What you will learn in this session The importance and general principles of infection prevention and control The nature of Healthcare Associated Infection (HCAI) Factors that may increase susceptibility to infection Individual responsibility to infection prevention & control Where to find information, including legislation, national guidance and local policies The role of hand hygiene in preventing transmission of infection Local infrastructure, initiatives and reporting procedures

Why is this important? Compliance with Health and Social Care Act (2008) Local procedures and guidance At least 300,000 Healthcare Associated Infections 5,000 patients die as a direct result of HCAI and it is one of the factors in another 15,000 deaths. Patients with a HCAI are approx. 7 times more likely to die in hospital than uninfected patients Costs the NHS over £1bn per year

What are Healthcare Associated Infections? Acquired as a result of healthcare interventions Develop as a direct result of contact in a healthcare setting Numerous factors increase the risk of individuals acquiring an infection Poor standards of infection control practice increase the risk of occurrence

Colonisation versus infection Colonisation is when micro-organisms (germs) exist in the body, but don’t invade tissue or cause detectable (clinical) damage Infection is when micro-organisms (germs) begin to invade the body tissues and cause detectable (clinical) damage

Chain of infection

Infectious agent… A micro-organism with the ability to cause disease Bacteria, viruses, fungi, parasites Possibility of infection related to: Virulence (ability to grow and multiply) Invasiveness (ability to enter tissue) Pathogenicity (ability to cause disease)

The reservoir Where micro-organisms reside and multiply: People Equipment Animals Water Food Soil

Site of exit The place of exit providing a way for a micro-organism to leave the body Examples include: Any orifice Break in skin Via any bodily substance

Transmission Direct contact Human-to-human contact Indirect contact No human-to-human contact

Site of entry… Inhalation Ingestion Sexual contact Breaks in the skin

Susceptible host Some people are more susceptible due to: Low immunity Poor physical resistance Being very young or old Being malnourished Underlying disease

Standard precautions Hand hygiene Use of Personal Protective Equipment (PPE) Safe use and disposal of sharps Management of sharps injuries Safe disposal of clinical waste Safe management of laundry Cleaning and decontamination of re-usable equipment Maintenance of a clean clinical environment Safe management of body fluid spillages Respiratory hygiene

Personal Protective Equipment (PPE) Gloves Aprons/gowns Masks Protective eyewear PPE is designed to protect healthcare workers from exposure to potentially infectious material

Decontamination Management of body fluid spillage Appropriate cleaning of equipment Use of appropriate cleaning/disinfection products Special precautions in high risk area and with high risk patients

Laundry Introduce you organisation’s policy for the management of linen and clothing

Clinical waste management Introduce your own organisation’s policy on waste management

Sharps management Ensure correct assembly of sharps container Dispose of sharps in approved container at the point of use Don’t exceed the fill limit Correct disposal of container when required

Management of inoculation injuries Include reference to your own organisations policy on management of inoculation injuries

Hand decontamination... One of the most effective measures in the prevention of transmission of infection Washing Hand sanitiser

The five moments

Barriers to effective hand hygiene Jewellery (esp. rings with stones) Nail varnish and false nails Wrist bands Wrist watches Long sleeves

Hand hygiene technique “This sink is for hand washing only” Wet hands thoroughly with warm water and apply liquid soap Palm to palm Right palm over left dorsum and left palm over right dorsum Palm to palm fingers interlaced Remember to include wrists, remove all soap, dry hands thoroughly with paper towels and use moisturiser at least three times a day. Alcohol hand gel should be applied in the same way briskly to increase evaporation Backs of fingers to opposing palms with fingers interlocked Rotational rubbing of right thumb clasped in left palm and vice versa Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa

Appropriate products Liquid soap Sanitiser Moisturiser

Bare below the elbows

Further information http://www.dh.gov.uk/en/index.htm http://www.npsa.nhs.uk http://www.hpa.org.uk/ http://www.rcn.org.uk/ http://www.hcai.dh.gov.uk/

Summary Healthcare Associated Infections are often preventable All staff have a responsibility to follow infection control procedures all of the time wherever they work in the healthcare economy Follow appropriate guidelines/policies and safe systems of care

Insert trainer’s name, telephone number and email here THANK YOU Any Questions? Insert trainer’s name, telephone number and email here