The Infection Control Toolbox is a set of themed links accessible from a single site which aims to help the Healthcare Worker access relevant infection control information quickly.
The information is compartmentalised for easy access.
Aged Care Quality Standards: Standard 3 requirement (3) (g)Minimisation of infection-related risks through implementing: standard and transmission-based precautions to prevent and control infection; and practices to promote appropriate antibiotic prescribing and use to support optimal care and reduce the risk of increasing resistance to antibiotics.
Guidance material to assist aged care services to comply with the Aged Care Quality Standards (Quality Standards) are available.
Prevention and control of infection and control in aged care (currently under review)
The Victorian Government has produced a guide to assist in the management and control of outbreaks of gastroenteritis (gastro) in aged care homes and other facilities.
The Gastro-Info Kit, developed by the Australian Government Department of Health and Ageing as a resource kit to assist aged care homes in the event of a gastroenteritis outbreak. It is not a set of guidelines to manage an outbreak of gastroenteritis.
Residents of aged care homes are at increased risk of Clostridioides difficile infection. These guidelines assist in preventing and controlling the spread of infection.
Scabies is found worldwide, and may affect people of all races and social classes. Facilities such as aged care homes are often sites of scabies outbreaks
The Victorian Department of Health has provided information for Carbapenamase Producing Enterobacteriaceae (CPE) specifically for Long Term Health Care Facilities
Managing a respiratory outbreak (suspected or confirmed) effectively requires a number of required actions. Influenza is not the only virus that may cause an outbreak in aged care homes. Other viruses include parainfluenza, respiratory syncytial virus (RSV), adenoviruses, and rhinoviruses The Victorian Department of Health Respiratory illness in management in residential and aged care facilities has a variety of tools and checklists to support the facility in the event of a single case or an outbreak.
The National guidelines offers further information in managing influenza outbreaks: Guidelines for the Prevention, Control and Public Health Management of Influenza Outbreaks in Residential Care Facilities.
The purpose of Antimicrobial Stewardship is to promote optimal management of antimicrobials in order to maximise the effectiveness of treatment and minimise potential for harm (including drug resistance and toxicity).
The National Centre for Antimicrobial Stewardship (NCAS) has provided resources to assist aged care homes.
Available to purchase is a book from National Quality Partners Antibiotic Stewardship Post-Acute and Long-Term Care Playbook™. This book offers practical strategies and useful resources for implementing high-quality antibiotic stewardship programs in post-acute and long-term care facilities. Internationally the Centers for Disease Control and Prevention (CDC) has tools to assist aged care homes with the Core Elements of Antibiotic Stewardship
AURA — Antimicrobial Use and Resistance in Australia is a surveillance system to support strategies to prevent and contain antimicrobial resistance
National Centre for Antimicrobial Stewardship (NCAS) is using a ‘One Health’ approach in tackling antimicrobial resistance. Antimicrobial resistance is seen as an ecologic problem that includes strategies that cover food production, veterinary prescribing, community general practice and hospital prescribing.
National Antimicrobial Prescribing Survey (NAPS) is a national survey which has been in use since 2011. It helps health services to assess their antimicrobial prescribing practises and provides valuable information on the utilisation of antimicrobials within Australia.
Specific modules include:
The Victorian Department of Health is making this aseptic technique learning module freely available for health services to use and adapt to meet the National Safety and Quality Health Service Standards of the Australian Commission on Safety and Quality in Health Care.
Aseptic technique risk matrix provides a score for the following factors
Has a large number of resources to assist ICPs in developing an aseptic technique program such as an action plan, assessment, workbooks and education.
ANTT® (Aseptic Non Touch Technique) program was developed in the UK. It uses a standardised approach to aseptic practice. It has become the de facto national standard aseptic technique in both the UK and Australia and continues to expand internationally.
The role of Infection Control teams in any construction work within the health care facility is as follows:
Construction practices may impact on patient wellbeing by disseminating bacteria and filamentous fungi causing hospital acquired infections.
Victorian DHHS document Infection Control Principles for the Management of Construction, Renovation, Repairs and Maintenance within HealthCare Facilities is a practical manual for reducing the risk of health care associated infection by dust and water borne micro-organisms.
Employing risk management principles
South Australian Department of Health has provided a similar toolkit: - Infection prevention and control during construction and renovation (2018)
The Australasian Health Facility Guidelines (AusHFG) have been made freely available. The 6 chapters are:
Cleaning standards for Victorian health facilities aim to improve the quality of healthcare provision by ensuring risks are identified and managed.
VICNISS offers a range of educational webinars annually. To registered users, modules are available on each surveillance module.
The Australasian College for Infection Prevention and Control (ACIPC) is the peak body for Infection Prevention and Control in the Australasian region. It offers a wide range of professional development opportunities for members and non-members:
NSQHS Standards: Action 3.13
The health service organisation has a risk based workforce immunisation program that:
a) Is consistent with the current edition of the Australian Immunisation Handbook
b) Is consistent with jurisdictional requirements for vaccine-preventable diseases
c) Addresses specific risks to the workforce and patients
Healthcare workers may be exposed to, and transmit, vaccine-preventable diseases such as influenza, measles, rubella and pertussis. Maintaining immunity in the healthcare worker population helps prevent transmission of vaccine-preventable diseases to and from healthcare workers and patients.
NSQHS Standards Workforce immunisation risk matrix may be used to calculate the risk response for the organisation’s workforce. This information can be used to prioritise action.
Adverse Events Following Immunisation-Clinical Assessment Network (AEFI-CAN) formerly known as SAEFVIC provides a central national reporting hub for adverse events.
The adverse event following immunisation (AEFI) reporting portal used by immunisers to report individuals who may have had a serious or unexpected adverse event following immunisation. The service is twofold.
1. Reported individuals are expertly reviewed and follow up by a specialist doctor maybe arranged
2. By getting as much information about AEFI, problems with vaccines or systems are detected as early as possible if they do occur.
Therapeutic Goods Administration (TGA) is another portal for reporting vaccine related adverse events.
Cold chain; breaches can affect the potency of the vaccine. There are clear processes to be followed for vaccine safety including delivery, storage and back up plans in the event of power outages. All immunisation providers should ensure effective cold chain management of vaccines in line with the National vaccine storage guidelines: Strive for 5
What to know
Webinar: Vaccine and Cold Chain Management
The Victorian Chief Health Officer recognises a number of study programs for the Nurse Immuniser
INSIG is a professional body of the Australian Nursing Midwifery Federation (ANMF Vic Branch) to support Nurses working in Immunisation Practice.
These eight standards have been developed to drive the implementation of safety and quality systems and improve the quality of health care in Australia.
Tools to assist:
Resources for NSQHS Standard – second edition. Includes a vast array of support material including workbooks, risk matrices and monitoring tools plus more.
On the Radar: A summary of some of the recent publications in the area of safety and quality in health care.
Subscription to regular emails is the easiest way to access this information
A-Z of infectious Diseases, once known as the ‘Blue Book' provides detailed information about common and rare diseases that pose public health concerns. Information included are notification requirements, school and childcare exclusion, identification of symptoms, incubation periods, and modes of transmission and control measures. The aim is to assist public health practitioners in the prevention and control of infectious diseases.
For public health safety, prescribed conditions must be notified to the Department of Health and Human Services. Notifiable conditions were once grouped into 4 groups (A, B, C & D). The groupings have now been simplified as “Urgent” or “Routine”. Notification procedures for infectious diseases clearly outline who is required to notify, what is to be notified and the timeline notification must occur.
Infectious disease surveillance in Victoria provides daily reports for notifiable diseases, and seasonal influenza reports
Brochures for culturally and linguistically diverse (CALD) in the Health Translations Directory has been produced by the Centre for Culture, Ethnicity and Health. This group is regularly reviewing the collection
Pneumonia is the most commonly described manifestation of Legionella infection and is termed Legionnaires’ disease. Legionella can also cause a self-limiting acute febrile illness termed Pontiac fever. Infection by Legionella occurs following inhalation or aspiration of aerosol droplets containing Legionella bacteria or host organisms infected with Legionella bacteria.
Guidelines for Legionella Control, published by the Australian Government, are designed to assist a health service’s Legionella risk management team to assess and manage the risk from Legionella in health and aged care facilities. These guidelines are also accessible from the Victorian Department of Health and Human Services - Legionella and water delivery systems.
Cooling tower systems are designed to remove heat, temporarily store water that is then recirculated. The water is sprayed or dripped into a large chamber which is then cooled by a thermostatically controlled fan. Potentially Legionella-contaminated droplets may be generated by the cooling tower systems and inhaled by susceptible people.
Managing the risk in cooling tower systems and water delivery systems includes registration and auditing of the systems
There is a specific risk that heater-cooler devices used in Cardiac Surgery may be contaminated with Mycobacterium chimaera (M. chimaera), and that exposure of patients to the aerosolised exhaust from these devices may cause infection.
M.Chimaera infections may not be clinically apparent for several years after exposure.
Staphylococcus aureus bacteraemia in Australian hospitals 2016-17 (SABs) reports on hospital associated infection (sensitive and resistant strains). SAB is an indicator of the safety and quality of hospital care.
AURA — Antimicrobial Use and Resistance in Australia is a surveillance system to support strategies to prevent and contain antimicrobial resistance
AGAR - is a unique collaboration of clinicians and scientists from major microbiology laboratories around Australia, who have tested and gathered information on the level of antibiotic resistance in bacteria causing important and life threatening infections since 1985. It is funded by the Australian Commission on Safety and Quality in Health Care (ACSQHC)
AGAR is now a working group of the Australian Society for Antimicrobials (ASA), and three Program Committees have been formed
Staphylococcus aureus (ASSOP – Australian Staphylococcal Sepsis Outcome Program)
Enterococcus spp. (AESOP – Australian Enterococcal Sepsis Outcome Program)
Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter spp. (GNSOP – Gram negative Sepsis Outcome Program)
Patient-centred risk management strategy for multi-resistant organisms provides a framework to assist clinicians in determining how to care for an individual with an MRO within their clinical setting.
What is MRSA brochure has been translated into 13 languages
The Victorian guideline on Carbapenamase-producing Enterobacteriaceae (CPE) for health services supersedes this risk management strategy and must be followed for all CPE cases.
C.auris is an emerging treatment resistant fungal infection of serious public health implications.
Confirmed or probable cases (invasive infection or colonisation) are to be notified by the treating clinician, by telephone, to the Department of Health and Human Services via 1300 651 160.
Additionally it is requested that all isolates of confirmed C. auris are forwarded to the Victorian Infectious Diseases Reference Laboratory for further confirmatory and susceptibility testing.
Guidelines for the management of Candida auris will soon be available following wide consultation within the health sector
VICNISS provides a wide range of resources for members. It includes the following
CPE, VRE & MRSA
Health Services should have their own procedures for managing exposures to blood or body fluids. Resources to aid development of procedure may be found at the Department of Health & Human Services: Managing exposures to blood and body fluids or substances
Under the Public Health and Wellbeing Regulations, only a ‘person of prescribed class’ may gain consent for blood borne virus testing. This person may be either a medical practitioner or a person whose competencies and training qualifications have been determined by the Secretary of the DHHS.
Nurses, may consent if they have completed a pre and post testing course to become a ‘prescribed person’.
Pre and post-test discussions (Hepatitis C) (Australian Government; as part of the National Hepatitis C Testing Policy 2007)
Australian guidelines for HCW with BBV/EPP
Victorian: Guidelines for the investigation of gastrointestinal illness, reviewed annually.
The guideline includes best practice infection control recommendations and detailed information for the investigation of sporadic cases of gastroenteritis and food or water borne outbreak investigations tailored for different clinical settings such as hospitals, aged care and children’s service centres. Each module contains documents to support cleaning practices, hand hygiene, signage, outbreak case lists and the notification process.
National: The Gastro-Info Gastroenteritis Kit, published by the Australian Government, is a resource to assist residential aged care facilities in the event of a gastroenteritis outbreak.
Health services are required to have a plan in place to address the possible impacts and consequences of pandemic influenza on their organisations, and their responsibilities to communities.
The Victorian action plan for pandemic influenza provides guidance to help organisations to complete or review their pandemic influenza plans.
Cleaning, disinfecting and sterilising re-usable medical devices and equipment is essential foundation for delivering safe and good-quality care.
The Australian Standard and New Zealand Standard (AS/NZS) 4187:2014, Reprocessing of reusable medical devices in health service organisations is available by subscription
ASUM/ACIPC (Australian Society for Ultrasound Medicine/Australasian College for Infection Prevention and Control) joint guidelines for the cleaning, Disinfection, and Reprocessing of Ultrasound Transducers
Ultrasound Infection Prevention Toolkit is a resource regarding infection prevention during the use and reprocessing of ultrasound probes in Australia
SRACA (Sterilising Research and Advisory Council of Australia (Victoria) Inc.) is the professional body of sterilising technology practitioners.
GENCA (Gastroenterological Nurses College of Australia) is the peak professional body that sets the gold standard for gastroenterological nursing. The mission of GENCA is to develop and promote excellence in gastroenterology nursing practice
GESA (Gastroenterological Society of Australia) is the peak membership organisation for health care professionals and researchers working in the fields of gastroenterology and hepatology. GESA’s Infection Control position statements is available here
NSQHS Standards: Standard 1
Governance, leadership and culture
Private health sector is represented by 15 services of which 7 are independent or community based and 8 are from a network.
Rural Infection Control Practice Group (RICPRAC) is an informal and voluntary group of regional Infection Control Practitioners (ICP) offering peer support to public health services within clearly defined regions. Each region operates under a different model.
Useful websites for rural members:
The Environment Protection Authority (EPA Victoria) regulates the storage, transport, treatment and disposal of clinical and related wastes in Victoria under the Environment Protection (Industrial Waste Resource) Regulations 2009.
EPA Victoria Publication: Clinical and Related Waste – Operational Guidance
Waste streams are regulated: Clinical (for incineration and non-incineration), Cytotoxic, Radioactive, Confidential, Recyclable, and General.
Victorian Department of Health links:
The Victorian Department of Health & Human services is committed to improving sustainability within the health system infrastructure.
This is documented in the department’s strategic plan—Environmental sustainability strategy 2018-19 to 2022-23.