Lets go on a Pseudomonas hunt Iona Bichan RN, MN etc Nelson - - PowerPoint PPT Presentation

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Lets go on a Pseudomonas hunt Iona Bichan RN, MN etc Nelson - - PowerPoint PPT Presentation

Nov 20, 2023 256 likes •477 views

INFECTION PREVENTION CONTROL NURSES COLLEGE CONFERENCE 2019 Lets go on a Pseudomonas hunt Iona Bichan RN, MN etc Nelson Marlborough DHB TODAYS TRIP AN EXPEDITION INTO THE WILDS OF ENDOSCOPY TO SEARCH FOR THE ELUSIVE PSEUDOMONAS BEAST

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Iona Bichan RN, MN etc

Nelson Marlborough DHB

Let’s go on a Pseudomonas hunt

INFECTION PREVENTION CONTROL NURSES COLLEGE CONFERENCE 2019

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TODAY’S TRIP

  • AN EXPEDITION INTO THE WILDS OF ENDOSCOPY TO

SEARCH FOR THE ELUSIVE PSEUDOMONAS BEAST

  • HOW DID WE SET UP AND CARRY OUT THE HUNT?
  • TIPS FOR FUTURE EXPEDITIONS
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THERE’S PSEUDOMONAS IN OUR WATER!

  • SCOPE SURVEILLANCE: POSITIVE

GROWTHS

  • GENCA PROCESS FOLLOWED
  • TAP WATER TESTED
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TOXIN-PRODUCING EXOTOXIN A- PREVENTS CELL PROTEIN SYNTHESIS EXOENZYME EXOU- DAMAGES CELL MEMBRANE PYOVERDINE- ROBS IRON FROM MITOCHONDRIA (YELLOW PIGMENT) PYOCYANIN- A BLUE PIGMENT

PSEUDOMONAS FACTS

  • PSEUDO/MONAS=FALSE/UNIT. AERUGINOSA=BLUE GREEN COLOUR
  • NORMALLY PRESENT IN WET ENVIRONMENTS
  • LIKES 37 BUT CAN LIVE UP TO 42 DEGREES CELSIUS
  • BIOFILM SPECIALIST
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CUTE & FLUFFY ....& DANGEROUS

  • OPPORTUNISTIC PATHOGEN
  • MAJOR SURVEILLANCE FINDING
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THE PSEUDOMONAS HUNT

  • HUNTING PARTY (IP TEAM, LAB, ENDO TEAM, MANAGERS, GALLAY)
  • TRACKING EQUIPMENT (SURVEILLANCE, DATA ANALYSIS)
  • PATIENT SAFETY DURING THE HUNT
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ENDOSCOPE PROCESSING

  • LONG NARROW TUBES
  • IMPOSSIBLE-TO-STERILISE MATERIALS
  • GOING IN TO UNPROTECTED PARTS OF

THE BODY

WHAT COULD GO WRONG?

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THE TERRAIN

Environment

Plant Processes People

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FOLLOWING THE FOOTPRINTS

  • PLANNING
  • COLLECTION OF FACTS/DATA
  • TRYING AND ELIMINATING VARIOUS TRAILS
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I’LL TAKE THE HIGH ROAD…..

  • INDIVIDUAL VARIATIONS IN CLEANING PROCESS
  • EXTRAS AND OMISSIONS
  • A HOME FOR EVERY OCTOPUS
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LOOKING UNDER EVERY STONE

  • PROCESS OF TESTING AND EXCLUDING EACH AREA
  • TEST SAMPLING
  • WORKFLOWS
  • MACHINERY
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FALSE TRAILS

NOT THE WATER SUPPLY NOT THE MANUAL CLEANING NOT THE SOLUSCOPES NOT THE DRYING CABINET NOT SAMPLING CONTAMINATION

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THE HUNT INTERFERES WITH BAU

  • REGIONAL BOWEL SCREENING PROJECT JUST STARTING
  • PRIVATE HOSPITAL EXPECTATIONS
  • INCREASED SURVEILLANCE WORKLOAD
  • EXTRA TRAFFIC IN THE ENDOSCOPY SUITE
  • PATIENT SAFETY IS THE LINE
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  • HAVING ELIMINATED ALL OPTIONS, RETURN TO THE START TO RE-ASSESS
  • PSEUDOMONAS LIVES IN WATER. WHAT IS WET IN THIS ROOM?

RETRACING OUR STEPS

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Is it the source?

ESR STRAIN TESTING

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TIPS FOR FUTURE EXPEDITIONS

  • PATIENT SAFETY COMES FIRST- IP’S CORE FUNCTION
  • SURVEILLANCE WORKS
  • STAFF NEED SUPPORT AND EDUCATION TO DO THEIR JOB PROPERLY
  • GOOD COMMUNICATION IS VITAL
  • BEAR HUNTS SOMETIMES FIND MORE THAN JUST BEARS
  • NEVER TRUST THE PLUMBER WHEN THEY SAY

“THE WATER’S OFF!”

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Thanks to Wairau endoscopy nurses & sterile services technicians Drs Richard Everts & Erana Gray, IP service Gillian Clarke, endo CNS Kendall Stewart, Gallay DHB Facilities & Management

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REFERENCES

  • GASTROENTEROLOGICAL NURSES COLLEGE OF AUSTRALIA & GASTROENTEROLOGICAL SOCIETY OF AUSTRALIA (2011). INFECTION CONTROL IN ENDOSCOPY 3RD ED
  • GAVEAU, A., COETSIRE, C., ROQUES, C., BCCHIN, E ET AL(2017). BACTERIA TRANSFER BY DEFORMATION THROUGH MICROFILTRATION MEMBRANE, JOURNAL OF MEMBRANE

SCIENCE 523. 446-555. DOI10.1016/JMEMSCI.016.10.023

  • KISKO G, SZABO-SZABO O (2011). BIOFILM REMOVAL OF PSEUDOMONAS STRAINS USING HOT WATER SANITATION. ACTA UNIV. SAPIENTIAE ALIMENTARIA 4:69-79.
  • OFSTEAD C., WITZLER, H., HEYMAN, O., JOHNSON, B., EILAND, J. & SHAW (2017) LONGITUDINAL ASSESSMENT OF REPROCESSING EFFEICTIVENESS FOR COLONOSCOPES

AND GASTROSCOPES; RESULTS OF VISUAL INSPECTIONS, CHEMICAL MARKERS AND MICROBIAL CULTURES. AMERICAN JOURNAL OF INFECTION CONTROL 45 DOI 10.1016/J.AJC

  • WICKHAM LABORATORIES (2019). FACT SHEET” PSEUDOMONAS AERUGINOSA WWW.WICKHAMLABS.CO.UK/TECHNICAL RESOURCE CENTRE
  • OFSTEAD, C.., HEYMANN, O., QUICK, M., EILAND, J., & WETZLER, H. (2018) RESIDUAL MOISTURE AND WATERBORNE PATHOGENS INSIDE FLEXIBLE ENDOSCOPES-EVIDENCE

FROM A MULTISITE STUDY OF ENDOSCOPE DRYING EFFECTIVENESS. AMERICAN JOURNAL OF INFECTION CONTROL 46, 680-96 DOI 10.1016/J.AJC.10.2018.03.002

  • XUE-YUE JI MM A, PEI-YONG NING, WEI ZHANG B, DONG-JING YANG, HE LIU A, JUN LIU, JIA SONG, CHUN-NAN FEI (2018). MICROBIOLOGIC ASSESSMENT OF flEXIBLE

GASTROINTESTINAL ENDOSCOPE REPROCESSING USING A PUMP-ASSISTED SAMPLING TECHNIQUE: AN INVESTIGATION INVOLVING ALL ENDOSCOPY UNITS IN TIANJIN,

  • CHINA. AMERICAN JOURNAL OF INFECTION CONTROL 46 E43-E48 DOI.ORG/10.1016/J.AJIC.2018.04.216
  • IMAGES: MICROBEWIKI.KENYON.EDU; FARVER, C., & ZANDER, D.(2009). MOLECULAR BASIS OF PULMONARY DISEASE. WWW. SCIENCEDIRECT.COM/TOPIC/AGRICULTURAL-

AND-BIOLOGICAL-SCIENCES/PSEUDOMONAS AERUGINOSA