Keynote Speakers

Prof. Shaheen Mehtar

Decontamination of medical devices in low resource settings – challenges to IPC

Decontamination of medical devices play a significant role in reducing surgical site infections (SSI) and preventing transmission of blood borne viruses. In high income countries, sterility of medical devices is taken for granted. However, in low to middle income countries (LMICS) there is little investment, both financially and human resources, in sterile services resulting in twice to four times higher SSIs particularly in C sections across Africa. The contribution of poor decontamination service and operating theatre conditions, and challenges towards improving these services will be discussed.

Developing appropriate education platforms for IPC

Given that IPC is essentially clinical, developing engaging IPC education programmes requires both didactic and practical aspects. In Africa the geographical distances makes it difficult to conduct face to face courses. Therefore virtual learning platforms such as Teleclasses (WebberTraining), ECHO and ICAN­­ VL have been developed by ICAN to allow the students to see the tutors as well as the presentation on the screen. It allows the audience to actively participate with the tutor, ask questions and discuss matters. It is also extremely cost effective in that it cuts down travel and subsistence costs. However this type of platform requires electricity (power) and a stable internet connection which is now becoming more robust in most LMICs especially Africa.

Prof Shaheen Mehtar is an Emeritus Professor at the Unit for Infection Prevention and Control (UIPC),  Faculty of Medicine & Health Sciences, Stellenbosch University. She trained in the United Kingdom in Medical Microbiology, and was Head of Microbiology at the North Middlesex Hospital & Senior Lecturer at Royal Free Hospital until 2000 when, she moved to South Africa.  In 2004 established the Unit of Infection Prevention and Control, Tygerberg Hospital & Stellenbosch Uni, and has trained more than 1000 students ranging from basic courses to a Masters in IPC across 34 countries in Africa.

She is an internationally recognised expert in IPC and has been instrumental in setting up IPC programmes globally. She served on the executive committees of HIS, BSAC, ESCMID, ISC and ISID. She serves on several WHO committees for global IPC policies.

Shaheen is a founder member, and Past Chair, of the Infection Control Africa Network (ICAN) through which she is involved in IPC, WASH and AMR training across Africa and setting up national IPC structures in 8 African countries. She was actively involved in Sierra Leone during the Ebola outbreak. She has published extensively (170 papers), authored two books and several chapters.


Julie Storr RGN BNurse MBA

Authentic leadership and the future of IPC

This session will focus on leadership for effective IPC with a special exploration of authentic leadership theory and its relevance to the infection preventionist. To support our understanding of what makes an effective IPC leader, the session will explore relevant literature on leadership challenges and opportunities including how to build capacity and capability. The session will draw on current thinking that shaped recent WHO IPC and quality handbooks and training resources – resources that support those responsible for leading the development and implementation of national and health care facility IPC and quality activities, policies, strategies and operational plans. The session will conclude with some personal reflections on a leadership journey in the quest for high quality people-centered IPC.

Patient empowerment 1999-2019

The role of patient empowerment in the prevention and control of infection has been on the table for over twenty years and has been described as a critical element of hand hygiene promotion. It has also been the subject of much academic debate with many questioning its value and feasibility. 2019 marks the twentieth anniversary of my own personal journey into patient empowerment and this session will look back on what has been learned since 1999. I will argue that the concept is perhaps, to some extent, misunderstood and will put forward the case that, as part of a multimodal strategy it can add tremendous value to the quest for zero avoidable infections and enhanced health related quality of life for patients.

 Julie is a graduate nurse from the University of Manchester, where she also trained as a Health Visitor and more recently studied for an MBA. Julie is a director at S3 Global and has over a decade of experience working with WHO on the development, implementation and evaluation of global improvement programmes in the field of patient safety, quality and infection prevention and control, with a focus on behaviour change. Julie has worked with WHO units focused on Water Sanitation and Health (WASH), Quality Systems and Resilience and Global Infection Prevention and Control (IPC). Her technical and leadership expertise was called on to support WHO’s Ebola response and recovery efforts in 2014/15, with a focus on national IPC policy development in Sierra Leone. She has led on the development of evidence based WHO Guidelines (Core Components of Infection Prevention and Control Programmes at the National and Acute Health Care Facility Level, 2016) and implementation support packages (Core Components and CRO). She was previously President of the Infection Prevention Society of the UK and Ireland, Assistant Director at the English National Patient Safety Agency and Director of the seminal cleanyourhands campaign. Julie has authored a book (Perspectives and Perceptions of IPC – highly commended at the 2016 BMA Medical Book Awards), published widely in the academic literature and is currently writing a follow up book focused on IPC and the social sciences. She is peer reviewer of a range of academic journals. One of her recent papers on infection prevention and control and universal health coverage and quality was awarded research paper of the year in the Journal of Research in Nursing in 2017. She is currently studying for a doctorate in public health (health care leadership and management) at Johns Hopkins Bloomberg School of Public Health, Baltimore.


Siouxsie Wiles – Microbiologist

Antimicrobial resistance: The end of modern medicine?

Antibiotics are a cornerstone of modern medicine, used to treat infectious diseases and prevent infection in vulnerable patients. In 2014, the World Health Organization (WHO) described how antibiotic-resistant bacteria are present in every region of the world, including Aotearoa New Zealand. Within a decade, antibiotic resistance will make routine surgery, organ transplantation and cancer treatment life-threatening. The WHO director general at the time, Margaret Chan, called the issue “…the end of modern medicine as we know it”. In her talk, Siouxsie will explain how this crisis came about and discuss the efforts she and her lab are making to find new antibiotics.

Prevention is better than cure – studying pathogen transmission in the lab

Despite its importance, transmission is missing from almost all experimental models used to investigate how bacteria cause disease in their mammalian hosts. Whereas we humans can be infected by eating contaminated food, say, laboratory animals are invariably infected by being injected with large doses of bacteria grown in rich laboratory media. In other words, the transmission step is missing in the experiment! We have recently pioneered a novel model to experimentally investigate the transmission of an infectious gut bacterium, with the ability to manipulate the bacterium, the host, and the environment. In her talk, Siouxsie will explain what their experiments are revealing about pathogen transmissibility.

Sponsored by 

Associate Professor Siouxsie Wiles studied medical microbiology at the University of Edinburgh, UK and then did a PhD in microbiology at the Centre for Ecology and Hydrology in Oxford. She spent several years working at Imperial College London where her research won the inaugural UK award for the humane use of animals in scientific research. In 2009, Siouxsie was awarded a Sir Charles Hercus Fellowship from the Health Research Council of New Zealand and relocated to the University of Auckland, where she heads up the Bioluminescent Superbugs Lab. Siouxsie also has a keen interest in demystifying science for the public; she is a tweeter, blogger, podcaster, In 2017 she published her first book, ‘Antibiotic resistance: the end of modern medicine?’, and recently collaborated with her daughter to make a kid’s show about microbiology. Siouxsie has won numerous awards for her science communication efforts, including the Prime Minister’s Science Media Communication Prize, and Royal Society Te Apārangi’s Callaghan Medal. She was one of three finalists for the 2018 Kiwibank New Zealander of Year award and this year was appointed a member of the New Zealand Order of Merit for services to microbiology and science communication.

 

 

Speakers

 John Aitken

Crohn’s Disease: Bacteria never sleep, so look busy
CWDM are bacteria with absent or rudimentary cell structures. They exist as part of the life cycle of Mycobacterium species.  Dormant CWDM are characterised by low metabolic activity and replication. and increased resistance to host/environmental stresses, including antibiotic action.    Crohn’s disease is sometimes associated with the human carriage of CWDM, particularly members of the Mycobacterium avium Complex (MAC).
Reactivation of tuberculosis is also attributed to escape from dormancy.
Previous work by us suggested that carriage of dormant CWDM was ubiquitous in both IBD patients and healthy controls.  This raised the possibility that variant forms of CWDM may be present in IBD patients. Here we report the findings of three studies on patients diagnosed with IBD and on healthy human controls.
Using already existing methods in combination with newly developed media we were able to demonstrate the carriage of CWDM in samples from healthy controls and IBD patients. We were also able to demonstrate and provisionally characterise variant CWDM forms present in human blood and deep ileal tissue of IBD patients but not in controls. These variant forms produced metabolites capable of causing inflammation.
The detection of variant forms of CWDM present in IBD patients may be a reliable biomarker, and several confirmatory studies have followed our preliminary observations.
To confirm pathogenicity and identity of these isolates, we are continuing with molecular testing, including next generation sequencing (NGS) on extracted DNA. Pathogenicity studies will be necessary. Demonstration of a newly described CWDM, if confirmed, may require infection control risk assessments.


John is a 68 year old free-lance medical laboratory scientist, and worked in medical microbiology for public and private providers for 43 years. He also helped to set up and run an environmental testing laboratory in my “spare time”.  He currently operates a private research laboratory, Otakaro Pathways Ltd.
John is particularly interested in antimicrobial resistance, and emerging bacterial infectious diseases. Most of his work involves an understanding of the underlying relationships between microorganisms, plants, and animals.
He believes that a solution can only be found if the life cycle of the problem organism is completely understood. The rest will then follow.
His experience in bacteriology and my international research relationships with other medical laboratory scientists have been invaluable in the investigation of emerging pathogenic organisms.
As in most businesses, his work is directed towards financially and sustainable solutions to complex problems.
John is presently involved in research in four areas:

  1. The relationship between autoimmune diseases and Mycobacterium species.
  2. Bioremediation, particularly in relation to the use of naturally occurring microorganisms.
  3. Biodiscovery of new antibiotic compounds.

Jane Barnett

Innovate, Integrate, Motivate – Conjoint Conference Infection Prevention and Control (IPAC), Canada and International Federation of Infection Control   

This year, IPAC Canada hosted a conjoint conference with the International Federation of Infection Control (IFIC) in Quebec City.  The IFIC component attracted delegates from every continent, which gave it a truly international flavour.  I was able to attend after receiving the BD travel award (2017) and with the support of Webber Training and my employer, Southern Cross Hospitals.  I will provide an overview of the key messages from this conference provided some key learnings on behavioural approaches in Infection Prevention and the patient experience.

 

Jane Barnett has worked in the field of Infection Prevention and Control for over 30 years.   Her experience spans three NHS trusts in the UK and both District Health Board and private surgical hospital here in NZ.  She is passionate about this area of practice and believes that we need to use our influence in this field to improve patient outcomes.  Jane currently works as the National IPC Lead for Southern Cross Hospitals and is based in Auckland (but remains a Cantabrian at heart!)

Josh Freeman

New Zealand CPE guidelines – 1 year on

In this talk Josh will provide an update on the national response to CPE and how the CPE IPC guidelines have contributed.  He will also seek to identify strengths and weaknesses of the national response and ongoing practical measures for local IPC teams and other stakeholders to focus on.

Josh Freeman is the Clinical Director of Microbiology at Canterbury DHB and was previously the Clinical Lead of the Hand Hygiene New Zealand Programme. He has a longstanding interest in infection prevention and in particular the transmission of resistant gram negative organisms. Currently he’s working on initiatives to improve implementation of NZ’s national response to the evolving epidemic of carbapenemase-producing Enterobacteriaceae (CPE).

Nikki Grae

Partnering to invest and expand best practices

Updates related to the current HQSC IPC programmes, Surgical Site Infection Improvement Programme (SSIIP) and Hand Hygiene New Zealand (HHNZ), will be presented. Building on the successes and learnings of this work will inform new initiatives. As the HQSC IPC programme matures into an HAI hub, the focus during the next year will be on two areas: replicating successes of the SSIIP to other procedures and determining what quality improvement activities will be most effective and beneficial.

 

Nikki Grae has been the senior advisor for the infection prevention and control programme at the Health Quality & Safety Commission since 2016. She has 11 years of infection prevention, quality, and patient safety experience in the healthcare sector. Prior to working at the Commission, she managed and led the infection prevention and patient safety programmes for a health system in the U.S. Nikki has also worked as a research scientist in cancer biology and microbiology. She has a Master of Science degree in microbiology. Nikki relocated to New Zealand to enjoy the friendly people and spectacular scenery while continuing her career in infection prevention and control.

Darryl Haines

IP&C and the design process

Darryl will discuss some of the challenges faced with the interface between Infection Prevention & Control and Design Team using the above project and a recent tour of European Hospitals.

 

Daryl is a Registered Architect and Christchurch based Principal at Warren and Mahoney.  Darryl is Project Architect for the new Christchurch Hospital Hagley Building (formerly known as Acute Services Building) for the last 7 years.

 

Alistair Humphrey

You can lead a horse to water, but you can’t make it drink:  Drinking water and the “post-Havelock environment”.

Safe drinking water was described by the Walkerton Inquiry as  “water posing such a negligible risk to health that a reasonable, informed consumer would be justified in not being worried about health risk”. Following the 2016 Havelock North waterborne campylobacter  outbreak which affected 5,500 residents and caused 5 deaths, the Havelock Inquiry produced a number of key recommendations which the current government is putting in to place.  As well as announcing the establishment of a national water regulator next year, the Ministry of Health have tightened up on risk assessment for water safety plans, including a requirement that “secure bore water status” no longer be relied on for safe drinking water and that all suppliers should disinfect their water. This has implications for many supplies across New Zealand, particularly those which currently are unchlorinated and have previously relied on the secure status of their groundwater.  Although Cabinet has announced that some supplies may be eligible for an exemption from the strict rules which will shortly apply, rural supplies are unlikely to be able to afford to upgrade their infrastructure to a level which meets the criteria. There are some European countries which provide safe, unchlorinated drinking water – what will New Zealand water suppliers need to do to meet the exacting standards required to also provide unchlorinated , but safe, drinking water and will it meet the new water regulators requirements?

Dr. Alistair Humphrey is a Public Health Physician and GP in Christchurch, New Zealand. He is a Medical Officer of Health for Canterbury, designated by and responsible to the Director General of the Ministry of Health.  Medical Officers of Health are senior public health physicians responsible for legislative aspects of health in a region, including alcohol licensing, drinking water regulation and other regulatory aspects of environmental health, communicable disease and emergencies.

Dr. Humphrey trained in Scotland (St. Andrews) and England (Manchester) before moving to New Zealand and Australia, where he completed his Master of Public Health at Monash University.  He has also completed a Master of Health Law at the University of Sydney.  He has held a post as an epidemiologist with the International Diabetes Institute, Melbourne, Australia where he carried out research into diabetes and other non-communicable diseases in Mauritius, Nauru, Samoa, Tonga and Tasmania.  He has also worked with Royal Flying Doctor Service in Australia in both a clinical and public health capacity and as a consultant public health physician in East London, England.

Dr. Humphrey has worked with the World Health Organisation and other United Nations groups, including the UN International Strategy for Disaster Reduction, the Towards a Safer World (TASW) group, the One Health/Global Risk Forum, the Asia-Europe Foundation Public Health network and BBC Media Action.

Dr. Humphrey holds an honorary senior lectureship post at the University of Otago Medical School.  He has been made a fellow of the Australasian Faculty of Public Health Medicine, Royal Australian College of General Practitioners, Australian College of Rural Medicine and a member of the UK Faculty of Public Health.  He is currently Chair of the Canterbury Hospitals Medical Staff Association, a board member of the New Zealand Medical Association, a member of the Clinical Governance board of the Rural Canterbury Primary Health Organisation and sits on the Health Practitioners Disciplinary Tribunal.

In his spare time he enjoys skiing, sailing and walking his three-legged dog, Chester.

Anne Hutley

Sponsored by

Bugs in colour

Bugs in colour is a visual educational tool. It serves as a colourful reminder of how organisms can easily be transferred from the environment, the healthcare worker and patient. The environment, healthcare worker and patient are each assigned a different colour, through the course of the video it will become evident how these colours/areas of contamination can easily be transferred to the patient.
This” transfer” places the invasive procedure at risk of contamination, which  places the patient at risk of infection. We have found it a useful tool to  help embed how the environment, healthcare worker and patient all play a role in the invasive procedure and if not managed correctly can lead to infection of the patient. Although this video revolves around a dressing change, the visual colourful message can also be applied to procedures such as IDC insertion, arterial line insertion, the taking of blood cultures, and many more.

 

Anne is a Registered Nurse, Clinical Nurse Specialist – Infection Prevention & Control (IP&C) for Counties Manukau Health. After completing her diploma from the Medical Nursing School, at the Medical Centre of the University of Bonn Germany, she worked as a registered nurse in Germany, the United Kingdom and New Zealand. She has been involved in infection prevention & control for the past 11+ years. As part of her role she holds the Surgical Site Infection (SSI) surveillance portfolio, submitting data to the National SSI Improvement Programme on behalf of the DHB. She is also the spokesperson for the IPC Nurses College, involved in the Orthopaedic and Cardiac SSI improvement Project Expert Faculty Groups.

Dr Robert Martynoga

Sponsored by

Sepsis: a major current issue for NZ & a road-map to eliminating preventable harm

Infection remains a leading cause of hospital admissions in New Zealand. Sepsis, the serious consequence of infection resulting in multi-organ dysfunction or failure, affects more than 1 in 100 New Zealanders each year and leads to about 10% of intensive care unit admissions. Sepsis carries high morbidity and mortality and has high associated costs – to the system, to the individual and their whanau. It is recognised that survival from sepsis, although increasing, results in the need for significant rehabilitation and some patients never regain their previous health status.
The NZ Sepsis Trust has been formed to champion best practice in sepsis prevention, recognition and treatment nationwide. Robert Martynoga is an ICU Specialist in Waikato and a founder Trustee. His talk will illustrate this pressing issue with a case history and will suggest a “road map” towards eliminating preventable harm from sepsis in NZ.


Robert is a UK and ANZ-trained intensivist and anaesthetist with an interest in sepsis that has resulted in becoming a Founder Trustee of the NZ Sepsis Trust – a not-for-profit charitable trust formed to promote awareness of sepsis and its consequences in NZ and to assist healthcare professionals in delivering best-practice in identification and care of patients with sepsis. Working with Waikato DHB, the Trust has delivered a successful “Sepsis Ready” programme which has demonstrated improvement in sepsis care by a variety of metrics. Robert has been at the forefront of this, developing pathways for patients with septic shock requiring access to intensive care. More information on the Trust’s activities can be found at: https://www.sepsis.org.nz

 


Prof. Mary-Louise McLaws

Sponsored by 

What hand hygiene would be like if kids ran hospitals

Hand hygiene is the first infection prevention and control activity we learn in childhood during toilet training. We are asked to learn a new approach at nursing and medical school. Yet, better handwashing after patient contact and in-depth discussions with mothers and children support the view that our childhood training influences our ward based compliance. Compliance with the introduction of the World Health Organization My Five Moments for Hand Hygiene identify Moments 3, 4 and 5, after different contacts, is universally better complied than before contact, Moment 1. I will discuss behavioural theories we can use to overcome our entrenched childhood behaviours.

CLABSI – Why targeting a zero benchmark is flawed

The Pronovost aseptic insertion program was attributed to successfully reducing in CLABSIs to a median of zero CLABSI per 1000 line days in USA. All Intensive Care Units in New South Wales public hospitals introduced the Pronovost program and reduced CLABSIs by 60% and if we reached zero why is this threshold setting us up for failure?

Mary-Louise is Professor of Epidemiology, Healthcare Associated Infection and Infectious Diseases Control at The University of New South Wales (UNSW) Australia, the Water-Health Leader for the UNSW Global Water Institute and Deputy President of the UNSW Academic Board. Her clinical epidemiology research is focused in patient safety improvement programs.
Mary-Louise has focused her research program on surveillance and hand hygiene. She performed the first Australian prevalence survey healthcare associated infections in the mid-1980s and went on to develop the first standardised semi-automated surveillance system for healthcare associated infections on behalf of the NSW Ministry of Health. In the mid-2000s she was the WHO Advisor to China and Malaysia for the development of their national HAI surveillance systems. She was a contributor to the WHO Guidelines for Hand Hygiene and an advisor to the WHO First Global Patient Safety Challenge: Clean Care is Safer Care project. Mary-Louise holds membership to the World Health Organization (WHO) Technical Steering Committee for the Infection Prevention and Control Global Unit.
As honorary epidemiologist to NSW Clinical Excellence Commission she collaborated on the first Australian hand hygiene intervention Clean Care Saves Live that preceded the national program while supervising early Australian behavioural aspects of hand hygiene intervention. She also collaborated on the NSW Clinical Excellence Commission CLABSI intervention that aimed at reducing central line associated infections in 32 intensive care units by introducing an aseptic insertion approach. This was adopted by ANZICS and rolled out nationally. She also collaborated on the Sepsis Kills intervention that aimed at early detection and treatment of sepsis in 32 emergency departments. This intervention saved over 200 lives and was awarded the Global Sepsis Alliance in the Government Category and in 2017 the Medical Journal of Australia/MDA awarded the publication Best Research Paper.
Post-SARS she collaborated with the Health Bureau to review the response to the outbreak in Beijing. In preparation of pandemic influenza the Chief Medical Officer appointed Mary-Louise to review the Australian Infection Prevention Guidelines for Healthcare Workers for evidence-based recommendations. Her capacity building in patient safety in low-medium resource settings includes ICU projects in Turkey, haemodialysis in Vietnam, hand hygiene for crowded healthcare settings in Vietnam, needlestick injury surveillance in Taiwan, water-related health in Vanuatu and Mali and understanding antibiotic prescribing practices and use of antibiotic in the community and food animals in Cambodia.
Her most recent projects have contested the reliability and validity of the human auditing used in the Australian national hand hygiene program against automation and clinicians’ behaviour around compliance.

 

Francie Morgan

Do infection prevention and control standards die or flourish in changing models of healthcare?

The New Zealand Health and Disability Services Standards are in review to better reflect current practice and changing models of healthcare. This includes 8134.3 2008 Infection Prevention and Control. The IPCN College has undertaken a search of international infection prevention and control standards that are similar in presentation and/or application to NZS 8134.3.  This has revealed that infection prevention and control principles should be bespoke to every type of healthcare service. Can modulising the current NZ 8134.3 meet the challenge of the ever-changing models of healthcare? What has been the experience of other developed countries following a modulised infection prevention and control standard? This brief presentation will provide insights gained from the literature search work undertaken to date.

 

Francie resides in Auckland and has been practicing as an Infection Prevention and Control Nurse Specialist for many years in various services within the healthcare sector.  Her interests include the professional development of NZ IPC Nurses; leadership styles in IPC; the surgical interface with IPC best practice principles.

Dr Ramon Pink

Just a Flight Away: Canterbury Measles Outbreak 2019

An outbreak of measles in Canterbury in February/March 2019, resulted in an ‘across system’ response, that included Infection Prevention and Control, particularly in the hospital setting. A global increase in measles outbreaks, heightens the risk of new cases being introduced into New Zealand at any time. This presentation looks at the outbreak response, and identifies some of the challenges and lessons learned.

 

Dr Ramon Pink, Te Aupouri Te Rarawa. Ramon is a Public Health Physcian, and Medical Officer of Health, employed by the Canterbury District Health Board. He has a special interest in Communicable Disease. He was a General Practitioner in Otara South Auckland over 10 years, before entering into public health. He is married with four children.

Deanna Sara and Sarah Metcalf

Clostridium difficile: one patient’s journey of rising from the ashes

Deanna will be sharing her personal journey with MRSA and C-diff, specifically how it  affected her life and changed her health. Dr. Sarah Metcalf will also share in the discussion and provide relevant medical background from an specialist infectious diseases perspective.

 

Deanna is a 38 year old mother of one and works part time as a Speech Language Therapist for Canterbury District Health Board. She works in community stroke rehab team as well as providing awake craniotomy speech testing services to the Neurosurgical team at Christchurch Hospital. She is originally from the United States and completed both her Bachelor’s and Master’s degrees in Speech Language Pathology at U.S. institutions. Deanna has been living in the southern hemisphere for the past 12 years between Wellington, Sydney and Christchurch.

 

Dr Sarah Metcalf is a graduate of the University of Otago, Christchurch School of Medicine. She is an Infectious Diseases and General Physician at Christchurch Hospital and is the Clinical Director of the Department of Infectious Diseases.
She is interested in all aspects of infectious diseases, antimicrobial stewardship and infection prevention and control in health care settings.

Dr Phil Schroeder and Kelly Robertson

Canterbury Primary Response Group (CPRG)

Managing Infectious Outbreaks – the Canterbury Collaborative Approach
The Canterbury Primary Response Group (CPRG) was formed in 2005 following the threats of SARS and avian influenza worldwide.  The possible impact of these virus’ alerted health care professionals that a community-wide approach was needed to manage and coordinate a response to any outbreak or potential outbreak.
Therefore CPRG took the responsibility to coordinate and manage the regional, out of hospital, planning and response coordination to annual influenza threats and the possible escalation to pandemic outbreaks.
This presentation will outline the bringing together of not only a wide range of health providers but also key community agencies to plan strategies and responses to infectious outbreaks. It will focus on what the group has learned during this journey and its future planning for seasonal influenza, and other possible infectious outbreaks.

Dr Phil Schroeder is a general practitioner with over 25 years’ experience as a rural GP initiating general practice services in the township of Rolleston, 20 kilometres South of Christchurch.
He became involved with CPRG, in 2005, when the district turned its attention to the H5N1 Avian Influenza threat.  This was exercised in full when H1N1 “Swine Flu” arrived in New Zealand in late April 2009 and Dr Schroeder headed the Primary Health Response in Canterbury where there was widespread use of flu centres to both treat and protect the Canterbury population.
Since then Phil has continued to provide clinical leadership for primary and community care in responding to both natural disasters and infectious outbreaks that the region have experienced.

 

Kelly Robertson is a Registered Nurse, with 40 years+ experience working in both the secondary and primary health care sectors. She is currently the Nursing Advisor for the Canterbury Primary Response Group (CPRG), and has been involved with CPRG since its inception in 2005.
Kelly was part of the planning and leadership team during the H1N1 (pdm09) outbreak and also lead the nursing team at the Central Flu Center during this time. She has continued to provide nursing leadership for the group, especially during the subsequent seismic events of 2010-2011 and 2016.

 

 

Lisa Stirling

Building resilience through change
This presentation explores the place of stress in modern living, the causes of it, and our default responses to it.  It focuses on understanding our responses to stressful events and the coping strategies we employ.  Also covered are the importance of de-escalation and self-care to prevent burn-out and build personal resilience.

 The presentation will allow delegates to:

  • Recognise and identify their own personal stressors
  • Use the Stress Escalator Tool to help visualise the elevating nature of stress
  • Identify the signs and symptoms of someone experiencing elevated and critical stress
  • Understand the need to be continually de-escalating
  • Incorporate practical strategies into everyday life to reduce stress and improve well-being

This presentation is interactive and shares practical ways to take ownership, be accountable and take responsibility for one’s own well-being and resilience.

Lisa Stirling works as a Staff Support Professional for Workplace Support.  Through this role Lisa provides support and assistance to individuals to improve their well-being within their work environment.  Support could include anything from anxiety and depression to family and relationship challenges, mental well-being and stress management.

Lisa is a sought-after workshop facilitator and adult educator who has led well-being and employment education workshops for various organisations including Canterbury District Health Board, Ministry of Social Development and Inland Revenue Department.

Lisa’s workshops are engaging, informative, practical and relevant.  She is personable and authentic and draws on her rich life experience.  Lisa is relatable and down to earth, has a great sense of humour and the ability to relay complex concepts into everyday language that people can grasp and implement into their daily lives.

Carolyn Stewart

On your best behaviours

Is leadership more about behaviour than style?  What are the leader behaviours which motivate and empower first line clinical staff to ‘get things done’?  This session draws on recent research exploring the relationship between leader empowering behaviours and first line clinical staff perceptions of empowerment.  IPCNs will explore the complex clinical environments in which they practice, in positons where they are often negotiating between management and firstline staff to bring IPC policies and procedures to life in the clinical context.  IPCNs are challenged, given the context and their position to think about those leader behaviours which empower and motivate firstline clinical staff, to get ‘infection prevention & control things’ done.

National Organisational Development Manager, Learning Solution Developer, Speaker, Trainer LMS Manager, Instructional Designer…Southern Cross Hospitals
Recognised for her many and varied roles in the area of health workforce capability development, Caro is on a mission to dramatically improve the way we develop and support our health workforce.  Caro draws on her extensive experience in tertiary education and also in the public and private health care delivery sector to develop integrated, applied – ‘real’ people development solutions.
Caro has completed a Masters of Social Science and recently a Masters in Business Administration with the University of Waikato.  Her Masters of Business Administration focused on Capability and Leadership development.

Shelagh Thomas

Wednesday 13th March – a day I will not forget

Wednesday 13th March a day I shall not forget in a hurry. The day sterile services in NZ came under the spotlight and it all happened when I was sitting at a workshop in the ministry of health.
This presentation looks at events of the day, how it was reported, the ministries response, all of NZ DHB’s responses  the investigation that took place at Hawkes Bay, the outcomes and what is happening going forward.

 

Shelagh is a Registered Sterile Technician and a Registered Nurse.  She has been the CSSD manager at Hutt Valley DHB for 12 years. During that time she also acted as theatre manager and CSSD manager at Wairarapa DHB.  Prior to her CSSD roles she was a theatre nurse at HVDHB. She is currently president of the NZSSA. She has also worked as a theatre nurse in rural South Africa. In her role at HVDHB she has full governance over all matters relating to reprocessing and purchasing of reusable medical devices and reprocessing equipment.
It has been her mission over the past 12 years to develop the role of sterile technicians through education, as an outcome of this sterile technicians are now professionals in their own right. The sterile technicians are now members of Allied Health NZ and are now being fully supported by the Allied Health Directorates within the DHB system.
When not living “Sterile Services and the NZSSA”, she enjoys travelling and spending time with my six grandchildren or trying to avoid them.

Chris Vanderweg

Illness and recovery – Living to tell the tale

After a weekend away hunting, and thinking I was reasonably fit and healthy, nothing could have prepared him for what would unfold in the weeks and months ahead.  From the initial doctor’s visit, to the mother’s lifesaving instincts, the baffled experts and the prompt medivac.
In an induced coma on life support, he couldn’t respond to any questions or give any information that might help the medical team. His family who never left his bedside were the ones that had to endure the daily struggle of the updates from the ICU staff, see his body go through some horrific things and literally watch him fade away.  He’ll never forget the relief he could see on their faces when he was finally able to talk to them again after so many potential complications.
However, as we would learn, the road to recovery is a long and arduous one.

 

Chris is a 36 years old and self-employed engineer based near Ashburton, Mid-Canterbury.  He was born and raised in Mid-Canterbury, educated at Christchurch Boys High School, and qualified with a NZ Diploma in Mechanical Engineering from CPIT.
He is one of three siblings, an uncle to a niece and two nephews and enjoy making time for friends and family.
As a keen outdoorsman, with a passion for hunting, fishing, and the great outdoors which means he is often found up a mountain, down a river or out on a lake.  With an extensive background in agriculture, his business focusses on fabrication, manufacturing, design and consultation for the agricultural and general engineering industries.
Prior to falling ill in 2018, besides back surgeries, he had never been hospitilised for a serious medical condition and would consider myself to be in fairly good health.
He looks forward to sharing with you my experiences of before, during and after his illness, and he hopes what he shares will further your understanding from a patient’s perspective.

 

 

Abstract presenters

Sue Atkins

Anywhere, Anytime, Anyone – Leading the aseptic technique AAA learning approach

Introduction
The Grampians Region Victoria Australia covers 47,980 square kilometres and has 11 public hospitals  with multiple campuses spread over large distances. In 2012-13 training of the workforce on aseptic technique was required under the National Safety and Quality Health Service Standards accreditation process. Online learning became the mode of training delivery due to distance, however it was not always effective as evidenced by clinician’s poor verbal recall of aseptic technique principles during clinical practice.
What could be used Anywhere, Anytime, and by Anyone to consolidate principles, practice the selection of aseptic technique, inspire clinician ongoing learning, maximise workforce coverage, and not rely on electronic systems? In 2013, a project commenced to investigate this potential.

Method
In 2014, two resources were developed and implemented. A simple hands-on educational tool  depicting a variety of complex and simple procedures to consolidate aseptic technique principles, and a flow chart to assist with the decision-making process on the selection of aseptic technique type during clinical practice.

Results
In 2019 clinician verbal recall of aseptic technique principles has improved significantly and the principles embedded into practice. The online learning has provided the theoretical knowledge, while the additional hands-on educational tools were successful in guiding knowledge into practice. The tools have provided a platform for agreement between peers on aseptic technique selection in everyday practice, engaged clinicians in ongoing learning, and contributed to a clinician led culture of reflection to maintain appropriate and safe aseptic practice.

Conclusion
These AAA resources have empowered clinicians to remind each other on safe aseptic practice and maintain momentum for clinician driven aseptic technique training and consolidation. These simple resources could be utilized in the New Zealand health care environment, so let’s try the AAA approach with this presentation!

Sue is a NZ trained Registered Comprehensive Nurse and Infection Control Practitioner, and an Australian Credentialed Infection Control Professional – Expert. Sue has spent the last 16 years working in infection prevention and control in a variety of Australian settings and is currently one of two Regional Infection Control Advisors for the Department of Health and Human Services, Grampians Region, Victoria. This position assists in facilitating a coordinated approach to the implementation of a state-wide infection prevention and control strategic framework, and supports the practitioners working in the Grampians Region Healthcare Services. Sue has delivered aseptic technique symposiums across Australia on behalf of the Australasian College for Infection Prevention and Control, and has provided aseptic technique resources, implementation tips, train the trainer education days, and ongoing support to meet accreditation requirements for many metropolitan, regional and rural healthcare services in Victoria.

Iona Bichan

Let’s go on a Pseudomonas hunt

Colonoscopes are used in the dirtiest areas of the human body, have long dark narrow channels and are constructed of materials that don’t tolerate the most effective sterilisation processes. What better place for Pseudomonas to take up residence? This presentation tells the story of a novice infection prevention nurse on the trail of recurring Pseudomonas contamination in a family of colonoscopes in a small regional hospital. Enlisting the support of various experts, the investigation led down several blind alleys until the culprit, hiding in plain view, was finally identified.

Iona Bichan is an old dog learning new tricks,  having left her previous career in emergency nursing to join the infection prevention team at Nelson Marlborough Health. She’s enjoying living in the sunny South Island and learning about the intricacies of her new career in infection prevention through the post graduate course at Toi Ohomai. Her current aim is to become proficient in both infection prevention and paddleboarding.

Ruth Barratt

Healthcare workers’ perceptions of respiratory infection risk; a mixed methods research study into protective mask use in routine practice

Introduction
The optimal use of personal protective equipment by healthcare workers (HCWs) is an important infection prevention measure in limiting transmission of infectious disease. Recent respiratory outbreaks, including Middle East respiratory syndrome (MERS), were notable for hospital transmission and HCW disease acquisition. Appropriate mask use during routine care is a forerunner to best practice in an outbreak and may limit the part HCWs play in infection transmission as vectors or victims of respiratory infectious disease. The purpose of this research was to explore the behaviour and decision making of HCWs in relation to their use of protective masks for infectious diseases during routine practice.

Methods
A cross-sectional, mixed methods study was undertaken, underpinned by participatory and behavioural change methodologies. A survey and video-reflexive ethnography were used to collect data in an emergency department and respiratory ward in a 950-bed tertiary hospital in Western Sydney. Qualitative findings were analysed using a thematic approach.

Results
The HCW perception of risk for respiratory infectious diseases and associated behaviour towards protective masks differs between clinical areas. Factors that influence mask use include the working environment and unit culture around transmission-based precautions. In the emergency department, the emphasis is for patients to wear a mask to prevent transmission of their infection. With the exception of wearing masks when attending to immune-suppressed patients, HCWs primarily associate their own mask use with self-protection and do not see their significance for preventing healthcare associated infections.

Conclusions
Sub-optimal mask use in the emergency department may be a risk for healthcare transmission in the early stages of an emerging respiratory infectious disease outbreak and has implications for pandemic planning. Infection prevention and control isolation policies should consider differences between clinical contexts.

 

Ruth is a registered nurse, quality advisor and researcher. She holds a Masters in Infection Prevention and Control and has over 22 years of experience in this field across the private and public sector. Ruth has authored several IPC journal publications and represented infection prevention and control professionals on a number of NZ national committees and working parties. Ruth is currently studying for her PhD through the University of Sydney, with her research focus on personal protective equipment practice among clinicians.

 

Louise Brown

Promoting social wellbeing in patients with spinal injury during MDRO isolation: a quality improvement project

Background
Patients with spinal cord injury often experience social disconnectedness and a sense of social isolation. Although research shows that that opportunities for social interactions can optimize well-being for these patients, this may be impaired during hospital stays when isolation precautions are required to prevent transmission of MDROs. Therefore, an IPC quality improvement project was initiated to promote social well-being of patients with spinal injury requiring MDRO isolation.

Method
The Plan, Do, Check, Act (PDCA) quality improvement tool underpinned development, implementation and evaluation of this IPC project.

Results
Learnings and results from stage one of this project i.e. PDCA-Cycle (Plan) will be presented, which included a literature review, expert consultation and development of new education resources and tools for staff on the spinal injury unit.

Discussion
Infection Prevention nurses can contribute to social well-being of spinal cord injured persons requiring MDRO isolation by ensuring policy and procedures are based on latest evidence and providing education and resources for health care workers on current best practice.

 

Louise has been nursing since 2000, after spending 10 years living and working in the UK and Australia.  After several years of surgical nursing, and parenting, the opportunity to pursue postgraduate qualifications came along.  Over several years she has obtained a Master’s Degree in Health Sciences (endorsed in clinical nursing).  She has also had the good fortune to spend time working in oncology in a chemotherapy day unit and then later in Sydney as a member of the EVIQ team.  More recently she has spent time as a continence advisor and finally settled into the wonderful and challenging role as a CNS in the IPC team in Christchurch – where she has been in for 3 ½ years.

 

Tanya Jackways

Reduction in surgical site infection in the Southern Cross Hospitals network, 2004-2015: successful outcome on a long-term surveillance and quality improvement project

Aim: To share with other Infection Prevention and Control Nurses the benefits that reporting infections rates can have on improving patient outcomes.  To show the reduction in the surgical site infection (SSI) rate in the Southern Cross Hospitals network over a 12-year period, 2004-2015, that we achieved following active surveillance and quality improvement actions.

Methods: Ten hospitals in the network performed prospective SSI surveillance using standard definitions across a range of ten surgical procedure groups. Data was manually collected on a standardised form and entered into a bespoke database. Information collected included timing and dose of surgical antibiotic prophylaxis, type of surgical site skin preparation used, and patient information on smoking, diabetes and body mass index (BMI). Patients were contacted 30 days after their elective surgery to detect SSIs presenting after discharge from hospital. Surveillance results were widely reported to infection control and clinical review committees. Quality improvement activities to increase use of best practice interventions for surgical antibiotic prophylaxis and alcohol-based skin preparations were initiated.

Results: 42,792 procedures performed in ten hospitals were analysed. There were 932 (2.2%) SSIs. The SSI rate decreased from 3.5% in 2004 to 1.2% in 2015, r -0.865, p  = <0.0001, a decrease of 59%, approximately 5% a year. Rates decreased in seven of the 10 hospitals, p ≤0.02 for each, and in five of the ten procedure groups, p ≤0.02 for each.  Diabetic patients, odds ratio (OR) 1.4 (95% confidence interval (CI) 1.1-1.9), obese patients (BMI>30), OR 2.0

Conclusions: This long-term surveillance and quality improvement programme has made a significant contribution to the overall reduced rate of SSIs in Southern Cross Hospitals. This reduction occurred despite patient risk factors for SSI increasing.

Extract from article published NZ Medical Journal

 

Tanya has worked in Infection Prevention and Control for 20 years both in the public and now more recent years in the private sector.   She was the lead infection control nurse at ADHB before moving south and am now an Infection Prevention and Control Consultant for Sothern Cross Hospitals.   She has enjoyed the change in focus of the Infection Control nurse role moving from being about control to now a greater focus on prevention of infections and patient outcomes.  She has published numerous articles on our surveillance results both at the DHB including the point prevalence results and the costs of infections and more recently the private sector on how we were able to reduce the number of surgical site infections.  Tanya has a keen interest in Surveillance and how you can use this information and the process to improve our patient outcomes.

Michelle Taylor

How many we help you?  All you wanted to know about the ACC ICNet expansion project and the New Zealand national service hub

Currently, the Accident Compensation Corporation (ACC) is coordinating a project and providing financial support to encourage all New Zealand District Health Boards (DHB) to implement the electronic infection surveillance system, ICNet™.  The project is called the ACC ICNet™ Expansion Project and its aim is to implement ICNet™ nationally, as a means of reducing the rates of healthcare-associated infections (HAI), the most frequently claimed event under the ACC’s treatment injury category.
ICNet™ is currently utilised by five DHB Infection Prevention and Control (IPC) services within New Zealand.  Features of the system include case management, auditing, reporting and data collection features.  Utilising these features will assist the IPC team to drive quality improvements activities and record and reduce HAI. With the roll-out of ICNet™ availability to all DHB, it was acknowledged that there was also a need for a centralised service to assist DHB prepare for, implement and fully utilise the system.  Due to Canterbury DHB’s (CDHB) extensive experience with using ICNet™ and supporting the Health Quality and Safety Commission’s (HQSC) Surgical Site Infection Improvement Project and National Monitor, it was decided that the national service hub should be provided by the CDHB.  The NZ National ICNet™ service hub aims to assist users to maximise their use of the system.  As a socio-technical system, the ICNet™ service hub activities will include providing a service desk, developing and providing implementation resources, support and training, hosting and maintaining the system, managing any changes and upgrades, supporting data quality and assurance and coordinating user groups and governance.
An overview of the ACC ICNet™ Expansion Project and how far the project has progressed will be presented and this will be followed by a discussion of the planning and development of the national service hub.

 

Michelle Taylor is the Clinical Nurse Specialist Infection Prevention and Control (ICNet Portfolio) for the Canterbury District Health Board (DHB). As the CNS (ICNet Portfolio) she facilitates and promotes the use of the ICNet™ Electronic Surveillance System to enhance infection prevention and control data collection, surveillance and patient case management, currently for Canterbury, West Coast and Taranaki DHBs.  She is a Registered Nurse who has completed a Master of Business Administration and a Bachelor of Health Science (Nursing) and has worked as a in the United States of America, Australia & New Zealand.  Michelle is also a member of the national New Zealand Health Quality & Safety Commission’s Surgical Site Infection Improvement programme team, providing advice and support to users nationally.

Claire Underwood and Sarah Thomas

Superman where are you now?

In July of 2018, an OXA-48 strain of carbapenemase producing enterobacterales (CPE) was detected in a routine stool sample in a patient in the Hutt Valley.  Although presentations of CPE have been recorded in New Zealand, this particular detection was unusual because it was not associated with overseas hospitalisation.
Over the last eleven months detection of 17 CPE cases to date, has resulted in an outbreak investigation in the community.  CPE was detected in routine urine and stool cultures.  Six patients had uncomplicated urinary tract infections, one had urosepsis, ten patients were colonised.   Of the total detections so far, six patients had had recent contact with the hospital which resulted in contact tracing events. To date, over 180 patients have been offered contact tracing.  One transmission event was detected as a result of this screening.
The infection prevention and control team have worked closely with public health (PH), and ministry of primary industries (MPI), to investigate the outbreak.  Questionnaires were used for all cases to assess foreign travel or hospitalisation, and food history.
The IPC team worked closely with wards and patients affected to conduct contact tracing and uphold standard precautions. This outbreak highlighted the implications for nursing staff, hospital cleaning and infection prevention and control teams.

 

Claire Underwood is a Clinical Nurse Specialist and team leader in Infection Prevention & Control at Hutt Valley DHB.  She has worked in infection control for the last nine years in both public and private sectors.  Claire is the editor of the Infection Controlla and a current member of the IPCNC Committee.  She is passionate about Infection Prevention, with special interests in Hospital Cleaning, hand hygiene and quality improvement projects.  Claire emigrated to New Zealand with her husband and three children thirteen years ago, and in her spare time loves creative writing and is a published author.

Sarah Thomas is a Clinical Nurse Specialist in Infection Prevention & control at Hutt Valley DHB. Her background is in Medical Nursing, working in a variety of roles in Scotland and New Zealand. Sarah has special interests in improving processes for prevention of Central Line Infections and Aseptic Technique.  Sarah is originally from Dunedin and lives in the Lower Hutt with her husband and two children and is a fabulous dressmaker in her spare time.

Holly Weale

Reprocessing in endoscopy

This session will be looking at ‘a day in the life of an endoscope’, the places it has to go and what we need to do to get it ready to go there!
We will look at the reprocessing of endoscopes and the guidelines available to set standards in Australasia.

 

Holly is the charge nurse manager of the gastrointestinal investigative unit (endoscopy) in Christchurch Hospital.  She trained and qualified as a nurse in the UK and only discovered a passion for gastroenterology nursing on my arrival to NZ in 2003.  She has recently gained a Masters in Health Science from the University of Otago and have completed and presented audits looking at the psychological services available for people living with inflammatory bowel disease.

 

Justine Wheatley

How do our hospitals ‘scrub up’

This presentation will qualitative the research on ‘How well do our hospitals scrub up? Discussing how ‘clean’ is measured and prioritised with Infection Prevention Nurses in New Zealand’ as it can extend our understanding about the ways in which New Zealand hospitals measure the effectiveness of their cleaning that is required by their environmental decontamination policies and what actually happens in practice. This study generates knowledge on the cleaning standards in our hospitals, sourced from the nurses directly involved in promoting cleanliness. I have collated and analysed information gained through interviews with Infection Prevention Nurses from 11 New Zealand hospitals.  The interview questions focused on the cleaning practices in relation to how it is conducted, audited and prioritised.  Data from the interviews illuminated the standard, reactionary and/or progressive approaches to cleaning and cleaning technologies and how cleaning decisions are made.  I would like to share this knowledge to increase our understanding about how cleaning is measured and prioritised in many New Zealand hospitals as told by the IPC nurse specialists. These findings will be beneficial as a platform for further research into cleaning and developing standards and policies in New Zealand. The research participants will benefit from the research by having their expert knowledge and experience acknowledged and valued in the research.

 

Justine has been an IPC Nurse specialist for the last seven years and facilitate the IPC programme at two surgical hospitals. She is currently on the IPCNC national committee with the role of membership coordinator. She is presently completing my Masters in IPC with a dissertation in hospital cleaning. Her interests are in educating both patients and healthcare staff in antibiotic resistant bacteria, standardising and measuring cleanliness in hospitals and relationship building in IPC to create a culture of patient safety.

 

 

Poster presenters

Sarah Berger and Carmel Hurley-Watts

Resilience & Re-emergence in hand hygiene auditing – CDHB’s improvement journey

Background/Introduction
In May 2014, Canterbury DHB (CDHB) established a hand hygiene governance group made up of an inter-professional team of clinical staff as well as Quality and Infection Prevention and Control representatives.  The National target has increased over time from 70% in 2013, 75% in June 2014 to 80% in June 2015. A CDHB Hand Hygiene Improvement Project Charter was written utilising the Process for Improvement. It identified the Need, Aim, Plan, Do, Study, Act (PDSA). The purpose was to report key stages and different PDSA cycles undertaken to reach an improvement from the 2013 result (62% compliance) to March 2017, reaching 80% compliance, and consistently maintaining over 80% since) while spreading  the programme to all 43 CDHB inpatient areas.

Methods
CDHB applied the ‘process for improvement’ for implementation of a sustainable Hand Hygiene Programme using a multi-modal approach such as an improvement toolkit for use at a local level, service specific training, the annual campaign, frequent data dashboard reports indicating status and consistent key messages, supported by the multidisciplinary hand hygiene governance group. Compliance with the World Health Organisation’s ‘5 moments of hand hygiene’ was assessed through audits as per the Health Quality Safety Commission/Hand Hygiene New Zealand (HQSC/HHNZ) Hand Hygiene New Zealand Auditing Programme. In 3 annual audit periods, all high risk wards were measured, as well as CDHB inpatient areas.

Results
The Hand Hygiene Programme has been implemented and embedded across all 43 CDHB in-patient areas as of 1 November 2018.  Notably, for the seventh consecutive audit period the 80% threshold has been sustained with 82% compliance for the audit period 1 November 2018 – 31 March 2019.

Conclusion
Through demonstrated dedication to Resilience and Re-emergence of the 5-Moments Hand Hygiene principles, CDHB will strive for continued improvements towards the aspirational goal of 100%.

 

Dr Sarah Berger MN(Hons) MBA BA RN has recently returned to Christchurch to take up the new role of Nursing Director for Canterbury DHB Infection Prevention & Control Service. This role has been established as part of the recommendations arising from a review of the IPC service. Sarah has spent the last seven years researching and teaching at the University Hospital Heidelberg, Germany. She completed her doctoral studies in Health Services Research on facilitation of collaborative decision-making in health care teams.

 

 

Carmel Hurley-Watts BN DipN RCpN Nurse Co-ordinator, Quality & Patient Safety (Canterbury DHB Hand Hygiene Co-ordinator Portfolio).  The hand hygiene programme sits within the Quality & Patient Safety team and the role holds this portfolio, managing this programme.  The HH Co-ordinator role supports the hand hygiene governance group, engages with Infection Prevention & Control Services team members, plays a key role in engaging frontline staff and senior management in improving hand hygiene efforts, and planning for the annual evaluation. Carmel has been in this role for the past 4 years, and has a nursing background in Operating Theatre nursing and management, with past involvement with IP&C through holding a link nurse representative role for Operating theatres and as a member of the IPCNC NZNO specialty group.

 

Carolyn Clissold

Sink or Slime

Hand hygiene sinks have increasingly been linked to outbreaks of gram negative bacteria- including ESBL and CPE in ICUs internationally. These bacteria form biofilm in the sinks and taps, and are transmitted by splash to other patients and equipment.
After some possible transmission of gram negative bacteria between patients, in the general surgical wared at CCDHB, the ward nursing practices were surveyed. This survey showed that hand hygiene sinks were being used for disposal of a variety of protein laden fluids, and for patient drinking water. Education and practice changes were made and the nursing activity resurveyed. The nurses were committed to making changes to their practice, however needed easy alternatives to their previous practices.

 

Carolyn Clissold (RN, BA, MA -Nurs) has spent the last 11 years as an Infection, Prevention and Control -Clinical Nurse Specialist at Capital and Coast DHB, initially working  in primary care (with GP practices, and the residential care sector) and then in the hospital role. She has been the Treasurer and is the current chair of the IPCNC. She also represent the IPCNC on the MOH Health Antimicrobial Resistance Committee which oversees the implementation of the Antimicrobial Resistance Action plan.

Mary Cooper

Gyms and Bug: A survey of gym users’ awareness relating to infection risk management

With increasing emphasis on wellness across the lifespan gym membership in New Zealand is on the rise with industry experts, Exercise Association New Zealand (ExerciseNZ, personal communication), indicating that the sector has grown by 6.5 per cent in recent years with approximately 15% of New Zealanders holding a gym membership. While the industry is focused on promoting health and wellbeing, gym services and facilities are a potential reservoir for microorganism and infection risk for users. Community acquired infections present a threat in an era of increasing anti-microbial resistance with studies revealing that MRSA is commonly found on gym surfaces (Stanforth, Krause, Starkey & Ryan, 2010) and gym bottles often contain a high microbial load (Silveria et al., 2019).

A small pilot study targeted public and private gyms in the Rotorua area, assessed gym users awareness of infection risks and strategies used to mitigate their potential within this setting.  A total of 55 participants, recruited from the nine gyms completed a short online survey probing infection risk awareness and use of precautionary measures. The findings of this small study reveal gym users predominantly engage in cardio-type routines with a high level of equipment sharing during highly paced sessions where there is increased risk of cross-infection exposure. While users demonstrate a good understanding of common preventative measures, including hand hygiene, only 37% use a towel as a barrier, as recommended by the industry.

This small study is the first to explore the understanding and practices of regular gym users in the New Zealand context. The study highlights that complacency around preventative strategies presents a threat in the public domain and highlights that gyms are a potential source of community acquired infections.

References
Silveira, M., Scudese, E., Senna, G., Ferreira, A., Dantas, E., Ribero, L., Alvares, A., & G. (2018). Microbial contamination in shaker bottles among members of fitness centers. Journal of Exercise Physiology Online, 21(4), 134-142.

Stanforth, B., Krause, A., Starkey, C., & Ryan, T. (2010). Prevalence of community-associated Methicillin-Resistant Staphylococcus Aureus in high school wrestling environments. Journal of Environmental Health, 6(12), 12-16. doi: https://www.jstor.org/stable/26328057

 

 

Mary is a lecturer at Toi Ohomai Institute of Technology and currently involved in teaching on two programmes that emphasise infection prevention and control: The Diploma in Infection Risk Management and the Diploma in Sterilisation Technology (Level 5).  She has been teaching at Toi Ohomai and its predecessor Waiariki Institute of Technology for approximately 10 years. She is currently undertaking the final paper towards a Post-Graduate Diploma in Public Health which has broadened my understanding and focus of infection prevention and control.

Francie Morgan

NZIPC Standard 8134.3 … do IPC standards survive or flourish during changing models of healthcare?

The New Zealand Health and Disability Services Standards are undergoing review to better reflect current practice and changing models of healthcare.  This includes 8134.3 2008 Infection Prevention and Control. An Operative Alliance (NZ Ministry of Health) has been formed to oversee and guide operational review of all the standards.  Phase One of initial sector consultation took place during 2017 – 2018.  Phase Two scoping workshops have been in action during May to August 2019. These have focused on health providers such as DHB, private hospital, residential, disability and home care.  Phase Three is now currently in development which includes the formation of working groups that will meet regularly for “dive deep” consultation.  As recognised subject matter experts, infection prevention and control healthcare professionals must come together to strengthen strategy and future development of the ongoing revision of 8134.3 for the various healthcare services aforementioned. The IPCN College has undertaken a search of international infection prevention and control standards that are similar in presentation and/or application to NZS 8134.3.  What does this reveal?
As a conference delegate the IPCN College encourages you to interact with the poster presentation question and offer your thoughts on a selection summary of recognised infection prevention and control standards or similar from first world healthcare models. Please visit this poster.

 

Francie resides in Auckland and has been practicing as an Infection Prevention and Control Nurse Specialist for many years in various services within the healthcare sector. Her interests include the professional development of NZ IPC Nurses; leadership styles in IPC; the surgical interface with IPC best practice principles.


Henrietta Sushames

End of bed hand gel

Hand sanitising gel was not at the end of each inpatient bed in CCDHB, compromising hand hygiene.  This quality initiative tackled the problem with a variety of helpful interventions.  These included redesign of gel holding brackets, troubleshooting fixture of brackets, routine supply of brackets to wards, and designating staff to replace brackets . However, these ‘work around’ solutions were insufficient.  Budget constraints stopped the core problem, gel holding brackets of poor design, being addressed.  A health culture of ‘control cost – make do’ resulted in increased work and compromised patient safety. This quality initiative provided evidence that a better product was needed (which has since been implemented).

 

RN, Master Health Practice (Child Health)

Henrietta has worked as a Clinical Nurse Specialist in IPC for one and a half years.  She manages the hand hygiene audit for Capital and Coast DHB.  Before this she worked 20+ years as an RN in Child Health at CCDHB.  She is passionate about alleviating poverty, and now of course, about people using hand sanitiser.

Sarah Thomas

Highlighting high-risk

A dramatic increase in the rate of Central Line Associated Bacteraemia (CLAB) was identified on a surgical in-patient ward despite introduction of insertion/ maintenance forms and increased in education on central lines management. All CLAB’s routinely have a Root-cause analysis (RCA) conducted which highlighted the increasing complexity of patients and, that ward practice hadn’t adapted to meet their needs.

Interventions
It was identified that the patients who developed CLAB’s had additional factors that increased their infection risk. Targeted teaching and competency assessments were completed and a high risk bundle developed. The Choosing wisely initiative also prompted a review by the surgical teams as to the necessity and appropriateness of lines in this unit.

While staff were aware of how to manage central lines there was no formal process in place to let them know what to do when a patient had multiple risk factors. Education around risk factors, what can be done to reduce these risks, and development of a guideline has resulted in a better outcome for these patients.

Outcome
So far we have seen a significant reduction in the CLAB  rates and the number of line days throughout the hospital. Staff awareness of the importance of line management has also increased and there has been on-going collaboration between interdisciplinary roles (IV/IPC/Surgical teams).

 

Sarah Thomas is a Clinical Nurse Specialist in Infection Prevention & control at Hutt Valley DHB. Her background is in Medical Nursing, working in a variety of roles in Scotland and New Zealand. Sarah has special interests in improving processes for Prevention of Central Line Infections and Aseptic Technique.  Sarah is originally from Dunedin and lives in the Lower Hutt with her husband and two children and is a fabulous dressmaker in her spare time.