ORCID Profile
0000-0001-8483-1335
Current Organisations
Bond University
,
Australian College of Perioperative Nursing
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Publisher: Wiley
Date: 30-10-2018
DOI: 10.1002/AORN.12391
Abstract: Patients undergoing surgery may be at risk for infection from airborne particles such as dust, skin scales, respiratory aerosols, and hair fibers emanating from multiple sources in the OR, including personnel, heater-cooler devices, and surgical smoke. This risk is increased in surgical patients undergoing procedures involving implanted devices. Surgical personnel also are at risk from exposure to surgical smoke, which can contain viable viral particles including human papillomavirus infection. Air quality in the OR is improved by engineering controls (eg, maintaining positive pressure). During the past decade, innovations in the field of adjunctive technology designed to improve OR air quality include using ultraviolet disinfection and mobile ultraviolet disinfection plus high-efficiency particulate air filtration. Some of these technologies additionally provide continuous monitoring of circulating air particle counts. Additional research regarding the benefits of adjunctive air-cleaning technology in the OR is warranted.
Publisher: Elsevier BV
Date: 11-2010
Publisher: Elsevier BV
Date: 2013
Publisher: Elsevier BV
Date: 06-2008
DOI: 10.1071/HI08019
Publisher: Elsevier BV
Date: 04-2000
Publisher: Elsevier BV
Date: 06-1999
DOI: 10.1053/IC.1999.V27.A96387
Abstract: There are no regulatory, legislative, or professional criteria stipulating minimum qualifications or experience that a health care worker must meet to be capable of coordinating an Australian infection control (IC) program. Measurement of IC competence is important to protect the public and for the ongoing credibility and growth of the profession. Our study group was all 1078 nonmedical and nonindustry members of the Australian Infection Control Association in 1996. The survey examined perceived level of proficiency, level of education, and experience in health care and infection control. Almost three quarters (65%) of the members responded, and almost all (85%) of these respondents fulfilled the inclusion criterion of coordinating an IC program. Experience in IC ranged from less than 2 years (33.6%) to more than 20 years (10.0%). The majority (65.0%) of infection control professionals (ICPs) had between 8 years and 12 years IC experience. The respective proportions of respondents' self-ranked levels of proficiency on a 5-point scale were novice (3.6%), advanced beginner (21.2%), competent (33.8%), proficient (34.7%), and expert (6.8%). Almost half (47%) of the novices agreed that a registered nursing (RN) qualification was required, whereas a majority (41%) of advanced beginners considered both an RN and a basic IC course (BASIC) were required. Competent ICPs agreed less often than the other levels about their requirements. However, 27% of competents identified a BASIC and an undergraduate degree (UG) as the minimum requirements for a competent ICP. Proficient ICPs agreed that they required an RN, UG, BASIC, and a postbasic course in IC. Nearly all experts (80.0%) agreed that they required an RN, UG, BASIC, postbasic course, and a course in hospital epidemiology (EP). Two thirds of experts expected a master's degree as a requirement. The Australian IC profession is in an exciting period of development however, the variation in ICP perception of the most appropriate qualifications and experience threatens the credibility and viability of the profession. This variation indicates the need for a clear-cut pathway that includes a system of credentialing, recognition of expertise, adoption of ergent roles, and improved networking. This pathway will lead to an increasingly credible and viable IC profession in Australia. Developing IC communities globally can benefit from the Australian experience.
Publisher: Elsevier BV
Date: 08-2001
Abstract: Debate remains over the core activities of infection control (IC) programs. Differences in stakeholder opinions must be considered if consensus panel guidelines and recommendations are to be broadly applied. This article describes a survey of administrators and clinicians employed in hospitals in New South Wales, Australia. Respondents self-reported their levels of agreement with affirmative statements regarding the role of the infection control practitioner (ICP) and the essential requirements and infrastructure of IC programs. The study population included administrators and clinicians in each public, private, and freestanding day hospital in New South Wales. Respondents reported the intensity of their agreement with 16 affirmative statements relating to IC program infrastructure and resources and the ICP's role and responsibilities. The overall response rate was 62.1% (587/945). Clinicians (349/587) and administrators (238/587) accounted for 59.5% and 40.5% of the response rate, respectively. Overall, administrators and clinicians reported greatest levels of agreement for those elements not requiring additional resources. The extent of ergence between administrators and clinicians is not so great that it can not be resolved. Our findings demonstrate the degree of administrator support that clinicians can expect for each element. We advocate better communication between clinicians and administrators in conjunction with objective strategic planning. Our findings provide a guide for ICPs to either establish or negotiate the core components of their IC program.
Publisher: Cambridge University Press (CUP)
Date: 11-2000
DOI: 10.1086/501720
Abstract: Routine use of mupirocin to prevent staphylococcal infections is controversial. We assessed attitudes and practices of healthcare professionals attending the Fourth Decennial International Conference on Nosocomial and Healthcare-Associated Infections regarding mupirocin prophylaxis. Eighty percent of participants did not use mupirocin routinely. At the end of the session, 58% indicated they would consider increased use of mupirocin.
Publisher: Cambridge University Press (CUP)
Date: 11-1997
DOI: 10.2307/30141326
Publisher: Cambridge University Press (CUP)
Date: 03-2007
DOI: 10.1086/512261
Abstract: Legislation aimed at controlling antimicrobial-resistant pathogens through the use of active surveillance cultures to screen hospitalized patients has been introduced in at least 2 US states. In response to the proposed legislation, the Society for Healthcare Epidemiology of America (SHEA) and the Association of Professionals in Infection Control and Epidemiology (APIC) have developed this joint position statement. Both organizations are dedicated to combating healthcare-associated infections with a wide array of methods, including the use of active surveillance cultures in appropriate circumstances. This position statement reviews the proposed legislation and the rationale for use of active surveillance cultures, examines the scientific evidence supporting the use of this strategy, and discusses a number of unresolved issues surrounding legislation mandating use of active surveillance cultures. The following 5 consensus points are offered. (1) Although reducing the burden of antimicrobial-resistant pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), is of preeminent importance, APIC and SHEA do not support legislation to mandate use of active surveillance cultures to screen for MRSA, VRE, or other antimicrobial-resistant pathogens. (2) SHEA and APIC support the continued development, validation, and application of efficacious and cost-effective strategies for the prevention of infections caused by MRSA, VRE, and other antimicrobial-resistant and antimicrobial-susceptible pathogens. (3) APIC and SHEA welcome efforts by healthcare consumers, together with private, local, state, and federal policy makers, to focus attention on and formulate solutions for the growing problem of antimicrobial resistance and healthcare-associated infections. (4) SHEA and APIC support ongoing additional research to determine and optimize the appropriateness, utility, feasibility, and cost-effectiveness of using active surveillance cultures to screen both lower-risk and high-risk populations. (5) APIC and SHEA support stronger collaboration between state and local public health authorities and institutional infection prevention and control experts.
Publisher: Elsevier BV
Date: 03-2010
Publisher: Elsevier BV
Date: 06-2006
DOI: 10.1071/HI06037
Publisher: Elsevier BV
Date: 08-2004
Publisher: Elsevier BV
Date: 06-2004
DOI: 10.1071/HI04057
Publisher: Oxford University Press (OUP)
Date: 15-12-2009
DOI: 10.1086/648418
Abstract: Health care-associated, central venous catheter-related bloodstream infections (HA-BSIs) are a major cause of morbidity and mortality. Needleless connectors (NCs) are an important component of the intravenous system. NCs initially were introduced to reduce health care worker needlestick injuries, yet some of these NCs may increase HA-BSI risk. We compared HA-BSI rates on wards or intensive care units (ICUs) at 5 hospitals that had converted from split septum (SS) connectors or needles to mechanical valve needleless connectors (MV-NCs). The hospitals (16 ICUs, 1 entire hospital, and 1 oncology unit 3 hospitals were located in the United States, and 2 were located in Australia) had conducted HA-BSI surveillance using Centers for Disease Control and Prevention definitions during use of both NCs. HA-BSI rates and prevention practices were compared during the pre-MV period, MV period, and post-MV period. The HA-BSI rate increased in all ICUs and wards when SS-NCs were replaced by MV-NCs. In the 16 ICUs, the HA-BSI rate increased significantly when SS-NCs or needles were replaced by MV-NCs (6.15 vs 9.49 BSIs per 1000 central venous catheter [CVC]-days relative risk, 1.54 95% confidence interval, 1.37-1.74 P < .001). The 14 ICUs that switched back to SS-NCs had significant reductions in their BSI rates (9.49 vs 5.77 BSIs per 1000 CVC-days relative risk, 1.65 95% confidence interval, 1.38-1.96 p < .001). BSI infection prevention strategies were similar in the pre-MV and MV periods. We found strong evidence that MV-NCs were associated with increased HA-BSI rates, despite similar BSI surveillance, definitions, and prevention strategies. Hospital personnel should monitor their HA-BSI rates and, if they are elevated, examine the role of newer technologies, such as MV-NCs.
Publisher: Elsevier BV
Date: 12-1999
DOI: 10.1016/S0196-6553(99)70024-6
Abstract: The prevalence of nosocomial infection in Australian hospitals is estimated to be between 5.5% and 6.3%. Since 1989, infection control professionals (ICPs) in hospitals accredited by the Australian Council on Health Care Standards (ACHS) have been encouraged to collect nosocomial infection data according to ACHS methodology. In 1996, we surveyed members of the Australian Infection Control Association to examine the time spent on surveillance, the practice of surveillance of all hospital infections (hospital-wide surveillance), case-finding methods, case definitions, and reporting routinely used by ICPs in acute care hospitals. We also examined the ICPs' education and experience in infection control (IC). The survey was completed and returned by 65% (644 of 993) of Australian Infection Control Association members. Of the ICPs who completed the survey, 47.8% (308 of 644 95% CI, 43.9%-51.7%) met the criteria for inclusion, because they coordinated an IC program in an acute care or surgical hospital and performed surveillance for either surgical wound infection, intravascular device-related bacteremia, or non-device-related bacteremia. Of the ICPs who reported their facility's accreditation status, 93.5% participated in ACHS system. Most (97.6%) ICPs had completed hospital-based general registered nurse training. Only 1.9% (6 of 308) of ICPs reported completion of continuing education relating to hospital epidemiology. The number of years of IC experience ranged from zero to 35 years, with a median of 4 years. ICPs spent a substantial proportion of their total weekly IC time on surveillance irrespective of ACHS accreditation 19.5 hours in ACHS hospitals and 15.6 hours in non-ACHS hospitals (P =.33). More than three quarters (76.0%) of ICPs performed hospital-wide surveillance. The case-finding methods, definitions of infections, and reporting formats varied greatly. The definition most commonly applied by ICPs (6.8% 95% CI, 4.1%-10.4%) to define surgical wound infection was infection within 30 days after the operative procedure, plus purulent drainage, plus isolation of organisms from a culture from the incision site, plus diagnosis by a medical officer. A 5-item definition of a patient being asymptomatic, plus afebrile on admission, plus infection occurring at least 48 hours after admission, plus the patient having a fever of >38 degrees C, plus a recognized culture from one or more bottles was used by 15.7% (95% CI, 11.3%-21.0%) of ICPs to define a case of bacteremia. Surveillance is the core business of Australian ICPs and consumes a substantial proportion of their time. The importance of surveillance, the epidemiologic limitations of the current ACHS system, and the nonstandard methods we report indicate that improved methodology is required for case finding and reporting of nosocomial infections. Australian ICPs should complete training in the principles of surveillance and epidemiology. With this training, ICPs can work collaboratively with other health care professionals to develop epidemiologically sound, local, nosocomial surveillance systems and lobby for a voluntary, national, standardized, risk-adjusted system of targeted nosocomial surveillance.
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.IDH.2017.10.001
Abstract: Increasingly, over the past decade, there has been a global shift in healthcare away from fixed "fee for service" payment mechanisms towards value-based reimbursement models rewarding safety and quality patient outcomes. Curbing the burgeoning costs of healthcare while incentivising higher quality and safer patient care are key drivers of this approach. At face value, this is clearly a worthwhile endeavour. However, there is a lack of conclusive evidence to support the effectiveness of such schemes where they have been introduced internationally. For this reason, Australia has largely been an observer of the shift in payment modalities that are occurring in other countries such as the United States and the United Kingdom. This paper presents an overview of current Australian practice in pricing for safety and quality in Healthcare. Recommendations are provided to help infection control professionals prepare for the upcoming introduction of funding reforms aimed at reducing complications acquired in Australian public hospitals. The implications for infection control professionals are wide-ranging. This will be a period of significant adjustment for the public health system in Australia.
Publisher: Elsevier BV
Date: 09-1998
DOI: 10.1071/HI98318
Publisher: Elsevier BV
Date: 12-2010
DOI: 10.1016/J.AJIC.2010.08.008
Abstract: This article is an executive summary of the APIC Elimination Guide for catheter-related bloodstream infections. Infection preventionists are encouraged to obtain the original, full-length APIC Elimination Guide for more thorough coverage of catheter-related bloodstream infections prevention.
Publisher: Elsevier BV
Date: 12-2010
DOI: 10.1016/J.AJIC.2010.08.009
Abstract: Research is an integral component of the mission of the Association for Professionals in Infection Control and Epidemiology (APIC). In January 2010, APIC 's Board of Directors decided to update and clarify the Association's approach to research. The purpose of this paper is to briefly review the history of APIC's role in research and to report on the recent vision and direction developed by a research task force regarding appropriate roles and contributions for APIC and its members in regards to research. APIC and its membership play critical roles in the research process, especially in terms of setting the research agenda so that research resources can be directed to important areas. Additionally, dissemination and implementation are areas in which APIC members can utilize their unique talents to ensure that patients receive the most up-to-date and evidence-based infection prevention practices possible.
Publisher: Elsevier BV
Date: 12-1997
Publisher: Elsevier BV
Date: 12-2011
DOI: 10.1071/HI11024
Publisher: Elsevier BV
Date: 03-2007
DOI: 10.1016/J.AJIC.2007.01.001
Abstract: Legislation aimed at controlling antimicrobial-resistant pathogens through the use of active surveillance cultures to screen hospitalized patients has been introduced in at least 2 US states. In response to the proposed legislation, the Society for Healthcare Epidemiology of America (SHEA) and the Association for Professionals in Infection Control and Epidemiology, Inc., (APIC) have developed this joint position statement. Both organizations are dedicated to combating health care-associated infections with a wide array of methods, including the use of active surveillance cultures in appropriate circumstances. This position statement reviews the proposed legislation and the rationale for use of active surveillance cultures, examines the scientific evidence supporting the use of this strategy, and discusses a number of unresolved issues surrounding legislation mandating use of active surveillance cultures. The following 5 consensus points are offered. (1) Although reducing the burden of antimicrobial-resistant pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), is of preeminent importance, the APIC and the SHEA do not support legislation to mandate use of active surveillance cultures to screen for MRSA, VRE, or other antimicrobial-resistant pathogens. (2) The SHEA and the APIC support the continued development, validation, and application of efficacious and cost-effective strategies for the prevention of infections caused by MRSA, VRE, and other antimicrobial-resistant and antimicrobial-susceptible pathogens. (3) The APIC and the SHEA welcome efforts by health care consumers, together with private, local, state, and federal policy makers, to focus attention on and formulate solutions for the growing problem of antimicrobial resistance and health care-associated infections. (4) The SHEA and the APIC support ongoing additional research to determine and optimize the appropriateness, utility, feasibility, and cost-effectiveness of using active surveillance cultures to screen both lower-risk and high-risk populations. (5) The APIC and the SHEA support stronger collaboration between state and local public health authorities and institutional infection prevention and control experts.
Publisher: Cambridge University Press (CUP)
Date: 11-2010
DOI: 10.1086/656912
Abstract: Jointly, the Association for Professionals in Infection Control and Epidemiology (APIC), the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), the Association of State and Territorial Health Officials (ASTHO), the Council of State and Territorial Epidemiologists (CSTE), Pediatric Infectious Diseases Society (PIDS), and the Centers for Disease Control and Prevention (CDC) propose a call to action to move toward the elimination of healthcare-associated infections (HAIs) by adapting the concept and plans used for the elimination of other diseases, including infections. Elimination, as defined for other infectious diseases, is the maximal reduction of “the incidence of infection caused by a specific agent in a defined geographical area as a result of deliberate efforts continued measures to prevent reestablishment of transmission are required.” (p24) This definition has been useful for elimination efforts directed toward polio, tuberculosis, and syphilis and can be readily adapted to HAIs. Sustained elimination of HAIs can be based on this public health model of constant action and vigilance. Elimination will require the implementation of evidence-based practices, the alignment of financial incentives, the closing of knowledge gaps, and the acquisition of information to assess progress and to enable response to emerging threats. These efforts must be under-pinned by substantial research investments, the development of novel prevention tools, improved organizational and personal accountabilities, strong collaboration among a broad coalition of public and private stakeholders, and a clear national will to succeed in this arena.
Publisher: Elsevier BV
Date: 1995
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.COLEGN.2013.06.003
Abstract: Australian healthcare workers and especially nurses repeatedly have their safety and health jeopardized through occupational exposures to blood and body fluids. Percutaneous or needlestick injuries are especially concerning and consistent. The purpose of this article is to again draw attention to the serious and costly issue of needlestick injuries in Australian healthcare settings. Specifically it considers the context of needlestick injuries and safety engineered devices within Standard 3 of the Australian Commission on Safety and Quality in Health Care's National Standards reform agenda. Given that Standard 3 alone will likely be insufficient to reduce needlestick injuries, this article also discusses improvements and current challenges in international needlestick injury reduction in an attempt to stimulate key opinion leader consideration of Australia adopting similar strategies.
Publisher: Elsevier BV
Date: 1995
Publisher: Elsevier BV
Date: 1997
Publisher: Elsevier BV
Date: 06-2006
DOI: 10.1071/HI06046
Publisher: Elsevier BV
Date: 05-2012
DOI: 10.1016/J.AJIC.2012.03.005
Abstract: Research is an integral component of the Association for Professionals in Infection Control and Epidemiology (APIC) Strategic Plan 2020. As the role of the infection preventionist (IP) has evolved toward consumers and implementers of research, it becomes increasingly necessary to assess which topics require further evidence and how best APIC can assist IPs. In 2010, APIC determined that the research priorities first described in 2000 needed to be re-evaluated. A 33-question Web-based survey was developed and distributed via e-mail to APIC members in March 2011. The survey contained sections inquiring about respondents' demographics, familiarity with implementation science, and infection prevention research priorities. Priorities identified by a Delphi study 10 years ago were re-ranked, and open-ended items were used to identify new research priorities and understand how APIC could best serve its members in relation to research. Seven hundred one members responded. Behavioral management science, surveillance standards, and infection prevention resource optimization were the highest ranked priorities and relatively unchanged from 2000. Proposed additional research topics focused on achieving standardization in infection prevention practices and program resource allocation. The majority of respondents described APIC's role in the field of research as a disseminator of low-cost, highly accessible education to its members. This report should be used as a roadmap for APIC leadership as it provides suggestions on how APIC may best direct the association's research program. The major research priorities described and ranked in 2000 continue to challenge IPs. APIC can best serve its members by disseminating research findings in a cost-effective and easily accessed manner. Recurrent assessments of research priorities can help guide researchers and policy makers and help determine which topics will best support successful infection prevention processes and outcomes.
Publisher: Wiley
Date: 10-1997
DOI: 10.1111/J.1445-2197.1997.TB07106.X
Abstract: Evidence-based medicine and measurement of outcome have become the foremost strategy of departments of health and quality care in Australia in the 1990s. The Australian Council of Healthcare Standards, (ACHS), formed in 1974, has introduced a Clinical Indicators Programme which monitors a number of clinical outcomes, including rates of specific nosocomial infections. It is the only formal system in Australia which attempts to monitor nosocomial infection in hospitals, and the ACHS acknowledges that the data provided to them are collected using a variety of sources and definitions. The present study discusses the validity of the present definitions of nosocomial surgical wound infection used for accreditation, how validity may be improved and the attempts by some international systems to improve their own data. The ACHS definitions of nosocomial surgical wound infection lack validity, and the rates provided lack generalizability. Several international surveillance systems have resources in place to provide members with standardized training for practitioners, and support for methodology, data analysis and reporting, which assists in improving the quality of the data collected. It is our belief that the validity of surgical wound infections will be improved by adoption of National Nosocomial Infection Surveillance (NNIS) definitions, stratification of surgical wound infections by anatomical site of infection for sentinel procedures. The ACHS system must adopt the proposed changes if the rates are to be used as a local and national indicator.
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1071/HI11030
Publisher: Elsevier BV
Date: 06-1999
DOI: 10.1053/IC.1999.V27.A92961
Abstract: Australian infection control practitioners (ICPs) have not been previously profiled. Knowledge of their practice is limited, making support and evaluation of their programs difficult. To investigate the current role, function, and attributes of this group, we undertook a national survey of members of the Australian Infection Control Association. In 1996 a questionnaire was sent to all 1078 nonmedical and nonindustry members of the Australian Infection Control Association. More than half (65%) of the membership responded to the questionnaire, which measured demographics, experience, infection control training and education, staffing levels, perceived deficits, and managerial support. Our results indicate that the typical Australian ICP works in a public acute-care facility with fewer than 251 beds, has 6 years experience in the field, and has completed hospital-based nursing training. Surveillance was the activity that consumed most of the ICPs' time. The majority of ICPs had responsibilities in addition to infection control, and although they considered management to be supportive, additional clerical support was identified as an area for program improvement. We have provided the first comprehensive profile of Australian ICPs and their practices. Our findings compel professional associations, such as the Australian Infection Control Association, to address the following: standardization in practice and surveillance, provision of appropriate training and ongoing education, and encouragement of research initiatives by infection control staff. These strategies are the key to future evidence-based infection control and will ensure survival of this specialty in Australia.
Publisher: Wiley
Date: 03-2000
DOI: 10.1046/J.1440-1762.2000.00347.X
Abstract: Standardised surveillance of nosocomial infections in Australia had not been addressed until June 1998 when the New South Wales Health Department funded the development and implementation of the first standardised surveillance system for hospital infection: the Hospital Infection Standardised Surveillance program (HISS). The introduction of a standardised surveillance system needs to balance the requirements of a Health Department and the needs of hospitals. The Health Department requires data to develop aggregated rates for the setting of thresholds for all nosocomial infections while hospitals require rates to reflect the quality of clinical care and provide data for evidence-based infection control practices. The Hospital Infection Epidemiology and Surveillance (HIES) Unit has attempted to balance these requirements using a 'sentinel surveillance' approach with standardised definitions and methodology. The HISS program utilizes eICAT software modified for its standardised requirements of data collection. To date, 10 hospitals surveyed sentinel multiple resistant organisms (MRO), eight also elected sentinel surgical procedures (SSP) and intravascular device-related bacteraemia (IVDRB) modules, and two the seasonal respiratory syncytial (RSV) and rota-virus modules in paediatric patients. The surgical site infection rates in three commonly monitored SSP were 1.8% (95% confidence interval (CI) 0.7-3.9%) for coronary artery bypass (CABG), 3.3% (95% CI 1.4-6.8%) lower segment Caesarean section (LSCS) and 7.7% (95% CI 3.4-14.6%) colorectal surgery. The rate of IVDRB was 4.7 per 1000 central venous catheter days (95% CI 2.2-8.6) and 1.1 per 1000 peripheral line-days (95% CI 0.1-3.9). Methicillin resistant Staphylococcus aureus (MRSA) accounted for 99% of all new infections diagnosed with an endemic MRO.
No related grants have been discovered for Cathryn Murphy.