The Infection Control Practitioner’s 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.
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 Department of Health (DH) 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:
AusHFG Parts
Cleaning standards for Victorian health facilities aim to improve the quality of healthcare provision by ensuring risks are identified and managed.
Auditing cleanliness
NSQHS Standards: Action 3.1, 3.5, 3.6. 3.7
Policies governing outbreaks or unusual clusters of infection or communicable diseases
Implementation of Transmission Based Precautions and environment cleaning
Australian Health Management Plan for Pandemic Influenza
Minimise transmissibility, morbidity & mortality
Minimise the burden on support health systems
Educate the public
Pandemic Order Register
Infection Prevention and Control information
Victorian DH Infection Prevention and Control Resources (COVID)
The resources include the following:
COVID-19 Infection control guidelines
Other Victorian Public Service sites:
Other Information
Victoria
National
Epidemiology
Coronavirus disease (COVID-19) weekly epidemiology reports, Australia, 2020Infection Prevention and Control Post Graduate Courses:
Short Courses
Australian Commission on Safety and Quality in Health Care: Infection Control Training Portal
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:
National Hand Hygiene Initiative
Hand Hygiene Compliance Application (HHCApp)
NHHI helpdesk Information
Hand Hygiene Resources
Hand hygiene online learning modules
Register/Login go to “Catalogue →Hand Hygiene Modules”
Hand Hygiene eLearning Modules
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-All immunisation providers should report any unexpected, serious or unusual adverse events following immunisation to their local surveillance body.
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.
Victorian reporting Services:
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
In Victoria, Nurse immunisers may administer specified vaccines and can manage adverse reactions where there may not be a medical practitioner present. Nurse immunisers are approved under regulation 8(1) and regulation 161 of the Drugs, Poisons and Controlled Substances regulations 2017
• Nurse Immuniser courses
Pharmacist immunisers must have completed a recognised course and administer vaccines to specific client groups in approved locations such as community pharmacies as part of the Victorian Pharmacist-Administered Vaccination Program.
• Pharmacist Immuniser courses
Immunisation Nurses Special Interest Group (INSIG)
INSIG is a professional body of the Australian Nursing Midwifery Federation (ANMF Vic Branch) to support Nurses working in Immunisation Practice.
Click her for Victorian Infection Control Guidelines
Australian Guidelines for the Prevention and Control of Infection in Healthcare 2019
These eight standards have been developed to drive the implementation of safety and quality systems and improve the quality of health care in Australia.
Standard 3 focuses on Preventing and Controlling Healthcare-associated infection and is aligned with Standard 1 (Clinical Governance) & Standard 2 (Partnering with consumers).
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.
Commission eNews: A quarterly eNewsletter features recent highlights from the Commission's work, as well as newly-released resources.
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. 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
Information 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
Therapeutic Guidelines: Antibiotics is an evidence base guide to appropriate antimicrobial prescribing. Available to Victorian Health Services via the Clinicians Health Channel
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.
Australian Government: Guidelines for Legionella Control, operation and maintenance of water distribution systems in health and aged care.
Victorian Department of Health:
Cooling towers 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.
Legionnaires’ disease is an urgent notifiable disease.
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.
Non-tuberculous Mycobacterium infections associated with heater cooler devices
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.
Australian Government: Australia’s National Antimicrobial Resistance Strategy—2020 and Beyond
Australian Group on Antimicrobial Resistance (AGAR) - A collaboration of clinicians and scientists from key microbiology laboratories around Australia that conduct targeted surveillance of selected pathogens and collect demographic, treatment and outcome data, and data on antimicrobial resistance rates. AGAR is an important core component of the Antimicrobial Use and Resistance Surveillance System (AURA).
Australian Society for Antimicrobials coordinates AGAR to collect, analyse and report on data submitted by participating laboratories for the following three programs
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.
Staphylococcus aureus – golden staph
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 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
Reporting of New and Emerging Pathogens of Significance
Non-tuberculous Mycobacterium infections associated with heater cooler devices
Health Services should have procedures for managing exposures to blood or body fluids. Resources to aid development of the procedure may be found at the Department of Health: Managing exposures to blood and body fluids or substances
Legislation change re HIV testing
The legislation, passed in Victoria 2019 (Public Health and Wellbeing Act 2008) will mean that Victorians can access HIV testing just by visiting their local health clinic, GP or pathology service, the same way they access blood tests for other blood borne viruses.
Consent for blood borne virus testing may be done by:
Pre and Post-test counselling courses
Australian guidelines for HCW with BBV/EPP
Australian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM)
National Testing Portal
National Hepatitis C Testing Policy 2020
Victorian HIV and Hepatitis Integrated Training and Learning (VHHITAL) offers a comprehensive program for GPs for the diagnosis, treatment and management of HIV, hepatitis B, hepatitis C and sexually transmitted infections (STI).
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.
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
Therapeutic Goods administration
Other Jurisdictions
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
Victoria public health has many rural & regional health services
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.
NSQHS Standards: Action 3.1
Uses safety and quality systems
Manages risk associated with healthcare associated infections
NSQHS Standards: Action 3.5
Application of standard and transmission-based precautions consistent with the current edition of the Australian Guidelines for the Prevention and Control of Infection in Healthcare and jurisdictional requirements
NSQHS Standards: Action 3.6
Clinicians assess infection risk and use transmission based precautions based on the risk of transmission of infectious agents
Standard precautions are the minimum infection prevention and control practices that must be used at all times for all patients.
Transmission-based precautions (TBP) are used, in addition to standard precautions with standard precautions alone may be insufficient to prevent transmission of infection. TBPs are used for patients known or suspected to be infected or colonised with epidemiologically important or highly transmissible pathogens that can transmit or cause infection.
The type of TBPs applied is based upon the mode of transmission of the pathogen. For diseases that have multiple routes of transmission, more than one TBP category is applied.
More information is available from the Australian Commission on Safety and Quality in Healthcare:
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.
The Clinical and related waste guidance – Supplement for healthcare staff has been developed to provide specific guidance to Victorian hospitals and health services on managing clinical and related wastes. The supplement is a user-friendly guide, providing a simple and practical decision-making process to help health service staff identify whether items are clinical waste, landfill waste or recyclable
Other Victorian Department of Health links:
The Victorian Department of Health 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.
Supporting tools include an action plan and progress report. These tools are in ‘word’ format for the internal use of the individual health service to map actions and progress.
