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October 2015

e-Bulletin Newsletter



Contact us

VICNISS Healthcare Associated Infection Surveillance Coordinating Centre
Doherty Institute. Level 2,    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:

VICNISS Surveillance Competency Units

Many of you may have had an opportunity to complete the VICNISS surveillance competencies. For those of you who haven’t had an opportunity, you can access the log in page from the link below.

The competency should be completed by ICPs and other personnel that collect and report VICNISS surveillance data. The competencies aim to ensure each participant has the knowledge required to adhere to VICNISS surveillance protocols, correctly identify infection events e.g. apply VICNISS case- definitions, and submit accurate and complete data, including that used for risk adjustment.

Each VICNISS competency comprises a training course (includes learning activities) followed by a quiz using multiple choice questions. A score of 85% or better will demonstrate adequate knowledge and understanding to perform the nominated VICNISS module. We hope you will find these units beneficial and they may assist you with training new infection control staff.

If the participant dos not successfully complete the module competency after three attempts further education by VICNISS staff will be arranged.

Click Here for more information on the competency for CDI, SAB & SSI.

VICNISS Self Service Reports Update

Health Service Performance Dashboard Report update

The Health Service Performance Dashboard Report  is a summary report which gives an overview of your health service results for all the indicators included in the Victorian Health Performance Monitoring Framework, plus individual hospital campus results. This provides a summary of how you have performed with respect to the Monitor for the completed quarter. Access this report via the user portal on the VICNISS website and select ‘View Health Service Performance Dashboard’.

De-identified Charts

Access the de-identified charts via the user portal. When logged on successfully, select ‘generate reports’, from the list of self service reports select the required de-identified chart e.g. ‘CLABSI - De-identified Hospital Data’, complete all data fields & finally select ‘view report’.

Central Line-associated Bloodstream (CLABSI)

CLABSI reports have been updated.  CLAMBI events are reported separately on the CLABSI report but are not  included in the CLABSI rate.

VICNISS Online Data Entry Forms (Web forms)

Occasionally ICPs have commented that web forms can be slow to refresh or they have trouble entering data in the free text box. Our website upgrade should improve this situation, however in the meantime try using an alternative web browser e.g. Google Chrome, which according to feedback improves the response time and functionality. Please let us know if you have ongoing issues:

Surveillance Plans & Performance Indicators 2015 - 2016

Both Type 1 and Type 2 updated plans are available on the VICNISS website. Please note these plans are to be signed by both the Executive Sponsor and Infection Control Consultant. All hospital sites / facilities participating in VICNISS surveillance must complete a separate surveillance plan. Plans are to be scanned or faxed to VICNISS.

National Hand Hygiene Initiative Update

Gold Standard Auditor Workshop in February 2016

The next 2 day Gold Standard workshop will be run at the Austin Hospital on the 15th and 16h February 2016. This date will be available for selection on the online booking page in mid to late October.

GSA workshops are in high demand and we have a number of people on the waitlist to attend. Due to increasing numbers of people needing to complete the GSA workshop we are no longer able to train unlimited numbers of staff from each hospital. The National Hand Hygiene Initiative uses a train-the-trainer model where any GSA is able to train their own staff members to be general auditors. Ward based auditors do not need to be trained as GSAs.

If there is an established program at your hospital and you are not part of this team and you will not be allocated the resources or time to train others to audit, it is likely you require General Auditor training. To arrange this you will need to contact the person coordinating the Hand Hygiene Program at your hospital.

Performance Indicators 2015-2016

While the 2015-16 version of the “High Performing Health Services” document has not yet been released, we have had ongoing discussions with DHHS to ensure that the requirements in the VICNISS Performance Indicator documents and hence requirements for surveillance plans reflect the contents of this document.

HCW Influenza Vaccination

Congratulations to everyone on the influenza vaccination results for 2015. While the results aren’t available publicly as yet, they continue to improve each year and this year was no exception. Reports for all hospitals that entered data (all public hospitals and any private hospitals that entered data) are now available via the VICNISS website. If you have any questions or problems with generating your reports, please contact the VICNISS Coordinating Centre via email ( or phone 9342 9333.

Type 1 Surveillance Update

Peripheral Venous Catheter (PVC) Module & Report

Type 1 hospitals can now participate in the PVC Use Monitoring surveillance module. This module includes process measures from insertion to removal and outcomes including infections. Reports for participating hospitals will be available via the user portal.

Data Submission

For those hospitals not using webforms or SHIINe to submit VICNISS data please ensure the most recent data collection form is used and all data fields are included. VICNISS data collection forms and istructions for completion of the forms can be found in the VICNISS Manual.

Type 2 Surveillance Update

VICNISS wish to acknowledge that it has been a particularly busy quarter for the ‘Type 2 Infection Control Practitioners’. Most have had to collect and submit data, aside from the usual required modules, for the ‘Health Care Workers and Influenza vaccination’, ‘Surveillance to reduce urinary tract infections (STRUTI)’ and ‘Aged Care National Antibiotic Prescribing Survey (acNAPS)’ modules.


The STRUTI Project team wish to thank all Type 2 health services that participated in the STRUTI Point Prevalence Survey. All feedback received will be seriously considered in any further development of a national STRUTI project. Hospitals and residential aged care facilities are now able to access their reports.

Surgical Antibiotic Prophylaxis

Access to the Surgical Antibiotic Prophylaxis module has changed on the VICNISS website. It is now listed as ‘Type 2 Surgical Antibiotic Prophylaxis (SAP) under ‘Modules’ on the VICNISS website. Data for this surveillance module is not submitted electronically. A hard copy data entry form is required to be completed and then faxed to VICNISS.

Hepatitis B and Measles

The revised Hepatitis B and Measles Healthcare Worker immunity modules will be on the VICNISS website ready for 2nd quarter data collection. Data should be entered onto a hard copy data form and faxed to VICNISS until the electronic webform is available at the end of 2015.


The pilot of the National Antibiotic Prescribing Survey for Aged Care runs until August 31st. This is a combined antibiotic use and infection survey, similar to the ones which have been run in Victoria for the past several years. The big difference is this will be the first national survey, hence the creation of the Australian Infection Surveillance (AIS) entity to hold the data. All aged care facilities are encouraged to participate at the following link: The first reports are expected to be available to participating facilities within two weeks.


A VICNISS Type 1 Education session designed for surveillance newcomers or ICPs that would like a refresher on VICNISS surveillance principles and any changes to the program is being held:

Date: Wednesday 21st October 2015

Time: 0900 -1630 hours

Venue: VICNISS Coordinating Centre

Seminar Room 1, Mezzanine Level

Doherty Institute

792 Elizabeth Street Melbourne

RSVP: by Friday 16th October to

Morning tea and lunch will be provided. Venue is readily accessible by public transport. Car parking and other travel costs are at your own expense. If you have further queries please contact the VICNISS Coordinating Centre via email or phone 9342 9333.



The Alfred Hospital are hosting an Infection Prevention Study Day on 22 October 2015 between 0830 and 1630.

Venue: AMREP Lecture Theatre, Alfred Hospital, 55 Commercial Road, Prahran VIC 3181

Alfred Health Infection Prevention is providing an opportunity to increase your knowledge on Infection Prevention issues from experts in the field.

Presenters from Infectious Diseases, Staff Immunisation & Exposure Management, Infection Prevention and Microbiology will provide up dates on the latest issues.

This day will focus on:

• Antibiotic resistance & the emergence of new organisms • Microbiology • Emerging Viral Infections

• Immunosuppressed Patient and Infections

• Infection Prevention - A brief history & Preview of new IP DVDs

• Hear about the personal experiences of

- a HCW as a Patient

- a nurse working in an Ebola Outbreak in Sierra Leone

Program Enquiries or To Register:

 To: Infection Prevention Alfred Health on 03 9076 3139 by 12 October 2015.

Morning tea, lunch and prizes included.

Trade Displays





0800 - 0830

Registration and welcome Gillian Land Infection Prevention Consultant

0830 - 0915 Antibiotic Resistance Up Date Professor Anton Peleg Professor of Infectious Diseases and Microbiology, Director, Dept of Infectious Diseases

0915 - 0945 A Doctor’s Perspective from the Other Side of the Bed Dr Glen Guerra Colorectal Research Fellow Peter McCallum Cancer Centre

0945 - 1030 Under the Microscope Amanda Dennison Principal Scientist Microbiology Alfred Health

1030 – 1045 MORNING TEA Trade displays

1045 - 1130 Infections in the Immunosuppressed Dr Orla Morrissey Infectious Diseases Unit

1130 - 1215 Emerging Viral Infections Professor Allen Cheng Infectious Diseases Physician Director of Infection Prevention and Healthcare Epidemiology

1215 - 1300 LUNCH Trade displays

1300 - 1400 Ebola Nursing in Sierra Leone Anne Lickliter Infection Prevention Nurse Consultant Austin Health

1400 - 1445 Staff Health Business Jonathan Chrimes Staff Immunisation & Exposure Management Alfred Health

1445 - 1515 MROs: An Alphabet Soup? Management of CRE Sue Borrell Senior Infection Prevention Consultant

1515 - 1600 A Brief History of Infection Prevention – from then to now! Previews of new Infection Prevention DVDs Infection Prevention Team

1600 - 1615 Quiz with Prizes Evaluations & Door prize Infection

Prevention Team Major Sponsor: Defries Industries

Associate Sponsors: Whiteley Corporation Ecolab and

Johnson & Johnson Medical P/L

6.5 hours contribute to professional development

$175 inc GST.             RSVP 12th October.


Infection Control Literature Review - October 2015

Improved hand hygiene compliance after eliminating mandatory glove use.

Wearing of gloves is not an alternative to hand hygiene, and previous reports have highlighted the use of gloves by healthcare workers as a risk factor for poor hand hygiene compliance. Cusini A et al. (Am J Infect Control 2015; 43:922-927) evaluated hand hygiene compliance in healthcare workers at a Swiss hospital prior to and after the elimination of mandatory gloving for care of patients requiring contact precautions.

The study was performed at a 950-bed hospital, including a 30-bed mixed ICU. In 2011, a policy change was made to remove mandatory gloving by healthcare workers caring for patients in contact precautions. Hand hygiene compliance was compared for periods prior to and after the policy change (Sept-Dec 2009 and Apr-Jun 2012). Patients requiring contact precautions because of infection with Clostridium difficile were excluded from the study. Prior to the policy change, healthcare workers were expected to perform hand hygiene and wear gloves before entering the room of a patient in contact precautions, and to change gloves and perform hand hygiene if an indication for hand hygiene occurred during the episode of clinical care. After 2011, glove use in this setting was only required according to standard precautions (contact with body fluids, non-intact skin or mucosa and before invasive procedures).

In the period before policy change (2009), a total of 426 hand hygiene indications were observed for 32 patients requiring contact precautions. Following the policy change (2012), a total of 492 indications were observed in 44 patients requiring contact precautions. A significant increase in hand hygiene compliance was observed between 2009 and 2012 for patients requiring contact precautions (51.9% vs. 85.4%, p<0.001). During the same period, hospital-wide hand hygiene compliance also increased (62.9% vs. 81.4%, p<0.001). The relative improvement was significantly higher patient encounters requiring contact precautions. Improved hand hygiene compliance for patients in contact precautions was particularly evident for settings before patient contact and before performing aseptic procedures.

Findings confirm previous studies which have identified glove use as a risk factor for poor hand hygiene. Elimination of mandatory glove use from contact precautions is associated with improved compliance. To adequately inform guidelines for infection prevention in healthcare settings, future studies must evaluate the impact of this practice change upon the risks for pathogen transmission.

Use of declination forms in healthcare worker influenza vaccination programs

Despite international guidelines recommending healthcare worker (HCW) influenza vaccination, uptake among HCWs frequently remains low. One strategy for improving vaccination uptake is use of a declination form program (DFP), to ensure that HCWs are informed of the rationale for influenza vaccination, dispel any misconceptions, and promote patient safety as the responsibility of all HCWs. LaVela S.L. et al. (Am J Infect Control 2015; 43:624-628) sought to implement a DFP for influenza vaccination of HCWs at 2 Veterans Affairs spinal cord injury centres in the United States.

The DFP included the requirement for a declination form to be completed in person and at the time that vaccination was offered. The form enabled HCWs to nominate either receipt or refusal of vaccination. If refused, the HCW was to indicate the reason for refusal and sign a statement acknowledging the risks to others because of non-receipt. An implementation strategy was followed, and influenza vaccination uptake and costs were evaluated.

The 2 study sites had varied roll-out of the DFP. At site 1, implementation was complete in <2 months, and 100% of HCWs completed a declination form. At site 2, implementation spanned a 4.5-month period, and 49% of HCWs were compliant. Vaccination uptake rates at sites 1 and 2 were 75.0% and 77.8%, respectively. In the year prior to DFP implementation, uptake was 53.9% and 53.3%, respectively. Combined data from the 2 centres demonstrated a significant increase following implementation, compared with the pre-implementation period (77.4% vs. 53.5%, p=0.01). 49.5 staff hours were required to support the program at site 1, and 26.5 hours were required at site 2. The average cost of staff time was $2,093 per site.

Findings indicate that improved influenza vaccination uptake by HCWs can be achieved by implementation of a DFP, even when compliance is less than 100%. Furthermore, required resources were not substantive. The strength of this study is that a single component of a vaccination strategy was tested, rather than the implementation of a multi-modal campaign. One limitation of this study is the fact that participating sites were specialist care centres, and HCWs may therefore have been more specialised or have had prior education or training. It is not clear if a comparable impact of a DFP would be observed in HCWs employed in general hospitals.