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Practice Standards

RACGP infection control standards for office-based practices

The RACGP Infection control standards for office-based Practices (4th Edition) (RACGP IC Standards) was launched at the recent RACGP Annual Scientific Convention in Brisbane.

The RACGP IC Standards have been written specifically for general practices and other health professionals in office based settings. The RACGP IC Standards have been reviewed by experts in infectious diseases, pathology and infection control. General practitioners, practice nurses, steriliser technicians and accreditation agencies participated in the review process. The RACGP IC Standards were also reviewed by the RACGP National Expert Committee on Standards for General Practices, and endorsed by RACGP Council.

The focus of the RACGP IC Standards is practice-based risk assessment and staff education in aspects of infection control relevant to the staff member’s role.

The RACGP IC Standards are divided into five sections.

Section 1 Infection Control Principles - requirements for staff education, basic microbiology, principles of hand hygiene, the appropriate use of standard and additional precautions and personal protective equipment.

Section 2 Protecting the health of staff - include staff immunisation, managing the health of health professionals and staff, safe sharps management and management of blood and body fluid exposure.

Section 3 Manage the practice physical environment. This section covers occupational health and safety or staff, cleaning of the practice, cleaning practice equipment, managing blood and body spills, linen and waste management.

Section 4 Processing of reusable equipment - off site sterilisation, monitoring and documentation, validation, single use items, etc

Section 5 Disease surveillance in office based practice - reporting requirements, and reception and triage in relation to potential or actual infectious diseases.

There are many tables, charts, photos and illustrations throughout the RACGP IC Standards. A CD containing many of the charts and templates for use by the practice is also included.

In some instances the RACGP IC Standards differ from the previous RACGP Sterilisation/Disinfection Guidelines and have departed from Australian texts such as the Australian Standards and the Department of Health and Aging Infection Control Guidelines

Examples are:

Hand hygiene
Hand hygiene facilities such as hand basins and taps or hand disinfectants need to be available in every treatment area.

Waste management
Practices need to be aware of local and State/Territory regulations that impact on waste management in the practice. In the absence of current NHMRC waste management guidelines the RACGP has written guidelines to assist practices to safely manage their waste whilst minimising environmental impact and financial cost.

Linen management
Practices may safely launder their own linen, provided appropriate precautions are used.

Monitoring of the sterilisation cycle
Practices using vacuum assisted Class S cycles should perform a weekly leak test but are not required to perform steam penetration tests. Practices using Class B cycles are required to perform leak tests and steam penetration tests, e.g. Bowie Dick or helix test.

Documentation of the cycle
Recording of the results of the steriliser cycle monitoring into the steriliser log book is essential. (The actual printout can be kept.)

Validation
Only one physical check of time at temperature is required and this can be performed during annual servicing and calibration either on or off site. Checks of penetration time, heat distribution and drying time and temperature can be performed concurrently with this check.

Off site validation
The physical checking of time at temperature as an essential part of validation can be performed off site in situations where it is not possible to arrange on site technical support. The microbiological checking must still be performed on site.

Single use equipment
Generally must not be reprocessed especially sharp items. In exceptional cases some devices may be safely reprocessed and used on other patients provided the practice performs a risk assessment eg: single patient use spacers cleaned and sterilised between uses. Single patient use equipment may be reprocessed for use by the same patient provided the manufacturer’s instructions are followed.

Staff immunisation
Extensive upgrading of this section and the need for employers to ensure education and maintain records.

Disease surveillance
This is a whole new area, and covers responsibilities practices have for the monitoring of and reporting of disease outbreaks. A chapter covering reception and triage functions pertaining to infection control is also included.

How to order

The RACGP Infection Control Standards for Office-based practices can be obtained from the RACGP Publications Department on 03 8699 0495, or by downloading the order form at www.racgp.org.au/publications/orders and faxing back to 03 8699 0400.

The cost is $88 for RACGP members and $132 for non-members.

For further information contact RACGP Publications on publications@racgp.org.au or standards@racgp.org.au.

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