INFECTION CONTROL

Why is Infection Control Important?

Florence Nightingale (1859) “Hospitals should do the sick no harm”. Florence Nightingale (1859)

Patients are vulnerable to infection

WHERE CAN MICRO-ORGANISMS BE FOUND ? Environment People Equipment Food WHAT DO MICRO-ORGANISMS NEED TO GROW? Warmth Moisture Food source Time

HOW DO THEY SPREAD? Hands Through the air Via equipment e.g. Commodes Puncture of the skin Food An infected person Droplets Contact Skin scales

Standard precautions are the minimal level of infection control precautions that apply to all patients at all times in all situations.

Who is responsible for implementing Standard Precautions?

We all are. All NHSGGC employees must follow the requirements of the Standard Precautions Policy – See your ward Infection Control Manual for information.

Isolating infectious patients Masks and Eye protection Hand hygiene Environment PPE There are 10 elements to Standard Precautions Clinical Waste Linen Occupational Exposure Isolating infectious patients Patient care equipment Spillages Cough Etiquette

Hand Hygiene The simplest and most effective method of preventing the spread of infection

Hand Hygiene Simple and effective Proven to reduce the risk of acquiring HAI Use of alcohol gels Performed between each patient intervention Ensure technique is good

Remember to wash past your wrists Palm to palm fingers interlaced. Wet hands, apply soap. Palm to palm. Right palm over left dorsum and left palm over right dorsum. Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa. Rotational rubbing of right thumb clasped in left palm and vice versa. Backs of fingers to opposing palms with fingers interlocked. Remember to wash past your wrists

Alcohol Hand Gel Used as a compliment to handwashing not a replacement Good for rapid disinfection of skin Can only be used on physically clean hands Suitable for use on ward rounds between patients. Should only be used up to 5 times then wash hands with soap and water Placed at every bed space within NHSGGC In our day to day lives we carry out risk assessment in an ongoing basis without really thinking about it. In order to manage a risk we have to know what the risk is. Infection control is about minimising risks, in order to do this it is necessary to know what the risk is. For example while the hand hygiene policy states that alcohol gel is at every bedside, but there will be areas where this might not be appropriate e.g. paediatrics and a risk assessment needs to be done by both the infection control nurses and the ward staff to ensure that the staff can decontaminate their hands and the patients are safe.

PERSONAL PROTECTIVE EQUIPMENT (PPE) Gloves Aprons Eye protection Face shields Masks

Isolation Protective Vulnerable patients, with poor immune systems. Patients who may be receiving chemotherapy Stop these patients catching an infection Source Patients identified as carrying bugs that could cause other patients to become ill if it was passed onto them.

Methicillin Resistant Staphylococcus Aureus (MRSA) What is MRSA? What are the predisposing risk factors? What is colonised, What is infected? How is MRSA transmitted

MRSA screening Who should be screened When should they be screened What samples should be taken What treatment should be given What about isolation

Clostridium difficile Symptoms Watery, foul smelling stools. Abdominal pain. Pyrexia (high temperature) Dehydration.

How to prevent spread of Clostridium Difficile to other patients If they have diarrhoea send a sample. Isolate them in a side room. Use Personal Protective Equipment. Encourage the patient to wash their hands after using the toilet. Clean the commode thoroughly after every use with Actichlor Plus.

OUTBREAKS

OUTBREAKS What is an outbreak When should infection control be notified What information is required Can patients be discharged/transferred Can patients attend for examinations e.g. x-ray Enhanced cleaning Outbreak is over, what now?

BRISTOL STOOL CHART Type 1 Separate hard lumps, like nuts hard to pass Long Transit e.g 100 hours Type 1 Separate hard lumps, like nuts hard to pass Type 2 Sausage shaped but lumpy Type 3 Like sausage but with cracks on the surface Type 4 Like sausage or snake, smooth and soft Type 5 Soft blobs with clear cut edges (passed easily) Type 6 Fluffy pieces with ragged edges, a mushy stool Type 7 Watery, no solid pieces Types 1-5 do not send specimens to microbiology. Types 6 and 7 send specimens to microbiology Short transit e.g 10 hours

Prevention and Control of Infection Team There are Prevention and Control of Infection Teams available for specialist Infection Control advice within NHSGGC Contact details of local Infection Control Teams (ICT) can be found within NHSGGC Prevention and Control of Infection Manual, via your local switchboard or website; www.nhsggc.org.uk/infectioncontrol