ThreeStageMandatoryT rainingforInfectionC ontrol B

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“ Three Stage Mandatory Training for Infection Control” Introduction Presented by Graham Wharton MSc; R.G.N; O.N.C; N.C.D.N; R.H.V; C.M.S. (NHS) : (ENB 934; 329; 910: WNB 6:) Health Protection Nurse Specialist NHS Orkney Health Board

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Infection prevention and control is the responsibility of every healthcare worker irrespective of discipline, role or grade. The overarching Standard in Infection Control expects all health care establishments to have a “Managed environment for minimising the risk of infection to patients staff and visitors” (NHSE 1999: CSBS 2001) To achieve this aim, all practitioners have to be involved in infection control as part of the Organisation’s Risk Management and Clinical Governance strategies. National Health Service Executive 1999 Controls Assurance Standard in Infection Control, Rev 03 (October 2002). NHSE, Leeds Clinical Standards board for Scotland 2001 (HAI) Infection control Standards. CSBS, Edinburgh

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This programme suggests three levels of training to meet the educational needs of all healthcare workers:- Basic Level Intermediate Level Advanced level

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Basic Level – for all healthcare workers You will have an Understanding of:- the impact of infection on patients, their family and on the organisation why infection control is necessary who does what in Infection Control what constitutes – universal / standard principles the importance of maintaining ones own health

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Intermediate Level If you are assessing patients, planning and evaluation care and carry out more than basic procedures. You will have knowledge and understanding of: the extent of the problem of healthcare-associated infections what is infection the Chain of infection safe practice the susceptible host

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Advanced Level You are responsible for: teaching of staff and applying theory to practice assessing and implementing care which reflects constantly changing risk factors auditing / evaluating knowledge and understanding of all staff members auditing / evaluating care

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“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Definition / The Impact Basic Level

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Definition / The Impact on patients, their families and on the organisation Any infection that is associated with healthcare, whether acquired in hospital or in the community, is termed Healthcare Associated Infection. The term Hospital Acquired Infection (HAI) is used specifically for those infections associated with healthcare delivered in hospitals. HAI are also referred to as nosocomial infections.

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Healthcare Associated Infections (HAI) remain one of the main complications suffered by patients. Healthcare Associated Infections (HAI) are costly in terms of human suffering and financial costs. (Ayliffe et al 1990; Plowman et al 1997;2000)

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Patient Impact costs such as pain, suffering and worry to patients, relatives and friends cannot be measured

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Patient impact – morbidity Examples of patient morbidity and post discharge are complication of the illness, delay in recovery pain and suffering prolonged or permanent disability discomfort of further investigations and procedures anxiety for the patient and family patient continues to bear the cost of drugs and dressings and takes additional time off work, around 11 days Loss of income is also a major difficulty for patients with infection 10-20% of patients develop symptoms consistent with the diagnosis of urinary tract, chest or surgical infections post discharge (Plowman et al 2000).

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Impact on hospitals and community The impact of HAI and CAI on hospitals can be far-reaching extra investigations and procedures invasive and possibly surgical interventions extra drugs disruption to the hospital litigation post discharge, patients with HAI have more contact with their GP and have more visits from district nurses (Plowman et al 2000)

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Impact on hospitals The infected patient requires extra medications especially antibiotics Increased use of antibiotics may result in: resistant bacteria which require highly toxic and expensive drugs resistant bacteria being transmitted to other patients a build up of a reservoir of resistant bacteria which is difficult to eradicate

Impact on hospitals – measuring the cost : 

Impact on hospitals – measuring the cost According to recent studies and reports (Plowman et al 1997: NAO 2000), hospital acquired infection costs the NHS around £1 billion each year The cost of HAI in Scotland is placed at £168m per year (NHSQIS 2003) Infection Control Teams believe 15% of this can be saved. That can result in savings of £150 million a year in England alone.

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The cost of healthcare-associated infection is both human as well as financial

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“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Why Do We Need Infection Control? Basic Level

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Patients, irrespective of where admitted, are at risk of acquiring infections. Many infections are unavoidable but approximately 15% can be prevented with effective Infection Control practice (NAO 2000). To a lesser degree, healthcare staff are also at risk of infection themselves. It is therefore vital that each healthcare establishment has a formalised structure in place to identify the hazards associated with health care practices and the environment and to take appropriate actions to minimise these risks.

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Why do we need Infection Control? Because the danger of infection is always present: in health care situations where a group of patients come together to receive treatment and care for staff members who are also exposed to microbes (germs) from patients and from care practices. You can also spread infection to other patients, colleagues and your family and friends in the environment

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Because infections: cause pain and suffering to patients and create anxiety and worry for relatives and friends lengthen patients’ hospital stay increase cost of patient care can result in death

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Because there are constant challenges posed by new infections such as: Creutzfeldt Jacob Disease (vCJD) Severe Acute Respiratory Syndrome (SARS) Antibiotic resistant conditions such as multi-drug resistant tuberculosis, methacillin resistant Staphylococcus aureus (MRSA), vancomycin resistant microbes, blood-borne viral infections These infections demand/require: Careful observation Strict precautions to prevent cross transmission Highly toxic drugs which often lead to further complications

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Because of legal implications There are possibilities of litigation with hospital acquired or clinically acquired infection An infection control programme is a legal requirement for insurance purposes There is a statutory duty to seek quality improvement through Clinical Governance

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Because of publicity Infections and outbreaks attract high profile media attention Such adverse publicity can affect: the Organisation’s reputation Patient confidence

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Infection Control Personnel The principal responsibility for developing an Infection Control strategy, that is, the creation of a safe environment in order to protect patients, their visitors and staff members, rests with the Infection Control personnel. This is done by: developing policies and procedures monitoring infections and Infection Control practices education of staff of all grades and disciplines in the safe principles of Infection Control practice

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What is the Infection Control Structure? The structure consists of:- the Infection Control team (ICT) which usually consists of the Infection Control Nurse(s) and Infection Control Doctor(s) and the Infection Control Committee which usually consists of the ICT and representatives of many other disciplines

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The ICT is involved with all aspects of prevention and control of infection on a 24 hour basis. Their functions include: advice and guidance on prevention and control of infection and management of infected patients surveillance of infection identification and management of outbreaks education of all staff in infection control procedures preparation of policy documents liaising with Occupational Health Service to develop guidance on staff health issues monitoring hygiene The ICT reports to the Chief Executive Officer

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Infection Control Committee (ICC) ICC supports the Infection Control Team to implement the Infection Control Programme. The membership of the Committee includes representatives from management, clinical, non-clinical, staff health and public health services. The ICC approves Infection Control Policies and Programme and influences the implementation of Infection Control Policies, Procedures and Standards.

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Once the structure is created the Infection Control personnel need your help and commitment to manage this environment. Whether your work brings you into direct physical contact with patients or not, your practice will have an impact on the Infection Control care of patients as well as your own safety. Universal Precautions / Standard Principles will help you protect patients as well as yourself. Do you know the names of the Infection Control staff in NHS Orkney and how to contact them?

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“ Three Stage Mandatory Training for Infection Control” The Chain of Infection Intermediate Level

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To deliver safe and effective infection control care, you need to understand the total chain of infection and the measures which can be taken to break individual links in this chain. This is the Basis of Good Practice

The aspects of the chain you need to understand are:: 

The aspects of the chain you need to understand are: The micro-organism (the infectious agents) that cause problems in clinical situations Where these micro-organisms may be found (the reservoir) The route by which these micro-organisms leave the reservoir The means by which the micro-organisms travel from their reservoir to the susceptible person The routes by which the micro-organisms enter the susceptible person The kind of conditions which make the person susceptible to infection

Breaking the Chain of Infection: 

Breaking the Chain of Infection INFECTIOUS AGENT Bacteria - Fungi -Viruses Rickettsiae – Protozoal Prions – Protozoa Helminths RESERVOIRS People Equipment Environment Water SUSCEPTIBLE HOST Immunosuppression Diabetes – Surgery – Burns Cardiopulmonary - Neonates PORTAL OF ENTRY Mucous membrane GI / urinary / Respiratory track Broken skin PORTAL OF EXIT Excretions - Secretions Skin - Droplets MEANS OF TRANSMISSION Direct Contact Fomites - Injection / Ingestion - Airborne aerosol INVOLVES ALL HEALTH PROFESSIONALS YOU Air flow control Food handling Isolation Trash & waste disposal Control of excretions and secretions Hand-hygiene Disinfection/ sterilization Environmental sanitation Employee health Care Rapid accurate identification of organism Treatment of underlying disease Recognition of high risk patients Aseptic Technique Catheter Care Wound Care Hand-hygiene Sterilization

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The chain needs to be unbroken for the micro-organism to cause problems. The aim is to break each of the links to prevent the infectious agent reaching a susceptible person.

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The next module will examine Links in detail and discuss practices and measures which help break these Individual Links in the Chain. Whilst you are learning the Chain, it is important to remember that, in order to cause infection, micro-organisms need a ‘mode of travel’ to get from the source to the susceptible individual Hands of healthcare workers are one of the main modes of transmission for micro-organisms.

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“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Universal Precautions / Standard Principles Steps Basic Level

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Standard Precautions Standard Precautions are a series of steps designed to protect healthcare workers and patients from the risk of infection. The risk of transmission of infection with micro-organisms can be from both recognised and unrecognised sources. Often it is not possible to tell if a person is infected or carrying blood-borne viruses such as human immunodeficiency virus (HIV), hepatitis B or hepatitis C viruses or any other disease which can pose a risk of infection to staff members or patients. Standard precautions therefore, are applied to all patients regardless of their diagnosis. Treat the blood, body fluids, excretions and secretions as potentially infectious. Can you list the eight steps that should be considered when following Standard Precautions?

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Standard Precautions – The Steps consist of: hand hygiene barrier precautions patient placement – taking specific precautions safe handling and disposal of sharps and management of sharps injuries safe handling and disposal of clinical waste Safe handling of used linen cleaning of patient care equipment and the environment management of exposure

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Hand-hygiene is the single most important practice you can carry out in order to protect patients as well as yourself from risk of infection. Hand-hygiene is therefore, the first line of defence in preventing and controlling infection.

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“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Universal Precautions / Standard Principles Hand-hygiene Basic Level

Ignaz Semmelweis, 1815-1865: 

Ignaz Semmelweis, 1815-1865 1840’s: General Hospital of Vienna Divided into two clinics, alternating admissions every 24 hours: First Clinic: Doctors and medical students Second Clinic: Midwives

The Intervention:Hand scrub with chlorinated lime solution: 

The Intervention: Hand scrub with chlorinated lime solution Hand hygiene basin at the Lying-In Women’s Hospital in Vienna, 1847.

Hand Hygiene: Not a New Concept: 

Hand Hygiene: Not a New Concept ~ Hand antisepsis reduces the frequency of patient infections ~ Adapted from: Hosp Epidemiol Infect Control, 2nd Edition, 1999. Semmelweis’ Hand Hygiene Intervention

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Hand Hygiene Hand hygiene is required: before and after coming into contact with blood, body fluids, secretions, excretions and contaminated patient care items, whether or not gloves are worn after removing gloves between patient contacts between procedures on the same patient – to prevent cross-contamination

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This diagram shows the areas on hands often missed during hand washing. The steps set out in the following slides will ensure that all areas of your hands have been washed / decontaminated adequately and thoroughly. (Taylor 1978)

Hand Hygiene - Technique: 

Hand Hygiene - Technique Wet hands under running water Apply 3 to 5mls of hand washing agent Apply vigorous friction during the mechanical action of hand washing Wash hands using friction for 10 to 15 seconds (Taylor 1978) Allows easy spread of agent Cover all surfaces of the hand i.e. palms, back of hands, fingers and beneath finger nails, including wrists Necessary to dislodge and remove dirt and microbes Allows sufficient contact time to achieve adequate: length of mechanical friction Hand antisepsis (when using antiseptic agent)

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Hands should be wet first. Take one squeeze of liquid soap from the dispenser. Wash as shown using five strokes on each movement and a total washing time of at least 10 seconds. (Ayliffe et al. 1978)

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Remove jewellery and watches before you start. If you keep a wedding ring on, move & wash under it.

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Make sure you have everything. If the waste bin is not pedal operated, open it now

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Turn on tap & wet hands before getting soap

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Use enough to give a good lather

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Rub Palm – to - Palm

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Then Palm to back – swap over

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Intermesh fingers as you rub

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Rub finger tips in palm centre – swap over

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Then knuckles

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Twist thumbs – swap hands

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Wash around your wrists

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Rinse thoroughly

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Turn off the taps without recontaminating.

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Dry hands by patting – rubbing can abrase the skin.

Steps for Good Hand Hygiene Practice: 

Steps for Good Hand Hygiene Practice Do NOT touch bin

Efficacy of Hand Hygiene Preparations in Killing Bacteria: 

Efficacy of Hand Hygiene Preparations in Killing Bacteria Good Better Best Plain Soap Antimicrobial soap Alcohol-based handrub

Ability of Hand Hygiene Agents to Reduce Bacteria on Hands: 

Ability of Hand Hygiene Agents to Reduce Bacteria on Hands Adapted from: Hosp Epidemiol Infect Control, 2nd Edition, 1999.

SummaryAlcohol-Based Handrubs: What benefits do they provide?: 

Summary Alcohol-Based Handrubs: What benefits do they provide? Require less time More effective for standard handwashing than soap More accessible than sinks Reduce bacterial counts on hands Improve skin condition

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Useful points ensure complete coverage of the hands with the hand-washing agent: part of the thumbs, backs of the fingers and underneath the fingernails are often missed (Taylor 1978) wetting the hands before applying the agent facilitates complete coverage and helps reduce drying effect of the agent debris collected underneath the fingernails can result in a high microbial count inside the gloved hands – use of a nail stick will avoid damage and subsequent colonisation of the subungual area

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Useful points (continued) any cuts and abrasions less than 24hours old should be covered with a waterproof dressing false nails have been found to host many potential pathogens including yeasts (Anon 1999; Moolenaar et al 2000) rings, if worn should be limited to the wedding band only – the bacterial counts are higher under and around rings. Bacteria can be removed effectively by manipulating rings during handwashing (Hoffman et al 1985; Jacobson et al 1985; Sailsbury et al 1997) thorough rinsing and drying of hands after washing will prevent skin irritation use disposable paper towels for drying hands (Ansari et al 1991) use a good quality hand cream to prevent skin dryness

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Please list the activities which can contaminate your hands with micro-organisms during work

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Please list the activities which can contaminate your hands with micro-organisms during work Direct physical contact with patients Handling patients’ clothing, wash cloths, bowls, and towels Handling used linen Sluice room activities Handling patient care equipment Touching soiled nappies, dressings, incontinent pads and other clinical waste Toughing curtains and bedside furniture Blowing or wiping own nose Visiting the lavatory

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If you have not already done so, it is important to familiarise yourself with the Hand-hygiene Policy available within your area of work.

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“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Universal Precautions / Standard Principles Barrier Precautions Basic Level

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Barrier Precautions Are designed to protect you from exposure to infectious material and reduce the risk of transmission of micro-organisms to patients Barrier Precautions – consist of: covering existing wounds or skin lesions with a waterproof dressing the use of gloves, plastic aprons, gowns, protective eyewear, masks and respirators. These are often referred to as Personal Protective Equipment (PPE)

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Gloves – to be worn when: coming into direct contact with blood, all body fluids, excretions or secretions of any patient contact with blood, all body fluids, excretions and secretions is anticipated coming into contact with non-intact skin, e.g. skin that is cut, chapped, cracked, broken or weeping handling instruments, equipment or surfaces that have been or may have been in contact with blood or body substances the care giver has cuts, scratches, skin lesions or other breaks in the skin on their hands

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Remove gloves after the procedure, discard in a clinical waste bin and wash hands. Important points: gloves cannot prevent penetrating injuries some gloves can cause adverse reactions and skin sensitivity. This should be reported.

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Plastic aprons plastic aprons are recommended for general use a full body gown should be worn when full body protection is required gowns should be moisture resistant and provide an effective barrier to body substances

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Gowns – should be used when: handling large amounts of blood and body substances that may be difficult to contain properly splashes or splattering of blood or body substances is likely Change aprons / gowns at the end of the procedure or when gross soiling occurs. Discard gowns and aprons with care, dispose of appropriately in a clinical waste bag and wash hands.

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Protective eyewear is used to prevent blood and body substances from contaminating the mucous membranes of the eyes should be worn during procedures where blood or body substances may be expected to splash or splatter Protective face shields are worn to prevent blood or body substances from contaminating the mucous membranes of eyes, nose and mouth during the procedure.

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Masks – standard surgical masks are used to: protect the mucous membrane of the nose and mouth from splashes or spraying of blood or body fluids prevent inhalation of micro-organisms that are spread by droplet routes prevent contamination of a sterile field by droplets from the surgical team Remove the mask by handling the straps, dispose of it in a clinical waste bag and wash and dry hands. Do not wear a mask around the neck, or place the mask from the neck back onto the face.

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Respirator Masks – are: specifically designed to filter small particles that may spread by the airborne route advised for personnel who care for patients with suspected or confirmed pulmonary tuberculosis and Severe Acute Respiratory Syndrome (SARS) Now read the Policy on Personal Protective Equipment

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“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Universal Precautions / Standard Principles Patient Placement Basic Level

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Universal Precautions / Standard Principles Patient Placement – specific precautions this is required for patients who are diagnosed with or suspected of infection or colonisation with certain highly pathogenic micro-organisms they may need to be placed in isolation and / or require precautions in addition to Standard Precautions an understanding of how the micro-organism spreads and how its transmission to another susceptible person can be prevented is important to help deliver safe care

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“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Universal Precautions / Standard Principles Safe Handling and Disposal of Sharps Basic Level

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Universal Precautions / Standard Principles Safe Handling and disposal of sharps There is always a potential for injury when using needles, scalpels and other sharp instruments Many blood-borne pathogens can be transmitted through sharps injury handle sharps with extreme care and without hurrying never remove, re-sheath, bend or break off used needles Dispose of used sharps promptly place used sharps in a sealed puncture-proof container

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Universal Precautions / Standard Principles In case of a sharps injury: if possible, put the injured area low to the ground to promote bleeding wash the area well with soap and water report and record the incident follow the NHS Orkney policy on the management of sharps injuries

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“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Universal Precautions / Standard Principles Safe Handling and Disposal of Waste Basic Level

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Universal Precautions / Standard Principles Safe Handling and Disposal of Clinical Waste All clinical waste carries potentially pathogenic micro-organisms wear protective gloves when handling clinical waste dispose of any clinical waste in a designated, usually orange, plastic bag immediately on completion of the procedure or task remove gloves and wash hands Hospital clinical waste is normally incinerated or autoclaved before disposal. Refer to NHS Orkney’s policy on the Disposal of Waste. Please familiarise yourself with the policy on identifying clinical and non-clinical waste. Non-clinical waste is usually placed in black plastic bags and sent to designated landfill sites.

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“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Universal Precautions / Standard Principles Management of Used Linen Basic Level

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Universal Precautions / Standard Principles Management of used linen Used linen is often contaminated with micro-organisms protective clothing should be worn when handling used linen used linen is processed according to whether it is just soiled or contaminated with blood, body fluids, excretions and secretions and/or from an infected patient used linen should be placed in an appropriate linen or plastic bag to facilitate its correct treatment linen contaminated with blood, body fluids, excretions and secretions or from an infected patient is placed in a water soluble or alginate bag to facilitate its wash without further handling wash hands after bagging the linen and discarding protective wear Please refer to NHS Orkney’s policy on the Management of Used Linen.

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“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Universal Precautions / Standard Principles Decontamination of Patient Care Equipment / Managing Spillages Basic Level

Slide88: 

Universal Precautions / Standard Principles Decontamination of patient-care equipment and the environment: the environment and equipment attract dust and dirt during normal daily activities unless cleaned, these become a potential breeding place for pathogens items of patient care equipment may become contaminated during use and can become a source of infection for another patient if not decontaminated between use

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Decontamination consists of 3 processes: cleaning disinfection sterilisation

Slide90: 

Cleaning is a process of removing dust, grease and debris and is carried out with household detergent and water and is adequate for: the hygiene of the environment and the items of equipment which do not come into contact with the patient – or only come into contact with the patients’ intact skin Cleaning is the first important stage in the decontamination process. For disinfection and sterilisation to be effective the items of equipment and instruments must be free from blood, body fluids, excretions and secretions

Slide91: 

Disinfection removes and / or reduces the micro-organisms which may cause harm and is carried out on: items of equipment which come into contact with the patient’s mucous membranes Disinfection does not kill spore-forming bacteria Cleaning as well as disinfection of both the environment and all equipment may be required during outbreaks or when patients with certain infections are admitted Spillage of blood, body fluids, excretions and secretions should be mopped up and the area disinfected without delay Micro-organisms will grow in damp moist surroundings. The environment as well as all items of equipment should be kept clean and dry.

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Sterilisation – kills all micro-organisms including spore-forming bacteria and is used for: all instruments that are likely to penetrate the intact skin and mucous membranes gowns and swabs and drapes that are to be used for the above procedures Please refer to NHS Orkney’s Policy on Decontamination Procedures

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“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Universal Precautions / Standard Principles Management of Exposures Basic Level

Slide94: 

Universal Precautions / Standard Principles Management of exposures: Often direct patient contact and care practices can pose a risk of exposure to certain infections and conditions which need to be followed up. On occasions you yourself may pose a risk of infection to patients if you: are suffering from certain infections have symptoms relating to an infection are exposed to an infection outside of the work place which can be transmitted to patients and / or other staff members

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Universal Precautions / Standard Principles Management of exposures (continued) Such infections include: diarrhoea and or vomiting or nausea which may or may not be accompanied by an abdominal cramp chickenpox pulmonary tuberculosis Sever Acute Respiratory Syndrome (SARS) scabies blood-borne viral infection It is vital that such instances are reported to NHS Orkney, your manager, and, sometimes to the Infection Control Personnel. NHS Orkney’s policy on the Management of Exposures is designed to protect both parties. Complete confidentiality is always assured.

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“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Universal Precautions / Standard Principles The Importance of Maintaining Ones Own Health Basic Level

Slide97: 

The Importance of Maintaining Ones Own Health The medical you received on employment was designed to: ensure that you were healthy check your immunisation status for tuberculosis, rubella, chickenpox, polio provide you with the protective immunisations such as Hepatitis B vaccine Policies and procedures are in place to protect you from adverse incidents. You also owe it to yourself to keep healthy.

Slide98: 

“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Food Hygiene Basic Level

Slide99: 

Food handlers in health care settings include catering staff, staff who deliver, serve or otherwise handle unwrapped food and patients who cook as part of their rehabilitation programme. Anyone making a slice of toast or opening a carton of milk thus becomes a food handler.

Slide100: 

The Food Safety regulations suggest that all health care personnel are liable for any adverse incident associated with food handling You need to be aware of what constitutes a safe food service.

Slide101: 

Practice points – wards wash and dry hands thoroughly before handling any food be it for patients’ or own consumption encourage hand-washing by patients after visiting the lavatory provide hand-washing facilities for bed-bound patients after they have used bedpans and commodes

Slide102: 

Practice points do not handle food if suffering from skin, nose, throat or bowel infection serve meals as soon as possible or within 15 minutes of receiving on the ward discard delayed meals; do not reheat in microwave ovens wash hands before frequenting ward kitchens. Surface and equipment such as refrigerators, dishwashers, microwave ovens can easily become contaminated by inadequately washed or unwashed hands

Slide103: 

Practice points - continued do not leave food exposed to air; store in pest-proof containers maintain a high level of cleaning standard in ward kitchens do not use kitchen wash basin for any other purpose than hand-washing do not allow staff to sit on work tops do not place food outside the window or external door for birds and cats – this encourages vermin

Slide104: 

If you have not already done so, it may be useful to familiarise yourself with the Food Hygiene Policy of NHS Orkney

Slide105: 

“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Finally Basic Level

Slide106: 

Finally Both patients and healthcare personnel can be at risk of infection in a healthcare environment. The Standard Precautions are provided to prevent or reduce the risk of infection to both parties

Slide107: 

This module should have helped you understand what we mean by Infection Control and the actions which help protect you and your patients from the risk of infection. Please complete the form appended to your handout and the assessment questions – you have 5 minutes for this exercise

Slide108: 

“Three Stage Mandatory Training for Infection Control” Healthcare Associated Infections (HAI) Assessment Questions Basic Level

Slide109: 

The risk of cross transmission of infection can be reduced by: a programme of screening of patients and staff the use of strict protocols the use of disposable instruments at all times the use of Standard precautions

Slide110: 

The risk of cross transmission of infection can be reduced by: a programme of screening of patients and staff the use of strict protocols the use of disposable instruments at all times the use of Standard precautions

Slide111: 

Standard Precautions are required: in high risk units such as critical care units, heamatology departments etc by certain groups of staff only at all times only when caring for patients infected with blood-borne viruses

Slide112: 

Standard Precautions are required: in high risk units such as critical care units, heamatology departments etc by certain groups of staff only at all times only when caring for patients infected with blood-borne viruses

Slide113: 

Standard Precautions are recommended for all patients in order to: reassure patients and relatives protect patients and staff from the risk of infection from each other meet government guidelines follow the ward / departmental policy / procedures

Slide114: 

Standard Precautions are recommended for all patients in order to: reassure patients and relatives protect patients and staff from the risk of infection from each other meet government guidelines follow the ward / departmental policy / procedures

Slide115: 

Standard Precautions are: wearing gloves, aprons and masks wearing gloves and aprons only assessing the risk of the task and applying the necessary precautions wearing a gown, apron, mask and overshoes

Slide116: 

Standard Precautions are: wearing gloves, aprons and masks wearing gloves and aprons only assessing the risk of the task and applying the necessary precautions wearing a gown, apron, mask and overshoes

Slide117: 

The organism in the chain of infection will cause infection because: the hospital environment is unclean it is inevitable the patients personal hygiene is poor it has managed to find a way to travel from its source to the susceptible patient

Slide118: 

The organism in the chain of infection will cause infection because: the hospital environment is unclean it is inevitable the patients personal hygiene is poor it has managed to find a way to travel from its source to the susceptible patient

Slide119: 

PREVENTION IS PRIMARY! Protect patients…protect healthcare personnel… promote quality healthcare!