Document Type: POLICY Title: Diarrhoea and Vomiting Scope: Trust Wide Author/Originator and title: Dr Sue Richardson, Consultant Occupational Physician Replaces: Version 2 Diarrhoea and Vomiting Policy CORP/POL/203 NHS Blackpool policy Diarrhoea and Vomiting Procedure in Community (Blackpool Locality), HR/12 Name Of: Divisional/Directorate/Working Group: HR & OD Policy Forum Validated by: Operational JNCC Unique Identifier: CORP/POL/203 Version Number: 3 Status: Ratified Classification: Organisational Responsibility: Human Resources and OD Directorate Description of amendments: Scope Timescale for submission of specimen Minor alterations and simplifying wording throughout Date of Meeting: 18/7/2013 Validation Date: 22 nd October 2013 Ratified by: Ratified Date: Strategic JNCC 22 nd October 2013 Review dates may alter if any significant changes are made Risk Assessment: Not Applicable Financial Implications Not Applicable Which Principles of the NHS Constitution Apply? 1-4 Issue Date: 22/10/2013 Review Date: 01/07/2014 Does this document meet the requirements of the Equality Act 2010 in relation to Race, Religion and Belief, Age, Disability, Gender, Sexual Orientation, Gender Identity, Pregnancy & Maternity, Marriage and Civil Partnership, Carers, Human Rights and Social Economic Deprivation discrimination? Initial Assessment
1 PURPOSE This policy addresses the measures needed to prevent isolated episodes of gastrointestinal infection in staff members posing a threat to Trust patients and other members of staff. Diarrhoea and / or vomiting caused by gastro-intestinal infections in health care workers (HCW) can pose a risk of infection to patients if not managed properly. In severe cases this could cause severe illness and possibly even deaths in vulnerable patient groups, and adverse publicity. The most likely agent to cause an outbreak is Norovirus, and this usually presents as profuse vomiting, with headache, but the virus is most easily detected in stool specimens. 2 SCOPE This policy applies to all staff employed by the Trust, or staff employed by contractors on behalf of the Trust. It includes students not directly employed by the Trust who may be on placement. It includes volunteers. 3 POLICY 3.1 Action by Employee With Diarrhoea and / or Vomiting You must follow the normal sickness reporting procedure. You must stay off work until you are well and the diarrhoea has stopped and you have a formed stool. If you have vomited, and you think you may be infectious you must stay off until you have not vomited for 48 hours, (unless you know your vomiting is not due to an infection (e.g. alcohol-related). If you have unexplained vomiting and there is Norovirus in the community or at work, OR if your diarrhoea has lasted more than 3 days or is blood stained, then you need to submit a stool specimen either via Occupational Health or via your GP. If you do this through your GP, please ask them to copy Occupational Health in on the request from. You do not need to stay off work until the result of any stool specimen is known. Once you are well and any diarrhoea has stopped, and/or you have not vomited for 48 hours, you should return to work. On the rare occasions when stool culture identifies an organism that requires a different period away from work, Environmental Health or Occupational Health will contact you to advise. 3.2 Action by Manager Your member of staff must follow the normal sickness reporting procedures so you should be aware that they are suffering from diarrhoea and/or vomiting from the first day of their illness. Page 2 of 6
If you are aware that any other members of staff (or patients) are suffering from the same symptoms, you must inform the Control of Infection Team and the Occupational Health Nursing Team straight away. This will give an early indication of an outbreak of gastrointestinal illness within the Trust. Your member of staff will not need to stay off work pending the results of a stool specimen. Your member of staff will not need to stay off work until cleared to return by Occupational Health. Your member of staff will only need to stay off work until their diarrhoea has ceased, and they have a formed stool, and/or they have not vomited for 48 hours. 3.3 Action by Occupational Health Staff When a manager notifies them of more than one incidence of diarrhoea and vomiting in a member of staff, the occupational health nurses will liaise with the control of infection team, and pass appropriate advice back to managers and the employee where necessary. If a member of staff contacts Occupational Health to arrange a stool specimen, they will arrange for the specimens and communicate the results back to the employee. If Occupational Health are copied into the results of a specimen via the GP, Occupational Health will contact the employee if the specimen is positive to advise. Occupational Health will act as an advice point for members of staff and managers when they are in doubt over the interpretation of this policy or if they wish further advice on the matter. 3.4 Equality and Diversity The trust believes that unlawful discrimination in any form, whether direct or indirect, intentional or unintentional, is totally unacceptable. This policy should be read in conjunction, where applicable, with the Equality and Diversity Strategy, Employee People with a Disability and the Single Equality Scheme, because of the requirements not to discriminate against people who possess a protected characteristic(s) (age, disability, gender, gender reassignment, race, religion or belief, sexual orientation, pregnancy and maternity and marriage and civil partnerships). Any employee who wilfully or negligently fails to comply with requirements of the above policies will be liable to action under the Disciplinary Procedure. 4 ATTACHMENTS Appendix Number Title 1 Equality Impact Assessment Tool 5 ELECTRONIC AND MANUAL RECORDING OF INFORMATION Electronic Database for Procedural Documents Held by Policy Co-ordinators/Archive Office Page 3 of 6
6 LOCATIONS THIS DOCUMENT ISSUED TO Copy No Location Date Issued 1 Intranet 22/10/2013 2 Wards, Departments and Service 22/10/2013 7 OTHER RELEVANT/ASSOCIATED DOCUMENTS Unique Identifier Title and web links from the document library CORP/POL/011 Management of Sickness Absence Policy http://fcsharepoint/trustdocuments/documents/corp-pol- 011.docx CORP/POL/602 Medical Workforce Absence http://fcsharepoint/trustdocuments/documents/corp-proc- 602.doc 8 SUPPORTING REFERENCES/EVIDENCE BASED DOCUMENTS References In Full 9 CONSULTATION WITH STAFF AND PATIENTS Name Designation Dr Ruth Palmer Consultant Microbiologist Mrs J Lickiss Control of Infection Team Sr Julie Peel Occupational Health Nurse 10 DEFINITIONS/GLOSSARY OF TERMS Diarrhoea A change from usual bowel habit to 3 or more loose stools in a 24 hour period Outbreak 2 or more epidemiologically linked cases involving the same organism Norovirus Small round structured virus, often presenting with profuse vomiting and headache 11 AUTHOR/DIVISIONAL/DIRECTORATE MANAGER APPROVAL Issued By Dr Sue Richardson Checked By Nick Grimshaw Job Title Consultant Occupational Job Title Director of HR and OD Physician Date October 2013 Date October 2013 Page 4 of 6
Appendix 1: Equality Impact Assessment Form Department Occupational Health Service or Policy CORP/POL/203 Date Completed: July 2011 GROUPS TO BE CONSIDERED Deprived communities, homeless, substance misusers, people who have a disability, learning disability, older people, children and families, young people, Lesbian Gay Bi-sexual or Transgender, minority ethnic communities, Gypsy/Roma/Travellers, women/men, parents, carers, staff, wider community, offenders. EQUALITY PROTECTED CHARACTERISTICS TO BE CONSIDERED Age, gender, disability, race, sexual orientation, gender identity (or reassignment), religion and belief, carers, Human Rights and social economic / deprivation. QUESTION RESPONSE IMPACT What is the service, leaflet or policy development? What are its aims, who are the target audience? Does the service, leaflet or policy/ development impact on community safety Crime Community cohesion Is there any evidence that groups who No should benefit do not? i.e. equal opportunity monitoring of service users and/or staff. If none/insufficient local or national data available consider what information you need. Does the service, leaflet or development/ No policy have a negative impact on any geographical or sub group of the population? How does the service, leaflet or policy/ No development promote equality and diversity? development explicitly include a commitment to equality and diversity and meeting needs? How does it demonstrate its impact? Does the Organisation or service Yes workforce reflect the local population? Do we employ people from disadvantaged groups Will the service, leaflet or policy/ No development i. Improve economic social conditions in deprived areas ii. Use brown field sites iii. Improve public spaces including creation of green spaces? development promote equity of lifelong learning? development encourage healthy lifestyles and reduce risks to health? development impact on transport? What are the implications of this? Does the service, leaflet or No policy/development impact on housing, housing needs, homelessness, or a person s ability to remain at home? Are there any groups for whom this No policy/ service/leaflet would have an impact? Is it an adverse/negative impact? Does it or could it (or is the perception that it could exclude disadvantaged or marginalised groups? Issue Action Positive Negative This policy addresses the measures needed to prevent isolated episodes of gastro-intestinal infection in staff members posing a threat to Trust patients and other members of staff No Yes Page 5 of 6
Appendix 1: Equality Impact Assessment Form Does the policy/development promote No access to services and facilities for any group in particular? Does the service, leaflet or No policy/development impact on the environment During development At implementation? ACTION: Please identify if you are now required to carry out a Full Equality Yes No (Please delete as Analysis appropriate) Name of Author: Signature of Author: Sue Grimshaw Date Signed: July 2011 Name of Lead Person: Signature of Lead Person: Name of Manager: Signature of Manager Date Signed: Date Signed: Page 6 of 6