Infection Control Care Plan. Patient Demographic / label. Hospital: Ward:

Transcription

1 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. This care plan should be followed to reduce the risk of transmitting faecal organisms to other patients, staff, carers and visitors. If it is not possible to follow this care plan, please notify a member of the Infection Control Team who will carry out a risk assessment on how best to care for this patient. 1 Accommodation A risk assessment should be carried out by the Infection Control Team / Nursing staff to determine the suitability of the patient for isolation. Isolate patient in a single room preferably with en suite facilities if en suite is unavailable ensure access to own commode. Place isolation sign on outside of door. Discontinuation of isolation precautions when patient is 48 hours symptom free. 2 Hand hygiene All HCWs must decontaminate their hands prior to patient contact, alcohol hand gel or liquid soap and water is sufficient. All HCWs must decontaminate their hands with liquid soap and water after patient contact, contact with the patient environment and on removal of PPE. Encourage patient to wash their hands regularly with soap and water or hand hygiene wipes, especially after using the toilet/commode/bedpan and prior to eating. 1

2 3 Specimens Obtain a stool specimen and send it to the Microbiology Laboratory for routine culture and sensitivity. If the patient has been on antibiotics please record this on the microbiology request form. If the first specimen is negative and loose stools persist, send two further specimens on separate occasions. Advice can be sought form ICT. If an infective organism is isolated use appropriate Infection Control Care Plan. 4 Decontamination of patient equipment Where possible equipment such as chairs, hoist sling etc. should be kept for use by that patient only and kept in the room. If equipment is taken out of the room it must be cleaned with 1000ppm chlorine based detergent (10,000ppm if contaminated with body fluids) Crockery/cutlery/medicine pots can be removed from the room and washed in the normal way. Keep items and equipment to a minimum in room 5 Laundry Place used linen in water soluble bag, then clear polythene bag, then into the white laundry bag Clean linen should be taken into the room when required. Do not store clean linen in room. 2

3 6 PPE Disposable aprons and gloves must be worn for all direct contact with the patient or patient s environment/equipment. Gloves and aprons are single use and must be disposed of into the clinical waste stream after use and then hands must be decontaminated with liquid soap and water. 7 Waste Dispose of all waste into a clinical waste bag inside room. A foot operated bin should be used. When the waste bag is ¾ full (and daily), fasten securely and label with ward identification number. 8 Environmental cleaning Domestic services staff must be informed that the patient is being isolated. Floor, surfaces, sink, toilet etc. must be cleaned twice daily by domestic staff using a chlorine based detergent as per SOP for Twice Daily Clean of an Isolation Room When isolation precautions are discontinued, domestic staff must carry out a terminal clean using a chlorine based detergent. Once the room is dry it can be used for another patient. Curtain/screen/blinds change is not always required. Contact a member of the Infection Control Team for advice. If the level of domestic cleaning is insufficient or ineffective then contact domestic supervisor and infection control nurse.. 3

4 9 Information to Explanation to the patient re reasons for isolation patient and carers and provide information leaflet if available. Ensure that all persons visiting the patient are aware of the reason for isolation precautions Relative with infectious symptoms e.g. diarrhoea must be instructed not to visit until at least 48 hours free of symptoms Please ensure relatives are given guidance on home laundering leaflet 10 Visitor restrictions Visitors must be instructed to report to nurse in charge before entering room Vulnerable people such as young children should be discouraged from visiting. Aprons and Gloves are NOT required to be worn by visitors but they should be instructed to wash their hands using soap and water on leaving the room. 11 Personal clothing All used patient clothing for home laundry should be placed in a water soluble patient clothing bag for uplift by relatives 12 Transfer to another department or hospital Where possible, avoid moving patients until they have been asymptomatic for 48 hours. If transfer is necessary, ensure the ward / department receiving the patient has a single room available where possible. Please contact the ICT prior to transferring the patient. 4

5 13 Documentation Commence stool chart and ensure all bowel motions are recorded including consistency as per Bristol Stool Chart. Commence fluid balance chart ensuring that all episodes of vomiting are recorded. 14 Toileting facilities Where possible, the patients should be allocated their own toilet or commode. If a commode is in use, it must be decontaminated after each use with chlorine based detergent (1:1000ppm). After cleaning, indicator tape should be used, e.g. Vernacare green tape. When handling bedpans wear disposable gloves and apron and decontaminate hands with soap and water on removal. 5