Can supervise: YES
© 2016 Paul Elliott, Julie Storr and Annette Jeanes. This book presents a variety of perceptions of and perspectives on infection prevention and control. In doing this, the chapters will reflect upon challenging and controversial new ways of looking at infection prevention and control aimed at generating both discussion and debate as well as practical solutions. With this in mind, the book will aim not only to challenge the existing status quo but also push the frontiers of knowledge, thinking and practice where infection prevention and control is concerned. This is vital when considered in the light of cross infection rates, the number of healthcare providers who are being identified by the Care Quality Commission as falling below acceptable standards of infection prevention and control and the almost compulsive persistent non-adherent behaviours of those involved in the provision of medicine, health, social care and other disciplines related to caring with regards to the undertaking of safe and appropriate standards of infection prevention and control. There is no doubt that this book will be challenging with regards to the readers’ perceptions and perspectives of infection prevention and control. Where this topic is concerned however, such a challenging approach is vital if the health, safety and well being of individuals is to be positively promoted among all those involved in the health and wellbeing of others.
Sheppard-Law, S, Ritz-Shala, D, Brogan, F, Cruickshank, M & Kornman, K 2019, 'Exploring Australian Parents’ Knowledge and Awareness of Pediatric Inpatient Falls: A Qualitative Study', Journal for Specialists in Pediatric Nursing, vol. 24, no. 4.View/Download from: UTS OPUS or Publisher's site
Purpose: While there has been extensive published research into adult inpatient falls, less is known about pediatric falls in Australia. Falls pose a safety risk to pediatric patients potentially causing harm, increased length of stay, and death. Parents play a central role in reducing falls-related incidents given that, as parents, they provide care and/or oversee care delivered to their child at the bedside. Developing a better understanding of what parents and carers know about falls and associated risks, particularly those hospital-naïve, is central to developing family centered strategies and targeted education to meet the needs of parents. Our study aimed to explore Australian parents’ knowledge and awareness of pediatric inpatient falls.
Design: Qualitative methods utilising descriptive thematic analysis.
Methods: Parents of children and/or young people hospitalized during the last six months were eligible to participate. Potential participants attending the outpatient clinics of two tertiary pediatric outpatient clinics hospitals in Sydney, Australia were invited to participate in the study. Willing participants consented to complete a face to face in-depth interview. Open-ended questions sought to explore participants’ knowledge, knowledge acquisition, and awareness of inpatient falls. Interviews were digitally recorded and transcribed verbatim. Data familiarization and open coding were completed by researchers independently. Researchers explored and discussed emerging categories until patterns emerged and a consensus of dominant themes were agreed upon.
Results: Interviews were conducted with mothers (n = 17) fathers (n = 4) or both parents together (n = 2) of a child or a young person who had been recently hospitalized. Four dominant themes emerged from the data namely: Supervision: falls won’t happen, unexpected, parent priorities, and ways of learning about inpatient falls and risks. Despite parents’ awareness of falls risk, parents were unaware t...
Grayson, ML, Stewardson, AJ, Russo, PL, Ryan, KE, Olsen, KL, Havers, SM, Greig, S, Cruickshank, M & Hand Hygiene Australia and the National Hand Hygiene Initiative 2018, 'Effects of the Australian National Hand Hygiene Initiative after 8 years on infection control practices, health-care worker education, and clinical outcomes: a longitudinal study.', The Lancet Infectious Diseases, vol. 18, pp. 1269-1277.View/Download from: UTS OPUS or Publisher's site
BACKGROUND:The National Hand Hygiene Initiative (NHHI) is a standardised culture-change programme based on the WHO My 5 Moments for Hand Hygiene approach to improve hand hygiene compliance among Australian health-care workers and reduce the risk of health-care-associated infections. We analysed its effectiveness. METHODS:In this longitudinal study, we assessed outcomes of the NHHI for the 8 years after implementation (between Jan 1, 2009, and June 30, 2017), including hospital participation, hand hygiene compliance (measured as the proportion of observed Moments) three times per year, educational engagement, cost, and association with the incidence of health-care-associated Staphylococcus aureus bacteraemia (HA-SAB). FINDINGS:Between 2009 and 2017, increases were observed in national health-care facility participation (105 hospitals [103 public and two private] in 2009 vs 937 hospitals [598 public and 339 private] in 2017) and overall hand hygiene compliance (36 213 [63·6%] of 56 978 Moments [95% CI 63·2-63·9] in 2009 vs 494 673 [84·3%] of 586 559 Moments [84·2-84·4] in 2017; p<0·0001). Compliance also increased for each Moment type and for each health-care worker occupational group, including for medical staff (4377 [50·5%] of 8669 Moments [95% CI 49·4-51·5] in 2009 vs 53 620 [71·7%] of 74 788 Moments [71·4-72·0]; p<0·0001). 1 989 713 NHHI online learning credential programmes were completed. The 2016 NHHI budget was equivalent to AUD$0·06 per inpatient admission nationally. Among Australia's major public hospitals (n=132), improved hand hygiene compliance was associated with declines in the incidence of HA-SAB (incidence rate ratio 0·85; 95% CI 0·79-0·93; p≤0·0001): for every 10% increase in hand hygiene compliance, the incidence of HA-SAB decreased by 15%. INTERPRETATION:The NHHI has been associated with significant sustained improvement in hand hygiene compliance and a decline in the incidence of HA-SAB. Key features include sustained central coordination of ...
Richards (Chair), M, Cruickshank, M, Cheng, A, Gandossi, S, Quoyle, C, Stuart, R, Sutton, B, Turnidge, J, Bennett, N, Buising, K, Cooper, C, Cooley, L, Ferguson, J, Gilbert, L, Greenough, J, Greig, S, Harrington, G, Howden, B, Iredell, J, Lum, G, Peleg, A, Rogers, B, Romanes, F & Waters, MJ 2017, 'Recommendations for the control of carbapenemase-producing Enterobacteriaceae (CPE): A guide for acute care health facilities: Australian Commission on Safety and Quality in Health Care', Infection, Disease and Health, vol. 22, no. 4, pp. 159-186.View/Download from: UTS OPUS or Publisher's site
© 2017 Australian Commission on Safety and Quality in Health Care Gram-negative bacteria that are resistant to antimicrobials, including carbapenems, have emerged as a significant global public health threat. Multidrug-resistant gram-negative bacteria, including carbapenemase-producing Enterobacteriaceae (CPE), place patients at risk of potentially untreatable infection. Australia has not reported a large number of CPE cases compared to Europe, North America, and the Middle East, creating an opportunity to prevent CPE from becoming established in Australia. An outbreak of Klebsiella pneumoniae carbapenemase in 2014 demonstrated there was variable testing, reporting, response to and communication of CPE. In response, the Australian Commission on Safety and Quality in Health Care formed a taskforce to assist health facilities to respond to the threat of CPE. Recommendations for state and territory health departments include coordinating a risk assessment, undertaking epidemiological and microbiological investigations, determining the requirement for control measures, and coordinating risk-communication activities. The response should take advice from experts in infectious diseases, microbiology, public health, infection prevention and control and epidemiologists. The guide aims to: • Alert healthcare professionals, health departments and hospital executives to the emerging threat of CPE in Australia• Recommend strategies to prevent, detect and contain CPE• Provide information and resources for hospital executives, healthcare professionals and consumers• Recommend laboratory screening and confirmation methods.The recommendations with rationale and commentary have been structured into sections depending on the burden of CPE in the health facility. The sections include: planning, preparing and prevention; CPE screening and surveillance; strategies to reduce CPE transmission; outbreak management; laboratory screening and confirmation methods.
Shaban, RZ, Maloney, S, Gerrard, J, Collignon, P, Macbeth, D, Cruickshank, M, Hume, A, Jennison, AV, Graham, RMA, Bergh, H, Wilson, HL & Derrington, P 2017, 'Outbreak of health care-associated Burkholderia cenocepacia bacteremia and infection attributed to contaminated sterile gel used for central line insertion under ultrasound guidance and other procedures.', American Journal of Infection Control, vol. 45, no. 9, pp. 954-958.View/Download from: UTS OPUS or Publisher's site
We report an outbreak of Burkholderia cenocepacia bacteremia and infection in 11 patients predominately in intensive care units caused by contaminated ultrasound gel used in central line insertion and sterile procedures within 4 hospitals across Australia.Burkholderia cenocepacia was first identified in the blood culture of a patient from the intensive care unit at the Gold Coast University Hospital on March 26, 2017, with 3 subsequent cases identified by April 7, 2017. The outbreak response team commenced investigative measures.The outbreak investigation identified the point source as contaminated gel packaged in sachets for use within the sterile ultrasound probe cover. In total, 11 patient isolates of B cenocepacia with the same multilocus sequence type were identified within 4 hospitals across Australia. This typing was the same as identified in the contaminated gel isolate with single nucleotide polymorphism-based typing, demonstrating that all linked isolates clustered together.Arresting the national point-source outbreak within multiple jurisdictions was critically reliant on a rapid, integrated, and coordinated response and the use of informal professional networks to first identify it. All institutions where the product is used should look back at Burkholderia sp blood culture isolates for speciation to ensure this outbreak is no larger than currently recognized given likely global distribution.
Stewardson, AJ, Stuart, RL, Marshall, C, Cruickshank, M & Grayson, ML 2017, 'More Doctor-Patient Contact Is Not the Only Explanation For Lower Hand-Hygiene Compliance in Australian Emergency Departments.', Infection Control and Hospital Epidemiology, vol. 38, no. 4, pp. 502-504.View/Download from: UTS OPUS or Publisher's site
Grayson, ML, Macesic, N, Huang, GK, Bond, K, Fletcher, J, Gilbert, GL, Gordon, DL, Hellsten, JF, Iredell, J, Keighley, C, Stuart, RL, Xuereb, CS & Cruickshank, M 2015, 'Use of an Innovative Personality-Mindset Profiling Tool to Guide Culture-Change Strategies among Different Healthcare Worker Groups', PLOS ONE, vol. 10, no. 10.View/Download from: Publisher's site
Cruickshank, M, Duguid, M, Gotterson, F & Carter, D 2014, 'Taking action to preserve the miracle of antibiotics', AUSTRALIAN VETERINARY JOURNAL, vol. 92, no. 1-2, pp. 3-7.View/Download from: Publisher's site
Earnshaw, S, Mendez, A, Monnet, DL, Hicks, L, Cruickshank, M, Weekes, L, Njoo, H & Ross, S 2013, 'Global collaboration to encourage prudent antibiotic use', LANCET INFECTIOUS DISEASES, vol. 13, no. 12, pp. 1003-1004.View/Download from: Publisher's site
Grayson, ML, Russo, PL, Cruickshank, M, Bear, JL, Gee, CA, Hughes, CF, Johnson, PDR, Mccann, R, McMillan, AJ, Mitchell, BG, Selvey, CE, Smith, RE & Wilkinson, IJ 2011, 'Outcomes from the first 2 years of the Australian National Hand Hygiene Initiative', Medical Journal of Australia, vol. 195, no. 10, pp. 615-619.View/Download from: Publisher's site
Objective: To report outcomes from the first 2 years of the National Hand Hygiene Initiative (NHHI), a hand hygiene (HH) culture-change program implemented in all Australian hospitals to improve health care workers' HH compliance, increase use of alcohol-based hand rub and reduce the risk of health care-associated infections. Design and setting: The HH program was based on the World Health Organization 5 Moments for Hand Hygiene program, and included standardized educational materials and a regular audit system of HH compliance. The NHHI was implemented in January 2009. Main outcome measures: HH compliance and Staphylococcus aureus bacteraemia (SAB) incidence rates 2 years after NHHI implementation. Results: In late 2010, the overall national HH compliance rate in 521 hospitals was 68.3% (168 641/246 931 moments), but HH compliance before patient contact was 10%-15% lower than after patient contact. Among sites new to the 5 Moments audit tool, HH compliance improved from 43.6% (6431/14740) at baseline to 67.8% (106 851/157 708) (P < 0.001). HH compliance was highest among nursing staff (73.6%; 116 851/158 732) and worst among medical staff (52.3%; 17 897/34 224) after 2 years. National incidence rates of methicillinresistant SAB were stable for the 18 months before the NHHI (July 2007-2008; P = 0.366), but declined after implementation (2009-2010; P = 0.008). Annual national rates of hospital-onset SAB per 10 000 patient-days were 1.004 and 0.995 in 2009 and 2010, respectively, of which about 75% were due to methicillin-susceptible S. aureus. Conclusions: The NHHI was associated with widespread sustained improvements in HH compliance among Australian health care workers. Although specific linking of SAB rate changes to the NHHI was not possible, further declines in national SAB rates are expected.
McNeil, V, Cruickshank, M & Duguid, M 2010, 'Safer use of antimicrobials in hospitals: the value of antimicrobial usage data', MEDICAL JOURNAL OF AUSTRALIA, vol. 193, no. 8, pp. S114-S117.
McNeil, V, Cruickshank, M & Duguid, M 2010, 'Safer use of antimicrobials in hospitals: The value of antimicrobial usage data', Medical Journal of Australia, vol. 193, no. SUPPL. 8.
The National Antimicrobial Utilisation Surveillance Program (NAUSP) collects aggregate data from hospitals in all Australian states and provides reports of monthly hospital inpatient antimicrobial usage to contributing hospitals. These data provide an Australian peer-group benchmark; hospitals can compare their usage with similar hospitals and identify areas of antimicrobial use that require more indepth analysis. Overall high usage has been used by hospitals and area health services as a stimulus for initiation or expansion of antimicrobial stewardship programs. High use of particular classes of antimicrobials has triggered individual drug audits and been used to tailor interventions. Longitudinal antimicrobial usage data have been used by hospitals to measure the effects of antimicrobial stewardship strategies and provide feedback to prescribers.
McNeil, V, Cruickshank, M & Duguid, M 2010, 'Safer use of antimicrobials in hospitals: the value of antimicrobial usage data.', The Medical journal of Australia, vol. 193, no. S8, pp. S114-S117.
The National Antimicrobial Utilisation Surveillance Program (NAUSP) collects aggregate data from hospitals in all Australian states and provides reports of monthly hospital inpatient antimicrobial usage to contributing hospitals. These data provide an Australian peer-group benchmark; hospitals can compare their usage with similar hospitals and identify areas of antimicrobial use that require more in-depth analysis. Overall high usage has been used by hospitals and area health services as a stimulus for initiation or expansion of antimicrobial stewardship programs. High use of particular classes of antimicrobials has triggered individual drug audits and been used to tailor interventions. Longitudinal antimicrobial usage data have been used by hospitals to measure the effects of antimicrobial stewardship strategies and provide feedback to prescribers.
Mitchell, B, Gardner, A, Collignon, P, Stewart, L & Cruickshank, M 2010, 'A literature review supporting the proposed national Australian definition for Staphylococcus aureus bacteraemia', Healthcare Infection, vol. 15, no. 4, pp. 105-113.View/Download from: Publisher's site
Staphylococcus aureus bacteraemia (SAB) is a major cause of morbidity and mortality. During 2009, a national surveillance definition for SAB was developed through the Australian Commission on Safety and Quality in Healthcare (ACSQHC). The aim of this paper is to review the literature surrounding SAB surveillance and in doing so, evaluate the recently developed Australian national definition for SAB. The issues examined in this paper that relate to SAB surveillance include detection, the management of duplicates, classification and acquisition of SAB. Upon reviewing the literature, it was clear that the national Australian SAB surveillance definitions developed by the ACSQHC Healthcare Associated Infection Surveillance Committee are consistent with the majority of literature. Where inconsistencies exist, for example the lack of acquisition information in SAB surveillance programs in the United Kingdom, it is clear that the Australian surveillance definitions are more robust and provide more useful information. The national surveillance definitions for SAB developed by the ACSQHC surveillance committee sets an improved standard for other countries. © Australian Infection Control Association 2010.
Collignon, P, Cruickshank, M & Dreimanis, D 2009, 'Staphylococcus aureus bloodstream infections: An important indicator for infection control. Chapter 2: Bloodstream infections an abridged version', Healthcare Infection, vol. 14, no. 4, pp. 165-171.View/Download from: Publisher's site
Staphylococcus aureus bloodstream (SAB) infections are common and serious causes of morbidity and mortality. They also cause considerable additional healthcare costs. In Australia, there are ∼7000 SAB infection episodes per year and most of these are associated with healthcare procedures. In hospitals, data on all S. aureus bacteraemia episodes are relatively easy to collect. Collecting this data gives an accurate indication of the incidence of SAB infection in individual hospitals and whether they are healthcare-related infections (e.g. arising from intravenous catheter infections or surgical sites). These data also measure the relative proportion of methicillin-resistant S. aureus infections. When hospitals investigate the causes of individual healthcare-associated SAB infections, preventable factors will be identified. This should result in changes in clinical practice and protocols, while ongoing surveillance will allow an assessment of the efficacy of control measures. This will result in a decrease in the number of serious and life-threatening infections. This article is an abridged version of Chapter 2: 'Bloodstream infections' from the publication 'Reducing harm to patients from health care associated infection: the role of surveillance.' Cruickshank M, Ferguson J, editors. Sydney: Australian Commission on Safety and Quality in Health Care; 2008. The complete publication is available online at: www.safetyandquality.gov. au. © 2009 Australian Infection Control Association.
Cruickshank, M, Ferguson, J & Bull, A 2009, 'Reducing harm to patients from health care associated infection: The role of surveillance. Chapter 3: Surgical site infection - An abridged version', Healthcare Infection, vol. 14, no. 3, pp. 109-114.View/Download from: Publisher's site
The following article is an abridged version of Chapter 3: 'Surgical site infection' from the publication 'Reducing harm to patients from health care associated infection: the role of surveillance.' In: Cruickshank M, Ferguson J, editors. Sydney: Australian Commission on Safety and Quality in Health Care; 2008. The complete publication is available online at: www.safetyandquality.gov. au. © Australian Infection Control Association 2009.
McDonald, AM, Li, Y, Cruickshank, MA, Elliott, EJ, Kaldor, JM & Ziegler, JB 2001, 'Use of interventions for reducing mother-to-child transmission of HIV in Australia', Medical Journal of Australia, vol. 174, no. 9, pp. 449-452.
Objective: To describe the extent and outcome of use of interventions for reducing the risk of HIV transmission from mother to child in Australia. Design: National surveillance for perinatal exposure to HIV. Participants and setting: Notified cases of HIV infection in women in Australia and their perinatally exposed children, 1982-1999. Outcome measures: Trends over time in use of interventions (antiretroviral therapy in pregnancy, elective caesarean delivery and avoidance of breastfeeding) and perinatally acquired HIV infection. Results: By 31 March 2000, 204 children were reported as having been born in 1982-1999 to 162 women whose HIV infection had been diagnosed by 31 December 1999. The child's HIV infection status was established for 182 (89.2%); the mother's HIV infection was diagnosed antenatally in 91 of these cases (50%). Among women diagnosed antenatally, use of elective caesarean delivery and antiretroviral therapy in pregnancy increased significantly, from 3% and 14% by women whose children were born in 1982-1993, to 21% (P=0.01) and 88% (P<0.001), respectively, by women whose children were born in 1994-1999. Most women (95%) diagnosed antenatally avoided breastfeeding their children. The percentage of infected children born to women diagnosed antenatally declined from 26% among children born in 1982-1993 to 19% among those born in 1994-1999. The percentage of infected children was significantly lower among those whose mothers used antiretroviral therapy in pregnancy (11% versus 36%; P=0.03). Conclusion: Antiretroviral use in pregnancy, elective caesarean delivery and avoidance of breastfeeding have been effective interventions for reducing the risk of mother-to-child HIV transmission in Australia. While the rate of perinatal HIV transmission has declined, it remains high in comparison with rates reported from other industrialised countries.
McDonald, AM, Cruickshank, M, Ziegler, JB, Elliott, E & Kaldor, JM 1997, 'Perinatal exposure to HIV in Australia, 1982-1994', MEDICAL JOURNAL OF AUSTRALIA, vol. 166, no. 2, pp. 77-80.View/Download from: Publisher's site
ZIEGLER, JB, PALASANTHIRAN, P, CRUICKSHANK, M & LANGDON, P 1993, 'PEDIATRIC HIV - AUSTRALIAN PERSPECTIVE', JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY, vol. 6, pp. S20-S23.