STANDARD INFECTION PREVENTION MEASURES

Staff

• Carry out regular and thorough hand hygiene
• Cover all cuts and grazes with waterproof dressings
• Know hepatitis B status
• Up-to-date with all vaccination
• Report any symptoms of diarrhoea and/or vomiting developed when off-duty to the occupational health team
• remain off work until symptom-free for 48 hrs
• Report any symptoms of vomiting and/or diarrhoea while on duty, to the staff member in charge
• inform your line manager
• return home until 48 hr after your symptoms have stopped
• Report any skin lesions or recurrent infections to the occupational health team

Patients

• Assess patients for infection risk on admission, before admission if possible and throughout their stay
• Check IC alert for any infection prevention alerts
• Consider infection risk in placement decisions
• Isolate patients with conditions that increase the risk of spreading micro-organisms to others
• suspected or known infectious diarrhoea
• exfoliative skin condition, large open wound
• productive cough
• Encourage patients to clean their hands
• before meals
• before taking oral medication
• after using the toilet, commode or bedpan/urinal
• at other times as appropriate
• Good oral hygiene
• consider use of oral chlorhexidine

Environment

• Maintain clean and dust-free environment
• Use hospital approved products for daily cleaning of hard surfaces in all adult areas
• Increase levels of cleaning in outbreak situations
• infection prevention team (IPT) will advise domestic services and ward manager on frequency and type of cleaning

General equipment

• Use single patient use or disposable equipment where possible
• Never attempt to decontaminate or reuse single use items
• Decontaminate reusable equipment after use
• Use hospital approved products
• Follow manufacturers’ instructions for cleaning

PPE

• For invasive procedures, during contact with sterile sites, non-intact skin and mucous membranes, and when handling sharps and contaminated equipment, wear gloves
• When there is a risk that clothing or uniform will become contaminated, or there is close contact with a patient, wear disposable apron
• Use fresh apron and gloves for each patient and for each different care activity on the same patient
• If risk of extensive splashing, wear full-body fluid-repellent gown
• If there is a risk of splashing into eyes or mouth, wear eye and face protection
• For multi-drug resistant pulmonary tuberculosis, SARS, covid-19, wear an FFP3 mask which previously has been fit-tested to ensure it is effective

Linen, waste and sharps

• Wear appropriate PPE
• Handle linen and waste correctly
• place soiled linen in skip at bedside
• place clinical waste in orange bag
• Needle safety devices should be used where there are clear indications that they will provide safer systems of working for healthcare staff
• Take sharps box (with blue tray) to point of use
• dispose of the sharp directly immediately into the sharps container after use
• never leave sharps for someone not involved in procedure to clear away
• Never re-sheath needles
• Dispose of needles attached to syringes as a single unit
• Do not fill sharps containers above the manufacturers marked line which indicates that they are full

Microbes isolated

• If alerted to identification of specific organism, see ESBL/MGNB/CARB, MRSA management or Cdifficile infection guidelines

Antimicrobials

• Use antimicrobials rationally. See appropriate guideline in Medical, Surgical or Antimicrobial prescribing guidelines
• use narrow spectrum agents whenever possible with aid of microbiology results
• document clinical indication and reason for choice in patient notes
• document clinical indication, route and duration on prescription chart

Review regularly

• Switch IV antimicrobials to oral route after 48 hr where possible
• Stop antimicrobials after a total of 5 days treatment (including IV treatment) unless a specific infection justifies an extended duration of treatment
• Review (Consultant or SpR) the indication for all prescribed gastric acid suppression
• If there is a compelling indication to prescribe acid suppression in a patient at risk of Cdifficile Infection:
• prefer H2 antagonist to PPI
• minimise dose and duration to the safest minimum