Infection Prevention Manuals for Primary Care by Karen Foulis

Infection Prevention and Control

Policies and Safe Practice Guidance Manual

Primary Care General Practice; Out-of-Hours and Urgent Care/Walk-in Centres

Infection Prevention Solutions Gordon House 1-6 Station Road Mill Hill London NW7 2JU T: 020 8906 2777 F: 020 8906 2233 E: info@infectionpreventionsolutions.co.uk

www.infectionpreventionsolutions.co.uk

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Infection Prevention Solutions

INFECTION PREVENTION & CONTROL PRIMARY MEDICAL CARE POLICIES AND SAFE PRACTICE GUIDANCE CONTENTS Title

Section Number

Policies: Infection Prevention and Control Management Policy Policy Statement for COVID-19 Recognition and management of an outbreak of infection Management of an outbreak of viral gastro-intestinal illness Antimicrobial Stewardship Policy Sepsis

1 2 3 4 5 6

Safe practice guidance – General: Infection Prevention & Control Principles - the spread of infection Standard Infection Control Precautions Hand Hygiene Policy Personal Protective Equipment (PPE) Safe Use and Disposal of Sharps Management of Healthcare Waste - Summary Environmental Cleaning Spillages of Blood and Body Fluids Pest Control Estates and Facilities Management Guidance on Facilities for Minor Surgery & MAI Laundry Management

7 8 9 10 11 12 13 14 15 16 17 18

Safe practice guidance – Clinical: Decontamination of Medical Devices Single Use and Single Patient Use Medical Devices Management Vaccine Management Guidelines Aseptic Technique and care of Invasive Devices Asepsis in Minor Surgical Procedures Isolation of Infectious Service Users in General Practice Collection of Microbiological Specimens Infections with specific alert organisms

19 20 21 22 23 24 25 26

Safe practice guidance – Personnel: Management of Occupational Exposure to Blood-borne Virus Risk Management of Infections in Staff Vaccination Programme for Staff and Service Users Uniform and Dress Code

27 28 29 30

Bibliography

Sample Client Issue Date: 00/00/0000 Review Date: 31/05/2025

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Appendices 1.1 1.2 1.4 1.5 1.6 1.7 2.1 2.2 3.1 3.2 3.3 4.2 4.5 5.1 5.2 6.1 7.1 8.1 9.1 9.2

How to Handwash poster How to apply alcohol rub 5 moments chair poster HandWash Areas missed Surgical Scrub poster Surgical Rub poster Glove Chart PPE Donning and Doffing poster Bristol Stool Chart D&V weekly record D&V Investigation Record Primary Care Colour coding Cleaning Equipment Spillage Cleaning Waste Disposal Chart Colour coding waste Type of room finish guidance Decontamination. Declaration Policy Statement for IPC Management Sharps injury prevention poster Sharps Injury action poster

Sample Client Issue Date: 00/00/0000 Review Date: 31/05/2025

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SPILLAGES OF BLOOD AND BODY FLUIDS See Appendix 4.5 to this Manual for guidance poster Blood and body fluid spillages must be dealt with immediately. In clinical areas this is usually a healthcare worker responsibility. In public access areas, e.g., corridors, lifts, public toilets, this is commonly a domestic staff responsibility. However, in premises without domestic staff on site during working hours, this responsibility must be clearly defined. The registered provider should ensure that local staff are aware of their responsibilities which should be included in staff induction and infection control training. Adequate and appropriate cleaning equipment, disinfectant preparations, protective clothing and clinical waste bags must be readily available. Floor signs indicating danger of slippage must be used where appropriate. Spillages of blood should be dealt with using a chlorine releasing agent e.g., sodium hypochlorite or one containing Na DCC (Sodium Dichloroisocyanurate). These are available as solutions and tablets (which require diluting to reach the correct concentration) or as powders and granules which contain the appropriate concentration. Powders and granules are available as spillage kits which also contain all the equipment required for the spill including apron, gloves, yellow bags, wipes and card/scoop for removal of spill. Powders and granules are the preferred method of disinfection as they require no pre-mixing and have a longer shelf-life. They are also easier to use. Urine and vomit spills should not be treated with chlorine-releasing products as these body substances are usually acidic (with a low pH) and can react with chlorine releasing noxious gases which may be inhaled (particularly in confined spaces such as toilets). Urine and vomit should be dealt with using detergent and water in the first instance (see appendix), alternatively several manufacturers now provide spill kits specifically for use on vomit and urine. Liquid preparations should be available in the correct concentration. A hypochlorite concentration of 10,000 ppm (parts per million) is necessary for use on blood spillages. A weaker concentration of 1,000 ppm is used for environmental cleaning. Preparations must be diluted immediately before use and any unused liquid must be discarded. Do NOT store reconstituted solution as it rapidly loses its efficacy.

Sample Client Issue Date: 00/00/0000 Review Date: 31/05/2025

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New Products New cleaning and disinfection products are being developed all the time. Many of them are marketed as effective against a wide-range of bacteria including bacterial spores and viruses. Before any decision is made to change products, a comprehensive evaluation of manufacturers’ product details needs to be undertaken. This should include requesting to see data relating to independent laboratory testing that was undertaken during product development ensuring compliance with relevant BS EN standards (products should be tested against a range of common bacteria, spores and viruses to demonstrate a log reduction). Full testing data should be requested from the manufacturer and a risk assessment made of the benefits of product change. It is worth remembering that the time taken for a log reduction using a specific product may require the product to be left in contact with the surface for up to 5 minutes. This is impractical and consideration should be given to this detail when making decisions.

Sample Client Issue Date: 00/00/0000 Review Date: 31/05/2025