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We are working within the government guidelines to help protect our staff and clients. Safe Hands Support Scotland Ltd Policy Statement:
The NHS Scotland National Infection Prevention and Control Manual was first published on 13 January 2012, updated on 17 May 2012, by the Chief Nursing Office. This national manual provides guidance to all those involved in care provision and this policy reflects the manual.
The manual aims to:
Make it easy for care staff to apply effective infection prevention and control precautions.
Reduce variation and optimise infection prevention and control practices throughout Scotland.
Help reduce the risk of Healthcare Associated Infection (HAI).
Help align practice, monitoring, quality improvement and scrutiny.
Although the Manual is not mandatory, as an organisation we will use the manual for guidance in meeting our regulatory requirements
As an healthcare organisation, we will demonstrate that we meet the regulations by own infection control system.
The Policy
The aim of the organisation is to prevent the spread of infection amongst staff, service users and the local community.
Goals – Infection Control
The goals of the organisation are to ensure that:
Service users, their families and staff are as safe as possible from acquiring infections through work-based activities
All staff at the organisation are aware of, and put into practice, basic principles of infection control.
The organisation will adhere to infection control legislation:
The Health and Safety at Work Act etc. 1974 (HSWA 1974) and the Public Health Infectious Diseases Regulations 1988, which place a duty on the organisation to prevent the spread of infection
The Reporting of Incidents, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR), which place a duty on the organisation to report outbreaks of certain diseases as well as accidents such as needle-stick accidents
The Control of Substances Hazardous to Health Regulations 2002 (COSHH), which place a duty on the organisation to ensure that potentially infectious materials within the organisation are identified as hazards and dealt with accordingly
The Environmental Protection Act 1990, which makes it the responsibility of the organisation to dispose of clinical waste safely
The Food Safety Act 1990
The NHS Scotland National Infection Prevention and Control Manual published on 13 January 2012, updated on 17 May 2012
As an organisation, we provide our service users with the following information on;
Our approach to prevention
Staff roles and responsibilities
People that can be contacted with concerns about prevention and control of infection
The Safe Hands Support Scotland Ltd, managers and staff recognises its own responsibilities in Infection Prevention Control (IPC) to:
Have systems and resources in place to facilitate the implementation of infection control precautions specified in the manual
Promote incident reporting and focus on improving systems to encourage safe working practices
Make the manual accessible to all staff
Ensure staff have adequate education and training
Ensure staff have adequate support and resources to meet the requirements
Ensure staff with health concerns (including pregnancy) have access to medical facilities either inside or outside of the organisation
Where necessary staff undergo the required health checks
Ensure staff have Infection Prevention and Control as an objective in their Personal Development Plans or equivalent
Staff must ensure they understand IPC principles
Maintain their competence, skills and knowledge through regular training and support
Communicate IPC practices without breaching confidentiality
Report to the line manager any training needs, equipment of facilities failure and any incident that may result in the transmission of an infection
Ensure staff do not provide care while a risk of potentially transmitting infectious agents to others
Risk Assessments
At the commencement of care or support, risk assessments are carried out on individual service users in relation to the prevention of infection
When risks are identified, steps are put in place to control these risks.
The identified risks and actions required to be taken to reduce these risks are recorded in the service user’s care or support plan
These actions are monitored and any further steps required are implemented.
Where necessary, outside professionals are involved in the implementation of infection control precautions.
Standard Infection Control Precautions (SIPs)
People must be promptly assessed for infection risk on arrival at the care area (if possible, prior to accepting a person from another care area) and should be continuously reviewed throughout their stay.
Persons who may present a cross-infection risk include those:
With diarrhoea, vomiting, an unexplained rash, fever or respiratory symptoms.
Known to have been previously positive with a Multi-Drug Resistant Organism (MDRO) e.g. MRSA, CPE.
Who have been hospitalised outside Scotland in the last 12 months.
The Infection Prevention Control Lead should:
Be responsible for the organisation’s infection prevention cleanliness, and water safety programme.
Have set priorities and objectives to meet the needs of the organisation in ensuring the safety of the service users, social care workers and the public
Oversee the implementation of organisational policies
Report directly to the registered manager
Challenge inappropriate practice including antimicrobial prescribing practice
Set and challenge standards of cleanliness
Be an integral part of the organisations’ governance on infection prevention and control
Produce an annual compliance and practice statement and make it available on request
The annual report will include the progress against the objectives set in the infection control and cleanliness programme
The IPC lead has 24-hour access to specialist infection control expertise
DETAILS OF LOCAL INFECTION CONTROL UNIT OR NURSE
Forth Valley Royal Hospital
Stirling Road
Larbert
FK5 4WR
Phone: 01324 566000 (Switchboard)
For more numbers visit the Forth Valley Royal Hospital section.
Falkirk Community Hospital
Westburn Avenue
Falkirk
FK1 5QE
Phone: 01324 624000 (Switchboard)
For more numbers visit the Falkirk Community Hospital section.
Stirling Health & Care Village
Livilands
Stirling
FK8 2AU
Phone: 01786 434000 (Switchboard)
For more numbers visit the Stirling Health & Care Village section.
Clackmannanshire Community Healthcare Centre
Hallpark Road
Sauchie
FK10 3JQ
Phone: 01259 215333 (Outpatient Reception)
Bo’ness Hospital
Dean Road
Bo’ness
EH51 0DH
Phone: 01506 829580
For more numbers visit the Clackmannanshire Community Healthcare Centre section.
Hand Hygiene
Effective Hand Washing
This organisation believes that most cases involving cross-infection in a care environment is caused by unwashed or poorly washed hands, which provide an effective transfer route for micro-organisms. The organisation believes that regular, effective hand washing and drying, when done correctly, is the most effective way to prevent the spread of communicable diseases. Staff who fail to adequately wash and dry their hands before and after contact with service users may transfer micro-organisms from one service user to another and may expose themselves, service users and the public to infection. Hand Hygiene posters are visible in training rooms and at the organisations office
In this organisation:
All staff should, at all times, observe high standards of hygiene to protect themselves and their service users from the unnecessary spread of infection
All staff should ensure that their hands are thoroughly washed and dried:
Between seeing each service user where direct contact is involved, no matter how minor the contact
After handling any body fluids or waste or soiled items
After handling specimens
After using the toilet
Before handling foodstuffs
Before and after any care or clinical activity
Hands should be washed thoroughly — liquid soaps and disposable paper towels should be used rather than bar soaps and fabric towels
All cuts or abrasions, particularly on the hands, should be covered with waterproof dressings at all times
Non- antimicrobial liquid soap is considered effective for routine use in removing dirt and reducing levels of transient micro-organisms on the skin to acceptably safe levels or caring for a person with vomiting or diarrheal illnesses or caring for a person with a suspected gastro-intestinal infection
The use of antiseptic or antimicrobial preparations is recommended if service users are known to have an infectious disease or are colonised with antibiotic-resistant bacteria, such as Methicillin Resistant Staphylococcus Aureus (MRSA)
Antiseptic hand washing solutions may also be used in situations where effective hand washing is not possible
The use of alcoholic products for hand decontamination is not intended to replace washing hands with soap and water but rather to supplement hand washing where extra decontamination is required, or else to provide an alternative means of hand decontamination in situations where standard facilities are unavailable or unacceptable (for example between service users or in unsanitary conditions)
To be effective, hands should be thoroughly washed before the use of an alcoholic rub and again after the procedure or service user contact has ended.
Skin care:
Dry hands thoroughly after hand washing using disposable paper towels.
Use an emollient hand cream during work and when off duty.
Do not use or provide communal tubs of hand cream in the care setting
Respiratory and cough hygiene.
Respiratory and cough hygiene is designed to minimise the risk of cross-transmission of respiratory illness (pathogens):
Cover the nose and mouth with a disposable tissue when sneezing, coughing, wiping and blowing the nose
Dispose of all used tissues promptly into a waste bin.
Wash hands with non-antimicrobial liquid soap and warm water after coughing, sneezing, using tissues, or after contact with respiratory secretions or objects contaminated by these secretions.
Staff may use hand wipes followed by Alcohol Based Hand Rubs (ABHR} and should wash their hands at the first available opportunity.
Keep contaminated hands away from the eyes, nose, and mouth.
Staff should promote good respiratory and cough hygiene helping those (e.g. elderly, children) who need assistance with this e.g. providing persons with tissues, plastic bags for used tissues and hand hygiene facilities as necessary.
Adequate and suitable personal protective equipment and clothing should be provided by the organisation.
All staff should who are at risk of coming into direct contact with body fluids, or who are performing personal care tasks, should use disposable gloves and disposable aprons.
Sterile gloves are provided for clinical procedures such as applying dressings. These should be worn at all times during service user contact and should be changed between service users. On no account, should staff attempt to wash and reuse these gloves.
Non-sterile gloves are provided for non-clinical procedures.
The responsibility for ordering and ensuring that supplies of gloves and aprons are readily available and accessible lies with Safe Hands Support Scotland Ltd Branch.
Any member of staff who suspects that they or a service user might be suffering from an allergic reaction to the latex gloves provided should stop using them immediately and inform their line manager.
Personal Protective Clothing
Management of Care Equipment
Adhere to manufacturers’ guidance for use and decontamination of all care equipment.
If reusable non-invasive care equipment must be rinsed and dried following decontamination, then stored clean and dry.
Decontamination protocols should include responsibility for; frequency of; and method of environmental decontamination.
An equipment decontamination status certificate will be required if any item of equipment is being sent to a third party e.g. for inspection, servicing or repair.
Guidance may be required prior to procuring, trialling or lending any reusable non-invasive equipment.
Before using any sterile equipment check that the packaging is intact, there are no obvious signs of packaging decontamination and the expiry date remains valid
Management of Care Environment
It is the responsibility of the person in charge to ensure that the care environment is safe for practice (this includes environmental cleanliness/maintenance). The person in charge must act if this is deficient.
The care environment must be:
Visibly clean, free from non-essential items and equipment to facilitate effective cleaning
Well maintained and in a good state of repair; and
Routinely cleaned in accordance with the Health Facilities Scotland (HFS) National Cleaning Specification: A fresh solution of general purpose neutral detergent in warm water is recommended for routine cleaning. This should be changed when dirty or at 15 minutes’ intervals or when changing tasks
Routine disinfection of the environment is not recommended. However, 1,000ppm available chlorine should be used routinely on sanitary fitting
Staff groups should be aware of their environmental cleaning schedules and clear on their specific responsibilities.
Cleaning protocols should include responsibility for, frequency of, and method of environmental decontamination.
Linen
Clean linen
Should be stored in a clean, designated area, preferably an enclosed cupboard.
If clean linen is not stored in a cupboard, then the trolley used for storage must be designated for this purpose and completely covered with an impervious covering that can withstand decontamination.
Clean linen that is deemed unfit for re-use e.g. badly torn, should be disposed of locally or returned to the laundry for disposal.
Linen used during person transfer
Any linen used during person transfer e.g. blankets, should be categorised at the point of destination.
For all used linen (previously known as soiled linen):
Wear protective clothing when handling soiled linen
Ensure a laundry receptacle is available as close as possible to the point of use for immediate linen deposit.
Do not:
o Rinse, shake or sort linen on removal from beds/trolleys
o Place used linen on the floor or any other surfaces e.g. a locker/table top
o Re-handle used linen once bagged
o Overfill laundry receptacles; or
o Place inappropriate items in the laundry receptacle e.g. used equipment/needles
For all infectious linen (this mainly applies to healthcare linen) i.e. linen that has been used by a person who is known or suspected to be infectious and/or linen that is contaminated with blood and/or other body fluids e.g. faeces:
Place directly into a water-soluble/alginate bag and secure; then place into a plastic bag e.g. clear bag and secure before placing in a laundry receptacle. This applies also to any item(s) heavily soiled and unlikely to be fit for reuse.
Used and infectious linen bags/receptacles must be tagged e.g. ward/care area and date.
Store all used/infectious linen in a designated, safe, lockable area whilst awaiting uplift. Uplift schedules must be acceptable to the care area and there should be no build-up of linen receptacles.
Management of Blood and Body Fluid Spillages
Spillages of blood and other body fluids may transmit blood borne viruses. Spillages must be decontaminated immediately by staff trained to undertake this safely.
Responsibilities for the decontamination of blood and body fluid spillages is care support worker on duty.
Appropriate personal protective equipment (e.g. single-use disposable gloves and plastic apron) should be worn when dealing with blood and other body fluid spillages.
Products (e.g. chlorine releasing solutions/granules) for management of blood and body fluid spillages should always be prepared and used in accordance with manufacturer’s instructions
Blood and body fluid spillages should be directly treated with a chlorine releasing agent such as sodium hypochlorite. Urine spillages should not be directly treated using a chlorine releasing agent such as sodium hypochlorite. A gelling agent may be used to solidify urine spills.
Soft furnishings that can withstand decontamination with chlorine releasing solutions should be cleaned using the recommended concentration solution. Soft furnishings that cannot withstand chlorine releasing agents should be subject to a risk assessment prior to decontamination and cleaned with a solution of detergent and warm/tepid water followed by steam cleaning. If soiling with blood or body fluids has occurred and items are incapable of being adequately decontaminated, then they should be disposed of. If the furnishings belong to a person or service user, they should be consulted prior to disposal.
Clinical and nominated staff members should deal with blood and other body fluid spillages. It is important that adequate training is given to all staff members involved in the management of blood and body fluid spillages to ensure both the protection of the staff member undertaking the cleaning and all others that may be affected by the spillage.
All waste is disposed of as clinical waste and put in appropriate bins.
Safe Disposal of Waste (including sharps)
The Handling and Disposal of Clinical and Soiled Waste
A risk assessment has been carried out assessing risk and measures are in place to manage the risk and the monitoring and auditing of work arrangements.
A waste management policy is in place which is monitored and audited.
All clinical waste should be disposed of in sealed yellow plastic sacks and each sack should be clearly labelled where available or follow individual care plan waste disposal procedures.
Non-clinical waste should be disposed of in normal black plastic bag, following individual care plan procedures.
When no more than three-quarters full, yellow sacks should be sealed and stored safely to await collection by an authorised collector as arranged. (where applicable)
Staff should alert the organisations office if they are running out or yellow sacks, disposable wipes, or any protective equipment.
Always dispose of waste:
Immediately and as close to the point of use as possible; and
Into the correct segregated colour coded UN 3291 approved waste bag (either orange/yellow for healthcare waste or black/clear/opaque for domestic) or container (sharps box)
Disposal of sharps
Boxes must: have a dedicated handle
Boxes must: have a temporary closure mechanism, which must be employed when the box is not in use
Boxes must: be disposed of when the manufacturers’ fill line is reached; and
Boxes must: be labelled with point of origin and date of closure.
Arrangements for the safe use and disposal of sharp
Provision of information and training to employees
Investigations and actions required in response to work related sharps injuries
Sharps handling must be assessed, kept to a minimum and eliminated if possible, with the use of approved safety devices
Manufacturers’ instructions for safe use and disposal must be followed
Needles must not be re-sheathed
Always dispose of needles and syringes as 1 unit
Staff Competency
As an organisation, we ensure that everyone working in the care setting, including agency staff, volunteers and contractors understand and comply with the requirements of preventing and controlling infection.
All workers including volunteers have infection control responsibilities in their job description
Infection prevention and control is part of induction and training is updated annually or whenever a situation changes in relation to infection control or further information is required.
If staff are required to develop skills for invasive techniques or aseptic techniques then specialised training is given by a health professional and this includes further infection control and prevention knowledge.
Regular staff competency observations are in place to monitor working practice in all areas of infection prevention and control
When staff are working with a service user in their own home, all basic infection control precautions are taken to prevent any infection being transferred to other service users.
If the service user requires specialised support in relation to infection control, then advice would be taken from the Health Protection Scotland and any further precautions would be put in place with the involvement of the service user.
Aseptic Technique.
If staff are required to have these skills for an individual service user then they are trained by a health professional.
Outbreaks of Communicable Diseases.
Staff are trained to recognise the signs of infections and to understand what actions they are required to take.
In the event of the suspected outbreak of an infectious disease at the organisation, advice on outbreaks can be sought from your local Health Protection team at Health Protection Scotland. If there is an outbreak or suspected outbreak of infection, it should be reported to: Health Protection Scotland who are responsible for advising on outbreak control and monitoring the outbreak.
We're unable to provide clinical advice to members of the public or service users so please contact your GP, NHS 111 or visit the NHS inform website.
Health Protection Scotland
Public Health Scotland
Meridian Court
5 Cadogan Street
Glasgow
G2 6QE
Tel: 0141 300 1100
Fax: 0141 300 1170
Email: NSS.HPSenquiries@nhs.net
If it is a suspected food related outbreak advice can be sought from Environmental Health Departments
The Handling and Storage of Specimens
Specimens should only be collected if ordered by a GP.
All specimens should be treated with equally high levels of caution.
Non-sterile disposable gloves should be worn when handling the specimen containers and hands should be washed afterwards.
Legionnaires Disease
When care is delivered to an individual within their own home, the reporting of such an outbreak lies with the health professionals involved in its management and is a very rare occurrence.
It is wise to take some precautions within a domestic setting.
If the property has been vacant for a long period, say for a hospitalisation or a respite break then taps should be run through before use
Showers should be run for 2 minutes after a week of non-use
Older type properties should have taps run in areas not used on a regular basis so that the water system is refreshed regularly as water sat or stagnated for long periods within the water system is one of the major causes of the infection
Air conditioning units are also a source, particularly within large buildings, such as residential flats, factories and office blocks
Symptoms develop 2-10 days after the aspiration of the droplets with pneumonia type signs, such as a cough, shortness of breath, chest pain, confusion in their mental state, as well as gastrointestinal nausea, vomiting or diarrhoea and the individual should be seen by a G.P.
Legionnaires is not contagious; but can be fatal within certain age groups.
Food Hygiene
All staff should adhere to the organisation’s Food Hygiene Policy and ensure that all food prepared for service users is prepared, cooked, stored and presented in accordance with the high standards required by the Food Safety Act 1990 and the Food Hygiene (Scotland) Regulations 2006.
Any member of staff who becomes ill while handling food should report at once to their line manager or supervisor, or to the organisation office.
Staff involved in food handling who are ill should see their GP and should only return to work when their GP states that they are safe to do so.
Reporting
The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR) oblige the organisation to report the outbreak of notifiable diseases to the Local Environmental Health Officer, who will inform the Health and Safety Executive (HSE). 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 outbreak, specifying dates and times, must be retained, and a completed disease report form sent to the HSE.
In the event of an incident, the Registered Manager is responsible for informing the HSE.
RIDDOR information is found on the HSE website and reports should be made using an online form.
Notifications must be sent to The Care Inspectorate”
Dress Code
This organisation has a dress code policy in place which ensures clothing worn by staff when carrying out their duties is clean and fit for purpose.
Immunisation of Service Users
A record is kept by the managers of all immunisations given to service users
This record is regularly reviewed in line with guidance from Public Health Scotland.
We liaise with the service users GP surgery or district nurse and remind all service users of the opportunities for relevant immunisations.
Occupational Health Services
OCCUPATIONAL HEALTH SERVICES STAFF CAN CONTACT TO ACCESS APPROPRIATE OCCUPATIONAL ADVICE
Location
Forth Valley Royal Hospital
Stirling Road
Larbert
FK5 4WR
Phone: 01324 566 663
Service Hours
Occupational Health staff are available:
Monday – Thursday 8.30 am – 5.00 pm
Friday 8.30 am – 4.00 pm
Out of hours, including Bank Holidays in an emergency we can be contacted via switchboard at Forth Valley Royal Hospital.
Monitoring and Audit
An audit programme is in place to ensure appropriate policies have been developed and implemented
The annual statement is reviewed and where indicated, acted upon
Antimicrobial prescribing decisions are regularly reviewed by the appropriate health professional
As an organisation, we recognise the importance of the sharing of information relating to the prevention of infection with health professionals, care and domestic staff when managing referrals, admissions, discharges and the movement of service users between social care and health care settings. To this end we use;
In relation of the transfer of information relating to infection control service user or they NoK consent form need to be sign off. Office Staff are not allowed to pass any information to external organisation without written agreement to do so. General Date Protection Act 2018
Related Policies
Accidents Incidents and Emergencies Reporting (RIDDOR)
Contingency and Emergency Planning
Co-operating with Other Providers
Confidentiality
Data Protection Legislative Framework (GDPR)
Death of a Service user
Dress Code
Good Governance
MRSA
Notifications
Prevention of Pressure Ulcer
Protective Clothing and Equipment
Vaccinations
Related Guidance
Health Protection Scotland http://www.hps.scot.nhs.uk/
National Infection Prevention and Control Manual http://www.nipcm.scot.nhs.uk/
NICE Guidelines NICE guidelines (CG139) on Infection: Prevention and control of healthcare-associated infections in primary and community care https://www.nice.org.uk/guidance/cg139 updated in February 2017
Training Statement
Safe Hands Support Scotland Ltd is committed to the continuous improvement of its services and views staff learning and training as core to delivering a quality service. With the Health and Social Care Standards, Principles and associated Codes of Practice we will take the opportunity to review our learning and training programme to ensure that the Care Standards and Principles are fully embedded and that they are reflected in all we do.
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