to assist you with case finding and application of the definitions.
To facilitate discussion please send VICNISS a synopsis of your case as per the following and we will put into a PowerPoint ready
for the day. You will only be required to talk about your case for 5 minutes or so before we move onto the discussion.
Infections from all surgical procedure groups are invited such as HPRO/KPRO/CSEC and COLO surgery. Example criteria for inclusion:
- Patient demographics (excluding identifiers) (eg. Sex, DOB).
- Procedure date and procedure.
- Relevant medical history.
- Summary of presenting problem post surgery, surgical notes (and by whom), micro notes, radiology notes to assist
in applying case definitions.
- Include dates for all pathology/radiology in logical order of events. AB treatment, return to theatre details etc.
If you intend to attend the user group meeting please forward your case(s) to Kylie Berry at vicniss @ mh.org.au at for collation.
If you would like to discuss prior to the meeting please
contact Claire Boardman.
| DATE: | Tuesday, 14th November 2006 |
| TIME: | 2.30pm - 16.30pm |
| VENUE: | VICNISS, 10 Wreckyn St, North Melbourne
(click here for a Map, PDF File
88kb, opens in new window) |
Register your interest in attending the User Group by RSVP to vicniss @ mh.org.au.
Updated VICNISS Website - www.vicniss.org.au
After many months of work we are pleased to present the updated VICNISS website. FEATURES include:
- Modernisation and enhancement of the functionality, technology and design of the site to allow for
anticipated future requirements.
- Increased security to each hospital's reports page (not visible by User).
- Defined areas, including one with general information on VICNISS, another for Health Care Workers
and another for Consumers. (The area with content specifically created for Consumers still has some
content to be finalised through consultation with consumer advisors and will be available in due course).
- The online education modules previously available on a separate site have been redeveloped and included.
However, the modules themselves are awaiting finalisation and content will be available shortly. Users will
still be able to undertake the exercises for each module, however individual results will not be recorded as
was the case previously. Clicking on an exercise answer will simply let you know whether that answer was
correct or incorrect and why.
- There is a new section detailing VICNISS journal publications and attendances at conferences, with abstracts.
- Each page is now fully printer-friendly.
We hope you find these improvements to your benefit. Please feel free to provide us with any
feedback on the website
.
Type 2 Surveillance Update
Just a couple of reminders...
The 'Surgical Infection Report' module is required for all hospitals. This module ensures significant
'in-house' or 'transferred' deep or organ space surgical site infections are counted.
Thank you... The official response rate to the Type 2 satisfaction survey was 68%
(Forty-five Infection control consultants employed across 60 hospitals responded). A summary of the results
will be distributed to all Infection Control Consultants employed in Type 2 hospitals.
Infection Control Literature Review, October 2006
Our most recent literature review, for October, compiled by Dr
Emma McBryde, VICNISS Infectious Diseases Physician, discusses current research on the following selected topics:
- Staphylococcus aureus Colonisation but does not Prevent Infection
- Isolation and Cohorting of Colonised Patients are Associated with Reduced MRSA Prevalence
- Risk Factors for Sternal Surgical Site Infection
Farewell Kylie (for now), and Welcome Doreen and Wendy
As some of you may know, Kylie Berry will be leaving the VICNISS Coordinating Centre at the end
of November to commence her maternity leave. On behalf of everybody at VICNISS Coordinating Centre we
wish her all the best in her exciting new adventure into parenthood. Kylie performs a diverse and
valuable range of tasks at VICNISS including keeping all of us in line and we are really going to miss her
while she is away. Kylie's leave will be for 12 months, and we are pleased to announce that Doreen Jenkins
will be replacing Kylie during this leave. Doreen has previously worked in Melbourne Health and in other health areas.
Also commencing is Wendy Wang in a new IT role at VICNISS, Graduate.Net Programmer. This new role has been
established to provide support to Simon, Database Manager, with the increasing day to day IT
requirements of the VICNISS Coordinating Centre.
We warmly welcome both Doreen and Wendy.
