2. Back to Basics
• Legislation
• Chain of infection
• Hand hygiene
• Glow Box
• PPE
3. Infection Prevention Levers - Legislation
• The Code of Practice came into force for all NHS
organisations from 2008
• From October 2010 all social care
organisations were required to
register with the CQC as being
compliant withThe Code of Practice.
• From 2012 the Code is applicable for
GPs and dentists.
4. Outcome 8: People
should be cared for in
a clean environment
and protected from
the risk of infection
5. IPC challenges in care homes
• Commissioned from LA,
CHC commissioned by CCG, CQC regulated
• Known reservoir for risk of infection – population – age,
compromised, increasing dependencies
• Clients home, balance between clinical function and cleanliness
requirements. Clutter
• Often high staff turnover, limited
training, inadequate basic supplies
6. Common problems
Poor hand hygiene facilities and
compliance
Damaged / dirty equipment
. Incorrect use of PPE
Dirty environment esp. toilet /
bathrooms / sluice
Lack of -
Untidy laundries
7. Common infections and outbreaks in
care homes
Common infections include:
• Urinary tract infections
• Skin/soft tissue
• Chest
• CDI (causes diarrhoea)
Outbreaks include (but not limited to)
• Norovirus (causes sickness and diarrhoea) – most common
• Scabies (skin)
• MRSA (skin, urine or chest infections) / PVL (skin)
• Streptococcus A (Scarlet fever, skin, invasive illness)
• Influenza (chest symptoms)
8. The Chain of Infection
Susceptible
host
Portal
of entry
Infectious
agent
Reservoir
Portal of
exit
Means of
transmission
Breaking any link in the chain will assist in preventing
the spread of micro-organisms.
16. How to wash your hands
• Naked from the elbow down
• Short / unvarnished nails / no false nails or nail art.
• Skin integrity / cuts and abrasions covered.
• Soap / water – to be used on visibly contaminated hands /
positioning of dispensers for soap, paper towels, foot operated
bin.
• Hand gels – require risk assessment / free standing, wall
mounted dispenser, individual bottles / not sporicidal / not to be
used on visibly contaminated skin.
• Hand creams to maintain skin integrity.
17.
18. Jewellery
• Total bacteria counts higher when rings are worn
• Avoid rings with ridges / stones
• Rings interfere with thorough handwashing
• Difficulty donning gloves
• Gloves may tear
• Nails harbour largest number of micro-organisms –
keep them short
• Artificial nails may increase microbial load and
discourage vigorous hand-washing
19. Personal Protective Equipment
• Reduces transmission of micro-
organisms
• All Healthcare facilities should have
the following available for all staff:
– Powder free disposable gloves (vinyl,
Nitrile) which conform to CE standards
(European).
– Disposable plastic aprons
– Safety glasses / visor and mask
20. PPE continued…
• Necessary when carrying out invasive
procedures or contact with sterile sites and
activities that carry a risk of exposure to blood,
body fluids, secretions or excretions and sharp
or contaminated instruments.
• They are all single use items.
• Must be stored appropriately.
21. Use of Gloves
• Increase in use over recent years
• Gloves are not a substitute for handwashing
• Hand contamination is possible during glove removal
• Hand washing after glove removal is essential and also before
sterile glove use
• Hypersensitivity to latex is increasing and powder-free gloves
should always be used
• Gloves must be changed:
– between clean and dirty tasks
– between patients
22. Putting On PPE
• Don’t=Decontaminate
• Ask=Apron
• My=Mask
• Great=Goggles
• Grandma=Gloves
Explanation of why IPC important in ALL care homes , emphasising we are not just talking about care of the elderly
There are many challenges to you all working within the community. That is why as IPC champions it is important for you to be reinforcing good practice and being good role models to other members of the team.
Some of the big problems that we all see when we are out and about is the above.
This is why the link champion is important ,challenging this out in the community.
What we do find in care homes are common infections that can cause outbreaks if standard precautions are not adhered to.
UTI a big problem in the community
We’ve all seen this slide before :
Food drink environment people
The most important thing you can do to ensure clean safe care is good hand hygiene.
Evidence shows that artifiacila nails harbour micro-organisms and have been proven to have spead infection.
Chance to use glow box. Talk about hand hygiene first then use the box
Mention, when not getting rid f micro-organisms from hands you are taking them home with you.
Shouldn’t put a pair of gloves on and then be answering phone with them on etc
Chance to use glow box
Decontamination is a general term for the destruction or removal of microbial contamination to render an item safe.
Cleaning
Cleaning is a process, using general-purpose detergent and hot water (<35°C), to physically remove contaminants, including dust, soil, large numbers of micro-organisms (germs) and the organic matter (e.g. faeces, blood) that protects them .
Cleaning remains the single most effective way of reducing the risk of infection from the environment and is usually the first stage before disinfection or sterilisation is attempted.
The value of cleaning cannot be over emphasised. Without cleaning an item first, it may not be possible to disinfect or sterilise it properly.
Disinfection
Environmental disinfection is a process used to reduce the number of micro-organisms, but not usually of bacterial spores.
The process does not necessarily kill or remove all micro-organisms, but reduces their number to a level which is not harmful.
A good resource
Decontamination is a general term for the destruction or removal of microbial contamination to render an item safe.
