Do you need updated infection control protocols?

Key Takeaways

• The rulebook has changed: AS 5369:2023 has officially superseded AS/NZS 4815 and AS/NZS 4187. If your practice reprocesses instruments (even just a few), you are now subject to a unified, rigorous standard that demands a risk-based approach.
• "Product Families" are the new norm: Under the new standard, you can no longer just run a generic cycle. You must classify your Reusable Medical Devices (RMDs) into "families" based on steam penetration resistance and validate your cycles accordingly.
• Ventilation is no longer invisible: Post-COVID, accreditation surveyors are scrutinising air changes per hour (ACH) and HEPA filtration, especially in procedure rooms. "Stagnant air" is now viewed as a compliance risk.
• Digital traceability is essential: The era of paper logbooks for sterilisation is ending. To prove compliance in court or an audit, you need digital, time-stamped cycle data linked directly to the patient file.
• Hand hygiene has stalled: While national compliance sits at a commendable 86-87%, fatigue is setting in. The "5 Moments" need a cultural refresh, not just another poster on the wall.

Introduction: The silent drift toward non-compliance

For the past few years, the Australian medical industry has been in crisis mode. You have battled a pandemic, managed workforce shortages, and navigated the telehealth revolution. In this high-pressure environment, it is easy for "business as usual" processes, like infection control, to drift.

However, while you were busy managing the frontline, the regulatory landscape shifted beneath your feet.

The release of AS 5369:2023 represents the most significant shake-up in reprocessing standards in a decade. It signals a move away from "prescriptive" checklists toward a "risk-based" responsibility model. At the same time, the Australian Commission on Safety and Quality in Health Care (ACSQHC) is tightening the screws on antimicrobial stewardship and environmental hygiene.

If your current infection control protocol is a laminated checklist from 2019, you are likely already non-compliant. This article explores the critical updates you need to know to protect your patients, your accreditation, and your reputation.

The new gold standard: Understanding AS 5369:2023

For years, Australian practices operated under two separate standards: AS/NZS 4187 for hospitals and AS/NZS 4815 for office-based practices (GPs, dentists, allied health).

That distinction is effectively gone.

AS 5369:2023 unifies the requirements. Whether you are a large day surgery or a suburban GP removing skin lesions, the standard for sterility is now the same. The virus doesn't care if it's in a hospital or a clinic, and neither does the new standard.

What you need to do:

• Classify "Product Families": You can no longer treat all instruments equally. You must group your devices based on their difficulty to sterilise (e.g., simple solid instruments vs. complex lumened devices).
• Validate your process: It is not enough to trust the green light on the autoclave. You need to perform Performance Qualification (PQ) validation for each product family.
• Gap Analysis: If you haven't done so already, run a gap analysis between your current AS/NZS 4815 procedures and the new AS 5369 requirements. This is the first thing an accreditor will ask for.

Air quality: The invisible vector

Before 2020, infection control was largely about surfaces: wiping down benches and sterilising steel. Today, the focus has expanded to the air itself.

The Australasian Health Facility Guidelines (AusHFG) and recent state-based mandates have placed a renewed emphasis on ventilation, particularly in waiting rooms and aerosol-generating procedure zones.

The shift in thinking. Surveyors are now asking questions like: "What is your air exchange rate?" and "When were your HVAC filters last changed?"

Practical application:

• Waiting Rooms: If you have a crowded waiting room with split-system air conditioning (which recycles air), you are creating a viral incubator. Consider installing commercial-grade HEPA air purifiers as a visible and effective mitigation strategy.
• CO2 Monitoring: An Australian business example is the widespread adoption of simple CO2 monitors in clinic waiting areas. If levels exceed 800ppm, it triggers a protocol to open windows or increase mechanical ventilation.

Staff compliance: Battling the "hygiene fatigue"

Australia has world-leading hand hygiene rates. According to the latest National Hand Hygiene Initiative data, compliance in Australian hospitals hovers around 87%.

However, in smaller practices and busy specialist suites, "hygiene fatigue" is a real threat. When staff are rushed, the "5 Moments for Hand Hygiene" often compress into "2 Moments", before and after the patient leaving.

The "Nudge" Theory: You cannot lecture staff into compliance. You have to design it into your workflow.

• Placement matters: Are your Alcohol-Based Hand Rub (ABHR) dispensers in the line of sight? If a nurse has to walk three steps to find sanitiser, compliance drops.
• Surface compatibility: A common issue in 2025 is the degradation of clinic furniture. Harsh viral disinfectants (like chlorine-based agents) are destroying vinyl chairs, creating cracks where bacteria hide.
• Solution: Audit your cleaning chemicals. Ensure they are TGA-listed and compatible with your upholstery. Replacing torn vinyl is far more expensive than switching to a gentler, pH-neutral hospital-grade wipe.

Digital traceability: Burn the logbook

In the event of a cross-infection scare, your only defence is your data. If your sterilisation records are hand-written in a logbook that is stored in a damp cupboard, you have a legal problem.

The new expectation: Accreditors and legal teams now expect digital traceability. They want to see a "closed loop":

1. Patient X has a procedure.
2. Instrument Kit Y was used.
3. Kit Y was sterilised in Cycle 1234.
4. Cycle 1234 passed all parameters (time, temp, pressure) at 10:00 AM on that date.
   
   

The Fix: Invest in automated tracking software or "data loggers" for your sterilisers. Many modern benchtop autoclaves (Class B) now come with USB or Wi-Fi logging. Ensure this data is backed up to your server, not just left on a USB stick.

Antimicrobial Stewardship (AMS): A leadership issue

Antimicrobial Resistance (AMR) is often called the "next pandemic." The Australian Commission on Safety and Quality in Health Care has made AMS a primary standard.

This is no longer just about doctors prescribing fewer antibiotics; it is about infection control preventing the need for them.

A realistic scenario: A patient develops a surgical site infection (SSI) after a minor procedure in your rooms. They are prescribed broad-spectrum antibiotics.

• Old thinking: "It happens. Treat the infection."
• New thinking: "Was this preventable?" Did the pre-operative skin prep fail? Was the instrument reprocessing validated?
  
  

Actionable Advice: Review your "Standard Precautions." Are you using single-use items where reprocessing is too risky? Moving to single-use sterile consumables for high-risk procedures (like biopsies) is a simple way to eliminate reprocessing risk entirely, aligning with AMS goals by reducing infection rates.

Conclusion: Compliance is an investment, not a cost

It is tempting to view these updated protocols as just more "red tape." However, in the Australian private practice market, trust is your currency. Patients are more health-literate than ever before. They notice the HEPA filter in the corner; they notice if you sanitise your hands before touching them.

Updating your infection control protocols to align with AS 5369:2023 and the new air quality standards is not just about passing accreditation. It is about future-proofing your business against liability and ensuring that your clinic remains a safe harbour in a health-conscious world.

Don't wait for the audit. Start your gap analysis today.