Key lessons from the establishment of a nurse-led infection prevention and control program for COVID-19 in an Australian hotel quarantine and isolation service.

BACKGROUND: A key aspect of Australia's response to the COVID-19 pandemic was to control transmission through legislated quarantine and isolation of overseas returning travellers and potentially infectious community members. In New South Wales, Special Health Accommodation (SHA) was rapidly established as a comprehensive health service for individuals that were at risk of having COVID-19, were confirmed to have COVID-19 or for those with complex health needs that were deemed inappropriate for management in Police managed Quarantine Hotels. SHA services were later expanded to care for community members who were COVID-19 positive and unable to effectively isolate, or contacts of individuals who were unable to quarantine effectively in their homes. SHA's unique nurse-led Infection Prevention and Control (IPC) program offers key lessons that may impact future programs. METHODS: A reflection on the experience of leading an Infection Prevention and Control program in SHA was undertaken. This was supported by a review of SHA admission, workforce and transmission data and data obtained from a cross-sectional questionnaire aimed to better understand the experiences of a novel population of health workers (HW) in a comprehensive health-led quarantine and isolation service. RESULTS: SHA program data demonstrates how its IPC program implementation prevented transmission of COVID-19 to SHA staff and patients. Responses from the questionnaire suggested staff felt safe and well-prepared through the IPC education they received. They also gained transferrable knowledge and skills, which they intend to use in future healthcare roles. CONCLUSION: The SHA nurse-led IPC program offered successful quarantine and isolation for COVID-19 in non-purpose-built facilities. A review of IPC strategies and key lessons from the establishment of the SHA IPC program are of critical importance to planning and management of current and future pandemics.

Evaluation of different methods to recover meticillin-resistant Staphylococcus aureus from hospital environmental surfaces.

The environment is implicated as a source of healthcare-associated infections (HAIs) and there is a need for evidence-based approaches to environmental sampling to assess cleanliness and improve infection prevention and control. We assessed, in vitro, different approaches to sampling the environment for meticillin-resistant Staphylococcus aureus (MRSA). In a laboratory-based investigation, the recovery of MRSA from two common hospital environments using six different sampling methods was evaluated, with a wild-type strain of MRSA. A 100 cm(2) section of mattress and a laboratory bench surface were contaminated with known inocula of MRSA. Bacteria were recovered by sampling at 30 min after inoculation, using either saline-moistened cotton swabs, neutralising buffer swabs, eSwabs or macrofoam swabs, which were all enriched in tryptone soya broth, or by sampling with direct contact plates or chromogenic 'sweep' plates. The sensitivity (i.e. the minimum number of bacteria inoculated on to a surface which subsequently produced a positive result) of each method was determined for each surface. The most sensitive methods were eSwabs and macrofoam swabs, requiring 6.1 × 10(-1) and 3.9 × 10(-1) MRSA/cm(2), respectively, to produce a positive result from the bench surface. The least sensitive swabbing method was saline-moistened cotton swabs, requiring 1.1 × 10(3) MRSA/cm(2) of mattress. The recovery of bacteria from environmental samples varies with the swabs and methodology used and negative culture results do not exclude a pathogen-free environment. Greater standardisation is required to facilitate the assessment of cleanliness of healthcare environments.

Sewer storage tank performance under climate change.

This paper describes a study of the potential effects of climate change on the design and performance of sewer storage tanks. A long-term synthetic rainfall time-series has been derived based on the IPPC medium-high emission scenario for a case study in London. Results indicate a 35% increase in the number of storm events that cause filling of the tank and a 57% increase in the average volume of storage required. A method to estimate the required future storage volume for any given return period has been developed and described. Indications are that significantly larger storage volumes will be required to maintain the same level of flood protection.