Adult Social Care 2022

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Infection Prevention and Control

Policies and Safe Practice Guidance Manual Scotland

Care Homes - Adult Social Care - Residential / Nursing

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

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Infection Prevention Solutions

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

Section

Policies: Infection Prevention and Control Management Policy Policy for COVID-19 Management Policy – Care Homes Recognition and management of an outbreak of infection Management of an outbreak of viral gastro-intestinal illness Antibiotic Prescribing Policy Sepsis

1 2 3 4 5 5a

Safe practice guidance – General: Infection Control Principles - the spread of infection Standard Infection Control Precautions Hand Hygiene Personal Protective Equipment (PPE) Safe Use and Disposal of Sharps Management of Healthcare Waste Laundry Management Environmental Cleaning Spillages of Blood and Body Fluids Pets in Residential Environments Working Animals Pest Control

6 7 8 9 10 11 12 13 14 15 15a 16

Safe practice guidance – Clinical: Decontamination of Medical Equipment Single Use and Single Patient Use Medical Devices Last Offices – care of the deceased Aseptic Technique and care of Invasive Devices Isolation of Infectious Patients Collection of Microbiological Specimens Infections with specific alert organisms Closure of rooms, wards and facilities

17 18 19 20 21 22 23 24

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

25 26 27 28

Bibliography

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RECOGNITION AND MANAGEMENT OF AN OUTBREAK OF INFECTION INTRODUCTION An outbreak of communicable disease/infection can be defined as the incidence of disease above that normally expected. Usually this means that there are two or more linked cases with the same illness/symptoms. In some instances, only one case may be sufficient to instigate investigation as an Incident, e.g. meningococcal meningitis. Outbreaks in social care settings will be similar to those experienced in acute hospital settings e.g. viral gastro-enteritis, influenza etc.

Outbreaks of infection may vary in extent and severity, ranging from a few cases of infestation to a large number of food poisoning cases, affecting hundreds of people.

Recognition of an outbreak in the early stages may be difficult, therefore medical and nursing staff must remain vigilant.

The Consultant in Communicable Disease Control (CCDC) at the local Health Protection Unit (HPU) at UK Health and Security Agency (UKHSA) has overall responsibility for outbreaks of infection in all health and social care provider settings (both NHS and independent sector) and the designated infection control advisor / senior manager on call must inform the local HPU of any suspected outbreak of infection. An on-call service is provided by the local (HPU) of (PHE) out-of-hours and at weekends.

STAFF RESPONSIBILITIES Individual staff – particularly senior clinical staff and senior managers should be able to recognise a potential outbreak of infection or food poisoning Staff should be familiar with the reporting system when they suspect an outbreak of infection. Staff should report their concerns promptly to the line manager who will investigate and advise necessary reporting.

Staff have a duty of care to prevent further transmission of the outbreak by implementing appropriate IPC measures as advised by Infection Control Advisor/HPU. Staff have a responsibility to maintain communication with interested parties, especially service users and visitors as well as other clinical staff/areas which may be affected.

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REPORTING STRUCTURE

Senior Manager / Lead Nurse / Clinician /Occupational Health Adviser (Identifying possible/probable outbreak)

Infection Control Advisor

Health Protection Unit on call team

ACTION WHEN SUSPECTING AN OUTBREAK OF INFECTION All outbreaks of suspected or confirmed infection must be reported through the line manager and to the designated infection control advisor (if in post). Once an outbreak is suspected then the first step is to liaise with the local HPU who will provide guidance on the appropriate steps to be taken. Local arrangements for ongoing support and guidance vary. In some areas the local HPU will undertake this function; in other areas it may be the local IPC teams in the acute hospital or community trust as well as local GPs with whom residents are registered. All senior staff should have easy access to local phone numbers which should be documented. Local teams contact details can be obtained here: https://www.gov.uk/guidance/contacts-phe-health-protection-teams

OUTBREAK MANAGEMENT TEAM Only large outbreaks (or those involving more than one facility) will require an outbreak control team to be convened and in the case of a care home, this requirement will be decided by the local HPU. If convened, membership of the Outbreak Control Team will usually include the following: • • • • • • • • • • • •

IC Advisor / IC lead HPU Consultant in UK Health Security Agency (usually the Chair) Environmental Health if required (food poisoning only) HPU health protection nurse Communications Manager if required Relevant physician/GP/health care professional Senior manager of area(s) concerned Pharmacist if required Estates and Facilities Housekeeping Occupational Health Advisor Other members as deemed appropriate

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OUTBREAK TEAM FUNCTION The function of the team will be to: • • • • • • • • • • • •

Review the problem; Decide on appropriate action; Specify tasks and responsibilities for team members; Communicate required action to affected care staff; Ensure all affected staff are aware of their responsibilities; Ensure appropriate supplies are available; Institute further investigation; Evaluate progress; Agree media statements and communication to service users/visitors/general public Ensure communication with senior managers and Board, local Clinical Commissioning Group (CCG) / acute NHS Trusts, ambulance Trust etc Agree report of outbreak and future recommendations to prevent similar recurrences; Prepare a final report at the end of the outbreak.

At the first meeting of the team an interim report of the outbreak will be prepared for the Chief Executive and the Management Board (or equivalent). The nominated lead person will inform all relevant external parties as appropriate. The team may also draw up a draft press release, as necessary.

A root cause analysis of the outbreak may be undertaken to systematically review all aspects of the management of the outbreak and to provide evidence for a final report including a review of actions taken, lessons learned and changes to be made to practice to avert a similar occurrence.

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OUTBREAK MANAGEMENT GUIDANCE

Is this an Outbreak?

YES Two or more service users and /or staff symptomatic with vomiting and/or diarrhoea / influenza etc.

NO Less than 2 residents and/or staff symptomatic

If NO Observe for further cases

If YES Contact Senior Manager immediately

Arrange for samples to be taken from Service Users and Staff who have symptoms if requested by IC Advisor or HPU / GP

Document all symptomatic service users/staff Secure communication daily to ICA / HPU or as advised

(Documents 3 and 4) Complete Incident

Report Form

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