Standard Precautions for Infection Control

Standard Precautions for Infection Control Author(s) & Designation Lead Clinician if appropriate In consultation with To be read in association with Ratified by Suzanne Golding-Ellis, Head of Patient Safety and Infection Prevention and Control Mary Lewis, Director of ursing and Therapies Infection Prevention Control Group Hand Hygiene Policy, Sharps policy, Laboratory Specimen policy, Linen policy, Vaccine storage and transport policy, Body fluid spillage management policy, Decontamination policy Infection Prevention Control Group Re-issue/Ratification date April 2017 Version 6 Review date June 2018 This policy supports compliance with the CQC 5 Domains: HSLA Risk Management Standard(s): Safe Caring Effective Responsive Well Led If you require this document in a different format, please contact the Quality and Governance team on 01275 546834 1

Contents 1. Purpose 3 2. Scope 3 3. Background 3 4. Risk Assessment 3 5. Responsibilities 4 6 Definitions 4 7 Specific Related Principles 5 8 Training 6 9 Audit 6 10 References 6 11 Appendices 6 Appendix A Standard Precautions 7 Appendix B Equality Impact Assessment 9 Appendix C Hand Hygiene Technique Audit template 12 Version Item Adjustment Date Author Ratifying Committee 3 Policy Ratified 4 Policy Job titles 5 Policy Review Oct 2012 Aug 2014 SGE SGE COIG /A June 2016 JB /A 6 Policy Removal of PPE Policy reference April 2017 JB /A 2

1. Purpose This policy is to ensure that every member of orth Somerset Community Partnership (SCP) staff involved in patient care and management is aware of the use of Standard Universal Precautions for infection control. It will be used in conjunction with other SCP policies that contribute to the prevention and management of infection and its spread. 2. Scope This policy applies to all services directly provided by SCP and all clinical staff should familiarise themselves with the policy. It is the responsibility of each independent contractor to reduce healthcare associated infections (HCAI) and the transmission of infection during interventional procedures. SCP recommends that contractors apply the principles of this policy as minimum standards within their practices to ensure that their professional and contractual responsibilities are discharged. 3. Background Since the 1980 s the term Universal Precautions has come to mean those interventions to be taken by all healthcare workers when coming into contact with blood and body fluids from a patient. Blood and body fluids of a patient in any healthcare setting may contain either a blood borne virus or other pathogens. It is not possible to determine the risk posed by individual patients until the results of microbiology and viral investigations are known. Therefore, it is recommended that all patients must be considered to be a risk for cross infection and that a system of universal or standard universal precautions must be adopted by all healthcare staff. More recently the term Standard Precautions was introduced based around the same principles but expands coverage and is the primary strategy in the reduction of Health Care Associated Infections (HCAI). Standard precautions underpin routine safe practice, protecting both staff and patients from infection. By applying standard precautions at all times and to ALL patients, best practice becomes second nature and the risks of infection are minimised (RC 2005). 4. Risk Assessment Risk assessment should underpin the principles of standard infection control precautions. Assessment of the risk of transmitting infection should form part of every clinical activity. It should consider the risk to both patients and health care workers and result in the appropriate level of infection control precautions (Wilson 2006). 3

Appropriate protective equipment must be used following an assessment of the risk of transmission of organisms to the patient and the risk of contamination to the health care worker clothing and skin from blood and bodily fluids. 5. Responsibilities orth Somerset Community Partnership responsibility: SCP has a responsibility to ensure that: Risk assessments are carried out and that appropriate equipment is available for staff to protect themselves from exposure to infections Staff are educated in the appropriate use of such equipment Employee responsibility All staff has a responsibility to: Adhere to SCP policies and procedures Ensure appropriate equipment is available Carry out a risk assessment for each clinical activity Dispose of PPE and equipment correctly Attend mandatory infection control annual update sessions Take personal responsibility for knowing how to access SCP policies CQC Registered Managers are responsible for ensuring that people are cared for safely and with acceptable standards of care. They are legally responsible for ensuring that national standards for safety and quality are met. They are also responsible for any notifications to the CQC. Locality Leaders have an overall responsibility for their area and for ensuring that all staff, guided by line managers, adheres to the correct procedure and process. 6 Definitions Universal or standard universal precautions consist of Hand Hygiene Personal Protective Equipment (PPE) Sharps Management Management of eedlestick Injury Linen Handling and segregation Blood and bodily fluid Spillage management Decontamination of Equipment and environment Handling and Transport of Specimens Waste Management When appropriately implemented these are designed to reduce the risk of transmission of micro-organisms. 4

Safe Systems of work The following principles form the basis of these guidelines and should be followed at all times. Apply good basic hygiene practices with regular hand decontamination using the six step technique (see Hand Hygiene policy). In order to safeguard the health and safety of all patients and healthcare workers, it is essential that good working practices are adopted at all times. This involves careful handling of all bloods and bodily fluids from all patients, regardless of whether a risk of infection has been identified or not. All blood and bodily fluid spillages should be dealt with immediately and staff should have received training in how to clean spillages safely and effectively. Cover any cuts or lesions with waterproof dressings. Protect mucous membranes of eye, nose and mouth from blood splashes. Healthcare workers should treat all blood/body fluid as potentially infectious. Hand hygiene should be practiced before and after each patient contact. Appropriate protective clothing, for example, disposable gloves and plastic aprons must be worn when in contact with blood and bodily fluids. Eye protection should be available and must be worn if splashing is anticipated Sharps must not be re-sheathed and must be disposed of appropriately (See Sharps and Blood Borne Viruses Policy). Additional precautions may be necessary for specific infections and advice must be sought from the Infection Control urse. 7 Specific Related Principles The specific methods and practices that employ Universal or Standard Universal Precautions are examined in detail in the following SCP policies Hand Hygiene Policy Transportation Specimens Policy Sharps and Blood Borne Viruses policy Linen policy Vaccine Transport and storage Policy Body fluid spillage Management policy Aseptic Technique policy Decontamination policy Medical devise policy Waste Management policy 5

8 Training All staff must receive training in infection control standard precautions as part of their induction programme as per SCP training matrix. Standard precautions should also be included in annual updates which are mandatory for all clinical staff. Infection Control should be discussed at staff appraisals and objectives set within Personal Development plans in line with the requirements of the Health and Social Care Act 2008. (See Appendix A Infection control checklist) 9 Audit Each Business Unit has an audit programme which includes Infection Control and is monitored quarterly. Infection Control audits will be conducted using the quality improvement tools which have been devised by The Infection Prevention Society, and as local need arises, for example, following complaints or incident trends (See appendix C Hand Hygiene Technique Audit template) as an example. 10 References Department of Health (2007) epic2. ational Evidence based Guidelines for Preventing Healthcare associated infections in HS hospitals in England. Journal of Hospital Infection. London.HMSO Wilson, J (2006) Infection Control in Clinical Practice. 3 rd edition Bailliere Tindall, London The Health and Social Care Act 2008. Code of Practice for the HS on the prevention and control of healthcare associated infections and related guidance. Department of Health ICE CG139 Infection Control Infection: prevention and control of healthcare associated infections in primary and community care. Issued: March 2012 www.nice.org.uk/cg139 11 Appendices 6

Appendix A Standard Precautions Standard Precautions Checklist Standard precautions underpin safe protection and should be used at all times for all patients. The following checklist is an easy guide to assist you. Laminate and display in clinical areas or bases. Have you washed your hands? Handwashing is the single most important step in reducing the spread of disease. Use the six step technique before and after each patient contact. Do you need to use personal protective equipment? Carry out a risk assessment if potential contamination with blood or bodily fluids is likely. Use disposable gloves, aprons, masks, goggles, or visors to protect yourself and the patient from these risks of cross infection. Also when using hazardous chemicals and some pharmaceuticals. Are you considering the prevention of sharps injuries? Keep handling to a minimum and never re-sheath. Dispose of sharps carefully in a special container at the point of use Are you disposing of waste safely? Ensure that you understand the correct procedure for disposing of different waste categories and the colour coding involved Do you deal with spillages promptly? Spillages must be dealt with quickly, using appropriate chemicals and you must ensure that you have been trained in the use of the appropriate chemical. Do you understand the need to decontaminate equipment before and after patient use? Consider the individual piece of equipment that you are using and check that you know exactly how to decontaminate appropriately. ot having enough time cannot be an excuse for not cleaning equipment appropriately. Are you maintaining a safe and clean environment? Ensure that you work in a clean, tidy and uncluttered environment. Ensure your workplace has a written, planned, cleaning schedule which is signed off from a designated senior member of staff and ensure that these records are kept for good practice and audit purposes. Plan regular Dump the Junk days. Do you know what to do in the Event of a eedlestick Injury? Attend to the injury, wash it well under running water. Do not bite or suck. If bodily fluids have splashed into eyes, irrigate with water. If they have splashed into mouth, do not swallow and rinse out several times with cold water. Report to line 7

manager, complete an Incident form and seek expert advice. eedlestick Injury Hotline number 01934 881150 Do you know and understand your responsibilities for your workplace procedures? Ensure you know where to locate, and are familiar with policies and procedures for infection control 8

Appendix B Equality Impact Assessment Equality Impact Assessment Section 1: Initial Assessment Policy Author Date of Assessment Julia Bloomfield June 2016 Title of Policy Standard Precautions Is this a new or existing policy? Existing - Reviewed 1. Briefly describe the aims, objectives and purpose of the Policy / Guidance Document: It ensures that every member of staff involved in patient care and management is aware of the use of Standard Universal Precautions for infection control. It will be used in conjunction with other policies that contribute to the prevention and management of infection and its spread. 2. Who is intended to benefit from the proposed process and in what way? Staff and patients as it provides clear processes to prevent spread of infection creating a cleaner and safer work and caring environment. 3. Who are the main stakeholders in relation to this Policy/Guidance? Staff, Patients and Visitors 4. Are there concerns that the Policy/Guidance does, or could have, a differential impact due to any of the equality areas? (Y/ delete as appropriate) Age Disability Gender reassignment Marriage and Civil Partnership Pregnancy and Maternity Race Religion or Belief Sex 9

Sexual orientation 5. What existing evidence (either presumed or otherwise) do you have for this? It applies equally to all stakeholders to protect them 6. Based on the answers given in questions 4 & 5 is there potential for an adverse Impact in this policy/guidance? o 7. Can this adverse impact be justified? /A If you have not identified adverse impact or you can justify the adverse impact, finish here. If you have identified adverse impact that cannot be justified, please continue to Section 2 Section 2: Full Impact Assessment 8. What experts/relevant groups have you approached to explore their views on the issues? Please list the relevant group/experts, how they were consulted and when. Relevant groups/experts How were the views of these groups obtained? Date contacted 9. Please explain in detail the views of these groups/experts on the issues involved: 10. Taking into account the views of the groups/experts and the available evidence, what are the risks associated with the policy, weighed against the benefits of the policy if it were to stay as it is: Risks Benefits 10

If you have found that the risks outweigh the benefits you need to review the policy further and put together an implementation plan which clearly sets out any actions you have identified as a result of undertaking the EIA. These may include actions that need to be carried out before the EIA can be completed or longer-term actions that will be carried out as part of the policy or development. 11. Monitoring arrangements and scheduled date to review the policy and Equality Impact Assessment: Review Date June 2018 11

Appendix C Hand Hygiene Technique Audit template 12