Ms Carmel Couch1, Ms Megan Brown1, Mr Christopher Russell2
1Illawarra Shoalhaven Local Health District, Shellharbour, Australia, 2Illawarra Shoalhaven Local Health District, Wollongong, Australia
Biography:
Carmel Couch is a CNC from the Illawarra Shoalhaven LHD with over 15-years of experience in a variety of settings including Critical Care, Cardiology, Public Health, Respiratory, Medical, and Surgical nursing.
She is and experienced IPC who is passionate about clinical innovation and education.
Abstract:
Traditionally, infection control has focused on direct person-to-person transmission of Carbapenemase-producing Enterobacteriaceae (CPE). However, emerging evidence highlights environmental reservoirs—particularly contaminated clinical hand basins (CHBs)—as critical transmission sources. This infection control initiative, based in a regional New South Wales hospital, sought to reduce environmental contamination through clinical innovation, collaborative redesign, and reinterpretation of infrastructure guidelines.
Environmental sampling of existing in-patient units identified genetically linked CPE and multi-resistant Gram-negative organisms in CHBs and patient samples. Existing Health Facility Guidelines were critically analysed and reinterpreted to change CHB placement and density as well as PPE station placement in proximity to CHB to reduce contamination. A multi-disciplinary partnership was established between infection control practitioners, the health infrastructure, and capitol works teams.
Despite existing regulations, we made the deliberate and courageous decision to locate PPE stations outside of the splash zone, change CHB locations and guiding metrics in a new build. A considered and collaborative approach to reinterpreting guidelines and evidence has led to the development of safer, more clinically discerning environment. These changes are now shaping new guidelines—demonstrating the power of trusted partnerships and informed, practical innovation.
Effective infection control requires context-driven innovation and broad collaboration. This initiative demonstrates how clinical expertise, collaborative design, and flexible reinterpretation of guidelines can shape safer hospital environments. It contributes to guiding principles for successful multi-site implementation strategies by leveraging local ownership and cross-disciplinary influence to achieve sustainable outcomes. This work demonstrated the power of advocacy and evidence-informed changes, directly influencing health infrastructure policy and improving infection control.