TRUST POLICY AND PROCEDURES FOR CARBAPENEM RESISTANT ENTEROBACTERIACEAE (CRE) AND CARBAPENEM RESISTANT ORGANISMS (CRO)
|
|
- Rosalyn McLaughlin
- 6 years ago
- Views:
Transcription
1 TRUST POLICY AND PROCEDURES FOR CARBAPENEM RESISTANT ENTEROBACTERIACEAE (CRE) AND CARBAPENEM RESISTANT ORGANISMS (CRO) Reference Number POL- IC/1082/14 Version Status Final Author: Helen Forrest Job Title Lead Nurse - Infection Prevention and Control Version/ Amendment History Version Date Author Reason 1 June 2014 D. Gnanarajah H. Forrest New Policy 1.1 October 2014 H. Forrest Minor amendments 1.2 November 2017 H. Forrest Review and Update Intended Recipients: All medical and clinical staff, Clinical Directors, Service Managers, Divisional Nursing Directors, Divisional Medical Directors, Clinical Governance Leads and Matrons. Training and Dissemination: Dissemination via the Trust Intranet. Two yearly infection prevention and control update training. To be read in conjunction with: Trust Policy for Standard Infection Control Precautions; Trust Policy and Procedure for Hand Hygiene; Trust Policy for Isolation. Trust policy for cleaning and disinfection. Trust policy for Inoculation incidents. Trust policy for sharps safety In consultation with and Date: Infection Control Operational Group (November 2017) Infection Control Committee (November 2017) EIRA stage one Completed Yes Stage two Completed N/A Approving Body and Date Approved Infection Control Committee Date of Issue January 2018 Review Date and Frequency Contact for Review January 2021 and every 3 years Lead Nurse Infection prevention and Control 1
2 Executive Lead Signature Approving Executive Signature Director of Patient Experience and Chief Nurse Director of Patient Experience and Chief Nurse 2
3 Contents Section 1 Introduction 4 2 Purpose and Outcomes 4 3 Definitions Used 5 4 Maintaining the Policy and Procedure for CRE/CRO Early recognition of Patients who may be Colonised / Infected Acting on Results of Screening / Isolation of Patients Infection Prevention and Control Measures Screening of Contacts Environmental and Equipment Cleaning / Disinfection Communication 9 5 Monitoring Compliance and Effectiveness 10 6 References 11 Appendix 1 Flowchart for the Screening of Patients for CRE and Isolation Requirements 12 3
4 TRUST POLICY AND PROCEDURES FOR CARBAPENEM RESISTANT ENTEROBACTERIACEAE (CRE) AND CARBAPENEM RESISTANT ORGANISMS (CRO) 1 Introduction Carbapenems are a valuable family of antibiotics normally reserved for serious infections caused by antibiotic resistant Gram negative bacteria, including Enterobacteriaceae. They include meropenem, ertopenem, imipenem and doripenem Enterobacteriaceae are a family of bacteria, (e.g. E.Coli, Klebsiella, Enterobacter, Serratia, Citrobacter that usually live harmlessly in the gut of humans and animals. These organisms can cause urinary tract infections, intra-abdominal and blood stream infections. Enterobacteriaceae can acquire resistance to Carbapenem antibiotics. If resistance is identified in this family of bacteria they are classed as Carbapenem Resistant Enterobacteriaceae or CRE. Carriage of CRE can be detected by rectal screening. Non Enterobacteriaceae bacteria, e.g. Pseudomonas, Acinetobacter, can also develop resistance to Carbapenems. These are classed as Carbapenem Resistant Organisms or CRO. CRO will be detected on clinical samples. CRO are not as easily transmitted to other bacteria like CRE. Carbapenmases, a group of clinically important β-lactamases that efficiently hydrolyse most β-lactams including the carbapenems, have emerged and spread among the Enterobacteriaceae family of bacteria worldwide. The emergence of carbapenemaseproducing Enterobactericeae (known as CPE) is currently a major public health concern, with a rapid increase in carbapenem non-susceptible Enterobacteriaceae worldwide. The number of referrals of these isolates to these organisms to Public Health England (PHE) is increasing year-on-year. These organisms are endemic in other areas of the world and there is strong evidence that when patients infected or colonised with CPE are transferred across borders this increases the risk of CPE being introduced into healthcare facilities in the country of destination. The clinical significance of infection with Carbapenem resistant organisms (CRE / CRO) is considerable. Due to their resistance to multiple antimicrobials, there are very limited therapeutic options available to treat infections caused by CRE/CRO. In addition to this, there are fewer new novel antimicrobial agents in the developmental pipeline and at present there are insufficient drug development programmes to provide therapeutic cover in years. It is already evident that human infections with CRE/CRO are associated with poorer patient outcomes, increased morbidity, mortality, prolonged hospital stay and higher hospital costs. 2 Purpose and Outcomes This purpose of this policy is to set out the infection prevention and control standards for patients with CRE/CRO colonisation or infection and to advice staff on the detection of colonised or infected patients to prevent, therefore reducing the risk of spread within the hospital 4
5 3 Definitions Used Carbapenem Gram negative bacteria Colonised Outbreak Decontamination Exposure Pathogen A valuable family of beta lactam antibiotics normally reserved for serious infections caused by antibiotic resistant Gram negative bacteria A class of bacteria that do not retain the crystal violet stain used in the Gram staining method of bacterial differentiation. Gram-negative bacteria cause infections including UTI, hospital acquired pneumonia, intra-abdominal infections, bloodstream infections, abdominal wound or surgical site infections, neonatal sepsis and meningitis in healthcare settings. Gram-negative bacteria are resistant to multiple drugs and are increasingly resistant to most available antibiotics. Bacteria present on the body without causing disease or infection. An outbreak may be defined as: - An incident affecting two or more people thought to have a common exposure to a potential source, in which they experience similar illness or proven infection. - A rate of infection or illness above the expected rate for that place and time, where spread is occurring through cross infection, or person-to-person. The process of cleansing an object or substance to remove contaminants such as micro-organisms or hazardous materials A state of contact or close proximity to a pathogen, by ingesting, breathing, or direct contact, e.g. on skin Micro-organism capable of causing disease 4 Managing the Policy and Procedures for CRE and CRO 4.1 Early Recognition of Patients who may be Colonised / Infected with CRE Admission Screening for CRE On admission patients must be assessed to determine if in the last 12 months the patient has: Been an inpatient, with an overnight stay, in a hospital abroad 5
6 OR Been an inpatient in a hospital in Manchester, Liverpool or London (these areas have had a problem with spread of CRE), with an overnight stay * OR Previously been colonised or had an infection with CRE or close contact with a person who has. Infection Prevention and Control will advise if other hot spot areas have been identified and should be included in the screening criteria If one of more of the above applies the following specimens should be sent to microbiology: Rectal swab or stool specimen o Rectal swab is taken it must have faeces present o Stool sample - collect a pea sized amount of stool to send to the laboratory, in a blue stool sample container Wound swab surgical wounds, leg ulcers, pressure sores, breaks in skin, other lesions Invasive device site, PEGS, Peripheral cannula, drain sites, central lines etc Urine sample if patient catheterised Sputum sample if patient is productive Label all specimen forms as CRE screening Screening must take place within 24 hours of admission to DTHFT. Any patients screened must be isolated under contact precautions unless the patient has diarrhoea when enteric precautions must be instigated. Patients admitted as a day case do not require screening unless the decision to admit for an overnight stay is made. Carbapenem resistance in non Enterobacteriaceae bacteria will be identified from clinical samples, e.g. sputum, wound swabs. Rectal screening or stool samples are not indicated. 4.2 Acting on Results of Screening / Isolation of Patients Any patient screened for CRE, following the criteria above, must be isolated immediately, with ensuite facilities under contact precautions. If the patient has diarrhoea they should be isolated under enteric precautions. Negative on screening the patient should remain in isolation until a further two samples test negative, samples being taken 48 hours apart. Once achieved the patient can be removed from isolation, no further screening is required. Should any of the samples test positive the patients should be managed as a positive case Positive on screening (or from a routine clinical sample from this admission episode) the patient must remain in isolation. The patient should be advised to practice good hand hygiene. Whilst in hospital, weekly screening samples are advised to maintain an understanding of the patient s risk status 6
7 Experience from other areas of the UK has shown that, on some occasions, patients apparently cleared of CRE can re-colonise to a detectable level in the gut. A previously positive individual with subsequent negative results can revert to a positive state, especially after a course of antibiotics. Carbapenamases are enzymes that destroy carbapenem antibiotics, conferring resistance. These are made by a growing number of Enterobacteriaceae strains. There are different types of carbapenemases, with differing transmission risks. The reference laboratory will identify the specific carbapenamase mechanism. The infection prevention and control team, following consultation with a Consultant Microbiologist, will discontinue isolation on patients if it is identified that the carbapenamse mechanism is of the type with a lower transmission risk. Should a patient who is colonised or has an infection require a diagnostic test or procedure that cannot be undertaken in the patient s room, the procedure should be planned at the end of the day s list and the equipment / furniture where the patients has had contact cleaned using a chlorine releasing agent at 1000ppm av. Chlorine. Patients with a known or recently confirmed CRE infection / colonisation who are visiting an outpatient area must go directly into an examination room, under standard precautions and not stay in the waiting area. The patient must remain in the room until the consultation is over, then directly leave the department. Patients with a known or recently confirmed CRE infection / colonisation who are admitted to a high risk day case area e.g. chemotherapy day case, renal dialysis unit must be isolated for the duration of their stay under contact precautions. Terminal cleaning of the isolation room, furniture and re-useable equipment should be undertaken using a chlorine releasing agent at 1000 ppm av. Chlorine. Curtains must be changed if the patient has had diarrhoea whilst in the department. This should be arranged via the facilities helpdesk. It is not necessary to isolate contacts whilst awaiting screening results cohort such contacts if possible. Patients identified as CRO positive from a clinical sample should be isolated, under contact precautions for the duration of their hospital stay. Re-screening is not routinely advised. Patients previously identified as CRE or CRO positive should be isolated on readmission to Derby Hospitals. Rectal swabs / stool sample and a swab of site identified as positive should be taken for patients that were CRE positive previously. Swabs / samples of previously positive sites should be taken for patients previously identified as CRO positive. Rectal swabs / stool samples are not required. Screening is not required for contacts of CRO positive patients 4.3 Infection Prevention and Control Measures All relevant staff must be made aware that the patient is a suspected or confirmed CRE/CRO colonisation or infection Decolonisation is not advised for the following reasons: 7
8 Skin decolonisation these bacteria generally colonise the gut rather than the skin; therefore skin decolonisation would not be effective. Gut decolonisation (by prescribing antibiotics) is not routinely recommended as there is concern that their use would contribute to increasing resistance in the long term Hand Hygiene Hand decontamination must be carried out after each contact with the patient and their environment; this must be with soap and water if a patient has diarrhoea / is cared for under enteric precautions It is vital that all patients are assisted to wash and dry their hands with soap and water after using the toilet and before eating. Visitors must be encouraged to wash and dry their hands with soap and water when entering and leaving the isolation room Personal Protective Equipment All healthcare staff are required to wear disposable long-sleeve gowns and gloves when caring for patients if any part of a staff uniform, not protected by an ordinary disposable apron, is expected to come into contact with the patient, e.g. when assisting movement for a dependant patient. Masks are NOT routinely required Visitors should wear disposable aprons and gloves whilst visiting the patient if assisting with personal care. Gloves and aprons should be removed and hands washed with soap and water after the care episode has ended. 4.4 Screening of Contacts Screening of contacts is only required if the index patient is CRE positive and the patient has not been isolated on admission, or during an outbreak situation. Screening of patients in the same setting is not normally required if the case was identified on admission and the patient isolated immediately Screening of patient contacts must be undertaken if the case has remained in a bay with other patients before, or despite, having a positive CRE result, the IPCT will advise. Screening should be undertaken on a weekly basis for a period of 4 weeks after the last case was identified. Screening should be restricted to patients who remain in hospital. Any patients screened as a contact found to be positive must be isolated immediately. If patients are found to be positive following contact screening, consideration, following discussion with PHE, will be given to screening the whole ward and discharged patients. Screening of household contacts and healthcare staff is not required. There is no compelling evidence to suggest that screening the household contacts or healthcare workers to check for colonisation will provide additional benefit in controlling spread in the healthcare setting 8
9 4.5 Environmental and Equipment Cleaning / Disinfection CRE/CRO can be eliminated from the environment and equipment by stringent cleaning and disinfection. Daily cleaning of the isolation room must take place using a chlorine releasing agent at 1000 ppm av. Chlorine and single use disposable cloths. Microfibre is not to be used in isolation rooms. Decontamination is most crucial following a patient leaving a specific area Specific Cleaning Requirements Isolation Rooms Terminal cleaning of the isolation room, furniture and re-useable equipment should be undertaken using a chlorine releasing agent at 1000 ppm av. Chlorine, enhanced by 6% hydrogen peroxide. Curtains must be changed and laundered. Unused wrapped single use items in the patient s room should be discarded as they may have become contaminated by hand contact. The burden of this may be minimised by keeping limited stock in the patient s room. Emergency Department A standard between patient clean should be undertaken if a patient is identified as requiring screening in the Emergency Department. Outpatient Department / Diagnostic tests or Procedures Should the patient visit another area for diagnostic test or procedures, e.g. X-ray, the surfaces and equipment used on/by the patients must be cleaned with a chlorine releasing agent at 1000 ppm av. Chlorine. Hydrogen Peroxide decontamination is not necessary. Endoscopy and Theatre Areas Endoscopy and theatre areas should discuss cleaning requirements with the IPCT. There are no extra decontamination requirements for endoscopes above the normal organisational procedures. Any attached cameras / equipment which cannot be thermally decontaminated should be protected using a single use covering and thoroughly chemically disinfected between patients once the covering has been removed. 4.6 Communication The patient must be informed of their diagnosis by the medical team and treatment options discussed. An information leaflet should also be given to the patient where appropriate. The Infection Prevention and Control Team will visit the patient when they have been told of their diagnosis to answer any additional questions the patient or their family may have Early Communication on Discharge or Medical Transfer of Patients Receiving organisations must be informed of patients that are colonised or infected with CRE/CRO, those screened on admission that are negative and the number of negative screens achieved and those patients screened as contacts prior to transfer. 9
10 The Infection Prevention and Control Team (IPCT) must be informed of all transfers as they will liaise with the IPCT of the receiving healthcare provider. Patient s are not to be transferred between base wards within the Trust unless it is clinically critical for the patients to do so. The IPCT must be informed of any internal transfer plans. Communication is required with The patient so they understand on discharge: Their current status (e.g. infection cleared but may still be a carrier) and the need for good hand hygiene That, should they or a close contact be admitted to hospital / healthcare setting for any reason, they need to inform healthcare staff of the exposure Healthcare colleagues Microbiologists, IPC teams in receiving healthcare providers, care homes, primary care services especially the GP plus any other relevant care provider along the patient pathway, including social care Any Trust where there is regular inter-trust transfer from one unit to another (where one unit is affected) The patients GP must be informed of the CRE/CRO diagnosis via e-discharge. 5. Monitoring Compliance and Effectiveness Monitoring Requirement : Monitoring Method: Report Prepared by: Monitoring Report presented to: Frequency of Report Any non-compliance with this policy will be reported using the Trust reporting mechanisms The Infection Prevention and Control Team will monitor compliance during ward visits. Report on non-compliance with this policy will be prepared by the relevant divisional IPC lead or Lead Nurse IPC Infection Control Operational Group items escalated to Infection Control Committee as necessary As required 10
11 6. References Public Health England Guidance. Acute Trust toolkit for the detection, management and control of carbapenemase producing Enterbacteroaceae. December 2013 Health Protection Agency. Standards for Microbiology Investigations. Laboratory Detection and Reporting of bacteria with Carbapenem Hydrolising β-lactamases (Carbapenemases)
12 Appendix One Screening of Patients for CRE and Isolation Requirements (Applies to patients admitted for an overnight stay, or patients admitted to Renal Dialysis Unit or Combined Day Unit) Patient identified as having admission to hospital abroad, Manchester, Liverpool or London, with an overnight stay, in the previous 12 months* or previously been told they are CRE positive YES NO Isolate under contact precautions. If the patient has diarrhoea isolate under enteric precautions Inform Infection Prevention and Control No further action required Screening required Rectal swab or stool sample (if stool sample collect pea sized amount to send to lab in a blue stool sample container) Wound swab Invasive device site swab Urine sample if catheterised Sputum if productive If screen results negative: If screen results positive: Isolate until further 2 negative samples achieved, each 48 hours apart Once achieved the patient can be removed from isolation Should any of the samples test positive manage as a positive case Patient to remain in isolation until isolation discontinued by IPCT Undertake weekly screening Patients to be isolated on readmission to DHFT and screening performed Screening of contacts is required if the index case was not isolated on admission It is not necessary to isolate contacts whilst awaiting screening results *This includes Renal Dialysis and Combined Day Unit 12
Carbapenemase Producing Enterobacteriaceae (CPE) Prevention and Management Toolkit for Inpatient Areas
Carbapenemase Producing Enterobacteriaceae (CPE) Prevention and Management Toolkit for Inpatient Areas This toolkit includes examples advice leaflets and forms which may be helpful for use by teams or
More informationInfection Prevention and Control. Carbapenemase Producing Enterobacteriaceae (CPE)
Infection Prevention and Control Carbapenemase Producing Enterobacteriaceae (CPE) IPCT CPE Policy V4 May 2018 Policy Title: Executive Summary: Carbapenemase Producing Enterobacteriaceae (CPE) This policy
More informationEarly detection, management and control of carbapenemase-producing Enterobacteriaceae Policy V3.0
Early detection, management and control of carbapenemase-producing Enterobacteriaceae Policy V3.0 01.05.2018 Summary - Patient admission flow chart for the infection prevention and control of carbapenemase-producing
More informationHEALTHCARE ASSOCIATED INFECTIONS RISK ASSESSMENT PROCEDURE
HEALTHCARE ASSOCIATED INFECTIONS RISK ASSESSMENT PROCEDURE Author: Jenny Boyce, Lead Infection Prevention & Control Nurse Approved by and date: March 2016 Any other linked ICP 000 - Infection Prevention
More informationCARBAPENEMASE PRODUCING ENTEROBACTERICAE (CPE): COMMUNITY TOOLKIT
CARBAPENEMASE PRODUCING ENTEROBACTERICAE (CPE): COMMUNITY TOOLKIT Rick Catlin 04/04/18 CPE Carbapenemase producing enterobactericae Gut bacteria (enterobactericae) that have developed resistance to multiple
More informationAssessing Evidence of Transmission and End of Transmission of Carbapenemase Producing Enterobacterales 1 (CPE)
Assessing Evidence of Transmission and End of Transmission of Carbapenemase Producing Enterobacterales 1 (CPE) CPE Expert Group National Guidance Document, Version 1.0 Scope of this Guidance This guidance
More informationInfection Prevention and Control Carbapenemase producing Enterobacteriaceae (CPE) Policy
Infection Prevention and Control Carbapenemase producing Enterobacteriaceae (CPE) Policy East Cheshire NHS Trust Infection Prevention and Control CPE V3 March 2016 1 Policy Title: Executive Summary: Carbapenemase
More informationPolicy for the Control and Management of patients Colonised or Infected with Vancomycin resistant enterococci (VRE)
Policy for the Control and Management of patients Colonised or Infected with Vancomycin resistant enterococci (VRE) Author: Responsible Lead Executive Director: Endorsing Body: Governance or Assurance
More informationAlert Organisms Multi-Resistant Gram Negative Bacteria (MR-GNB) excluding MRSA
Infection Prevention and Control Assurance - Standard Operating Procedure 22 (IPC SOP 22) Alert Organisms Multi-Resistant Gram Negative Bacteria (MR-GNB) excluding MRSA Why we have a procedure? To ensure
More informationOther (please specify): Note: This document has been assessed for any equality, diversity or human rights implications
Post holder responsible for Procedural Document Author of Policy Division/ Department responsible for Procedural Document Contact details Nicola Colborne, Infection Prevention and Control Nurse Specialist
More informationTRUST POLICY AND PROCEDURE FOR THE MANAGEMENT AND CONTROL OF DIARRHOEA AND VOMITING (NOROVIRUS) INFECTIONS
TRUST POLICY AND PROCEDURE FOR THE MANAGEMENT AND CONTROL OF DIARRHOEA AND VOMITING (NOROVIRUS) INFECTIONS Reference Number POL-IC/1079/2011 Old ref no. CL-RM/2014/066 Version 1.2.0 Status Final Author:
More informationCarbapenemase Producing Coliforms (CPC)
Carbapenemase Producing Coliforms (CPC) Corporate Division Patient Information Leaflet What is CPC? CPC stands for Carbapenemase producing Coliforms. Coliforms are bacteria that normally live in the gut.
More informationProcedure for the Management and Control of Carbapenemase-producing Enterobacteriaceae (CPE)
SH CP 177 Procedure for the Management and Control of Carbapenemase-producing Enterobacteriaceae (CPE) Infection Prevention and Control Policy: Appendix 21 Version 2 Summary: Defines the actions and management,
More informationSection J - Management of Patients with Multi Resistant Organisms:
Section J - Management of Patients with Multi Resistant Organisms: Carbapenemase-Producing Enterobacteriaceae (CPE) Vancomycin-Resistant Enterococci (VRE) Penicillin-Resistant Pneumococci (PRP) Extended
More informationDeveloped in response to: Best Practice Infection Prevention and Control
Transfer of patients within MEHT Clinical Guideline Developed in response to: Best Practice Infection Prevention and Control Version Number 1.0 Issuing Directorate Corporate Governance Approved by Clinical
More informationPreventing Further Spread of CPE
Provisional Guidance relating to CPE for General Practice. May 26 2017. Issued by the HSE Health Care Associated Infection and Antimicrobial Resistance Response Team. What is CPE (Carbapenemase Producing
More informationCarbapenemase-Producing Enterobacteriaceae (CPE) and Carbapenemase-Producing Organisms (CPO)
Carbapenemase-Producing Enterobacteriaceae (CPE) and Carbapenemase-Producing Organisms (CPO) Information for patients and visitors This leaflet explains how we test for, treat and prevent the spread of
More informationSection J - Management of Patients with Multi Resistant Organisms:
Section J - Management of Patients with Multi Resistant Organisms: Carbapenemase-Producing Enterobacteriaceae (CPE) Vancomycin-Resistant Enterococci (VRE) Penicillin-Resistant Pneumococci (PRP) Extended
More informationChecklists for Preventing and Controlling
Checklists for Preventing and Controlling Clostridium difficile Infection (CDI) This document has been developed to specifically assist senior management and all ward staff to take appropriate actions,
More informationInfection Prevention Control Team
Title Document Type MRSA Policy for NHS Borders Policy Version Number 4.0 Approved by Infection Control Committee Issue date June 2014 Review date June 2017 Distribution Prepared by Developed by All NHS
More information01/09/2014. The very first requirement in a hospital is that it should do the sick no harm!!!!
Infection Prevention and Control A Foundation Course Update on recent Guidelines and Recommendations Ros Cashman Cork University Maternity Hospital, Cork 2014 The very first requirement in a hospital is
More informationDefinitions. Healthcare Acquired Infection (HCAI)
Infection Prevention and Control Assurance - Standard Operating Procedure 21 (IPC SOP 21) Alert Organisms Glycopeptide Resistant Enterococci (GRE) and Vancomycin Resistant Enterococci (VRE) Why we have
More informationPrevention and Control of Infection in Care Homes. Infection Prevention and Control Team Public Health Norfolk County Council January 2015
Prevention and Control of Infection in Care Homes Infection Prevention and Control Team Public Health Norfolk County Council January 2015 Content for today Importance of IPAC -refresher IPAC audits in
More informationReducing the risk of healthcare associated infection
i Reducing the risk of healthcare associated infection Healthcare associated infection Introduction The Royal Marsden takes the safety of our patients very seriously. That means doing everything we can
More informationClostridium difficile Infection (CDI) Trigger Tool
Hospital ward/clinical Area Date Trigger Tool Commenced Date Trigger Tool Closed Person closing the CDI Trigger Health Protection Scotland March 2014 Version 3.0 A CDI trigger is the number of new CDI
More informationSECTION 11.4 VANCOMYCIN RESISTANT ENTERCOCCUS (VRE)
SECTION 11.4 VANCOMYCIN RESISTANT ENTERCOCCUS () Introduction Definitions Associated with Risk Groups Signs and Symptoms Source Mode of Transmission Diagnosis Treatment Screening Transport Communication
More informationMETICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (M.R.S.A.) DECOLONISATION GUIDANCE PRIMARY CARE. Purpose of Issue/Description of Change
METICILLIN RESISTANT STAPHYLOCOCCUS AUREUS (M.R.S.A.) DECOLONISATION GUIDANCE PRIMARY CARE First Issued by/date Issue Version Purpose of Issue/Description of Change Planned Review Date 10/2008 1 Guidance
More informationINFECTION PREVENTION AND CONTROL. Multi- Resistant Gram Negative Bacilli Including E.coli and Acinetobacter Species Policy
INFECTION PREVENTION AND CONTROL Multi- Resistant Gram Negative Bacilli Including E.coli and Acinetobacter Species Policy IPCT Multi-Resistant Gram Negative Bacilli Policy, V4, Dec 16 Page 1 Policy Title:
More informationInfection Control Care Plan. Patient Demographic / label. Hospital: Ward:
Patient Demographic / label Infection Control Care Plan for a patient with loose stools of unknown origin Statement: This care plan should be used with patients who have loose stools of unknown origin.
More informationReducing the risk of healthcare associated infection
i Reducing the risk of healthcare associated infection Healthcare associated infection Introduction The Royal Marsden takes the safety of our patients very seriously. That means doing everything we can
More informationToolkit for the early detection, management and control of carbapenemase-producing Enterobacteriaceae in Scottish acute settings
Toolkit for the early detection, management and control of carbapenemase-producing Enterobacteriaceae in Scottish acute settings Version: 1.0 Date: May 2016 Owner/Author: HPS Review Date: May 2017 1 Document
More informationThe Management of Extended Spectrum Beta Lactamase-Producing Organisms Policy. Infection Prevention and Control
The Management of Extended Spectrum Beta Lactamase-Producing Organisms Policy Infection Prevention and Control This policy describes the key processes and protocols for patients colonised or infected with
More informationClostridium difficile Infection (CDI) Trigger Tool
Hospital ward/clinical Area Date Trigger Tool Commenced Date Trigger Tool Closed Person closing the CDI Trigger Health Protection Scotland V2.0 November 2011 A CDI Trigger is the point at which the Infection
More informationOutbreak Management 2015
Outbreak Management 2015 Learning Outcomes For staff to be able to Define an outbreak To recognise an outbreak Identify the actions to be taken when an outbreak occurs Implement specific actions to be
More informationInfection Control Care Plan for a patient with Group A Streptococcus
Infection Control Care Plan for a patient with Group A Streptococcus Statement: This Care Plan should be used with patients who are suspected of or are known to have Group A Streptococcal infection. This
More informationCarbapenamase Producing Enterobacteriaceae: A Draining Concern
Carbapenamase Producing Enterobacteriaceae: A Draining Concern Heather Candon, B.Sc., M.Sc., MHM, CIC Lorraine Maze dit Mieusement, RN, MN, CIC Natasha Salt, B.Sc., B.A.Sc., CPHI (C), CIC Introduction
More informationPatient Demographic / Label. Infection Control Care Plan for a patient with MRSA
Patient Demographic / Label Infection Control Care Plan for a patient with MRSA Statement: This Care Plan should be used with patients who are suspected of or are known to have MRSA. This Care Plan should
More informationYou have questions about CPE and CRE? Issued by the HSE Health Care Associated Infection and Antimicrobial Resistance Response Team.
You have questions about CPE and CRE? Issued by the HSE Health Care Associated Infection and Antimicrobial Resistance Response Team. May 2017 This sheet gives answers to some common questions that patients
More informationInfection Control Care Plan for a patient with confirmed/ suspected Active Pulmonary Tuberculosis. Patient Demographic / Label
Patient Demographic / Label Infection Control Care Plan for a patient with Statement: This Care Plan should be used with patients who are suspected of or are known to have active pulmonary tuberculosis.
More informationIsolation Care of Patients in Isolation due to Infection or Disease
Infection Prevention and Control Assurance - Standard Operating Procedure 6 (IPC SOP 6) Isolation Care of Patients in Isolation due to Infection or Disease Why we have a procedure? The spread of infection
More informationHealthcare-Associated Infections
Healthcare-Associated Infections A healthcare crisis requiring European leadership Healthcare-associated infections (HAIs - also referred to as nosocomial infections) are defined as an infection occurring
More informationApproval Signature: Date of Approval: December 6, 2007 Review Date:
Personal Care Home/Long Term Care Facility Infection Prevention and Control Program Operational Directive Management of Methicillin-Resistant Staphylococcus Aureus (MRSA) Approval Signature: Supercedes:
More informationInfection Prevention and Control Guidelines: Spillage Management
Infection Prevention and Control Guidelines: Spillage Management CLINICAL GUIDELINES ACE 639 (formerly section 6 of 16 from ACE153) VERSION No 2 DATE OF FIRST ISSUE May 2017 REVIEW INTERVAL 2 Yearly AUTHORISED
More informationPrevention and Control of Multi-Resistant Gram Negative Bacteria including Acinetobacter; Infection Prevention and Control
Document Details Title Trust Ref No 890-38356 Local Ref (optional) Main points the document covers Who is the document aimed at? Author Approval process Approved by (Committee/Director) Prevention and
More informationCENTRAL MANCHESTER UNIVERSITY HOSPITALS NHS FOUNDATION TRUST
CENTRAL MANCHESTER UNIVERSITY HOSPITALS NHS FOUNDATION TRUST Agenda Item 9.1 Report of: Paper prepared by: Cheryl Lenney - Chief Nurse Consultant Nurse Infection Prevention and Control Julie Cawthorne
More informationGuideline for the Management of Patients with Known or Suspected Diarrhoea / Viral Gastroenteritis
Guideline for the Management of Patients with Known or Suspected Diarrhoea / Viral Gastroenteritis 1. Introduction 1.1 Patients with diarrhoea pose a risk to other patients from micro-organisms contaminating
More informationPolicy Objective To provide Health Care Workers (HCWs) with details of the precautions necessary to minimise the risk of MRSA cross-infection.
Page 1 of 16 Policy Objective To provide Health Care Workers (HCWs) with details of the precautions necessary to minimise the risk of MRSA cross-infection. This policy applies to all staff employed by
More informationThe most up to date version of this policy can be viewed at the following website:
Page Page 1 of 6 Policy Objective To ensure that HCWs are aware of the actions and precautions necessary to minimise the risk of cross-infection and the importance of diagnosing patients clinical conditions
More informationVancomycin-Resistant Enterococcus (VRE)
Approved by: Vancomycin-Resistant Enterococcus (VRE) Vice President & Chief Medical Officer Corporate Policy & Procedures Manual VI-40 Date Approved July 14, 2016 August 12, 2016 Next Review (3 years from
More informationStandard Precautions must always be used in addition to Transmission Based Precautions.
4. Airborne Precautions Airborne Precautions are recommended in addition to Standard Precautions to prevent the transmission of infections spread by very small respiratory particles which are expelled
More informationINFECTION C ONTROL CONTROL CONTROL EDUCATION PROGRAM
INFECTION CONTROL EDUCATION PROGRAM Isolation Precautions Isolating the disease not the patient The Purpose is To protect compromised patient from environment To prevent the spread of communicable diseases.
More informationDeveloped in response to: Health and Social Care Act 2008 Contributes CQC Core Standard Outcome 8
GRE (Glycopeptide Resistant Enterococci) Clinical Guideline Register No: 08028 Status: Public Developed in response to: Health and Social Care Act 2008 Contributes CQC Core Standard Outcome 8 Consulted
More informationProtocol for the Prevention and Management of Clostridium difficile.
Protocol for the Prevention and Management of Clostridium difficile. Policy Profile Policy Reference: Clinical care protocol 14. App D Clin 2.0 Version: Version 2.1 Author: Selma Mehdi, Lead Nurse Infection
More informationDirect cause of 5,000 deaths per year
HOSPITAL ACQUIRED (NOSOCOMIAL) INFECTION Policies MRSA Policy Meningitis Policy Blood and body fluid Exposure Policy Disinfection Policy Glove Policy Tuberculosis Policy Isolation Policy DEFINITION: ANY
More informationRequirements for Screening of Patients for Carbapenemase-Producing Enterobacteriales (CPE) 1 in the Acute Hospital Sector CPE Expert Group
Requirements for Screening of Patients for Carbapenemase-Producing Enterobacteriales (CPE) 1 in the Acute Hospital Sector CPE Expert Group POLICY DOCUMENT These guidelines are aimed at all health professionals
More informationPreventing Infection Workbook
Guidance for staff providing Care at Home Preventing Infection Workbook Guidance for staff providing Care at Home Name Job Title 1 Section 5: Content Section 4: Specific infections Section 3: Key topics
More informationNHS GREATER GLASGOW & CLYDE CONTROL OF INFECTION COMMITTEE STANDARD OPERATING PROCEDURE (SOP) GROUP A STREPTOCOCCUS (Streptococcus pyogenes)
Page Page 1 of 9 SOP Objective To ensure Healthcare Workers (HCWs) are aware of the actions and precautions necessary to minimise the risk of cross-infection and the importance of diagnosing patients clinical
More informationStandard Precautions
Standard Precautions Speciality: Infection Control 1. Indications 1.1 Background Standard Precautions This definition broadens the coverage of the previously known Universal Precautions by recognizing
More informationSTANDARD PRECAUTIONS POLICY Page 1 of 8 Reviewed: May 2017
Page 1 of 8 Policy Applies to: All Mercy Staff, Credentialed Specialists, Allied Health Professionals, students, patients, visitors and contractors will be supported to meet policy requirements Related
More informationCarbapenemase-producing Enterobacteriaceae (CPE) in HSE acute hospitals in Ireland monthly report December 2017
Carbapenemase-producing Enterobacteriaceae (CPE) in HSE acute hospitals in Ireland monthly report December 2017 The terms carbapenem resistant Enterobacteriaceae (CRE) and carbapenemase-producing Enterobacteriaceae
More informationCystic Fibrosis Foundation Recommendations
Hospital Epidemiology and Infection Control Department Presenters: Sandra Kistler, RN, PHN, MSN, ICP Cystic Fibrosis Foundation Recommendations Contact Precautions for ALL patients with Cystic Fibrosis
More informationThe Clatterbridge Cancer Centre. NHS Foundation Trust MRSA. Infection Control. A guide for patients and visitors
The Clatterbridge Cancer Centre NHS Foundation Trust MRSA Infection Control A guide for patients and visitors Contents Information... 1 Symptoms... 1 Diagnosis... 2 Treatment... 2 Prevention of spread...
More informationGuidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE) 2012 CRE Toolkit
Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE) 2012 CRE Toolkit National Center for Emerging and Zoonotic Infectious Diseases Division of Healthcare Quality Promotion Guidance for
More informationTrust Policy, Infection Control
Trust Policy, Infection Control Title: Methicillin Resistant Staphylococcus Aureus () and Methicillin Sensitive Staphylococcus Aureus (MSSA) Screening and Infection Control Management Policy. (Key Words:,
More informationCleaning policy. Document author Assured by Review cycle. 1. Introduction Purpose or aim Scope Definitions...
Cleaning policy Board library reference Document author Assured by Review cycle P005 Head of Estates and Facilities Quality and Standards Committee 3 years This document is version controlled. The master
More informationWhat you can do to help stop the spread of MRSA and other infections
MRSA wash it away As a patient it is important that you get better quickly and stay well. This leaflet gives you information about MRSA and other health care associated infections, so that you know what
More informationClostridium difficile Infection (CDI) in children (3-16 years ) Transmission Based Precautions
Page 1 of 9 Standard Operating procedure (SOP) Objective To provide HCWs with details of the care required to prevent cross-infection in children s with Clostridium difficile Infection (CDI). This SOP
More informationPROCEDURE FOR TAKING A WOUND SWAB
CLINICAL PROCEDURE PROCEDURE FOR TAKING A WOUND SWAB Issue History Issue Version Purpose of Issue/Description of Change Planned Review Date 2 To provide a standardised process of the fundamental principles
More informationISOLATION TABLE OF CONTENTS STANDARD PRECAUTIONS... 2 CONTACT PRECAUTIONS... 4 DROPLET PRECAUTIONS... 6 ISOLATION PROCEDURES... 7
ISOLATION TABLE OF CONTENTS STANDARD PRECAUTIONS... 2 BARRIERS INDICATED IN STANDARD PRECAUTIONS... 2 PERSONAL PROTECTIVE EQUIPMENT... 3 CONTACT PRECAUTIONS... 4 RESIDENT PLACEMENT... 4 RESIDENT TRANSPORT...
More informationComply with infection control policies and procedures in health work
Student Information Course Name Course code Contact details Partial completion of one of these qualification Description of this unit against the qualification Descriptor Comply with infection control
More informationCommunity Infection Prevention and Control Guidance for Health and Social Care
Community Infection Prevention and Control Guidance for Health and Social Care Version 1.02 August 2017 Harrogate and District NHS Foundation Trust 16 August 2017 Version 1.02 Page 1 of 13 Please note
More informationInfection Control Safety Guidance Document
Infection Control Safety Guidance Document Lead Directorate and Service: Corporate Resources - Human Resources, Safety Services Effective Date: June 2014 Contact Officer/Number Garry Smith / 01482 391110
More informationMRSA: Help us to help to help you
MRSA: Help us to help to help you Information on MRSA within The Queen Elizabeth Hospital 1 At QE Gateshead we are committed to reducing the risk of infection. What is MRSA? There are many different types
More informationHereford Hospitals NHS Trust
Hereford Hospitals NHS Trust Universal Meticillin Resistant Staphylococcus Aureus (MRSA) Screening Protocol IC.08 IF THIS DOCUMENT HAS BEEN PRINTED, IT SHOULD NOT BE ASSUMED TO BE THE LATEST VERSION. Document
More informationNational Standards for the prevention and control of healthcare-associated infections in acute healthcare services.
National Standards for the prevention and control of healthcare-associated infections in 2017 1 Safer Better Care Note on terms and abbreviations used in these standards A full range of terms and abbreviations
More informationInfection Prevention and Control. Study guide
Infection Prevention and Control Study guide Infection prevention and control Regulations CQC Outcome 8 Non Clinical Introduction All staff must be aware of the importance of Infection Prevention and Control
More informationHealthcare associated infections across the health and social care community
Healthcare associated infections across the health and social care community Professor Brian Duerden CBE Inspector of Microbiology and Infection Control, Department of Health, London Infection is different..it
More informationInfection Prevention and Control
Infection Prevention and Control Infection Prevention and Control Program IPAC program consists of three healthcare professionals IPAC department is located on the 9 th floor and is available Monday to
More informationInfection Control Prevention Strategies. For Clinical Personnel
Infection Control Prevention Strategies For Clinical Personnel What is Infection Control? Infection Control is EVERYONE s responsibility It protects patients, employees and visitors by preventing and controlling
More informationPolicy for the control and management of patients colonised or infected with Meticillin Resistant Staphylococcus aureus (MRSA)
Policy for the control and management of patients colonised or infected with Meticillin Resistant Staphylococcus aureus (MRSA) Author: Responsible Lead Executive Director: Endorsing Body: Infection Prevention
More informationEveryone Involved in providing healthcare should adhere to the principals of infection control.
Infection Control Introduction The prevention and control of infection is an integral part of the role of all health care personnel. Healthcare Associated Infections (HCAIs) affect an estimated one in
More informationClostridium difficile policy
Clostridium difficile policy Document level: Trustwide (TW) Code: IC5 Issue number: 4 Lead executive Director of Infection, Prevention and Control Author and contact number Infection Prevention and Control
More informationNOSOCOMIAL INFECTION : NURSES ROLE IN MINIMIZING TRANSMISSION
NOSOCOMIAL INFECTION : NURSES ROLE IN MINIMIZING TRANSMISSION DR AHMAD SHALTUT OTHMAN JAB ANESTESIOLOGI & RAWATAN RAPI HOSP SULTANAH BAHIYAH ALOR SETAR, KEDAH Nosocomial infection Nosocomial or hospital
More informationInfection Prevention Isolation Precautions Toolkit
Infection Prevention Isolation Precautions Toolkit The toolkit provides: Link(s) to revised Isolation Policy on The Point Link to ICON training video and key changes to policy (NEW) Quick Review Chart
More informationAcute Hospital Carbapenemase Producing Enterobacteriales (CPE) Outbreak Control Checklist, Version 1.0 March 2018
Acute Hospital Carbapenemase Producing Enterobacteriales (CPE) Outbreak Control Checklist, Version 1.0 March 2018 CPE Expert Group POLICY DOCUMENT These guidelines are aimed at all Health professionals
More informationReport of the unannounced inspection at the Mater Misericordiae University Hospital, Dublin.
Report of the unannounced inspection of the prevention and control of healthcare associated infection at X Hospital Report of the unannounced inspection at the Mater Misericordiae University Hospital,
More informationInfection Prevention and Control for Phlebotomy
Page 1 of 10 POLICY STATEMENT: It is Sunnybrook s Policy to prevent the spread of infection within the health care institution from patient to patient, patient to staff, staff to patient by: a) providing
More informationName of Assessor Unit Date. Element Yes No Action Needed
Figure 10.5 Checklist: Contact Precautions Name of Assessor Unit Date Element Yes No Action Needed CONTACT PRECAUTIONS GENERAL Contact Precautions are used for patients with known or suspected infections
More informationStandard Operating Procedure Template
Standard Operating Procedure Template Title of Standard Operation Procedure: Cleaning Toys, Games and Play Equipment on the Paediatric Ward Reference Number: Version No: 1 Issue Date: Purpose and Background
More informationInfection Prevention and Control (IPC) Standard Operating Procedure for LICE (PEDICULOSIS AND PHTHIRIASIS) in a healthcare setting
Infection Prevention and Control (IPC) Standard Operating Procedure for LICE (PEDICULOSIS AND PHTHIRIASIS) in a healthcare setting WARNING This document is uncontrolled when printed. Check local intranet
More informationReport of the unannounced inspection at Wexford General Hospital.
Report of the unannounced inspection of the prevention and control of healthcare associated infection at X Hospital Report of the unannounced inspection at Wexford General Hospital. Monitoring programme
More informationINCREASED INCIDENT /OUTBREAK OF DIARRHOEA AND/OR VOMITING
INCREASED INCIDENT /OUTBREAK OF DIARRHOEA AND/OR VOMITING Documentation to support the management of an increased incident or outbreak of Diarrhoea and/or Vomiting including Norovirus Developed by Amanda
More informationGlycopeptide/Vancomycin Resistant Enterococci (GRE/VRE) Policy
Glycopeptide/Vancomycin Resistant Enterococci (GRE/VRE) Policy Post holder responsible for Procedural Document Author of Policy Division/ Department responsible for Procedural Document Contact details
More informationMethicillin Resistant Staphylococcus aureus (MRSA) Procedure
Document title: Document number: Staff involved in Development (job titles): Document author/owner: Directorate: Department: For use by: Methicillin Resistant Staphylococcus aureus (MRSA) Procedure DN339
More informationPrevention and Control of Carbapenem Resistant Enterobacteriaceae Infections
01.41 - Prevention and Control of Carbapenem Resistant Purpose To prevent healthcare-associated infections in patients caused by carbapenem-resistant Enterobacteriaceae (CRE). Audience All healthcare workers
More informationMRSA in Holland What is Behind the Success Gertie van Knippenberg-Gordebeke
MRSA situations in Holland: What is behind the success? ICP, VieCuri Medical Centre Venlo, The Netherlands Hosted by Paul Webber paul@webbertraining.com www.webbertraining.com INFECTION CONTROL HISTORY
More informationInfection Control Prevention Strategies. For Clinical Personnel
Infection Control Prevention Strategies For Clinical Personnel What is Infection Control? Infection Control is EVERYONE s responsibility It protects patients, employees and visitors by preventing and controlling
More informationInvestigating Clostridium difficile Infections
CALIFORNIA DEPARTMENT OF PUBLIC HEALTH Investigating Clostridium difficile Infections Erin P. Garcia, MPH, CPH Healthcare-Associated Infections (HAI) Program Center for Health Care Quality California Department
More information2014 Annual Continuing Education Module. Contents
This self-directed learning module contains information you are expected to know to protect yourself, our patients, and our guests. Content Experts: Infection Prevention Target Audience: All Teammates
More informationHow to Add an Annual Facility Survey
Add an Annual Facility Survey https://nhsn.cdc.gov/nhsndemo/help/patient_safety_component/how_to/add_an_annual... Page 1 of 1 10/9/2017 Show Patient Safety Component > How To > Facility > Add an Annual
More information