eBulletin June 2007 Edition 27
In this Edition:
 |
Type 1 & 2 Reminders: |
Data Due
3rd August |
Reports posted
14th September |
SHIINe - Surveillance Software Update
After much anticipation, the pilot version of SHIINe [Safer Hospitals Integrated Information Network] became live at St Vincent’s
Hospital on Tuesday 29th May. In the first instance SHIINe will be programmed to undertake surveillance on orthopaedic
procedures. Whilst the pilot is running, collection of data will need to be continued to ensure all the procedures are being captured.
This is an exciting step forward in the implementation of the software. Many thanks to Joanne Cocks, Maree Somerville and the
Infection Control team for their hard work and cheerful cooperation, as well as the executive sponsors and IT staff at St Vincent’s.
Over the next month the functionality of the pilot version will be increased to enable surveillance on other surgical procedures,
and the ICU surveillance. Draft plans are being developed on the roll out of SHIINe to the other Type 1 hospitals. To assist in the
roll out of SHIINe, letters are being sent to the IT Departments of each of the Type 1 hospitals seeking information about
the current IT systems presently in use. This information is required to help plan the integration process at each site.
Type 1 User Groups
On Wednesday 16th May two User Groups were conducted. For the first time, participants were able to join in
using a teleconference facility. Four staff joined in on the NNL User Group. For the SSI session there were 8 participants
on the phone and four at the VICNISS Coordinating Centre.
The feedback from participants was very positive. They indicated that the teleconference format worked well from the user end,
and that they would be willing to use this facility again. Although there is no limit as to how many can participate, we are
considering restricting numbers to about 10 to ensure everybody has a chance to contribute, and conversations do not get too confusing.
There were several interesting items discussed at the User Groups that required clarification.
We sought advice from Teresa Horan at the National Health and Safety Network [NHSN, formerly NNIS] CDC who has been able
to provide input on these issues.
NNL User Group: One of the major issues arising out of this User Group and one we have been aware of in Adult ICU Central Line Associated
Bloodstream Infection [CLABSI] surveillance relates to Criteria 2b and 3b and the commencement of antibiotic therapy in the
CLABSI definition. To help us further explore this issue a survey will be sent out in the near future asking Infection Control
staff to indicate how they apply the definitions using case scenarios.
Surgical Site Infection [SSI] - Clarifying Organ Space and Deep SSI: Several differing opinions were also
offered in the SSI User Group as to the differentiation between DEEP and ORGAN SPACE SSI. To help clarify this we have outlined
some points to remember below.
With regards to drainage:
- When there is no drainage through the incision – the SSI remains an Organ Space SSI.
- If there is spontaneous drainage through the incision – the SSI becomes a Deep SSI [Criteria (a) of Deep SSI]
- If there is no spontaneous drainage through the incision, but the wound is deliberately opened – remains an Organ Space SSI.
This last point followed discussion in the User Group about the situation when a patient is taken back to theatre or has the wound
deliberately opened. To assist us in providing the correct advice, we went back to the original source of the definition,
Teresa Horan at National Health and Safety Network, CDC for her advice.
Teresa comments “When we wrote these definitions the surgeons wanted to indicate that when the wound dehisces, it is a
complication of the wound, not the organ/space under it, so they wanted to capture that information by calling the infection Deep.
In this case, the surgeon opened the wound (which presumably allows him to evacuate the pus and clean it out), indicating that
the wound itself didn't ‘fail’. Therefore, I think it fits better under the O/S category”.
Given the level of interest in this discussion, we will be conducting another SSI User Group:
UPCOMING SURGICAL SITE INFECTION VUG
| Time: | Tuesday, 21st August 2007 at 10.30 - 11.30am via phone conference |
| Audience: | Type 1 participants |
| Discussion: | Difficult surgical cases, e.g., COLO, CSEC, HPRO, KPRO procedure groups |
As with previous User Groups, participants will be invited to present difficult or interesting cases.
To assist with preparation for the VUGs please RSVP by Tuesday, 14th August to
vicniss @ mh.org.au
and Judy will forward a template to complete for each of your cases which she will compile and distribute prior
to the VUGs
Details of how to participate via phone will be forwarded prior to the VUG along with case
presentations for discussion. You will be given a phone number to call and an access code.
High Infection Rates Notification
Since October 2004, following a recommendation from the VICNISS Advisory Committee, when a hospital is identified as having a
significantly high infection rate, a notification letter is sent to the Chief Executive Officer and copied to the Infection Control
Coordinator informing them of the data. This notification process continues.
The Quality and Safety Branch of DHS have now advised the VICNISS Coordinating Centre seek a response from the hospital.
The response from the hospital is to include an outline of an action plan to be implemented to address the high infection rate.
On receiving an outline of the action plan from the hospital, the VICNISS Coordinating Centre will then pass this information on to the
Quality and Safety Branch DHS. This process is to come into effect immediately.
Type 2 Surveillance Update
Just a reminder...
All hospitals are required to complete the Surgical Infection Report module. In the near future a VICNISS employee will be contacting
the Type 2 Infection Control Consultants to ask how they find potential cases.
The current version of the Type 2 Surveillance Manual is 9. All data collection forms being used should have this documented in the ‘footnote’.
Some Category 1A recommendations for ‘catheter site care-cutaneous antisepsis’ are outlined on page 14 of the CDC 2002 Guidelines
for the Prevention of Intravascular Catheter-Related Infections. These recommendations were not included in the ‘Peripheral
Venous Catheter Use’ module only because they were considered too difficult to measure.
VICPA/VICNISS Journal Club
The VICPA/VICNISS Journal Club was initiated with the aim of providing a forum for infection
control professionals to more widely engage with literature and published data in the
field. To date we have had three meetings with more than 25 participants attending each session.
Evaluations demonstrate that attendees value the information presented and, the ability to
discuss contemporary issues presented in the literature reviews.
The next journal club will be on Friday 10th August 2007. Due to renovations at the VICNISS Coordinating Centre,
the venue has been moved to the Kingston Centre (Southern Health - on the corner of Warrigal and Kingston Roads).
Further details regarding room details, presenters and topics for the next journal club will be
available on both the VICNISS and VICPA websites: (www.vicpa.org.au).
In 2007 VICPA & VICNISS will be co-hosting 5 sessions held bi-monthly that will be held at hospitals
around Melbourne. Click here for further Journal Club dates and venues
www.vicpa.org.au/Default.aspx?c=367&ct=3
For further enquiries please contact VICPA Education Officer, Lorraine Wilson at
lorrainew @ fmh.com.au
or Judy Brett at VICNISS.
*Reminder* - VICNISS International Conference Award
- Asia Pacific Society of Infection Control (APSIC), July 2007 Kuala Lumpur
IMPORTANT UPDATE:
There has been a change to the criteria for applications to this award. Unexpectedly, there are no free
oral presentations at APSIC 2007. Therefore it has been decided to change the criteria.
Previously the award was only available to those who had an ORAL presentation accepted.
This criterion has now been amended to include those who have had a POSTER PRESENTATION accepted.
ALL OTHER CRITERIA REMAIN UNCHANGED and must be met.
Please attach a draft or final version of your poster with your application.
Given the late change to the criteria we will extend the application date to 6th July 2007.
Unfortunately this means that you will most likely need to pay for your attendance at APSIC prior to a final decision being awarded. We apologise for any inconvenience as a result of this late change.
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 available to those who have a POSTER Presentation accepted for the conference. Please check all other criteria in the Application form before applying. 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 6th July 2007.
To view details of this conference, go to
www.apsic2007.com/.
VICNISS Coordinating Centre wish to acknowledge and are very grateful for the support
of VPAC with this award.
Staff Movements at VICNISS Coordinating Centre
Dr Emma McBryde has taken up the position of Head of Epidemiology at the Victorian Infectious Diseases Service at Royal Melbourne Hospital.
We wish Emma all the best in her now role and thank her for all her hard work during her brief time at the VICNISS Coordinating Centre.
At the same time we welcome Dr Leon Worth who has recently commenced with us. Leon is an ID Physician with experience in infection
control particularly in hospital acquired infections in immunocompromised patients and is currently undertaking his PhD in
catheter related bloodstream infections in immunocompromised patients. Welcome Leon.
And of course congratulations to Claire Boardman on the arrival of Xavier in the early hours of Monday 7th May. We wish
Claire, Xavier and her family all the best in the future.
VICNISS Coordinating Centre Renovations
As you would be aware, the VICNISS Coordinating Centre is co-located in the Victorian Infectious Diseases Laboratory [VIDRL].
Over the next 12-18 months the World Health Organisation [WHO] Flu Centre is to take up residency in VIRDL also.
To accommodate the WHO Flu Centre, major renovations of the VIDRL building are required.
For several months during this renovation, we will be relocating within VIDRL whilst new offices are built.
This may mean some temporary disruption in our usual office work flows, but we will endeavour to ensure these disruptions
do not effect our service delivery. Activities such as Education Workshops and User Groups may need to be held off site.
At this stage all works are due for completion in March 2008.
Infection Control Literature Review, June 2007
Our most recent
literature review, for June, compiled by Dr Leon Worth, ID Physician,
discusses current research on the following selected topics:
- Australian Study of Interventions to Reduce MRSA Infection or Colonisation
- VICNISS Validation Study of Victorian CABG Surgical Site Infection Surveillance Data
