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June 2017

e-Bulletin Newsletter



Contact us

VICNISS Healthcare Associated Infection Surveillance Coordinating Centre
792 Elizabeth Street
Melbourne 3000
Victoria Australia
Phone: +61 3 9342 9333
Fax: +61 3 9342 9355
Email: VICNISS @


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Reminders - Data:


If you have a Twitter account please follow us  @VICNISS_CC 

Carbapenemase-producing Enterobacteriaceae (CPE)

Update to carbapenemase-producing Enterobacteriaceae (CPE) Transmission Risk Area (TRA) 

The CPE TRA list was recently updated on 7 June 2017.  Remember to regularly check the list of TRA classified wards within Victorian hospitals at: as this site is updated when any new area where local transmission of CPE has been identified.

To access the TRA summary health professionals must be registered for the VICNISS website and approved for access to this information.  If you have any issues at all please don’t hesitate to contact the VICNISS Coordinating Centre.

Revision of Victorian Guideline on CPE

The Department of Health and Human Services recently published the revised Victorian guideline on CPE for health services and the new Victorian guideline on CPE for long-term residential care facilities, April 2017. These guidelines are available at:  

Clostridium difficlle Infection (CDI) Investigation Guide

VICNISS has developed a CDI investigation guide to enable hospitals to perform a thorough investigation of patients with CDI, to identify the primary cause and contributing risk factors, and, through system change, reduce the risk of further CDIs occurring. The CDI Investigation guide is available on the VICNISS website in pdf and doc formats.

Important! Upcoming changes to the surveillance plan management and data quality checks

VICNISS has changed to electronic submission and management of surveillance plans. Surveillance Plans for 2017-2018 were due 1st June 2017, so if not already submitted please complete ASAP. If you require assistance please contact us at VICNISS or click here for access to a webinar held in May which explains how to complete the new online submission.

Commencing July 1 2017, the Surveillance Plan will have other functions that allows you to check the data you have submitted. More webinars to explain this new tool further will be scheduled in July 2017. For the small hospital group this will replace the need for the Monthly Summary Form.

Update to VICNISS Manual

The VICNISS manual is currently being updated and the new manual will be available by 1st July 2017. A Webinar to outline and discuss any changes is planned for June 2017. Details will be provided as soon as possible.

National Hand Hygiene Initiative Update

National Hand Hygiene Benchmark

Please note that from 2017 onwards the National Hand Hygience Benchmark has been set to 80%. This benchmark relates to all five moments of hand hygiene and all healthcare worker types. For further information please click here.

Gold Standard Auditor Training

There is just one more Gold Standard Auditor (GSA) Workshop scheduled for 2017. It will be held on September 26th and 27th at Box Hill Hospital.

If you would like to attend this workshop please go to and select the correct workshop from the drop down list at question 7 (Choose the workshop you would like to register for).

Data validation

It is the responsibility of the Organisation Administrator at each hospital to ensure that hand hygiene data is validated before submission. This includes ensuring:

  • all auditors submitting data have collected 100 moments and completed their online auditor validation in the last twelve months
  • the minimum number of required Moments (based on acute bed numbers) have been collected
  • all the correct departments have been included
  • compliance by moment and healthcare worker type follows the ‘normal pattern’ e.g. usually higher M3’s & M4’s
  • there are no obvious discrepancies i.e. Domestics or Administrative staff performing Moment 2’s.

New HCW code in HHCApp

Please note that the healthcare worker code AMB (ambulance and patient transport workers) is now available for selection in HHCApp.

Accessing Workshop Resources Page

Remember, if you are a Gold Standard Auditor and planning to train General Auditors in your facility all the required resources are available on the HHA website. If you do not know how to access these resources please contact or phone 9342 9356.

iPad minis (‘Toolkit/s’)

In order to use your iPad mini to its full ability please ensure you have removed the restrictions and the HHA Apple ID. If you don’t know how to do this or are having any other issues with the device please contact or phone 9342 9356.

2017 HCW Influenza Vaccination Module

Hospitals will be in the middle of their influenza campaign. The 2017 HCW Influenza Vaccination Uptake webform will be available for you to enter your results by July 2017. The final date for data submission is 18th August 2017.

Change to VICNISS Performance Indicators 2017-2018

We have recently been advised that the Victorian Health Services Performance Monitor (not yet published) contains a change for the coming year which will affect hospitals performing colorectal surgery.

This change will require all hospitals (regardless of size, type 1 & 2) performing >50 colorectal procedures (does not include endoscopy procedures) annually to perform continuous COLO SSI surveillance for the 12 months July 1 2017 to June 30 2018.

The 2017-2018 VICNISS performance indicators have been updated to reflect this change and hospitals that have already submitted their surveillance plan will be required to update and re-submit their surveillance plan to include SSI - COLO if you perform >50 colorectal procedures per year.

If you have any enquiries re submission of your annual surveillance plan and the required modules please don’t hesitate to contact VICNISS Coordinating Centre: or 9342 9333

Type 2 Surveillance Update

Hepatitis B Point Prevalence Survey

The required PPS for the 2016-2017 surveillance year is the Hepatitis B immunity module. ICPs have until June 30, 2017 to submit data for this survey.

Please NOTE: hospitals that participated in the QA project or the DHHS HCW Hepatitis B immunity and Blood Borne Virus scoping survey, both in 2016, are exempt from completing the PPS. There are a significant number of hospitals who are yet to submit the PPS data. If you are not sure if you are exempt or need to submit the PPS data, please call VICNISS.

Surgical Antibiotic Prophylaxis (SAP) module

The 2017-2018 Performance Indicators for Small Hospitals detail a change in the requirements for surgical antibiotic prophylaxis surveillance for Hospitals with 50-99 beds. Hospitals may chose one of the following:

  • Participate in the VICNISS SSI module (if hospital performs > 30 procedures in a single VICNISS procedure group annually); OR
  • Complete the SAP module (at least 50 consecutive procedures);OR
  • Complete surgical NAPs



Aged Care National Antimicrobial Prescribing Survey (acNAPS) 

Just a reminder……

  • All public service residential aged care homes will be expected to participate in this year’s acNAPS.
  • In 2017, the official timeframe for participation in the acNAPS is between Monday June 19th and Friday September 1st.
  • The methodology for 2017 mostly remains the same as 2016. The revised User Guide and data collection forms will be available soon on the NAPS website.
  • Optional online training sessions will be held on Tuesday June 20th (1400 hrs), Thursday June 22nd (1000 hrs), Wednesday June 28th (1400 hrs) and Tuesday July 4th (1400 hrs).
  • On site assistance is available for aged care homes that have not previously participated.

EDUCATION - Save the Date - 29th August, 2017

A Master Class will be held at The Peter Doherty Insititute on 29 August 2017 titled Data Speaks. The aim of this class is to help you understand, interpret and report surveillance data.  

Infection Control Literature Review - June 2017

Automated hand hygiene compliance monitoring – comparison with traditional methods

The World Health Organization considers observation the gold standard for determining hand hygiene compliance. However, human observation has a number of limitations, including reproducibility, timing of auditing being dependent upon staff availability, and the ‘Hawthorne effect’, where workers are more likely to be compliant when they know they are being watched. McCalla S, et al. (Am J Infect Control 2017; 45:492-497) compared an automated system for monitoring with traditional methods of auditing hand hygiene compliance in an ICU and step-down facility at a US centre.

During 2014, hand hygiene compliance was recorded manually by human observers on a sporadic, part-time basis. In 2015, an automated hand hygiene compliance system was implemented. A wearable device prompted healthcare workers to perform hand hygiene (electronic badges glowed yellow, then red until hand hygiene was performed). The system differentiated between healthcare workers categories. A chemical sensor in the badge detected the presence of alcohol, confirming that the badge-wearer had sanitised their hands. Upon completing a shift, healthcare workers removed badges for re-charging at a base station, enabling data entry to a central repository.

During 2014 and 2015, patient characteristics in the study ICU and step-down unit were comparable. Median stays in the unit were 3.06 and 2.88 in 2014 and 2015, respectively. Human observation of hand hygiene in 2014 revealed compliance for 167/169 opportunities (98.8%) in ICU and 308/311 opportunities (99.0%) in the ICU step-down unit. Continual automated data collection during 2015 revealed compliance for 210648/221396 opportunities (95.2%) in ICU and 397476/411008 opportunities (96.7%) in the ICU step-down unit. Compared with human observers, automated monitoring showed statistically significant lower compliance (p<0.05).

Findings are valuable in informing future and novel hand hygiene monitoring programs. While automated methods have previously been trialled, few have compared with manually-collected data. It is noteworthy that automated monitoring revealed lower compliance than manual methods, and this is consistent with a Hawthorne effect. Looking ahead, prospective tandem data (manual and automated) would be of value, in addition to linking automated compliance monitoring with incidence of healthcare-associated infections.

Candida auris in US healthcare facilities

Candida auris was first described in association with otitis media infections in 2009. Over the last 12-months, an increased number of invasive infections have been reported, particularly bloodstream infections. This fungus is notable for resistance to fluconazole, as well as variable susceptibility to other azoles, amphotericin B & echinocandins. Tsay S, et al. (MMWR May 19 2017; 66:514-515) recently reported clustering and possible transmission of C. auris in US healthcare facilities.

As of May, 2017 a total of 77 U.S. clinical cases of C. auris had been reported to the Centers for Disease Control (CDC) from seven states. All cases were identified through cultures taken as part of routine clinical care. Screening of close contacts of these patients (e.g. same ward as index cases) identified an additional 45 patients with C. auris colonisation. Whole-genome sequencing revealed four distinct clades, and isolates within each state were highly related.