Infection Control - Residential

Infection control is the name given to a wide range of policies, procedures and techniques intended to prevent the spread of infectious diseases amongst staff, service users and the community.  Many infectious diseases have the capacity to spread within residential establishments, where large numbers of people, many of whom may be susceptible to infection, share eating and living accommodation.  

The use of Infection Control Policies and Procedures can minimise the spread of infection in houses and is cost effective.

Policy Statement

Hayfield believes that the adherence to strict guidelines on infection control is of paramount importance in ensuring the welfare of both service users and staff.  It also believes that good, basic hygiene is the most powerful weapon again infection, particularly with respect to cleaning and hand washing.

Aim

The aim of the residential service is to prevent the spread of infection amongst service users, staff and the local community.

Goals

The goals of the residential service are to ensure the following.

• Service users, their families and staff are as safe as possible from acquiring infections within their residence.

• All residential staff are aware of, and put into practice, the basic principle of infection control.

Personnel

Suzanne Finnigan is the overall infection control lead for the residential services with Team Leaders being responsible for their particular residence.

Legal Considerations and Statutory Guidance

The residential services should adhere to the following infection control legislation.

• The Health & Safety at Work Act 1974 and the Public Health Infectious Diseases Regulations 1988 which place a duty on the residential services to prevent the spread of infection.

• The Reporting of Incidents, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR) which places a duty on the residential services to report outbreaks of certain diseases, as well as accidents such as needle stick injuries.

• The Control of Substances Hazardous to Health Regulation 1999 (COSHH) which places a duty on the residential services to ensure that potentially infectious materials within the homes are identified as hazardous and dealt with accordingly.

• The Environmental Protection Act 1990, makes it the responsibility of the service to dispose of clinical waste safely, if applicable.  

Hand Washing

Why ?

Consistent with modern infection control evidence and research, hand washing is the single most important measure in reducing cross infection but studies have shown that it is rarely carried out in a satisfactory manner.  The areas of the hands, which are often missed, are the wrist creases, thumbs, finger tips and under the finger nails and under jewellery, which should, for this reason, be kept to an absolute minimum (wedding band only) and removed while washing.  All staff should ensure that their hands are thoroughly washed and dried at various times and encouragement and training should also be given to the service users to adopt the same guidelines.

When ?

Hands should be washed...

• Before and after physical contact with each service user.

• After handling contaminated items such as body fluid, waste or soiled items.

• Before putting on and after removing protective clothing.

• After using the toilet, blowing the nose, covering a sneeze.

• Whenever hands become visibly soiled.

• Before eating, drinking or handling food.

How ?

Hand washing should be performed as follows...

• Liquid soap should be used for all routine hand washing.  Bacteria can grow in bar soap, which can then become a source of infection.

• Wet the hands up to the wrists before applying hand cleanser/soap.

• Apply the cleanser/soap.

• Smooth it evenly over the hands, including the thumbs and in between the fingers, and lather well, rubbing vigorously.

• Rinse off every trace of lather with running water.

• Dry really thoroughly, taking special care between the fingers.  More than one paper towel may be necessary.

General Cleaning and Procedure for Cleaning of Spillages

All staff have a responsibility to help keep their residence clean and tidy and to identify areas which fall below acceptable and safe standards.

Management of the routine cleaning of the residential services is the overall responsibility of Suzanne Finnigan with Team Leaders being responsible for the particular residence.

Staff should be aware that the cleaning of spillages such as excreta, blood and body fluids should be carried out as quickly as possible and treated as potentially infectious.

For the above spillages, a 10,000ppm hypochlorite solution (household bleach) should be used.  Guidelines for cleaning and protective clothing are as follows...

• A disposable apron and gloves should always be worn when dealing with excreta, blood and body fluids.  If there is a risk of splashing, then eye protection should also be worn.

• Prepare the hypochlorite solution.  Care should be exercised when using this solution and the manufacturers instructions should be followed.

• Cover the spillage with paper towels soaked in the solution and carefully wipe up the spillage with more towels.

• Dispose of waste in a sealed bag.

• Remove protective clothing.

• Wash hands in soap and water.

Hayfield provides gloves and disposable aprons for all staff that are at risk of coming into direct contact with body fluids.  It is therefore staff’s responsibility to ensure that they are used.  The responsibility for ordering and ensuring that supplies are readily available and accessible, lies with the Team Leader of each residence.

Disposal of Sharps

In the event that Hayfield admits a service user who requires staff to take blood sugar readings or become involved in the administering or supervision of someone using hypodermic syringes, we will make contact with the local Health Centre and obtain sharps boxes as required.

Sharps, such as needles, lancets or ampoules, should be disposed of in proper, purpose built sharps containers, complying with BS7320.  It is important that staff follow the correct guidelines for disposal and ensure that these boxes are kept out of reach of service users and visitors.

• Wash hands before putting on and after removing protective clothing, i.e. gloves and apron.

• After carrying out the procedure, never re-sheath needles or place other sharp implements in their packaging.  All single use sharp objects should be placed directly into the sharps container.

• Boxes should be sealed when ¾ full.

• When sealed, they should be marked as hazardous waste and clearly labelled with the home details.

• The Team Leader of each residence should return filled containers to the Health Centre.

Accidents involving risk of blood-borne infection.

Such accidents include...

• All sharps/needle injuries.

• Contamination of abrasions with blood and body fluids.

• Human scratches/bites causing bleeding.

• Splashes of body fluids onto mucous membranes, e.g. mouth or eyes.

These incidents should be dealt with as follows...

• Bleeding from the wound should be encouraged by applying pressure around the wound.

• The wound should be washed in soap and warm, running water.

• The wound should be covered with a clean, dry dressing.

• The incident should be reported to the immediate supervisor.

• Only at this stage should an attempt be made to identify the source of the needle/sharp.

• The person who sustained the wound should see his or her General Practitioner as soon as possible.

• All information should be recorded in the Accident Book.

The Storage and Preparation of Food

Certain foods will present more of a risk of food borne illness to service users than others.  These foods include meat, fish, eggs and milk and products made from them.  If these foods are improperly handled, prepared and stored, any bacteria which may be present or have contaminated them, may multiply and/or produce poisons to levels which are likely to cause illness.  The danger of food borne illness posed to service users will be reduced with the proper implementation of a system of identifying and controlling food safety risks and the appropriate training of food handling staff.  See Residential Policy on food preparation and handling.

Any staff suffering from food poisoning, diarrhoea or vomiting should report it to their line manager and see their GP as soon as possible for advice.

Handling and Storage of Specimens for Laboratory Examination

Specimens should only be collected if requested by a GP or hospital consultant.  If requested, the following guidelines should apply...

• Wash hands before putting on and after removing protective clothing, i.e. gloves and apron.

• Laboratory approved containers must be labeled with person identification, date of specimen and details.  The lids should be screwed tightly and placed in an individual transparent plastic bag.

• Specimens must never be kept in the same fridge as food products or medicines.

• Specimens collected should be delivered to the Health Centre for collection by the local laboratory.

Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR).

The residential department must report the outbreak of notifiable disease to the Health & Safety Executive.  Notifiable diseases include:  cholera, food poisoning, smallpox, typhus, dysentery, measles, meningitis, mumps, rabies, rubella, tetanus, typhoid fever, viral haemorrhagic fever, hepatitis, whooping cough, leptospirosis, tuberculosis and yellow fever.  Records of any such outbreaks must be kept, specifying dates and times and a completed disease report must be sent to the Health & Safety Executive.  In the event of any such report,  it is the responsibility of Suzanne Finnigan to inform the Health & Safety Executive.

In the event of a suspected outbreak of an infectious disease within the residence, a local consultant in communicable disease control or communicable disease team, should be contacted immediately.  Contact the local Health Centre applicable to the particular residence.

Infection Control Training:

As part of induction training, all new staff will be instructed in the basic principles of Infection Control and will also be given the opportunity to read the Hayfield policies on infection control and food preparation and handling.  In addition to this, all staff will undertake external in-house training, which will be organised by management.