Infection Control Matters

25 years of Contact Precautions, but benefit or harm and what is the evidence? With Prof Jennie Wilson

In this week’s episode, Martin Kiernan talks to Professor Jennie Wilson of the Richard Wells Research Centre at the University of West London and current Infection Prevention Society President. We discuss her recent editorial, co-written with Associate Professor Jacqui Prieto from the University of Southampton. After 25 years of contact precautions, first introduced as putative best practice, the evidence to support this intervention has not appeared and there are suggestions that harms may be being caused through poor implementation. Contact precautions add PPE and physical isolation to Standard Precautions, however does this lead to over, and inappropriate use of PPE that is not required?
 
Papers cited during the podcast include:
Wilson J, Prieto J. Re-visiting contact precautions – 25 years on. Journal of Infection Prevention. 2021;22:242-4. Doi: 1177/17571774211059988
Bearman G, Abbas S, Masroor N, Sanogo K, Vanhoozer G, Cooper K, et al. Impact of Discontinuing Contact Precautions for Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococcus: An Interrupted Time Series Analysis. Infect Control Hosp Epidemiol. 2018;39:676-82. https://www.ncbi.nlm.nih.gov/pubmed/29580304
 

Ventilation and pathogen transmission with Simon Witts

In this podcast, Phil and Brett talk to Simon Witts on a wide ranging topics related to ventilation and also touch on air scrubbers (purifiers). Simon is Director of Engineering at VA Science, with extensive experience in hospital and building ventilation design. We cover topics such as air changes, what makes a good ventilation system and hotel quarantine.  We also cover practical things like where best to sit on a bus to reduce the risk of infection.
 

Australia‘s Chief Nursing and Midwifery Officer - Alison McMillan on leadership and negotiation

In this podcast, Phil and Brett talk to Adjunct Professor Alison McMillan on the topics of leadership and negotiation. Alison is Australia's Chief Nursing and Midwifery Officer. We hear first hand experiences related to COVID and tips for building relationships and nursing leadership.
 
Professor (Practice) Alison McMillan PSM was appointed as Australia's Chief Nursing and Midwifery Officer in November 2019. In June 2021 Alison was awarded a Public Service Medal for outstanding public service to driving the Government’s national health response priorities during the COVID-19 pandemic, particularly to infection prevention measures. 

Wearable proximity devices and contact tracing with Steph Curtis

In the last ACIPC conference special podcast, Brett and Phil talk to Stephanie Curtis about wearable proximity devices for nurses and doctors - and their use for contact tracing. We also talk about other potential uses. Stephanie is an epidemiologist at the National Critical Care and Trauma Response Centre. She worked on the COVID-19 response in Victoria over 2020-2021 and recently completed Australia's field epidemiology training program, the MAE, based at Alfred Health and Burnet Institute.
 
Stephanie's presented findings from pilot work of proximity trackers at the ACIPC conference. The paper for this study is published in Infection, Disease and Health https://www.idhjournal.com.au/article/S2468-0451(21)00098-5/fulltext 

The science of pathogen transmission via the air with Prof Lidia Morawska - ACIPC conference special

In this third special edition from the 2021 ACIPC Conference, Brett and Martin talk to Distinguished Professor Lidia Morawska about the science of air. Lidia was named in Times magazine as one of the 100 most influential people in the world for helping highlight the airborne spread of COVID-19.  Topics includes in this podcast include the science of aerosolisation from the respiratory tract, activities or source that dictate particle size and terminology around droplet and airbourne transmission.
About Lidia:
Professor Lidia Morawska is a Distinguished Professor in the School of Earth and Atmospheric Sciences, at the Queensland University of Technology (QUT) in Brisbane. Lidia is an author of over 950 journal papers, book chapters and conference papers and has also been involved at the executive level with a number of relevant national and international professional bodies and has been acting as an advisor to the WHO.
Significant papers:
1. Zhou L, Yao M, Zhang X, Hu B, Li X, Chen H, et al. Breath-, air- and surface-borne SARS-CoV-2 in hospitals. J Aerosol Sci. 2021;152:105693. https://www.ncbi.nlm.nih.gov/pubmed/33078030 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7557302/pdf/main.pdf 2. Morawska L, Buonanno G. The physics of particle formation and deposition during breathing. Nat Rev Phys. 2021:1-2. https://www.ncbi.nlm.nih.gov/pubmed/33778373 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7985916/pdf/42254_2021_Article_307.pdf3. Cortellessa G, Stabile L, Arpino F, Faleiros DE, van den Bos W, Morawska L, et al. Close proximity risk assessment for SARS-CoV-2 infection. Sci Total Environ. 2021;794:148749.   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8242194/pdf/main.pdf 4. Morawska L, Tang JW, Bahnfleth W, Bluyssen PM, Boerstra A, Buonanno G, et al. How can airborne transmission of COVID-19 indoors be minimised? Environ Int. 2020;142:105832. https://www.ncbi.nlm.nih.gov/pubmed/32521345 5. Stockwell RE, Ballard EL, O'Rourke P, Knibbs LD, Morawska L, Bell SC. Indoor hospital air and the impact of ventilation on bioaerosols: a systematic review. J Hosp Infect. 2019;103:175-84.  https://www.ncbi.nlm.nih.gov/pubmed/31279762
6. Morawska L, Milton DK. It Is Time to Address Airborne Transmission of Coronavirus Disease 2019 (COVID-19). Clin Infect Dis. 2020;71:2311-3. https://www.ncbi.nlm.nih.gov/pubmed/32628269
 

Use of video reflexive ethnography in IPC, clinical care and nurse education - an ACIPC 2021 special with Dr Mary Wyer and Dr Su-Yin Hor

In this second special edition from the 2021 ACIPC Conference, Brett Mitchell and Martin Kiernan talk to Drs Mary Wyer and Su-yin Hor. Mary and Su-Yin's work on Video Reflexive Ethnography (VRE - not that one) is world-reknowned with many publications. In this discussion they outline how the use of  video to examine and develop practice has helped in biopreparedness as well as its uses in other areas of infection prevention and control and nurse education.
Papers referred to in this podcast:
https://pubmed.ncbi.nlm.nih.gov/32089464/
Iedema, R., Carroll, K., Collier, A., Hor, S. Y., Mesman, J., & Wyer, M. (2018). Video-reflexive ethnography in health research and healthcare improvement: theory and application. CRC Press.

Urinary catheter awareness - an ACIPC Conference special with Dr Gillian Ray-Barruel

In this special ACIPC conference episode, Brett Mitchell and Martin Kiernan talk to Dr Gillian-Ray-Barruel, from Griffith University School of Nursing and Midwifery and QEII Jubilee Hospital, Brisbane.
Gillian is presenting at the 2021 virtual ACIPC Conference on urinary catheter awareness. Gillian has an long standing interest in medical device placement, and this paper focuses on patient and staff awareness of the need for the catheter. Naturally we digress into other areas such as consent and nurse advocacy!
Papers that we refer to in this session:
https://pubmed.ncbi.nlm.nih.gov/11042237/

Staph. capitis in NICU - Global problem or just another CoNS trick? - with Dr Alicia Demirjian

In this podcast, Martin Kiernan talks to Dr Alicia Demirjian about the issue of seemingly increasing reports of Staphylococcus capitis cases in neonates. Alicia is Consultant Epidemiologist at the Evelina Children's hospital in London and leads the antimicrobial resistance and prescribing team at the UK Health Security Agency (UKHSA) - formerly Public Health England. Alicia has been working on this issue for a while now and we discuss the problem (and if there is one), findings to date and possible interventions. Some of the papers that we discuss are here, as is a link to the video on how to clean an incubator, a complex piece of equipment that is often still contaminated after cleaning and disinfection.
Cleaning video:
https://www.youtube.com/watch?v=ELF-0MTFJfE
 
Papers:
Wirth, T., M. Bergot, et al (2020) Niche specialization and spread of Staphylococcus capitis involved in neonatal sepsis. Nat Microbiol, 5, 735-745. https://www.ncbi.nlm.nih.gov/pubmed/32341568
Thorn, L. M., et al (2020) Risk factors for Staphylococcus capitis pulsotype NRCS-A colonisation among premature neonates in the neonatal intensive care unit of a tertiary-care hospital: a retrospective case-control study. Infect Prev Pract, 2, 100057. https://www.ncbi.nlm.nih.gov/pubmed/34368703Decalonne, M., et al. (2020) Staphylococcus capitis isolated from bloodstream infections: a nationwide 3-month survey in 38 neonatal intensive care units. Eur J Clin Microbiol Infect Dis, 39, 2185-2194. https://www.ncbi.nlm.nih.gov/pubmed/32519215
Ory, J., et al (2019) Successful implementation of infection control measure in a neonatal intensive care unit to combat the spread of pathogenic multidrug resistant Staphylococcus capitis. Antimicrob Resist Infect Control, 8, 57. https://www.ncbi.nlm.nih.gov/pubmed/30962919
Laurent, F. & M. Butin (2019) Staphylococcus capitis and NRCS-A clone: the story of an unrecognized pathogen in neonatal intensive care units. Clin Microbiol Infect, 25, 1081-1085. https://www.ncbi.nlm.nih.gov/pubmed/30928561
Butin, M., et al (2019) Sources and reservoirs of Staphylococcus capitis NRCS-A inside a NICU. Antimicrob Resist Infect Control, 8, 157. https://www.ncbi.nlm.nih.gov/pubmed/31636900
Butin, M., et al (2017) Worldwide Endemicity of a Multidrug-Resistant Staphylococcus capitis Clone Involved in Neonatal Sepsis. Emerg Infect Dis, 23, 538-539. https://www.ncbi.nlm.nih.gov/pubmed/28221122 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5382751/pdf/16-0833.pdf
Butin, M., et al (2016) Wide geographical dissemination of the multiresistant Staphylococcus capitis NRCS-A clone in neonatal intensive-care units. Clin Microbiol Infect, 22, 46-52. https://www.ncbi.nlm.nih.gov/pubmed/26404028 https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(15)00850-2/pdf
 

Fundamental and missed care impacts on healthcare-associated infection with Prof Heather Loveday

In this episode, Martin Kiernan talks to Prof Heather Loveday, Director of the Richard Wells Research Centre at the University of West London about an lecture recently given at the 2021 IPS Conference. The topic discussed centres on the role that fundamental care has in the prevention of healthcare-associated infections and the impact of 'missed' care.
Papers for futher reading on these topics are listed below.
Journal of Clinical Nursing special issue on fundamental care: https://onlinelibrary.wiley.com/toc/13652702/2018/27/11-12
Richards, DA, Hilli, A, Pentecost, C, Goodwin, VA, Frost, J. Fundamental nursing care: A systematic review of the evidence on the effect of nursing care interventions for nutrition, elimination, mobility and hygiene. J Clin Nurs. 2018; 27: 2179– 2188. https://doi.org/10.1111/jocn.14150
 
Vollman KM. Interventional patient hygiene: discussion of the issues and a proposed model for implementation of the nursing care basics. Intensive Crit Care Nurs. 2013 Oct;29(5):250-5. doi: 10.1016/j.iccn.2013.04.004. Epub 2013 Jun 6. PMID: 23746440. https://www.sciencedirect.com/science/article/abs/pii/S0964339713000414?via%3Dihub
 
Interventional patient hygiene model: Infection control and nursing share responsibility for patient safety
Maryanne McGuckin, Dr. ScEd, MT(ASCP), Arlene Shubin, Marianne Hujcs, RN, MSN
DOI:https://doi.org/10.1016/j.ajic.2007.01.010
 
Recio-Saucedo A, Dall'Ora C, Maruotti A, Ball J, Briggs J, Meredith P, Redfern OC, Kovacs C, Prytherch D, Smith GB, Griffiths P. What impact does nursing care left undone have on patient outcomes? Review of the literature. J Clin Nurs. 2018 Jun;27(11-12):2248-2259. doi: 10.1111/jocn.14058. Epub 2017 Oct 16. PMID: 28859254; PMCID: PMC6001747. https://onlinelibrary.wiley.com/doi/full/10.1111/jocn.14058

Monoclonal antibodies and future IPC priorities - a chat with Jon Otter

In this week's episode, Martin Kiernan talks to Dr Jon Otter of Guy's and St Thomas' Hospital NHS Trust in the UK about a couple of Jon's recent blog postings on the popular "Reflections" blog (https://reflectionsipc.com/). We first discuss a paper in the New England Journal of Medicine that reported on a study that examined the use of monoclonal antibodies in preventing infection in unvaccinated household contacts of COVID that can be found here https://www.nejm.org/doi/full/10.1056/NEJMoa2109682.
Then we go on to discuss Jon's recent presentation on future priorities for iPC in healthcare, the slides for which are available here (https://jonotter.files.wordpress.com/2021/10/211014-the-future-of-healthcare-and-ipc.pptx).